CPT 96376
The standard charge for Intravenous infusion, for treatment, prophylaxis, or diagnosis-same drug add on is $329.00. 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
$329.00Insurance Discount
-$263.20Price Negotiated by Insurer
$65.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$20.80HC CBC W WBC AUTO DIFF
$29.16HC COMPREHENSIVE METABOLIC PANEL
$159.00HC GLUCOSE TESTING POC
$27.40HC HYDRATION INFUSION EA ADDL HR
$33.60HC IV PUSH EA ADDL SEQ NEW DRUG
$100.40HC IV PUSH SINGLE OR INIT DRUG
$100.40HC ROUTINE URINALYSIS
$27.00HC SBBB PHLEBOTOMY
$40.00HC SOM MAGNESIUM RANDOM UR
$1.48HC TROPONIN-T
$63.00MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.67ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.88TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$5.61This 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
$329.00Insurance Discount
-$113.21Price Negotiated by Insurer
$215.79Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$68.21HC CBC W WBC AUTO DIFF
$95.63HC COMPREHENSIVE METABOLIC PANEL
$521.44HC GLUCOSE TESTING POC
$89.86HC HYDRATION INFUSION EA ADDL HR
$110.19HC IV PUSH EA ADDL SEQ NEW DRUG
$329.26HC IV PUSH SINGLE OR INIT DRUG
$329.26HC ROUTINE URINALYSIS
$88.55HC SBBB PHLEBOTOMY
$131.18HC SOM MAGNESIUM RANDOM UR
$4.86HC TROPONIN-T
$206.61MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$4.72ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$113.73TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$157.42This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$9.71HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC GLUCOSE TESTING POC
$4.92HC HYDRATION INFUSION EA ADDL HR
$87.94HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94HC IV PUSH SINGLE OR INIT DRUG
$401.55HC ROUTINE URINALYSIS
$4.75HC SBBB PHLEBOTOMY
$13.63HC SOM MAGNESIUM RANDOM UR
$10.05HC TROPONIN-T
$18.70MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$136.53ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$149.70This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$148.05Price Negotiated by Insurer
$180.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$7.12HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC GLUCOSE TESTING POC
$3.61HC HYDRATION INFUSION EA ADDL HR
$64.49HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49HC IV PUSH SINGLE OR INIT DRUG
$294.47HC ROUTINE URINALYSIS
$3.49HC SBBB PHLEBOTOMY
$10.00HC SOM MAGNESIUM RANDOM UR
$7.37HC TROPONIN-T
$13.72MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.21TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$82.25Price Negotiated by Insurer
$246.75Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$6.47HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC GLUCOSE TESTING POC
$3.28HC HYDRATION INFUSION EA ADDL HR
$58.63HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63HC IV PUSH SINGLE OR INIT DRUG
$267.70HC ROUTINE URINALYSIS
$3.17HC SBBB PHLEBOTOMY
$9.09HC SOM MAGNESIUM RANDOM UR
$6.70HC TROPONIN-T
$12.47MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$2.71ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Price 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.
HC CBC WITHOUT DIFFERENTIAL
$63.90HC CBC W WBC AUTO DIFF
$76.80HC COMPREHENSIVE METABOLIC PANEL
$104.53HC GLUCOSE TESTING POC
$84.13HC HYDRATION INFUSION EA ADDL HR
$103.17HC IV PUSH EA ADDL SEQ NEW DRUG
$991.00HC IV PUSH SINGLE OR INIT DRUG
$991.00HC ROUTINE URINALYSIS
$30.19HC SOM MAGNESIUM RANDOM UR
$65.77HC TROPONIN-T
$188.45MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$8.22ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.94TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.91This 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
$329.00Insurance Discount
-$148.05Price Negotiated by Insurer
$180.95Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$57.20HC CBC W WBC AUTO DIFF
$80.19HC COMPREHENSIVE METABOLIC PANEL
$437.25HC GLUCOSE TESTING POC
$75.35HC HYDRATION INFUSION EA ADDL HR
$92.40HC IV PUSH EA ADDL SEQ NEW DRUG
$276.10HC IV PUSH SINGLE OR INIT DRUG
$276.10HC ROUTINE URINALYSIS
$74.25HC SBBB PHLEBOTOMY
$200.00HC SOM MAGNESIUM RANDOM UR
$7.41HC TROPONIN-T
$173.25MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.13ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$25.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$5.02This 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
$329.00Insurance Discount
-$118.44Price Negotiated by Insurer
$210.56Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$66.56HC CBC W WBC AUTO DIFF
$93.31HC COMPREHENSIVE METABOLIC PANEL
$508.80HC GLUCOSE TESTING POC
