CPT 96415
The standard charge for Chemotherapy infusion-each additional hour is $631.00. 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, 92373CONTACT
877-558-6248 Visit WebsiteLoma Linda University Medical Center 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 Medical Center 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 Medical Center 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
$631.00Insurance Discount
-$504.80Price Negotiated by Insurer
$126.20Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$5.28HC CBC W WBC AUTO DIFF
$10.40HC CHEMO INFUSION INITIAL
$353.20HC COMPREHENSIVE METABOLIC PANEL
$14.00HC INTRODUCER 3FR TEARAWAY
$17.00HC IV PUSH EA ADDL SEQ NEW DRUG
$119.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.48SODIUM 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$0.62SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$312.03This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$247.79Price Negotiated by Insurer
$383.21Deductible 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]
$408.37HC CBC W WBC AUTO DIFF
$31.58HC CHEMO INFUSION INITIAL
$1,072.49HC COMPREHENSIVE METABOLIC PANEL
$42.51HC INTRODUCER 3FR TEARAWAY
$51.62HC IV PUSH EA ADDL SEQ NEW DRUG
$2,696.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.76This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$495.35Price 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]
$87.11HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$94.81SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$11.79This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$531.53Price 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]
$1.95HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC INTRODUCER 3FR TEARAWAY
$46.75HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.21SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$120.28This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$1.80HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC INTRODUCER 3FR TEARAWAY
$63.75HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price Negotiated by Insurer
$742.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.39HC CBC W WBC AUTO DIFF
$56.57HC CHEMO INFUSION INITIAL
$742.00HC COMPREHENSIVE METABOLIC PANEL
$76.99HC INTRODUCER 3FR TEARAWAY
$41.16HC IV PUSH EA ADDL SEQ NEW DRUG
$742.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$90.86SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price Negotiated by Insurer
$990.00Deductible 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]
$0.21HC CBC W WBC AUTO DIFF
$11.48HC CHEMO INFUSION INITIAL
$990.00HC COMPREHENSIVE METABOLIC PANEL
$15.63HC INTRODUCER 3FR TEARAWAY
$49.92HC IV PUSH EA ADDL SEQ NEW DRUG
$990.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.21SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.25This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$347.05Price Negotiated by Insurer
$283.95Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$160.35HC CBC W WBC AUTO DIFF
$23.40HC CHEMO INFUSION INITIAL
$794.70HC COMPREHENSIVE METABOLIC PANEL
$31.50HC INTRODUCER 3FR TEARAWAY
$38.25HC IV PUSH EA ADDL SEQ NEW DRUG
$269.10ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$11.88SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.58This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$126.20Price Negotiated by Insurer
$504.80Deductible 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]
$14.28HC CBC W WBC AUTO DIFF
$41.60HC CHEMO INFUSION INITIAL
$1,412.80HC COMPREHENSIVE METABOLIC PANEL
$56.00HC INTRODUCER 3FR TEARAWAY
$68.00HC IV PUSH EA ADDL SEQ NEW DRUG
$478.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$32.36This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$227.16Price Negotiated by Insurer
$403.84Deductible 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]
$0.60HC CBC W WBC AUTO DIFF
$33.28HC CHEMO INFUSION INITIAL
$1,130.24HC COMPREHENSIVE METABOLIC PANEL
$44.80HC INTRODUCER 3FR TEARAWAY
$54.40HC IV PUSH EA ADDL SEQ NEW DRUG
$382.72ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$230.38SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.65This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$164.06Price Negotiated by Insurer
$466.94Deductible 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]
$0.43HC CBC W WBC AUTO DIFF
$38.48HC CHEMO INFUSION INITIAL
$1,306.84HC COMPREHENSIVE METABOLIC PANEL
$51.80HC INTRODUCER 3FR TEARAWAY
$62.90HC IV PUSH EA ADDL SEQ NEW DRUG
$442.52ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.83SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$6.89This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$495.35Price 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]
$21.68HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$333.05SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$247.06This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$531.53Price 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]
$80.36HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.94SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$8.47This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price Negotiated by Insurer
$90.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$4.59HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.65This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$508.92Price 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]
$127.10HC CBC W WBC AUTO DIFF
$10.49HC CHEMO INFUSION INITIAL
$568.96HC COMPREHENSIVE METABOLIC PANEL
$14.26HC INTRODUCER 3FR TEARAWAY
$34.00HC IV PUSH EA ADDL SEQ NEW DRUG
$79.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.68SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$40.00This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$25.05HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC INTRODUCER 3FR TEARAWAY
