Request An Estimate

It is the policy of Missouri Delta Medical Center and it’s entities to provide a Good Faith Estimate for non-emergent services and items that are reasonably expected for your health care needs.

Request an estimate by phone 573-472-7657 or by using the form below.

Request an estimate using the form below

Providing your insurance information will allow us to provide the most accurate out of pocket cost estimate.

Under the law, health care providers need to give patients who don’t have insurance, or who are not using insurance, an estimate of the bill for medical services and items.

    • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services or items. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
    • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a medical service.
    • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
    • Make sure to save a copy or picture of your Good Faith Estimate.

If you have health insurance, your plan may have better information about how much you will be asked to pay. Please call the number on the back of your insurance card.

For questions or more information about your right to a Good Faith Estimate, contact 1-800-985-3059 or visit