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]
$385.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$158.40HC CBC W WBC AUTO DIFF
$30.00HC CHEMO INFUSION EA ADDL HOUR
$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]
$55.85SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$920.37This 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
$369.00Price Negotiated by Insurer
$571.26Deductible 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]
$1,199.79HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$519.47HC CBC W WBC AUTO DIFF
$64.66HC CHEMO INFUSION EA ADDL HOUR
$243.05HC CHEMO INFUSION INITIAL
$1,162.96HC COMPREHENSIVE METABOLIC PANEL
$87.88HC IV PUSH EA ADDL SEQ NEW DRUG
$163.24ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$179.41SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1,199.79SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1,199.79This 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
-$230.10Price Negotiated by Insurer
$138.90Deductible 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]
$0.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HOUR
$138.90HC CHEMO INFUSION INITIAL
$637.25HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$90.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$52.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.02This 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
-$267.14Price Negotiated by Insurer
$101.86Deductible 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 BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$435.60HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HOUR
$101.86HC CHEMO INFUSION INITIAL
$467.31HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$66.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$80.61SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.19SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01This 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
-$276.40Price Negotiated by Insurer
$92.60Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$594.00HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HOUR
$92.60HC CHEMO INFUSION INITIAL
$424.83HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$60.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.02This 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
$1,036.00Deductible 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]
$0.66HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$508.23HC CBC W WBC AUTO DIFF
$80.26HC CHEMO INFUSION EA ADDL HOUR
$1,036.00HC CHEMO INFUSION INITIAL
$1,036.00HC COMPREHENSIVE METABOLIC PANEL
$109.24HC IV PUSH EA ADDL SEQ NEW DRUG
$1,036.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.15SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.98SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.99This 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]
$4.59HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$356.40HC CBC W WBC AUTO DIFF
$67.50HC CHEMO INFUSION EA ADDL HOUR
$221.85HC CHEMO INFUSION INITIAL
$621.45HC COMPREHENSIVE METABOLIC PANEL
$357.75HC IV PUSH EA ADDL SEQ NEW DRUG
$225.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.12SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$275.94This 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]
$34.43HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$506.88HC CBC W WBC AUTO DIFF
$96.00HC CHEMO INFUSION EA ADDL HOUR
$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]
$1.34SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$870.77SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$21.84This 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
$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]
$33.60HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$586.08HC CBC W WBC AUTO DIFF
$38.48HC CHEMO INFUSION EA ADDL HOUR
$364.82HC CHEMO INFUSION INITIAL
$1,021.94HC COMPREHENSIVE METABOLIC PANEL
$588.30HC IV PUSH EA ADDL SEQ NEW DRUG
$371.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.39SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.78SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$16.60This 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
$369.00Insurance Discount
-$230.10Price Negotiated by Insurer
$138.90Deductible 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]
$78.09HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HOUR
$138.90HC CHEMO INFUSION INITIAL
$637.25HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$90.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.80SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.79SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.02This 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
-$267.14Price Negotiated by Insurer
$101.86Deductible 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]
$2.04HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HOUR
$101.86HC CHEMO INFUSION INITIAL
$467.31HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$66.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.23This 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
-$276.40Price Negotiated by Insurer
$92.60Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$107.21HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HOUR
$92.60HC CHEMO INFUSION INITIAL
$424.83HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$60.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$26.85SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.20SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$6.55This 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.
Total estimated charges
$369.00Insurance Discount
-$110.70Price Negotiated by Insurer
$258.30Deductible 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]
$2.48HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$554.40HC CBC W WBC AUTO DIFF
$105.00HC CHEMO INFUSION EA ADDL HOUR
$345.10HC CHEMO INFUSION INITIAL
$966.70HC COMPREHENSIVE METABOLIC PANEL
$556.50HC IV PUSH EA ADDL SEQ NEW DRUG
$351.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$420.00SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.81SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.63This 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
-$216.21Price Negotiated by Insurer
$152.79Deductible 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]
$0.52HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$316.80HC CBC W WBC AUTO DIFF
$12.82HC CHEMO INFUSION EA ADDL HOUR
$152.79HC CHEMO INFUSION INITIAL
$700.97HC COMPREHENSIVE METABOLIC PANEL
$17.42HC IV PUSH EA ADDL SEQ NEW DRUG
$99.38ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.10SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.07SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.44This 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
-$267.14Price Negotiated by Insurer
$101.86Deductible 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]
$0.12HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$316.80HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HOUR
$101.86HC CHEMO INFUSION INITIAL
$467.31HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$66.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.88SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.32SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.27This 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]
$3,583.48HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION EA ADDL HOUR
$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]
$50.45SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10,009.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.58This 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]
$1.74HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$475.20HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION EA ADDL HOUR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$477.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.14SODIUM 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
-$217.14Price Negotiated by Insurer
$151.86Deductible 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]
$75.21HC CBC W WBC AUTO DIFF
$12.74HC CHEMO INFUSION EA ADDL HOUR
$151.86HC CHEMO INFUSION INITIAL
$696.72HC COMPREHENSIVE METABOLIC PANEL
$17.32HC IV PUSH EA ADDL SEQ NEW DRUG
$98.78ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$75.21SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$75.21SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$75.21This 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]
$7.54HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$0.02HC CBC W WBC AUTO DIFF
$11.34HC CHEMO INFUSION EA ADDL HOUR
$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]
$0.22SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$12.71SODIUM 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
$369.00Insurance Discount
-$255.10Price Negotiated by Insurer
$113.90Deductible 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]
$77.34HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HOUR
