This estimate is an estimate of your costs and is not a contract or guarantee of the actual costs for the services that may be provided to you. The prices this estimate is based on are subject to change at any time without notice. Your final out-of-pocket costs may be greater than the amount of this estimate. This estimate is calculated based on the healthcare services, hospital location, and health insurance plan you selected, along with any deductible, coinsurance, and out-of-pocket cost information you inserted into Freedom Behavioral’s price estimator. A hospital visit or encounter might vary from patient-to-patient for the same service depending on length of stay or services provided due to the patient's health status.

Your actual costs may vary depending upon the hospital location and timing of other outstanding payments affecting your deductible or out-of-pocket costs. You are encouraged to consult with your insurance provider to confirm your payment responsibilities, deductibles, and other details of your insurance plan. In addition, you may incur other charges from physicians and other healthcare providers separate from the hospital charges for the services identified in this estimate. Physician-related charges are billed directly by your physician, and other third-party charges (charges for services by providers other than the hospital and your physician) are billed directly by the third-party provider.

I have read and understood the above disclaimer. This is only an estimate and my actual charges may be different from the estimat

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