CPT 96415
The standard charge for Chemotherapy infusion-each additional hour is $493.00. 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
$493.00Insurance Discount
-$394.40Price Negotiated by Insurer
$98.60Deductible 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]
$0.04HC CBC W WBC AUTO DIFF
$29.16HC CHEMO INFUSION INITIAL
$276.20HC COMPREHENSIVE METABOLIC PANEL
$159.00HC IV PUSH EA ADDL SEQ NEW DRUG
$100.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.60SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.21This 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
$493.00Insurance Discount
-$169.64Price Negotiated by Insurer
$323.36Deductible 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]
$1.18HC CBC W WBC AUTO DIFF
$95.63HC CHEMO INFUSION INITIAL
$905.80HC COMPREHENSIVE METABOLIC PANEL
$521.44HC IV PUSH EA ADDL SEQ NEW DRUG
$329.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.50This 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
$493.00Insurance Discount
-$357.35Price Negotiated by Insurer
$135.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.04HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$493.00Insurance Discount
-$393.53Price Negotiated by Insurer
$99.47Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.39HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.96SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.96This 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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.09HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.50This 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
$493.00Price Negotiated by Insurer
$991.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.40HC CBC W WBC AUTO DIFF
$76.80HC CHEMO INFUSION INITIAL
$991.00HC COMPREHENSIVE METABOLIC PANEL
$104.53HC IV PUSH EA ADDL SEQ NEW DRUG
$991.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.25This 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
$493.00Insurance Discount
-$221.85Price Negotiated by Insurer
$271.15Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$9.82HC CBC W WBC AUTO DIFF
$80.19HC CHEMO INFUSION INITIAL
$759.55HC COMPREHENSIVE METABOLIC PANEL
$437.25HC IV PUSH EA ADDL SEQ NEW DRUG
$276.10ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.33SODIUM 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
$493.00Insurance Discount
-$177.48Price Negotiated by Insurer
$315.52Deductible 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]
$0.25HC CBC W WBC AUTO DIFF
$93.31HC CHEMO INFUSION INITIAL
$883.84HC COMPREHENSIVE METABOLIC PANEL
$508.80HC IV PUSH EA ADDL SEQ NEW DRUG
$321.28ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.68SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.47This 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
$493.00Insurance Discount
-$128.18Price Negotiated by Insurer
$364.82Deductible 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]
$0.88HC CBC W WBC AUTO DIFF
$107.89HC 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]
$0.05SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$8.83This 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
$493.00Insurance Discount
-$357.35Price Negotiated by Insurer
$135.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.53HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$39.85SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.33This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$393.53Price Negotiated by Insurer
$99.47Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$5.10HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.20SODIUM 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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$21.80HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$94.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$370.92Price Negotiated by Insurer
$122.08Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.82HC CBC W WBC AUTO DIFF
$10.49HC CHEMO INFUSION INITIAL
$568.96HC COMPREHENSIVE METABOLIC PANEL
$14.26HC IV PUSH EA ADDL SEQ NEW DRUG
$79.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.69SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$4.77HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.44SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.24This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$73.95Price Negotiated by Insurer
$419.05Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08HC CBC W WBC AUTO DIFF
$123.93HC 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]
$3.57SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$28.63This 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
$493.00Insurance Discount
-$197.20Price Negotiated by Insurer
$295.80Deductible 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]
$5.76HC CBC W WBC AUTO DIFF
$87.48HC 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]
$54.00SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.07This 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
$493.00Insurance Discount
-$344.69Price Negotiated by Insurer
$148.31Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$124.53HC CBC W WBC AUTO DIFF
$12.74HC CHEMO INFUSION INITIAL
$691.18HC COMPREHENSIVE METABOLIC PANEL
$17.32HC IV PUSH EA ADDL SEQ NEW DRUG
$96.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$124.53SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$124.53This 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
$493.00Insurance Discount
-$456.90Price Negotiated by Insurer
$36.10Deductible 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]
$1.24HC CBC W WBC AUTO DIFF
$11.34HC 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]
$0.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$16.36This 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
$493.00Insurance Discount
-$381.77Price Negotiated by Insurer
$111.23Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.61HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$518.38HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$53.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$53.08This 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
$493.00Insurance Discount