$113.90HC CHEMO INFUSION INITIAL
$522.54HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$60.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$19.52SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$33.92SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.77This 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
$369.00Insurance Discount
-$134.69Price Negotiated by Insurer
$234.31Deductible 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]
$13.77HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$502.92HC CBC W WBC AUTO DIFF
$33.02HC CHEMO INFUSION EA ADDL HOUR
$313.06HC CHEMO INFUSION INITIAL
$876.93HC COMPREHENSIVE METABOLIC PANEL
$44.45HC IV PUSH EA ADDL SEQ NEW DRUG
$318.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.90SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$68.58SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$155.26This 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
-$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]
$8.61HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$0.02HC CBC W WBC AUTO DIFF
$12.82HC CHEMO INFUSION EA ADDL HOUR
$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]
$9.10SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.55SODIUM 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
-$239.36Price Negotiated by Insurer
$129.64Deductible 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]
$1.42HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$467.28HC CBC W WBC AUTO DIFF
$10.88HC CHEMO INFUSION EA ADDL HOUR
$129.64HC CHEMO INFUSION INITIAL
$594.76HC COMPREHENSIVE METABOLIC PANEL
$14.78HC IV PUSH EA ADDL SEQ NEW DRUG
$84.32ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.79SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$33.28This 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
-$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]
HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$190.08HC CBC W WBC AUTO DIFF
$12.48HC CHEMO INFUSION EA ADDL HOUR
$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]
$665.37SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2,911.31This 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
$369.00Insurance Discount
-$252.32Price Negotiated by Insurer
$116.68Deductible 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]
$10.88HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$554.40HC CBC W WBC AUTO DIFF
$9.79HC CHEMO INFUSION EA ADDL HOUR
$116.68HC CHEMO INFUSION INITIAL
$535.29HC COMPREHENSIVE METABOLIC PANEL
$13.31HC IV PUSH EA ADDL SEQ NEW DRUG
$75.89ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.40SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$27.00SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.49This 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
-$244.92Price Negotiated by Insurer
$124.08Deductible 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]
$20.16HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$554.40HC CBC W WBC AUTO DIFF
$10.41HC CHEMO INFUSION EA ADDL HOUR
$124.08HC CHEMO INFUSION INITIAL
$569.27HC COMPREHENSIVE METABOLIC PANEL
$14.15HC IV PUSH EA ADDL SEQ NEW DRUG
$80.71ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$999.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.09SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$278.85This 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
-$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]
$1.44HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$633.60HC CBC W WBC AUTO DIFF
$120.00HC CHEMO INFUSION EA ADDL HOUR
$394.40HC CHEMO INFUSION INITIAL
$1,104.80HC COMPREHENSIVE METABOLIC PANEL
$636.00HC IV PUSH EA ADDL SEQ NEW DRUG
$401.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.16SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$8.16SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$8.16This 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
-$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]
$6.00HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$514.80HC CBC W WBC AUTO DIFF
$33.80HC CHEMO INFUSION EA ADDL HOUR
$320.45HC CHEMO INFUSION INITIAL
$897.65HC COMPREHENSIVE METABOLIC PANEL
$516.75HC IV PUSH EA ADDL SEQ NEW DRUG
$326.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.51SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2,846.01This 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]
$0.22HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$127.50HC CHEMO INFUSION EA ADDL HOUR
$419.05HC CHEMO INFUSION INITIAL
$1,173.85HC COMPREHENSIVE METABOLIC PANEL
$675.75HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.28SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$6.12SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$28.56This 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]
$1.44HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$475.20HC CBC W WBC AUTO DIFF
$90.00HC CHEMO INFUSION EA ADDL HOUR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$477.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.66SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.44SODIUM 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
-$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]
$0.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$475.20HC CBC W WBC AUTO DIFF
$90.00HC CHEMO INFUSION EA ADDL HOUR
$295.80HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$72.28ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$14.23SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$426.20This 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
$369.00Price 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]
$2.76HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HOUR
$1,461.00HC CHEMO INFUSION INITIAL
$1,461.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$251.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$43.98SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$42.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.07This 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
$369.00Price 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]
$5.87HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HOUR
$1,352.00HC CHEMO INFUSION INITIAL
$1,352.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$608.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01This 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]
$15.76HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HOUR
$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]
$0.07SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.28This 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
$369.00Price 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]
$176.46HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION EA ADDL HOUR
$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]
$0.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$29.22SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.88This 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
-$276.40Price Negotiated by Insurer
$92.60Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$45.86HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HOUR
$92.60HC CHEMO INFUSION INITIAL
$424.83HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$60.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$45.86SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$45.86SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$45.86This 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
$369.00Insurance Discount
-$230.10Price Negotiated by Insurer
$138.90Deductible 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]
$217.59HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION EA ADDL HOUR
$138.90HC CHEMO INFUSION INITIAL
$637.25HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$90.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$37.48SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.54This 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
-$267.14Price Negotiated by Insurer
$101.86Deductible 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]
$209.47HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION EA ADDL HOUR
$101.86HC CHEMO INFUSION INITIAL
$467.31HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$66.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$51.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.32SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.13This 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
-$276.40Price Negotiated by Insurer
$92.60Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.18HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION EA ADDL HOUR
$92.60HC CHEMO INFUSION INITIAL
$424.83HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$60.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$366.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.14SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$669.82This 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.