Pricing Request

Thank you for allowing us the opportunity to serve you. If you would like an estimated (may be higher or lower than the actual cost) cost of a procedure or treatment, please fill out the form below, complete the information and we will reply back to you within two business days.

For additional information or questions, please call our scheduling department at 620-252-1523 during the hours of 8:30 a.m. to 5:00 p.m., Monday through Friday. Once you have submitted this form, you will receive an email or telephone call from us within two business days.

Thank you for choosing Coffeyville Regional Medical Center and allowing us the opportunity to serve you.