Patient Cost Estimator

Estimate a patient's share before the visit: enter the allowed amount, remaining deductible, coinsurance, and copay, and watch the cost breakdown re-flow live. Nothing you enter is stored.

Allowed amount$400The payer's allowed amount for the service — from the fee schedule or a prior EOB, not the billed charge.Deductible remaining$250What is left of the patient's annual deductible — from the eligibility response.Coinsurance20%The patient's percentage share after the deductible is met.Copay$0Any fixed per-visit copay for this service type.

Estimated patient responsibility

$280

Estimated plan payment

$120

This is an estimate using the standard cost-share arithmetic — the deductible applies first, coinsurance applies to the remainder, and any fixed copay is added. The payer’s actual adjudication governs the real balance: plan designs vary (some apply copays instead of coinsurance for certain services), and the allowed amount depends on the contract. Use the eligibility response for the deductible and cost-share figures, and see estimating patient cost-share before service for the full workflow.

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