Financial Discloure

Exceeding Expectations One Patient at a Time

At Center For Specialized Surgery, we’re committed to providing you and your loved ones with exceptional care in a compassionate and friendly atmosphere. We believe that our patients deserve the best care, and we make an effort to make sure you always feel welcome and at ease.

Prior to your procedure a member of our staff will review with you the total estimated charge for your procedure and any ancillary billing that you may incur. A financial worksheet will be provided to you for your review and will include the following:

Total Estimated Base Charge: $
Estimate of Surgical Guest’s Financial Responsibility $
Calculation Notes, if any


Payment in full of surgical guest’s financial responsibility is expected at time of service.
Special payment arrangements, if needed, can be discussed and approved by Administration.

Financial Disclosure to Surgical Guest:
 Please note that this is an estimate of your financial responsibility.
 You should be aware that this base charge does not include any additional labs, pathologies, radiology procedures, additional operative procedures that may be deemed necessary by your physician.
 Itemized charges will be calculated post operatively and actual charges will be billed in addition to the base fee.
 Anesthesia services are not included in the base or itemized charge and will be separately by the Anesthesiologist/CRNA that renders anesthesia.