CPT 96417
The standard charge for Chemotherapy infusion-additional IV pushes of the same medication is $369.00. 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
$369.00Insurance Discount
-$295.20Price Negotiated by Insurer
$73.80Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08HC CBC W WBC AUTO DIFF
$10.40HC CHEMO INFUSION EA ADDL HR
$98.60HC CHEMO INFUSION INITIAL
$276.20HC COMPREHENSIVE METABOLIC PANEL
$14.00HC IV PUSH EA ADDL SEQ NEW DRUG
$100.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.92SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.44This 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
$369.00Insurance Discount
-$126.97Price Negotiated by Insurer
$242.03Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.76HC CBC W WBC AUTO DIFF
$34.11HC CHEMO INFUSION EA ADDL HR
$323.36HC CHEMO INFUSION INITIAL
$905.80HC COMPREHENSIVE METABOLIC PANEL
$45.91HC IV PUSH EA ADDL SEQ NEW DRUG
$329.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.76SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$516.85SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.76This 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
$369.00Insurance Discount
-$233.35Price Negotiated by Insurer
$135.65Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.15HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HR
$135.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$369.00Insurance Discount
-$269.53Price Negotiated by Insurer
$99.47Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.59HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HR
$99.47HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.59SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.08This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$17.05HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$11.07SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.05This 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
$369.00Price Negotiated by Insurer
$991.00Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.34HC CBC W WBC AUTO DIFF
$76.80HC CHEMO INFUSION EA ADDL HR
$991.00HC CHEMO INFUSION INITIAL
$991.00HC COMPREHENSIVE METABOLIC PANEL
$104.53HC IV PUSH EA ADDL SEQ NEW DRUG
$2,489.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$21.69SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.84SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.16This 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
$369.00Insurance Discount
-$202.95Price Negotiated by Insurer
$166.05Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.77HC CBC W WBC AUTO DIFF
$23.40HC CHEMO INFUSION EA ADDL HR
$221.85HC CHEMO INFUSION INITIAL
$621.45HC COMPREHENSIVE METABOLIC PANEL
$31.50HC IV PUSH EA ADDL SEQ NEW DRUG
$225.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.46SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.73This 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
$369.00Insurance Discount
-$132.84Price Negotiated by Insurer
$236.16Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.08HC CBC W WBC AUTO DIFF
$33.28HC CHEMO INFUSION EA ADDL HR
$315.52HC CHEMO INFUSION INITIAL
$883.84HC COMPREHENSIVE METABOLIC PANEL
$44.80HC IV PUSH EA ADDL SEQ NEW DRUG
$321.28ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.53SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.14SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.29This 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
$369.00Insurance Discount
-$95.94Price Negotiated by Insurer
$273.06Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.04HC CBC W WBC AUTO DIFF
$38.48HC CHEMO INFUSION EA ADDL HR
$364.82HC CHEMO INFUSION INITIAL
$1,021.94HC COMPREHENSIVE METABOLIC PANEL
$51.80HC IV PUSH EA ADDL SEQ NEW DRUG
$371.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.99SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$34.43SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06This 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
$369.00Insurance Discount
-$233.35Price Negotiated by Insurer
$135.65Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.24HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HR
$135.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$67.32SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.20SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.33This 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
$369.00Insurance Discount
-$269.53Price Negotiated by Insurer
$99.47Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HR
$99.47HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$240.97SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.40SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.14This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.17HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$58.39SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.26This 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
$369.00Insurance Discount
-$246.92Price Negotiated by Insurer
$122.08Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.27HC CBC W WBC AUTO DIFF
$10.49HC CHEMO INFUSION EA ADDL HR
$122.08HC CHEMO INFUSION INITIAL
$568.96HC COMPREHENSIVE METABOLIC PANEL
$14.26HC IV PUSH EA ADDL SEQ NEW DRUG
$79.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.03SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.12This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.06HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.38SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.22This 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
$369.00Insurance Discount
-$55.35Price Negotiated by Insurer
$313.65Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.12HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION EA ADDL HR
$419.05HC CHEMO INFUSION INITIAL
$1,173.85HC COMPREHENSIVE METABOLIC PANEL
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.20This 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
$369.00Insurance Discount
-$147.60Price Negotiated by Insurer
$221.40Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.06HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION EA ADDL HR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$28.42SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.14SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.13This 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
$369.00Insurance Discount
-$220.69Price Negotiated by Insurer
$148.31Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$715.88HC CBC W WBC AUTO DIFF
$12.74HC CHEMO INFUSION EA ADDL HR
$148.31HC CHEMO INFUSION INITIAL
$691.18HC COMPREHENSIVE METABOLIC PANEL
$17.32HC IV PUSH EA ADDL SEQ NEW DRUG
$96.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$715.88SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$715.88SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$715.88This 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
$369.00Insurance Discount
-$320.97Price Negotiated by Insurer
$48.03Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
HC CBC W WBC AUTO DIFF
$11.34HC CHEMO INFUSION EA ADDL HR
$36.10HC CHEMO INFUSION INITIAL
$48.03HC COMPREHENSIVE METABOLIC PANEL
$15.44HC IV PUSH EA ADDL SEQ NEW DRUG
$35.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.52SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
This 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
$369.00Insurance Discount
-$257.77Price Negotiated by Insurer
$111.23Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$7.98HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$111.23HC CHEMO INFUSION INITIAL
$518.38HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$7.98SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$22.62SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.98This 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
$369.00Insurance Discount
