Q. I have commercial insurance How much will I have to pay?

    A. You are only responsible for the amount that you owe based on your health insurance plan and its determination of the allowed payment amount. For example, the total billed to an insurer is $1,000.00, the in- network allowed amount determined by the insurer is $600.00, $525.00 of which was covered and paid by the insurance. In this example, the patient pay amount is $75.00. ($50.00 for remaining deductible + $25.00 for coinsurance). You DO NOT PAY the unallowed balance amount of $400.00.

    Service
    Date
    Procedure
    Code
    Units of
    Service
    Billed
    Amount
    Allowed
    Amount
    Insurance
    Discount
    Deductible
    Amount
    Co-insurance
    Copayment
    Amount
    Claims
    Payment
    1/15/17881201$1,000.00$600.00$400.00$50.00$25.00$525.00