CPT 74177
The standard charge for CT scan of abdomen & pelvis with contrast material is $3,967.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
11234 Anderson Street, Loma Linda, CA, 92354CONTACT
877-558-6248 Visit WebsiteLoma Linda University Children's Hospital is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.
In compliance with federal law, Loma Linda University Children's Hospital provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.
I understand that the list of standard charges includes only hospital services and does not contain professional fees for non-Loma Linda University Children's Hospital physicians or advanced practice providers. It does not contain professional fees for anesthesia, physicians or advanced practice providers.
I understand that a single line item charge may not represent a complete medical service. In general, multiple charge line items are necessary to represent all components of a service (e.g. procedures, supplies, and drugs).
I understand that the list of standard charges is not intended for media use.
I understand prices are the list price of all hospital charges and not necessarily what my insurance company will pay or what I will owe to the hospital. My actual bill may include one or more of list price charges.
The hospital typically accepts a rate that is less than the list charges. Your insurer will determine what you will owe after they have paid their agreed upon amount.
We know that the billing and payment processes may seem overwhelming at times. Please contact our team at 877-558-6248.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$3,967.00Insurance Discount
-$3,173.60Price Negotiated by Insurer
$793.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$10.40HC COMPREHENSIVE METABOLIC PANEL
$14.00HC LIPASE
$14.05HC ROUTINE URINALYSIS
$6.60HC VENIPUNCTURE W/SPECIMEN
$9.40IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.11This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,213.00Price Negotiated by Insurer
$2,754.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$34.11HC COMPREHENSIVE METABOLIC PANEL
$45.91HC LIPASE
$46.08HC ROUTINE URINALYSIS
$21.64HC VENIPUNCTURE W/SPECIMEN
$30.83IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.15This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,286.35Price Negotiated by Insurer
$680.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC LIPASE
$10.34HC ROUTINE URINALYSIS
$4.75HC VENIPUNCTURE W/SPECIMEN
$13.63IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,467.85Price Negotiated by Insurer
$499.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC LIPASE
$7.58HC ROUTINE URINALYSIS
$3.49HC VENIPUNCTURE W/SPECIMEN
$10.00IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.64This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.46This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,530.87Price Negotiated by Insurer
$2,436.13Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$76.80HC COMPREHENSIVE METABOLIC PANEL
$104.53HC LIPASE
$67.96HC ROUTINE URINALYSIS
$30.19IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$73.62This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,539.20Price Negotiated by Insurer
$2,427.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$34.79HC COMPREHENSIVE METABOLIC PANEL
$46.83HC LIPASE
$47.00HC ROUTINE URINALYSIS
$22.08HC VENIPUNCTURE W/SPECIMEN
$31.44This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,364.33Price Negotiated by Insurer
$1,602.67Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$22.98HC COMPREHENSIVE METABOLIC PANEL
$30.94HC LIPASE
$31.05HC ROUTINE URINALYSIS
$14.59HC VENIPUNCTURE W/SPECIMEN
$20.77This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,181.85Price Negotiated by Insurer
$1,785.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$23.40HC COMPREHENSIVE METABOLIC PANEL
$31.50HC LIPASE
$31.62HC ROUTINE URINALYSIS
$14.85HC VENIPUNCTURE W/SPECIMEN
$21.15IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.78This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,428.12Price Negotiated by Insurer
$2,538.88Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$33.28HC COMPREHENSIVE METABOLIC PANEL
$44.80HC LIPASE
$44.97HC ROUTINE URINALYSIS
$21.12HC VENIPUNCTURE W/SPECIMEN
$30.08IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.39This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,031.42Price Negotiated by Insurer
$2,935.58Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$38.48HC COMPREHENSIVE METABOLIC PANEL
$51.80HC LIPASE
$51.99HC ROUTINE URINALYSIS
$24.42HC VENIPUNCTURE W/SPECIMEN
$34.78IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$88.71This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,286.35Price Negotiated by Insurer
$680.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC LIPASE
$10.34HC ROUTINE URINALYSIS
$4.75HC VENIPUNCTURE W/SPECIMEN
$13.63IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,467.85Price Negotiated by Insurer
$499.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC LIPASE
$7.58HC ROUTINE URINALYSIS
$3.49HC VENIPUNCTURE W/SPECIMEN
$10.00IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,354.41Price Negotiated by Insurer
$612.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$10.49HC COMPREHENSIVE METABOLIC PANEL
$14.26HC LIPASE
$9.30HC ROUTINE URINALYSIS
$4.28HC VENIPUNCTURE W/SPECIMEN
$12.27IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.24This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$595.05Price Negotiated by Insurer
$3,371.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$44.20HC COMPREHENSIVE METABOLIC PANEL
$59.50HC LIPASE
$59.72HC ROUTINE URINALYSIS
$28.05HC VENIPUNCTURE W/SPECIMEN
$39.95IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,586.80Price Negotiated by Insurer
