Patient Forms

General Forms

Florida Transparency Bill

Services may be provided by other healthcare providers who may bill separately.

APS
4919 Memorial Highway, Suite 200 
Tampa, FL 33634 
(866) 631-7005

Quest
500 Plaza Dr.
Secaucus, NJ 07094
(888) 295-2584

LabCorp
PO Box 2240
Burlington, NC 27216
(800) 845-6167

Estimator Tool for Shoppable Services

Important! Before using this cost estimation tool, please carefully consider the following information. 

  • By clicking on the estimator tool, you are acknowledging that you have read this information, and that you are accessing the information for the purpose of determining your estimated costs associated with healthcare services.
  • Nothing on this site guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage information from your healthcare insurance carrier.
  • Please keep in mind, the costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Again, the estimates are based on the contract rates/fee schedule with your insurance carrier. Your actual cost may be higher or lower than the estimate for various reasons. You will be responsible for the cost of procedures or services not covered by your insurance plan.

Why costs may vary:

The cost estimates provided by our tool may be different from your actual costs for several reasons, including but not limited to:

  • The medical services/treatment you receive will be based on decisions made by you or your health care provider and may be different from the services you selected while using the price estimator tool.
  • The medical service/treatment you receive may be impacted by complications, secondary conditions, and/or other unknown factors that this price estimator tool cannot consider.
  • The location where your services are received differs from what is selected during this estimation process.
  • If your year-to-date benefit information changes from the time at which you receive this estimate and the time at which you receive care.
  • If your healthcare provider’s contract with your insurance carrier changes.
  • If you have a unique insurance plan design that is not currently supported by the tool.

For more information on how your cost estimate was determined, please contact us.

In addition to using our cost estimation tool, your insurance carrier can help you understand insurance terms such as out-of-pocket maximums, deductibles and copayments that will affect what you ultimately pay.

Estimator Tool