Estimates for Services

Charges for our most common procedures can now be found online!
Procedure Charge Lookup
 

Estimates for out-of-pocket expenses related to procedures can be requested via e-mail or by calling directly: 920-743-5566 option #2.
A Financial Counselor will call you regarding the cost of the procedure or services requested.
 
To e-mail your request, we will need the following information:
e-mail to: patientaccounting@dcmh.org
 
Contact Person:
Daytime phone number:
Procedure name (or CPT code if available):
Procedure date:
Ordering/Referring Physician:
 
Insurance Information:
Name:
Phone number:
Deductible/co-insurance:

 
 
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