Payment Estimate

PATIENT PRICE ESTIMATE REQUEST INFORMATION:

Are you looking for the cost of a procedure? Would you like to know what your out-of-pocket expenses will be? At Tyson Eye, we believe it is important for our patients to be able to make informed decisions about their healthcare.

Services may be provided in this health care facility by the facility as well as by other health care providers who may separately bill the patient and who may or may not participate with the same health insurers or health maintenance organizations as the facility.

Patients and prospective patients may request from this facility and other health care providers a more personalized estimate of charges and other information. Patients and prospective patients should contact each health care practitioner who will provide services in the ASC to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.

You may pay less for this procedure or service at another facility or in another health care setting.

You should contact your insurer or health maintenance organization regarding your cost-sharing responsibilities.

Complete the form on this page to request your price estimate* request.

"*" indicates required fields

First Name*

Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Phone*

Alternate Phone

Email*

Would you like to receive your estimate by mail or by fax?*

Fax

If fax, enter fax number:

Do you want us to phone you with a verbal estimate in addition to sending a letter?*

Yes

Physician's Name (if available)

Description of Procedure*

How Do You Intend to Pay?*

Self-Pay

Insurance

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Name

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*As a reminder, this request is for an estimate and is not a guarantee of coverage. Depending on the individual case, you may be held liable for additional services which are medically necessary as a part of patient care and not included on the estimate.

AAAHC ACCREDITED SURGERY CENTER:

Eye Surgery & Laser Center, P.A.
4120 Del Prado Blvd. S.
Cape Coral, FL, 33904
239-542-2020

Health care providers that may provide services and procedures at our surgery centers are listed below. Also noting these providers may separately bill the patient. All providers listed below may be reached at (239) 542-2020.

OPHTHALMOLOGISTS:

Farrell C. Tyson, MD, FACS
J. David Stephens, MD
Cristos Ifantides, MD, MBA

ANESTHESIOLOGIST:

John T. Patrick, MD

LABORATORY TESTING:

Quest Diagnostics
4817-1 Milton St
Cape Coral, FL 33904

ADDITIONAL RESOURCES:
Visit FloridaHealthFinder.gov for consumer health care information.
Visit Florida Health Price Finder for information about this facility’s pricing. The service bundle information on the Florida Health Finder Pricing website is a non-personalized estimate of costs that may be incurred by the patient for anticipated services. Actual costs will be based on services you receive.

Click here for Patient Rights Under Florida Transparency Act of 2016.

Self-Pay Policy
Financial Assistance and-or Charity Care

CHARITABLE INVOLVEMENT:

Naples Lion’s Club
8769 Hideaway Harbor Ct.
Naples, FL 34120

Lighthouse of SWFL
35 West Mariana Avenue
North Fort Myers, FL 33903