CPT 52356
The standard charge for Crushing of stone in urinary duct (ureter) with stent using an endoscope is $17,383.00. 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
$17,383.00Insurance Discount
-$13,906.40Price Negotiated by Insurer
$3,476.60Deductible 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]
$0.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.07HC CATH PRIMO MALE 16" 12FR COUDE
$4.43HC GLUCOSE TESTING POC
$2.60HC INTRODUCER 3FR TEARAWAY
$17.00HC STENT METAL URETERAL
$780.00HC WIRE ABBOTT ASAHI SION
$124.20INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.14ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.16PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.60PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$16,983.00Price Negotiated by Insurer
$400.00Deductible 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]
$266.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.61HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$266.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$266.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$266.44PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.44PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$33.27TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$6,816.00Price Negotiated by Insurer
$10,567.00Deductible 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]
$4.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$99.07HC CATH PRIMO MALE 16" 12FR COUDE
$13.45HC GLUCOSE TESTING POC
$7.89HC INTRODUCER 3FR TEARAWAY
$51.62HC WIRE ABBOTT ASAHI SION
$377.13INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$13.12INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$134.47ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.93PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.38PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$7.29TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.73This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$7,694.12Price Negotiated by Insurer
$9,688.88Deductible 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]
$181.10FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.31HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$4.92HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$5.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$15.45ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.32PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.09PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$3.31TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$181.10This 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
$17,383.00Insurance Discount
-$10,277.82Price Negotiated by Insurer
$7,105.18Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.25FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$47.18HC CATH PRIMO MALE 16" 12FR COUDE
$12.18HC GLUCOSE TESTING POC
$3.61HC INTRODUCER 3FR TEARAWAY
$46.75HC STENT METAL URETERAL
$2,145.00HC WIRE ABBOTT ASAHI SION
$341.55INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$2.83INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.13ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.17PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.14PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.22This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$61.70FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.41HC CATH PRIMO MALE 16" 12FR COUDE
$16.61HC GLUCOSE TESTING POC
$3.28HC INTRODUCER 3FR TEARAWAY
$63.75HC STENT METAL URETERAL
$2,925.00HC WIRE ABBOTT ASAHI SION
$465.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$4.50INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.95ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$641.52PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$18.00PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.32This 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
$17,383.00Insurance Discount
-$10,964.00Price Negotiated by Insurer
$6,419.00Deductible 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]
$0.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.68HC CATH PRIMO MALE 16" 12FR COUDE
$10.72HC GLUCOSE TESTING POC
$6.29HC INTRODUCER 3FR TEARAWAY
$41.16HC STENT METAL URETERAL
$1,780.74HC WIRE ABBOTT ASAHI SION
$300.69INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.02INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.02PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$4.07TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.01This 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
$17,383.00Insurance Discount
-$8,802.00Price Negotiated by Insurer
$8,581.00Deductible 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]
$33.25FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.84HC CATH PRIMO MALE 16" 12FR COUDE
$13.00HC GLUCOSE TESTING POC
$7.63HC INTRODUCER 3FR TEARAWAY
$49.92HC STENT METAL URETERAL
$2,159.43HC WIRE ABBOTT ASAHI SION
$364.71INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.12INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.31ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$159.95PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.86PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.51TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.86This 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
$17,383.00Insurance Discount
-$7,091.33Price Negotiated by Insurer
$10,291.67Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$7,822.35Price Negotiated by Insurer
$9,560.65Deductible 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]
$99.00FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$3.00HC CATH PRIMO MALE 16" 12FR COUDE
$12.18HC GLUCOSE TESTING POC
$7.15HC INTRODUCER 3FR TEARAWAY
$46.75HC STENT METAL URETERAL
$2,145.00HC WIRE ABBOTT ASAHI SION
$341.55INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$29.70INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.77PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.65PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$4.20This 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
$17,383.00Insurance Discount
-$3,476.60Price Negotiated by Insurer
$13,906.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$46.70HC CATH PRIMO MALE 16" 12FR COUDE
$17.71HC GLUCOSE TESTING POC
$10.40HC INTRODUCER 3FR TEARAWAY
$68.00HC STENT METAL URETERAL
$3,120.00HC WIRE ABBOTT ASAHI SION
$496.80INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.82INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$90.14ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$169.60PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.86PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$12.12TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$6,257.88Price Negotiated by Insurer
$11,125.12Deductible 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]
$1.23FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$175.90HC CATH PRIMO MALE 16" 12FR COUDE
$14.17HC GLUCOSE TESTING POC
$8.32HC INTRODUCER 3FR TEARAWAY
$54.40HC STENT METAL URETERAL
$2,730.00HC WIRE ABBOTT ASAHI SION
$397.44INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.06INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$59.81ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.70PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$25.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$21.00TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$4,519.58Price Negotiated by Insurer
$12,863.42Deductible 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]
$0.55FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.53HC CATH PRIMO MALE 16" 12FR COUDE
$16.38HC GLUCOSE TESTING POC
$9.62HC INTRODUCER 3FR TEARAWAY
$62.90HC STENT METAL URETERAL
$2,730.00HC WIRE ABBOTT ASAHI SION
$459.54INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.97ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$11.72PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$17.95PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.71TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.65This 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
$17,383.00Insurance Discount
-$7,694.12Price Negotiated by Insurer
$9,688.88Deductible 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]
$9.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$19.89HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$4.92HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$9.82INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$216.75ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$59.75PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.18TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.29This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$10,277.82Price Negotiated by Insurer
