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]
$6.72HC CBC W WBC AUTO DIFF
$10.40HC CHEMO INFUSION INITIAL
$276.20HC COMPREHENSIVE METABOLIC PANEL
$14.00HC IV PUSH EA ADDL SEQ NEW DRUG
$100.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$25.81SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$15.55HC CBC W WBC AUTO DIFF
$34.11HC CHEMO INFUSION INITIAL
$905.80HC COMPREHENSIVE METABOLIC PANEL
$45.91HC IV PUSH EA ADDL SEQ NEW DRUG
$329.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$15.55This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.06HC 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]
$0.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.59HC 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]
$0.59SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.59This 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]
$0.05HC 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]
$1.09SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.35This 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
$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]
$1.02HC 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]
$2.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$341.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$493.00Insurance Discount
-$271.15Price Negotiated by Insurer
$221.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$37.62HC CBC W WBC AUTO DIFF
$23.40HC CHEMO INFUSION INITIAL
$621.45HC COMPREHENSIVE METABOLIC PANEL
$31.50HC IV PUSH EA ADDL SEQ NEW DRUG
$225.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.92SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$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]
$9.53HC CBC W WBC AUTO DIFF
$33.28HC CHEMO INFUSION INITIAL
$883.84HC COMPREHENSIVE METABOLIC PANEL
$44.80HC IV PUSH EA ADDL SEQ NEW DRUG
$321.28ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.22This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$11.44HC CBC W WBC AUTO DIFF
$38.48HC CHEMO INFUSION INITIAL
$1,021.94HC COMPREHENSIVE METABOLIC PANEL
$51.80HC IV PUSH EA ADDL SEQ NEW DRUG
$371.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.06SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$60.21This 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
-$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]
$5.67HC 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]
$20.40SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.04This 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]
$22.13HC 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]
$0.17SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.74HC 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]
$4.67SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.12This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.20HC 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]
$0.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.11This 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]
$69.60HC 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]
$26.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.34This 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
-$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]
$0.24HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION INITIAL
$1,173.85HC COMPREHENSIVE METABOLIC PANEL
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$22.25SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.31HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.81SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$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]
$0.43HC 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]
$90.99SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.72This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$3.51HC 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]
$0.78SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$6.64This 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]
$172.55HC 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]
$0.12SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$55.48This 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.
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]
$320.16HC CBC W WBC AUTO DIFF
$34.68HC CHEMO INFUSION INITIAL
$921.13HC COMPREHENSIVE METABOLIC PANEL
$46.69HC IV PUSH EA ADDL SEQ NEW DRUG
$334.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.17SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.11This 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]
$0.07HC 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]
$167.62SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.43This 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
$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]
$0.45HC 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]
$4.07SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.12This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$57.60HC CBC W WBC AUTO DIFF
$12.48HC CHEMO INFUSION INITIAL
$331.44HC COMPREHENSIVE METABOLIC PANEL
$16.80HC IV PUSH EA ADDL SEQ NEW DRUG
$120.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.28This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.58HC 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]
$10.28SODIUM 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
-$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]
$1.69HC 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]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.59This 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]
$0.08HC CBC W WBC AUTO DIFF
$41.60HC CHEMO INFUSION INITIAL
$1,104.80HC COMPREHENSIVE METABOLIC PANEL
$56.00HC IV PUSH EA ADDL SEQ NEW DRUG
$401.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.59This 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]
$70.08HC CBC W WBC AUTO DIFF
$33.80HC CHEMO INFUSION INITIAL
$897.65HC COMPREHENSIVE METABOLIC PANEL
$45.50HC IV PUSH EA ADDL SEQ NEW DRUG
$326.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$49.31This 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
$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]
$1.79HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION INITIAL
$1,173.85HC COMPREHENSIVE METABOLIC PANEL
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.64SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.09This 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]
$2.40HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$14.04SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.67This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$380.52HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$828.60HC COMPREHENSIVE METABOLIC PANEL
$42.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.37SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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
$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]
$19.81HC 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
$251.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.53HC 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
$251.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$13.71SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.34This 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
$493.00Price 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]
$9.61HC 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]
$32.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$5.00This 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]
$1.50HC 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]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.03This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$0.26HC 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]
$0.26SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.26This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$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]
$3.28HC 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]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.73This 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
$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]
$4.44HC 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]
$9.38SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$6.83This 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
-$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]
$22.44HC 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]
$12.24SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.84This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.