Price Estimates Form

Price Estimates

Indiana University Health is committed to helping patients address their financial concerns and questions, which includes providing good faith cost estimates before care is received.

Please complete the form below, providing as much detail as possible, and click submit. Once your request is submitted, and all relevant information has been received, our team members will generate a personalized good faith estimate based on your insurance status, the location you will be receiving the service, and the service you indicated.

We will then email your estimate within two business days and will include all anticipated practitioner services.

If you would prefer to discuss your estimate by phone you may do so by calling the Price Estimates team at 317.963.2541 or 833.722.6050 or email us directly at We look forward to serving you.

If you currently live outside of the United States and have questions about services please contact our Destination Services team at or call 317.963.2020. You may also visit Destination Services.

Question about your bill?

If you have a question about a bill for services that you have already received please contact our Customer Service team at 317.612.2754 or 877.668.5621.

Price Estimates Form