$87.68HC HYDRATION INFUSION EA ADDL HR
$107.52HC IV PUSH EA ADDL SEQ NEW DRUG
$321.28HC IV PUSH SINGLE OR INIT DRUG
$321.28HC ROUTINE URINALYSIS
$86.40HC SBBB PHLEBOTOMY
$128.00HC SOM MAGNESIUM RANDOM UR
$4.74HC TROPONIN-T
$201.60MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.24ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.68TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.21This 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
$329.00Insurance Discount
-$85.54Price Negotiated by Insurer
$243.46Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$76.96HC CBC W WBC AUTO DIFF
$107.89HC COMPREHENSIVE METABOLIC PANEL
$588.30HC GLUCOSE TESTING POC
$101.38HC HYDRATION INFUSION EA ADDL HR
$124.32HC IV PUSH EA ADDL SEQ NEW DRUG
$371.48HC IV PUSH SINGLE OR INIT DRUG
$371.48HC ROUTINE URINALYSIS
$99.90HC SBBB PHLEBOTOMY
$148.00HC SOM MAGNESIUM RANDOM UR
$5.48HC TROPONIN-T
$233.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.03TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$9.71HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC GLUCOSE TESTING POC
$4.92HC HYDRATION INFUSION EA ADDL HR
$87.94HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94HC IV PUSH SINGLE OR INIT DRUG
$401.55HC ROUTINE URINALYSIS
$4.75HC SBBB PHLEBOTOMY
$13.63HC SOM MAGNESIUM RANDOM UR
$10.05HC TROPONIN-T
$18.70MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$21.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$242.90TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$11.73This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$7.12HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC GLUCOSE TESTING POC
$3.61HC HYDRATION INFUSION EA ADDL HR
$64.49HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49HC IV PUSH SINGLE OR INIT DRUG
$294.47HC ROUTINE URINALYSIS
$3.49HC SBBB PHLEBOTOMY
$10.00HC SOM MAGNESIUM RANDOM UR
$7.37HC TROPONIN-T
$13.72MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.18ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.00TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$44.57This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$6.47HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC GLUCOSE TESTING POC
$3.28HC HYDRATION INFUSION EA ADDL HR
$58.63HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63HC IV PUSH SINGLE OR INIT DRUG
$267.70HC ROUTINE URINALYSIS
$3.17HC SBBB PHLEBOTOMY
$9.09HC SOM MAGNESIUM RANDOM UR
$6.70HC TROPONIN-T
$12.47MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$3.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.69This 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
$329.00Insurance Discount
-$197.40Price Negotiated by Insurer
$131.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$8.73HC CBC W WBC AUTO DIFF
$10.49HC COMPREHENSIVE METABOLIC PANEL
$14.26HC GLUCOSE TESTING POC
$4.43HC HYDRATION INFUSION EA ADDL HR
$79.15HC IV PUSH EA ADDL SEQ NEW DRUG
$79.15HC IV PUSH SINGLE OR INIT DRUG
$361.39HC ROUTINE URINALYSIS
$4.28HC SBBB PHLEBOTOMY
$12.27HC SOM MAGNESIUM RANDOM UR
$9.04HC TROPONIN-T
$16.83MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$190.95ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.08TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$197.40Price Negotiated by Insurer
$131.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$6.47HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC GLUCOSE TESTING POC
$3.28HC HYDRATION INFUSION EA ADDL HR
$58.63HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63HC IV PUSH SINGLE OR INIT DRUG
$267.70HC ROUTINE URINALYSIS
$3.17HC SBBB PHLEBOTOMY
$9.09HC SOM MAGNESIUM RANDOM UR
$6.70HC TROPONIN-T
$12.47MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$84.80ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.38TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.78This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$88.40HC CBC W WBC AUTO DIFF
$123.93HC COMPREHENSIVE METABOLIC PANEL
$675.75HC GLUCOSE TESTING POC
$116.45HC HYDRATION INFUSION EA ADDL HR
$142.80HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70HC IV PUSH SINGLE OR INIT DRUG
$426.70HC ROUTINE URINALYSIS
$114.75HC SBBB PHLEBOTOMY
$170.00HC SOM MAGNESIUM RANDOM UR
$6.30HC TROPONIN-T
$267.75MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.35ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$6.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$11.22This 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
$329.00Insurance Discount
-$131.60Price Negotiated by Insurer
$197.40Deductible 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.
