CPT 72193
The standard charge for CT scan, pelvis, with contrast is $2,761.00. 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
$2,761.00Insurance Discount
-$2,208.80Price Negotiated by Insurer
$552.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$30.00HC COMPREHENSIVE METABOLIC PANEL
$159.00IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$1.06This 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
$2,761.00Insurance Discount
-$7.00Price Negotiated by Insurer
$2,754.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$64.66HC COMPREHENSIVE METABOLIC PANEL
$87.88IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$4.51This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,422.62Price Negotiated by Insurer
$338.38Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,512.85Price Negotiated by Insurer
$248.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$4.27This 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
$2,761.00Insurance Discount
-$2,535.41Price Negotiated by Insurer
$225.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$3.98This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$989.27Price Negotiated by Insurer
$1,771.73Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$80.26HC COMPREHENSIVE METABOLIC PANEL
$109.24IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$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
$2,761.00Price Negotiated by Insurer
$3,286.34Deductible 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.
HC CBC W WBC AUTO DIFF
$69.15HC COMPREHENSIVE METABOLIC PANEL
$32.27This 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
$2,761.00Insurance Discount
-$1,518.55Price Negotiated by Insurer
$1,242.45Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$67.50HC COMPREHENSIVE METABOLIC PANEL
$357.75IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$2.39This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Price Negotiated by Insurer
$3,296.64Deductible 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.
HC CBC W WBC AUTO DIFF
$33.28HC COMPREHENSIVE METABOLIC PANEL
$44.80IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Price Negotiated by Insurer
$3,811.74Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$38.48HC COMPREHENSIVE METABOLIC PANEL
$51.80IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$3.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,422.62Price Negotiated by Insurer
$338.38Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,512.85Price Negotiated by Insurer
$248.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$101.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,535.41Price Negotiated by Insurer
$225.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$6.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Price Negotiated by Insurer
$3,605.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$36.40HC COMPREHENSIVE METABOLIC PANEL
$556.50IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$83.92This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,388.78Price Negotiated by Insurer
$372.22Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.82HC COMPREHENSIVE METABOLIC PANEL
$17.42IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$2.12This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,512.85Price Negotiated by Insurer
$248.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$1.92This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$414.15Price Negotiated by Insurer
$2,346.85Deductible 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.
HC CBC W WBC AUTO DIFF
$127.50HC COMPREHENSIVE METABOLIC PANEL
$675.75IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$1,104.40Price Negotiated by Insurer
$1,656.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$90.00HC COMPREHENSIVE METABOLIC PANEL
$477.00IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$71.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,391.03Price Negotiated by Insurer
$369.97Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.74HC COMPREHENSIVE METABOLIC PANEL
$17.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,417.52Price Negotiated by Insurer
$343.48Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.34HC COMPREHENSIVE METABOLIC PANEL
$15.44IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,535.41Price Negotiated by Insurer
$225.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56This 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
$2,761.00Price Negotiated by Insurer
$3,270.89Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$33.02HC COMPREHENSIVE METABOLIC PANEL
$44.45IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$4.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,372.55Price Negotiated by Insurer
$388.45Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$12.82HC COMPREHENSIVE METABOLIC PANEL
$17.46IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,445.17Price Negotiated by Insurer
$315.83Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$10.88HC COMPREHENSIVE METABOLIC PANEL
$14.78IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$70.73This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,098.36Price Negotiated by Insurer
$662.64Deductible 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.
HC CBC W WBC AUTO DIFF
$12.48HC COMPREHENSIVE METABOLIC PANEL
$16.80IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$1.86This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,476.76Price Negotiated by Insurer
$284.24Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$9.79HC COMPREHENSIVE METABOLIC PANEL
$13.31IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.41This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,458.71Price Negotiated by Insurer
$302.29Deductible 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.
HC CBC W WBC AUTO DIFF
$10.41HC COMPREHENSIVE METABOLIC PANEL
$14.15IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$5.43This 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
$2,761.00Insurance Discount
-$552.20Price Negotiated by Insurer
$2,208.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$41.60HC COMPREHENSIVE METABOLIC PANEL
$56.00IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$95.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$966.35Price Negotiated by Insurer
$1,794.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$33.80HC COMPREHENSIVE METABOLIC PANEL
$516.75IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$77.92This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Price Negotiated by Insurer
$4,378.35Deductible 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.
HC CBC W WBC AUTO DIFF
$127.50HC COMPREHENSIVE METABOLIC PANEL
$59.50IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.75This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Price Negotiated by Insurer
$3,090.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$90.00HC COMPREHENSIVE METABOLIC PANEL
$477.00IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$1,104.40Price Negotiated by Insurer
$1,656.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$31.20HC COMPREHENSIVE METABOLIC PANEL
$477.00IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.53This 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
$2,761.00Insurance Discount
-$1,991.75Price Negotiated by Insurer
$769.25Deductible 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.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$3.88This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$1,991.75Price Negotiated by Insurer
$769.25Deductible 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.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$59.94This 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
$2,761.00Insurance Discount
-$1,991.75Price Negotiated by Insurer
$769.25Deductible 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.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$1,991.75Price Negotiated by Insurer
$769.25Deductible 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.
HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$2,761.00Insurance Discount
-$2,535.41Price Negotiated by Insurer
$225.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56This 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
$2,761.00Insurance Discount
-$2,422.62Price Negotiated by Insurer
$338.38Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.49This 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
$2,761.00Insurance Discount
-$2,512.85Price Negotiated by Insurer
$248.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.49This 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
$2,761.00Insurance Discount
-$2,535.41Price Negotiated by Insurer
$225.59Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56IOPROMIDE 370 MG IODINE/ML INTRAVENOUS SOLUTION [247558]
$0.48This 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.