Claim details

Riverside Surgical Center

Outpatient surgery · Jun 13, 2026

In-network

Cost breakdown

Billed amount$2000

$1400

Applied to $1400

Applied to $0

Plan paid$0

You owe (per )$1400

Claim CLM-260613-004

See the coverage rules behind this 's and .

Outpatient surgery

30% coinsurance applies · Medical · Procedures