-$122.88Price Negotiated by Insurer
$246.12Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.29HC CBC W WBC AUTO DIFF
$34.68HC CHEMO INFUSION EA ADDL HR
$328.83HC CHEMO INFUSION INITIAL
$921.13HC COMPREHENSIVE METABOLIC PANEL
$46.69HC IV PUSH EA ADDL SEQ NEW DRUG
$334.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$7.96SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.32This 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
$369.00Insurance Discount
-$314.68Price Negotiated by Insurer
$54.32Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.38HC CBC W WBC AUTO DIFF
$12.82HC CHEMO INFUSION EA ADDL HR
$40.83HC CHEMO INFUSION INITIAL
$54.32HC COMPREHENSIVE METABOLIC PANEL
$17.46HC IV PUSH EA ADDL SEQ NEW DRUG
$40.45ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$30.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.15SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$48.26This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$31.77HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.07SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.37SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$42.49This 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
$369.00Insurance Discount
-$280.44Price Negotiated by Insurer
$88.56Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.17HC CBC W WBC AUTO DIFF
$12.48HC CHEMO INFUSION EA ADDL HR
$118.32HC CHEMO INFUSION INITIAL
$331.44HC COMPREHENSIVE METABOLIC PANEL
$16.80HC IV PUSH EA ADDL SEQ NEW DRUG
$120.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.49SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$16.07This 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
$369.00Insurance Discount
-$255.06Price Negotiated by Insurer
$113.94Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.33HC CBC W WBC AUTO DIFF
$9.79HC CHEMO INFUSION EA ADDL HR
$113.94HC CHEMO INFUSION INITIAL
$531.03HC COMPREHENSIVE METABOLIC PANEL
$13.31HC IV PUSH EA ADDL SEQ NEW DRUG
$73.87ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$63.54SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$26.28This 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
$369.00Insurance Discount
-$247.82Price Negotiated by Insurer
$121.18Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.78HC CBC W WBC AUTO DIFF
$10.41HC CHEMO INFUSION EA ADDL HR
$121.18HC CHEMO INFUSION INITIAL
$564.74HC COMPREHENSIVE METABOLIC PANEL
$14.15HC IV PUSH EA ADDL SEQ NEW DRUG
$78.56ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.05SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.23This 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
$369.00Insurance Discount
-$73.80Price Negotiated by Insurer
$295.20Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.03HC CBC W WBC AUTO DIFF
$41.60HC CHEMO INFUSION EA ADDL HR
$394.40HC CHEMO INFUSION INITIAL
$1,104.80HC COMPREHENSIVE METABOLIC PANEL
$56.00HC IV PUSH EA ADDL SEQ NEW DRUG
$401.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$16.76SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.18This 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
$369.00Insurance Discount
-$129.15Price Negotiated by Insurer
$239.85Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.97HC CBC W WBC AUTO DIFF
$33.80HC CHEMO INFUSION EA ADDL HR
$320.45HC CHEMO INFUSION INITIAL
$897.65HC COMPREHENSIVE METABOLIC PANEL
$45.50HC IV PUSH EA ADDL SEQ NEW DRUG
$326.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.00SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.19SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.05This 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
$369.00Insurance Discount
-$55.35Price Negotiated by Insurer
$313.65Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.86HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION EA ADDL HR
$419.05HC CHEMO INFUSION INITIAL
$1,173.85HC COMPREHENSIVE METABOLIC PANEL
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$232.83SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.60SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$369.00Insurance Discount
-$147.60Price Negotiated by Insurer
$221.40Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.56HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION EA ADDL HR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.66SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.73This 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
$369.00Insurance Discount
-$147.60Price Negotiated by Insurer
$221.40Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.06HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION EA ADDL HR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$70.36ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06This 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
$369.00Price Negotiated by Insurer
$1,461.00Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$58.76HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HR
$1,461.00HC CHEMO INFUSION INITIAL
$1,461.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$676.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$95.80SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.63SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$11.71This 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
$369.00Price Negotiated by Insurer
$1,352.00Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.64HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HR
$1,352.00HC CHEMO INFUSION INITIAL
$1,352.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$663.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.30SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$72.77This 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
$369.00Price Negotiated by Insurer
$887.00Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$7.49HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HR
$887.00HC CHEMO INFUSION INITIAL
$887.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$662.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.26SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.03This 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
$369.00Price Negotiated by Insurer
$813.00Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.03HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HR
$813.00HC CHEMO INFUSION INITIAL
$813.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$605.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$107.78SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$118.85This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.44HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.17SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.44SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$369.00Insurance Discount
-$233.35Price Negotiated by Insurer
$135.65Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.55HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HR
$135.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.12SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.14This 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
$369.00Insurance Discount
-$269.53Price Negotiated by Insurer
$99.47Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.53HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HR
$99.47HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.83SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.40This 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
$369.00Insurance Discount
-$278.57Price Negotiated by Insurer
$90.43Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$25.50HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HR
$90.43HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.71SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$34.67SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$28.55This 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.