CPT 42821
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
Price Negotiated by Insurer
$32,312.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.09DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.74FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1,199.79HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$519.47LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$1,199.79ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$268.95PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$268.95SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$1,199.79ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$6,396.35Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$52.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$52.02ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$52.02PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$52.02SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.02ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$52.02This 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
Price Negotiated by Insurer
$4,690.65Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$80.61DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$80.61HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$435.60LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$80.61ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$80.61PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$80.61SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.01ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.70This 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
Price Negotiated by Insurer
$4,264.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.02HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$594.00LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.16ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.02PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.02SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$158.36ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$9,104.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$17.39DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.50FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$36.76HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$508.23LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$70.87ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$13.58PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.99SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$3.64ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$1.66This 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
Price Negotiated by Insurer
$6,262.29Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$25.80DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$40.42FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$176.41LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$40.42ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$54.00SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$4.10ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$6,396.35Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$5.57DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.59FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.58HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$3.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.42PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.18SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.29ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$309.21This 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
Price Negotiated by Insurer
$4,690.65Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$30.60DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$39.85FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$174.38HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$366.18ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$32.67SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.33ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$15.30This 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
Price Negotiated by Insurer
$4,264.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$58.39DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.14HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$49.95PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.89SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$3.36ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.21This 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
Price Negotiated by Insurer
$7,035.98Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.16DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$99.48HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$316.80LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.81ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$20.53PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.44SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.09ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$3.10This 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
Price Negotiated by Insurer
$4,690.65Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1,466.80DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$58.65HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$316.80LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.46ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.25PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$10.85SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$249.27ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$2.72This 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
Price Negotiated by Insurer
$6,993.34Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$75.21DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$75.21FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$97.63LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$381.66ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$75.21PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$75.21SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$75.21ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$97.63This 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
Price Negotiated by Insurer
$340.25Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.11DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.36FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.22HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$0.02LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$160.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.07PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.07SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$3.25ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.22This 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
Price Negotiated by Insurer
$4,264.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$77.34DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.35FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$34.11LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$47.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.19PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$33.92SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$77.34ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$77.34This 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
Price Negotiated by Insurer
$384.81Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$8.74DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$105.66FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$8.82HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$0.02LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$345.84ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$16.83PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$154.68SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$19.13ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.67This 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
Price Negotiated by Insurer
$5,969.92Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.52DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.07FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.60HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$467.28LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$6.02ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.19PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$74.76SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.56ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$5,372.93Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.63DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.54FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.03HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$554.40LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$1.98ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$33.60PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.02SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$8.25ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$2.03This 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
Price Negotiated by Insurer
$5,714.07Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.26DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.23FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.13HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$554.40LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.23PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.52SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.03ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$303.66This 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
Price Negotiated by Insurer
$6,565.51Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
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
Price Negotiated by Insurer
$6,498.52Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
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
Price Negotiated by Insurer
$16,122.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.12DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.22FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$5.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$12.27PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$53.29SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$7.72This 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
Price Negotiated by Insurer
$10,165.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1,511.13DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.49FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.15HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.78ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.45PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$180.04SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.04This 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
Price Negotiated by Insurer
$9,312.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.45DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.55FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$11.00HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$396.00LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$0.41ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$7.63PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$5.89SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.10ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$4,264.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$45.86DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$51.22FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$45.86LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$45.86ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$45.86PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$45.86SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$45.86ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$6,396.35Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.56DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.09FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$25.33HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$16.32ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$83.65SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$0.03ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$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
Price Negotiated by Insurer
$4,690.65Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.88DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.26FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.21HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$84.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.63PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.26SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$21.12ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$70.30This 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
Price Negotiated by Insurer
$4,264.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$2.60DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.70FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$257.10HC BRUSH CYTOLOGY OLYMPUS PEDS 1.2MM
$673.20LACTATED RINGERS INTRAVENOUS SOLUTION [4318]
$4.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$50.69PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$19.89SUCCINYLCHOLINE(PF)100 MG/5 ML (20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE [216150]
$26.52ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION [8878]
$0.17This 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.