-$164.17Price Negotiated by Insurer
$328.83Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.49HC CBC W WBC AUTO DIFF
$97.25HC CHEMO INFUSION INITIAL
$921.13HC COMPREHENSIVE METABOLIC PANEL
$530.26HC IV PUSH EA ADDL SEQ NEW DRUG
$334.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.17SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.24This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$452.17Price Negotiated by Insurer
$40.83Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.14HC CBC W WBC AUTO DIFF
$12.82HC 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]
$4.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.38This 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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.62HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$24.85This 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
$493.00Insurance Discount
-$374.68Price Negotiated by Insurer
$118.32Deductible 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]
$0.46HC CBC W WBC AUTO DIFF
$34.99HC CHEMO INFUSION INITIAL
$331.44HC COMPREHENSIVE METABOLIC PANEL
$190.80HC IV PUSH EA ADDL SEQ NEW DRUG
$120.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.61SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$32.12This 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
$493.00Insurance Discount
-$379.06Price Negotiated by Insurer
$113.94Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.33HC CBC W WBC AUTO DIFF
$9.79HC CHEMO INFUSION INITIAL
$531.03HC COMPREHENSIVE METABOLIC PANEL
$13.31HC IV PUSH EA ADDL SEQ NEW DRUG
$73.87ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$371.82Price Negotiated by Insurer
$121.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.44HC CBC W WBC AUTO DIFF
$10.41HC CHEMO INFUSION INITIAL
$564.74HC COMPREHENSIVE METABOLIC PANEL
$14.15HC IV PUSH EA ADDL SEQ NEW DRUG
$78.56ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$29.40SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$29.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$98.60Price Negotiated by Insurer
$394.40Deductible 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]
$209.09HC CBC W WBC AUTO DIFF
$116.64HC 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]
$0.26SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.38This 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
$493.00Insurance Discount
-$172.55Price Negotiated by Insurer
$320.45Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$155.10HC CBC W WBC AUTO DIFF
$94.77HC 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]
$33.59SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.36This 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
$493.00Insurance Discount
-$73.95Price Negotiated by Insurer
$419.05Deductible 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]
$2.55HC CBC W WBC AUTO DIFF
$123.93HC 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]
$0.26SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$18.36This 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
$493.00Insurance Discount
-$197.20Price Negotiated by Insurer
$295.80Deductible 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]
$22.52HC CBC W WBC AUTO DIFF
$87.48HC 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]
$0.65SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$11.88This 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
$493.00Insurance Discount
-$197.20Price Negotiated by Insurer
$295.80Deductible 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]
$21.60HC CBC W WBC AUTO DIFF
$87.48HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$477.00HC IV PUSH EA ADDL SEQ NEW DRUG
$70.36ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$380.52SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$380.52This 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
$493.00Price 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]
$0.02HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$1,461.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$676.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.27SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$14.85This 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
$493.00Price 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]
$17.10HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$1,352.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC IV PUSH EA ADDL SEQ NEW DRUG
$663.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.16SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$122.82This 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.
Total estimated charges
$493.00Price 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]
$0.41HC CBC W WBC AUTO DIFF
$6.29HC 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]
$45.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.29This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Price 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]
$1.85HC CBC W WBC AUTO DIFF
$6.29HC 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]
$0.20SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$92.02This 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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$53.08HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$53.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.17This 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.
Total estimated charges
$493.00Insurance Discount
-$357.35Price Negotiated by Insurer
$135.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$40.80HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.61SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.34This 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
$493.00Insurance Discount
-$393.53Price Negotiated by Insurer
$99.47Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.61SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.36This 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
$493.00Insurance Discount
-$402.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.28HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.67SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.