HC CBC WITHOUT DIFFERENTIAL
$62.40HC CBC W WBC AUTO DIFF
$87.48HC COMPREHENSIVE METABOLIC PANEL
$477.00HC GLUCOSE TESTING POC
$82.20HC HYDRATION INFUSION EA ADDL HR
$100.80HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20HC IV PUSH SINGLE OR INIT DRUG
$301.20HC ROUTINE URINALYSIS
$81.00HC SBBB PHLEBOTOMY
$120.00HC SOM MAGNESIUM RANDOM UR
$4.45HC TROPONIN-T
$189.00MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$2.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.45TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Price Negotiated by Insurer
$973.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$9.59HC CBC W WBC AUTO DIFF
$11.34HC COMPREHENSIVE METABOLIC PANEL
$15.44HC GLUCOSE TESTING POC
$3.36HC HYDRATION INFUSION EA ADDL HR
$973.00HC IV PUSH EA ADDL SEQ NEW DRUG
$35.77HC IV PUSH SINGLE OR INIT DRUG
$83.70HC ROUTINE URINALYSIS
$4.65HC SOM MAGNESIUM RANDOM UR
$10.01HC TROPONIN-T
$14.23MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.59ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.87TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$109.56Price Negotiated by Insurer
$219.44Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$69.37HC CBC W WBC AUTO DIFF
$97.25HC COMPREHENSIVE METABOLIC PANEL
$530.26HC GLUCOSE TESTING POC
$91.38HC HYDRATION INFUSION EA ADDL HR
$112.06HC IV PUSH EA ADDL SEQ NEW DRUG
$334.83HC IV PUSH SINGLE OR INIT DRUG
$334.83HC ROUTINE URINALYSIS
$90.05HC SBBB PHLEBOTOMY
$133.40HC SOM MAGNESIUM RANDOM UR
$4.94HC TROPONIN-T
$210.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$1.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.39TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$320.16This 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
$329.00Insurance Discount
-$203.65Price Negotiated by Insurer
$125.35Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$10.85HC CBC W WBC AUTO DIFF
$12.82HC COMPREHENSIVE METABOLIC PANEL
$17.46HC GLUCOSE TESTING POC
$3.80HC HYDRATION INFUSION EA ADDL HR
$27.74HC IV PUSH EA ADDL SEQ NEW DRUG
$40.45HC IV PUSH SINGLE OR INIT DRUG
$94.66HC ROUTINE URINALYSIS
$5.26HC SBBB PHLEBOTOMY
$76.20HC SOM MAGNESIUM RANDOM UR
$11.32HC TROPONIN-T
$16.09MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$14.88ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$138.53TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$125.35Price Negotiated by Insurer
$203.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$6.47HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC GLUCOSE TESTING POC
$3.28HC HYDRATION INFUSION EA ADDL HR
$58.63HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63HC IV PUSH SINGLE OR INIT DRUG
$267.70HC ROUTINE URINALYSIS
$3.17HC SBBB PHLEBOTOMY
$9.09HC SOM MAGNESIUM RANDOM UR
$6.70HC TROPONIN-T
$12.47MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$135.38ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.17TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$296.61This 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
$329.00Insurance Discount
-$250.04Price Negotiated by Insurer
$78.96Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$24.96HC CBC W WBC AUTO DIFF
$34.99HC COMPREHENSIVE METABOLIC PANEL
$190.80HC GLUCOSE TESTING POC
$32.88HC HYDRATION INFUSION EA ADDL HR
$40.32HC IV PUSH EA ADDL SEQ NEW DRUG
$120.48HC IV PUSH SINGLE OR INIT DRUG
$120.48HC ROUTINE URINALYSIS
$32.40HC SBBB PHLEBOTOMY
$48.00HC SOM MAGNESIUM RANDOM UR
$1.78HC TROPONIN-T
$75.60MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.07ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.85TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.41This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$98.70Price Negotiated by Insurer
$230.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$8.15HC CBC W WBC AUTO DIFF
$9.79HC COMPREHENSIVE METABOLIC PANEL
$13.31HC GLUCOSE TESTING POC
$4.13HC HYDRATION INFUSION EA ADDL HR
$73.87HC IV PUSH EA ADDL SEQ NEW DRUG
$73.87HC IV PUSH SINGLE OR INIT DRUG
$337.30HC ROUTINE URINALYSIS
$3.99HC SBBB PHLEBOTOMY
