Request a Self-Pay Estimate

Use the form below to request a cost estimate for self-pay services at Johns Hopkins All Children’s Hospital.

Johns Hopkins All Children’s provides discounted self-pay rates for our patient families. Please provide an answer for each question, if applicable. It’s important that we receive all necessary information on the form so that we can provide an estimate for you in a timely manner. If any necessary information is missing or unclear, you may receive a call to clarify the request.

All electronic communication sent from Johns Hopkins All Children’s Hospital is done in a secure environment and may require additional steps to access your email, to ensure that your family’s personal information is kept private.

A number of factors influence the cost of care, making it higher or lower than the amount of an estimate you may receive—for example, your child’s individual needs, physician treatment choices, and actual services performed.

That’s why we cannot guarantee the amounts of any estimate provided and it should not be viewed as a binding quote but as a good faith estimate. Estimates provided are based on average payments and payment ranges for a particular service. The actual cost will be based on the services actually provided to the patient.

If you have questions about how to request a self-pay estimate, or questions about an estimate you have received, please call our Estimate Unit at 727-767-7016.

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