$34.00HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$266.94SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$56.06This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$94.65Price Negotiated by Insurer
$536.35Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$4.79HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION INITIAL
$1,501.10HC COMPREHENSIVE METABOLIC PANEL
$59.50HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$508.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.20SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.64This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$252.40Price Negotiated by Insurer
$378.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.07HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$1,059.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC INTRODUCER 3FR TEARAWAY
$51.00HC IV PUSH EA ADDL SEQ NEW DRUG
$358.80ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.33SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.46This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$63.10Price Negotiated by Insurer
$567.90Deductible 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]
$3.73HC CBC W WBC AUTO DIFF
$46.80HC CHEMO INFUSION INITIAL
$1,589.40HC COMPREHENSIVE METABOLIC PANEL
$63.00HC INTRODUCER 3FR TEARAWAY
$76.50HC IV PUSH EA ADDL SEQ NEW DRUG
$538.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.92SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$387.72This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$482.69Price 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]
$15.04HC 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]
$0.72SODIUM 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$594.04Price Negotiated by Insurer
$36.96Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$7.74HC CBC W WBC AUTO DIFF
$11.61HC CHEMO INFUSION INITIAL
$174.62HC COMPREHENSIVE METABOLIC PANEL
$15.81HC INTRODUCER 3FR TEARAWAY
$0.02HC IV PUSH EA ADDL SEQ NEW DRUG
$973.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.21SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$519.77Price 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]
$53.08HC 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]
$0.41SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$29.30This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$495.35Price 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]
$1.72HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC INTRODUCER 3FR TEARAWAY
$42.50HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.25SODIUM 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$210.12Price Negotiated by Insurer
$420.88Deductible 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]
$11.91HC CBC W WBC AUTO DIFF
$34.68HC CHEMO INFUSION INITIAL
$1,177.92HC COMPREHENSIVE METABOLIC PANEL
$46.69HC INTRODUCER 3FR TEARAWAY
$56.70HC IV PUSH EA ADDL SEQ NEW DRUG
$398.87ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$204.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.17This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$590.17Price 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]
$29.39HC CBC W WBC AUTO DIFF
$12.82HC CHEMO INFUSION INITIAL
$54.32HC COMPREHENSIVE METABOLIC PANEL
$17.46HC INTRODUCER 3FR TEARAWAY
$0.02HC IV PUSH EA ADDL SEQ NEW DRUG
$40.45ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.55SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$10.09This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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 INTRODUCER 3FR TEARAWAY
$52.62HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$17.83SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.01This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$504.80Price Negotiated by Insurer
$126.20Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.22HC CBC W WBC AUTO DIFF
$10.40HC CHEMO INFUSION INITIAL
$353.20HC COMPREHENSIVE METABOLIC PANEL
$14.00HC INTRODUCER 3FR TEARAWAY
$17.00HC IV PUSH EA ADDL SEQ NEW DRUG
$119.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.34SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.80This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$509.82Price Negotiated by Insurer
$121.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.24HC CBC W WBC AUTO DIFF
$10.41HC CHEMO INFUSION INITIAL
$564.74HC COMPREHENSIVE METABOLIC PANEL
$14.15HC INTRODUCER 3FR TEARAWAY
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$78.56ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$78.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.97This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$509.82Price 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]
$5.04HC CBC W WBC AUTO DIFF
$10.41HC CHEMO INFUSION INITIAL
$564.74HC COMPREHENSIVE METABOLIC PANEL
$14.15HC INTRODUCER 3FR TEARAWAY
$59.50HC IV PUSH EA ADDL SEQ NEW DRUG
$78.56ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.05SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$144.76This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$157.75Price Negotiated by Insurer
$473.25Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$42.30HC CBC W WBC AUTO DIFF
$39.00HC CHEMO INFUSION INITIAL
$1,324.50HC COMPREHENSIVE METABOLIC PANEL
$52.50HC INTRODUCER 3FR TEARAWAY
$63.75HC IV PUSH EA ADDL SEQ NEW DRUG
$448.50ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$72.00SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$32.40This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$220.85Price Negotiated by Insurer
$410.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.36HC CBC W WBC AUTO DIFF
$33.80HC CHEMO INFUSION INITIAL