$11.45HC SOM MAGNESIUM RANDOM UR
$8.44HC TROPONIN-T
$15.71MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$30.86ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.51This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$98.70Price Negotiated by Insurer
$230.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$8.67HC CBC W WBC AUTO DIFF
$10.41HC COMPREHENSIVE METABOLIC PANEL
$14.15HC GLUCOSE TESTING POC
$4.40HC HYDRATION INFUSION EA ADDL HR
$78.56HC IV PUSH EA ADDL SEQ NEW DRUG
$78.56HC IV PUSH SINGLE OR INIT DRUG
$358.72HC ROUTINE URINALYSIS
$4.25HC SBBB PHLEBOTOMY
$12.18HC SOM MAGNESIUM RANDOM UR
$8.98HC TROPONIN-T
$16.71MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$10.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$29.40TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$65.80Price Negotiated by Insurer
$263.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$83.20HC CBC W WBC AUTO DIFF
$116.64HC COMPREHENSIVE METABOLIC PANEL
$636.00HC GLUCOSE TESTING POC
$109.60HC HYDRATION INFUSION EA ADDL HR
$134.40HC IV PUSH EA ADDL SEQ NEW DRUG
$401.60HC IV PUSH SINGLE OR INIT DRUG
$401.60HC ROUTINE URINALYSIS
$108.00HC SBBB PHLEBOTOMY
$160.00HC SOM MAGNESIUM RANDOM UR
$5.93HC TROPONIN-T
$252.00MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$8.88ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.07TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$115.15Price Negotiated by Insurer
$213.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$67.60HC CBC W WBC AUTO DIFF
$94.77HC COMPREHENSIVE METABOLIC PANEL
$516.75HC GLUCOSE TESTING POC
$89.05HC HYDRATION INFUSION EA ADDL HR
$109.20HC IV PUSH EA ADDL SEQ NEW DRUG
$326.30HC IV PUSH SINGLE OR INIT DRUG
$326.30HC ROUTINE URINALYSIS
$87.75HC SBBB PHLEBOTOMY
$130.00HC SOM MAGNESIUM RANDOM UR
$4.82HC TROPONIN-T
$204.75MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$150.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.17TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$139.71This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$88.40HC CBC W WBC AUTO DIFF
$123.93HC COMPREHENSIVE METABOLIC PANEL
$675.75HC GLUCOSE TESTING POC
$116.45HC HYDRATION INFUSION EA ADDL HR
$142.80HC IV PUSH EA ADDL SEQ NEW DRUG
$426.70HC IV PUSH SINGLE OR INIT DRUG
$426.70HC ROUTINE URINALYSIS
$114.75HC SBBB PHLEBOTOMY
$170.00HC SOM MAGNESIUM RANDOM UR
$6.30HC TROPONIN-T
$267.75MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$2.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.06TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$131.60Price Negotiated by Insurer
$197.40Deductible 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.
HC CBC WITHOUT DIFFERENTIAL
$62.40HC CBC W WBC AUTO DIFF
$87.48HC COMPREHENSIVE METABOLIC PANEL
$477.00HC GLUCOSE TESTING POC
$82.20HC HYDRATION INFUSION EA ADDL HR
$100.80HC IV PUSH EA ADDL SEQ NEW DRUG
$301.20HC IV PUSH SINGLE OR INIT DRUG
$301.20HC ROUTINE URINALYSIS
$81.00HC SBBB PHLEBOTOMY
$120.00HC SOM MAGNESIUM RANDOM UR
$4.45HC TROPONIN-T
$189.00MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$33.84ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.14TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.65This 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
$329.00Insurance Discount
-$131.60Price Negotiated by Insurer
$197.40Deductible 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.
HC CBC WITHOUT DIFFERENTIAL
$62.40HC CBC W WBC AUTO DIFF
$87.48HC COMPREHENSIVE METABOLIC PANEL
$477.00HC GLUCOSE TESTING POC
$82.20HC HYDRATION INFUSION EA ADDL HR
$70.36HC IV PUSH EA ADDL SEQ NEW DRUG
$70.36HC IV PUSH SINGLE OR INIT DRUG
$321.24HC ROUTINE URINALYSIS
$81.00HC SBBB PHLEBOTOMY
$120.00HC SOM MAGNESIUM RANDOM UR
$4.45HC TROPONIN-T
$189.00MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$21.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.48TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$21.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Children's Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Children's Hospital directly.
