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STEP 1: Please enter your insurance information below.

Select your insurance plan:

Select your insurance plan type:

What is your co-pay?

What is your unmet annual deductible?

What is your co-insurance percentage?

What is your unmet annual maximum out of pocket cost limit?
 




DISCLAIMER:
The cost estimator is intended to provide you an estimate for your bill from Pomona Valley Hospital Medical Center (PVHMC). You may receive separate bills for physician services you receive during your stay.
*** I HAVE READ THE FULL DISCLAIMER BELOW AND UNDERSTAND THIS IS AN ESTIMATE ONLY. MY ACTUAL BALANCE AMOUNT DUE MAY BE DIFFERENT.***
This estimate is for hospital charges on anticipated care and recovery, taking insurance coverage, co-payments, deductibles, co-insurance, and other information into consideration that may affect personal out-of-pocket costs. Actual charges on the final hospital bill may vary from the estimate, based on patient’s medical condition, unknown circumstances or complications, final diagnosis, and treatment ordered by the attending physician(s). This estimate covers hospital charges only and does not include the price of implants, or professional fees for services such as those provided by a physician, radiologist, pathologist, anesthesiologist, nurse practitioner or other independent practitioner. Persons with insurance should contact their health benefits administrator for the most accurate information regarding plan structure, deductibles, co-payments, and any other factors that might affect personal liability for anticipated health care services. Physicians or other practitioners who provide professional services may not participate in an individual patient’s health benefit plan. Please be advised that while PVHMC attempts to estimate the cost of hospital charges as accurately as possible, there may be significant variations between the estimate provided and the actual charges. Accordingly, PVHMC makes no representations, express or implied, and disclaims any and all liability, as to the accuracy of this estimate.