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]
$47.52HC 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]
$2.21SODIUM 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
-$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]
$75.93HC 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]
$7.98SODIUM 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
-$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]
$2.78HC 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
$363.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.43SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$134.47This 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
-$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]
$0.18HC 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]
$1.39SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$8.12HC 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]
$6.60SODIUM 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
-$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]
$228.60HC 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]
$0.02SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.92This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$1,833.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.96SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$2.90HC 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]
$0.01SODIUM 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
-$283.95Price Negotiated by Insurer
$347.05Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.16HC CBC W WBC AUTO DIFF
$28.60HC CHEMO INFUSION INITIAL
$971.30HC COMPREHENSIVE METABOLIC PANEL
$38.50HC INTRODUCER 3FR TEARAWAY
$46.75HC IV PUSH EA ADDL SEQ NEW DRUG
$328.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$29.70SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$15.59This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.26HC 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]
$0.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$9.94This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$56.24HC 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]
$15.13SODIUM 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
-$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]
$0.34HC 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]
$1.33SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$12.60This 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 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]
$0.16HC 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]
$62.48SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.03This 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
-$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]
$8.64HC 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]
$0.31SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$49.62This 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]
$19.83HC 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]
$19.83SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$4.28This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.26HC 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]
$0.27SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$172.32This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$5.18HC 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]
$0.32SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$62.62This 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]
$0.56HC 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]
$1.49SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.17This 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
-$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]
$4.65HC 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]
$0.05This 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]
$0.23HC 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]
$0.14SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$570.78This 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 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]
$237.61This 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 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]
$9.04HC 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
$36.62ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.11SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$3.73HC 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]
$5.18SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.12This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.10HC 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]
$2.98SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.00This 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
-$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]
$0.27HC 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]
$0.45SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$519.59This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$5.77HC 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]
$8.85SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$8.72This 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
-$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]
$0.06HC 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]
$0.04SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$148.56This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$30.19HC 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]
$4.60SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$3.27This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$116.59HC 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]
$101.75SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$2.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$134.40HC 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]
$8.96SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$7.77This 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]
$83.69HC 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]
$3.48SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$16.82This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.08HC 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]
$22.05SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.47This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$9.17SODIUM 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]
$2.55HC 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]
$0.29SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$111.94This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$56.26HC 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]
$9.68SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.27This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.31HC 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]
$0.46SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$53.86HC 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]
$10.63SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$0.10HC CBC W WBC AUTO DIFF
$31.20HC CHEMO INFUSION INITIAL
$1,059.60HC COMPREHENSIVE METABOLIC PANEL
$42.00HC INTRODUCER 3FR TEARAWAY
$51.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$37.80SODIUM 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
$631.00Price 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]
$5.54HC 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]
$28.64SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$21.91This 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 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]
$16.11HC 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
$299.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$90.50SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$139.40This 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
$631.00Price Negotiated by Insurer
$887.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.04HC 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]
$0.04SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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 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]
$0.57HC 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]
$0.08SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$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 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]
$32.09SODIUM 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]
$1.46HC 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]
$0.69SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$0.26This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$28.56HC 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]
$2.45SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.26This 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 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]
$19.12HC 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]
$12.24SODIUM CHLORIDE 0.9% INJECTION FOR CNR (WRAP) [4081190]
$1.70This 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 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.