Total estimated charges
$329.00Insurance Discount
-$164.50Price Negotiated by Insurer
$164.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$5.24HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC GLUCOSE TESTING POC
$2.65HC HYDRATION INFUSION EA ADDL HR
$676.00HC IV PUSH EA ADDL SEQ NEW DRUG
$251.00HC IV PUSH SINGLE OR INIT DRUG
$676.00HC ROUTINE URINALYSIS
$2.56HC SBBB PHLEBOTOMY
$2.43HC SOM MAGNESIUM RANDOM UR
$5.43HC TROPONIN-T
$10.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.62ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.95TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$28.64This 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
$329.00Price Negotiated by Insurer
$663.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$5.24HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC GLUCOSE TESTING POC
$2.65HC HYDRATION INFUSION EA ADDL HR
$663.00HC IV PUSH EA ADDL SEQ NEW DRUG
$663.00HC IV PUSH SINGLE OR INIT DRUG
$251.00HC ROUTINE URINALYSIS
$2.56HC SBBB PHLEBOTOMY
$2.43HC SOM MAGNESIUM RANDOM UR
$5.43HC TROPONIN-T
$10.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$95.47ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$72.91TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$19.28This 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
$329.00Insurance Discount
-$164.50Price Negotiated by Insurer
$164.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$5.24HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC GLUCOSE TESTING POC
$2.65HC HYDRATION INFUSION EA ADDL HR
$662.00HC IV PUSH EA ADDL SEQ NEW DRUG
$251.00HC IV PUSH SINGLE OR INIT DRUG
$662.00HC ROUTINE URINALYSIS
$2.56HC SBBB PHLEBOTOMY
$2.43HC SOM MAGNESIUM RANDOM UR
$5.43HC TROPONIN-T
$10.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.73ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.29TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Price Negotiated by Insurer
$605.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$5.24HC CBC W WBC AUTO DIFF
$6.29HC COMPREHENSIVE METABOLIC PANEL
$8.55HC GLUCOSE TESTING POC
$2.65HC HYDRATION INFUSION EA ADDL HR
$84.00HC IV PUSH EA ADDL SEQ NEW DRUG
$251.00HC IV PUSH SINGLE OR INIT DRUG
$251.00HC ROUTINE URINALYSIS
$2.56HC SBBB PHLEBOTOMY
$2.43HC SOM MAGNESIUM RANDOM UR
$5.43HC TROPONIN-T
$10.10MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.19ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$12.29TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$9.71HC CBC W WBC AUTO DIFF
$11.65HC COMPREHENSIVE METABOLIC PANEL
$15.84HC GLUCOSE TESTING POC
$4.92HC HYDRATION INFUSION EA ADDL HR
$87.94HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94HC IV PUSH SINGLE OR INIT DRUG
$401.55HC ROUTINE URINALYSIS
$4.75HC SBBB PHLEBOTOMY
$13.63HC SOM MAGNESIUM RANDOM UR
$10.05HC TROPONIN-T
$18.70MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.32ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.24TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$60.64This 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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$7.12HC CBC W WBC AUTO DIFF
$8.55HC COMPREHENSIVE METABOLIC PANEL
$11.62HC GLUCOSE TESTING POC
$3.61HC HYDRATION INFUSION EA ADDL HR
$64.49HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49HC IV PUSH SINGLE OR INIT DRUG
$294.47HC ROUTINE URINALYSIS
$3.49HC SBBB PHLEBOTOMY
$10.00HC SOM MAGNESIUM RANDOM UR
$7.37HC TROPONIN-T
$13.72MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$0.09ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.58TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$329.00Insurance Discount
-$49.35Price Negotiated by Insurer
$279.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CBC WITHOUT DIFFERENTIAL
$6.47HC CBC W WBC AUTO DIFF
$7.77HC COMPREHENSIVE METABOLIC PANEL
$10.56HC GLUCOSE TESTING POC
$3.28HC HYDRATION INFUSION EA ADDL HR
$58.63HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63HC IV PUSH SINGLE OR INIT DRUG
$267.70HC ROUTINE URINALYSIS
$3.17HC SBBB PHLEBOTOMY
$9.09HC SOM MAGNESIUM RANDOM UR
$6.70HC TROPONIN-T
$12.47MORPHINE 50 MG/50 ML IN NS IV PCA SYRINGE [40820379]
$3.65ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$19.17TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$88.43This 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.