$2,380.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$31.20HC COMPREHENSIVE METABOLIC PANEL
$42.00HC LIPASE
$42.16HC ROUTINE URINALYSIS
$19.80HC VENIPUNCTURE W/SPECIMEN
$28.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$71.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,222.82Price Negotiated by Insurer
$744.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.74HC COMPREHENSIVE METABOLIC PANEL
$17.32HC LIPASE
$11.30HC ROUTINE URINALYSIS
$5.20HC VENIPUNCTURE W/SPECIMEN
$14.91This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,493.58Price Negotiated by Insurer
$473.42Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.34HC COMPREHENSIVE METABOLIC PANEL
$15.44HC LIPASE
$10.21HC ROUTINE URINALYSIS
$4.65IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,321.01Price Negotiated by Insurer
$2,645.99Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$34.68HC COMPREHENSIVE METABOLIC PANEL
$46.69HC LIPASE
$46.86HC ROUTINE URINALYSIS
$22.01HC VENIPUNCTURE W/SPECIMEN
$31.35IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.41This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,431.58Price Negotiated by Insurer
$535.42Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.82HC COMPREHENSIVE METABOLIC PANEL
$17.46HC LIPASE
$11.55HC ROUTINE URINALYSIS
$5.26HC VENIPUNCTURE W/SPECIMEN
$17.91IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,014.92Price Negotiated by Insurer
$952.08Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.48HC COMPREHENSIVE METABOLIC PANEL
$16.80HC LIPASE
$16.86HC ROUTINE URINALYSIS
$7.92HC VENIPUNCTURE W/SPECIMEN
$11.28IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$1.86This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,395.25Price Negotiated by Insurer
$571.75Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$9.79HC COMPREHENSIVE METABOLIC PANEL
$13.31HC LIPASE
$8.68HC ROUTINE URINALYSIS
$3.99HC VENIPUNCTURE W/SPECIMEN
$11.45IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.81This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,358.95Price Negotiated by Insurer
$608.05Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$10.41HC COMPREHENSIVE METABOLIC PANEL
$14.15HC LIPASE
$9.23HC ROUTINE URINALYSIS
$4.25HC VENIPUNCTURE W/SPECIMEN
$12.18IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.39This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$793.40Price Negotiated by Insurer
$3,173.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$41.60HC COMPREHENSIVE METABOLIC PANEL
$56.00HC LIPASE
$56.21HC ROUTINE URINALYSIS
$26.40HC VENIPUNCTURE W/SPECIMEN
$37.60IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.84This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,388.45Price Negotiated by Insurer
$2,578.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$33.80HC COMPREHENSIVE METABOLIC PANEL
$45.50HC LIPASE
$45.67HC ROUTINE URINALYSIS
$21.45HC VENIPUNCTURE W/SPECIMEN
$30.55IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$77.92This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$595.05Price Negotiated by Insurer
$3,371.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$44.20HC COMPREHENSIVE METABOLIC PANEL
$59.50HC LIPASE
$59.72HC ROUTINE URINALYSIS
$28.05HC VENIPUNCTURE W/SPECIMEN
$39.95IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$6.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,586.80Price Negotiated by Insurer
$2,380.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$31.20HC COMPREHENSIVE METABOLIC PANEL
$42.00HC LIPASE
$42.16HC ROUTINE URINALYSIS
$19.80HC VENIPUNCTURE W/SPECIMEN
$28.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$1,586.80Price Negotiated by Insurer
$2,380.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$31.20HC COMPREHENSIVE METABOLIC PANEL
$42.00HC LIPASE
$42.16HC ROUTINE URINALYSIS
$19.80HC VENIPUNCTURE W/SPECIMEN
$28.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$71.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,480.82Price Negotiated by Insurer
$1,486.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC LIPASE
$5.58HC ROUTINE URINALYSIS
$2.56HC VENIPUNCTURE W/SPECIMEN
$2.43IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.44This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,480.82Price Negotiated by Insurer
$1,486.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC LIPASE
$5.58HC ROUTINE URINALYSIS
$2.56HC VENIPUNCTURE W/SPECIMEN
$2.43IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.44This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,480.82Price Negotiated by Insurer
$1,486.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC LIPASE
$5.58HC ROUTINE URINALYSIS
$2.56HC VENIPUNCTURE W/SPECIMEN
$2.43IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.88This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$2,480.82Price Negotiated by Insurer
$1,486.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC LIPASE
$5.58HC ROUTINE URINALYSIS
$2.56HC VENIPUNCTURE W/SPECIMEN
$2.43IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,286.35Price Negotiated by Insurer
$680.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC LIPASE
$10.34HC ROUTINE URINALYSIS
$4.75HC VENIPUNCTURE W/SPECIMEN
$13.63IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,467.85Price Negotiated by Insurer
$499.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC LIPASE
$7.58HC ROUTINE URINALYSIS
$3.49HC VENIPUNCTURE W/SPECIMEN
$10.00IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$3,967.00Insurance Discount
-$3,513.23Price Negotiated by Insurer
$453.77Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC LIPASE
$6.89HC ROUTINE URINALYSIS
$3.17HC VENIPUNCTURE W/SPECIMEN
$9.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.51This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.