$1,147.90HC COMPREHENSIVE METABOLIC PANEL
$45.50HC INTRODUCER 3FR TEARAWAY
$55.25HC IV PUSH EA ADDL SEQ NEW DRUG
$388.70ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.33SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$153.49This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$0.44HC 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]
$108.03SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.44This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$94.65Price Negotiated by Insurer
$536.35Deductible 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.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.20HC CBC W WBC AUTO DIFF
$44.20HC CHEMO INFUSION INITIAL
$1,501.10HC COMPREHENSIVE METABOLIC PANEL
$59.50HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$508.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.71SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$50.45This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$535.14Price Negotiated by Insurer
$95.86Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.28HC CBC W WBC AUTO DIFF
$8.24HC CHEMO INFUSION INITIAL
$446.74HC COMPREHENSIVE METABOLIC PANEL
$11.19HC IV PUSH EA ADDL SEQ NEW DRUG
$62.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.13SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.13This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$531.53Price 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]
$0.54HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC INTRODUCER 3FR TEARAWAY
$34.00HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.49SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$84.80This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$252.40Price Negotiated by Insurer
$378.60Deductible 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]
$23.71HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$1,059.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC INTRODUCER 3FR TEARAWAY
$51.00HC IV PUSH EA ADDL SEQ NEW DRUG
$358.80ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.20This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$252.40Price Negotiated by Insurer
$378.60Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.11HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$1,059.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC INTRODUCER 3FR TEARAWAY
$51.00HC IV PUSH EA ADDL SEQ NEW DRUG
$70.36ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.59SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.54This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price 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]
$2.06HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$1,461.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC INTRODUCER 3FR TEARAWAY
$42.50HC IV PUSH EA ADDL SEQ NEW DRUG
$676.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.17SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.21This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price 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]
$1.21HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$1,352.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC INTRODUCER 3FR TEARAWAY
$42.50HC IV PUSH EA ADDL SEQ NEW DRUG
$663.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$72.77SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.28This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price 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]
$12.01HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$887.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC INTRODUCER 3FR TEARAWAY
$42.50HC IV PUSH EA ADDL SEQ NEW DRUG
$662.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$17.97SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$238.51This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Price 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]
$0.39HC CBC W WBC AUTO DIFF
$6.29HC CHEMO INFUSION INITIAL
$813.00HC COMPREHENSIVE METABOLIC PANEL
$8.55HC INTRODUCER 3FR TEARAWAY
$42.50HC IV PUSH EA ADDL SEQ NEW DRUG
$605.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.66SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.43This 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 Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$9.17HC 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]
$1.54SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.17This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$495.35Price 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]
$0.78HC CBC W WBC AUTO DIFF
$11.65HC CHEMO INFUSION INITIAL
$632.17HC COMPREHENSIVE METABOLIC PANEL
$15.84HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$87.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.26SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.29This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$531.53Price 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]
$1.84HC CBC W WBC AUTO DIFF
$8.55HC CHEMO INFUSION INITIAL
$463.60HC COMPREHENSIVE METABOLIC PANEL
$11.62HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$64.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$12.98This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.
Total estimated charges
$631.00Insurance Discount
-$540.57Price 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]
$52.58HC CBC W WBC AUTO DIFF
$7.77HC CHEMO INFUSION INITIAL
$421.45HC COMPREHENSIVE METABOLIC PANEL
$10.56HC INTRODUCER 3FR TEARAWAY
$72.25HC IV PUSH EA ADDL SEQ NEW DRUG
$58.63ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.01SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.90This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center 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 Medical Center directly.