$7,105.18Deductible 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]
$68.29FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$4.28HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$3.61HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.71INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$69.72ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$159.37PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$5.67This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$0.05FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.26HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$3.28HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$11.22INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.35ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.60PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$10.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$4.28TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$8,663.01Price Negotiated by Insurer
$8,719.99Deductible 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]
$2.60FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$17.64HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC GLUCOSE TESTING POC
$4.43HC INTRODUCER 3FR TEARAWAY
$34.00HC STENT METAL URETERAL
$1,560.00HC WIRE ABBOTT ASAHI SION
$248.40INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$4.41INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.57PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$22.56PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$9.60TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$71.65This 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$0.94FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.40HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC GLUCOSE TESTING POC
$3.28HC INTRODUCER 3FR TEARAWAY
$34.00HC STENT METAL URETERAL
$1,560.00HC WIRE ABBOTT ASAHI SION
$248.40INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.16INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$9.09ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.54PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$5.91PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$9.73TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$2,607.45Price Negotiated by Insurer
$14,775.55Deductible 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]
$0.65FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.08HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$11.05HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.22INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.31ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.28PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$22.86PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$4.29This 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
$17,383.00Insurance Discount
-$6,953.20Price Negotiated by Insurer
$10,429.80Deductible 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]
$0.39FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.14HC CATH PRIMO MALE 16" 12FR COUDE
$13.28HC GLUCOSE TESTING POC
$7.80HC INTRODUCER 3FR TEARAWAY
$51.00HC STENT METAL URETERAL
$2,340.00HC WIRE ABBOTT ASAHI SION
$372.60INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.03INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$84.29ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.69PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.96PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$14.23TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$1,738.30Price Negotiated by Insurer
$15,644.70Deductible 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]
$3.24FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.90HC CATH PRIMO MALE 16" 12FR COUDE
$19.93HC GLUCOSE TESTING POC
$11.70HC INTRODUCER 3FR TEARAWAY
$76.50HC STENT METAL URETERAL
$3,510.00HC WIRE ABBOTT ASAHI SION
$558.90INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$162.00PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$77.42PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.05TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$65.34This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$6,789.83Price Negotiated by Insurer
$10,593.17Deductible 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]
$0.72FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.72HC GLUCOSE TESTING POC
$5.38INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.72INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.72ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.72PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.72PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$15.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$15.04This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$16,410.00Price Negotiated by Insurer
$973.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.11FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.62HC GLUCOSE TESTING POC
$3.44HC INTRODUCER 3FR TEARAWAY
$0.02INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.11INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.11ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.39PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.83PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.62TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$7.74This 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$1.14FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.44HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$13.34INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.37ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.44PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.44PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$53.08TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.26This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$7,694.12Price Negotiated by Insurer
$9,688.88Deductible 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]
$1.81FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.15HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC GLUCOSE TESTING POC
$4.92HC INTRODUCER 3FR TEARAWAY
$42.50HC STENT METAL URETERAL
$1,950.00HC WIRE ABBOTT ASAHI SION
$310.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$2.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$54.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.94PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$169.93PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$162.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$157.82This 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
$17,383.00Insurance Discount
-$5,788.54Price Negotiated by Insurer
$11,594.46Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$18.50FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$18.80HC CATH PRIMO MALE 16" 12FR COUDE
$14.77HC GLUCOSE TESTING POC
$8.67HC INTRODUCER 3FR TEARAWAY
$56.70HC STENT METAL URETERAL
$2,601.30HC WIRE ABBOTT ASAHI SION
$414.21INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.05INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$8.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.00PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.76PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$4.68TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$45.86This 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
$17,383.00Insurance Discount
-$16,710.29Price Negotiated by Insurer
$672.71Deductible 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]
$1.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$8.89HC CATH PRIMO MALE 16" 12FR COUDE
$8.44HC GLUCOSE TESTING POC
$3.80HC INTRODUCER 3FR TEARAWAY
$0.02HC STENT METAL URETERAL
$1,485.90HC WIRE ABBOTT ASAHI SION
$236.60INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$138.53ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$14.88PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.10PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.49This 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$7.69FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.09HC CATH PRIMO MALE 16" 12FR COUDE
$13.70HC GLUCOSE TESTING POC
$3.28HC INTRODUCER 3FR TEARAWAY
$52.62HC STENT METAL URETERAL
$2,414.10HC WIRE ABBOTT ASAHI SION
$384.40INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.12INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.21ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$47.80PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$295.50PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$24.49TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$7.98This 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
$17,383.00Insurance Discount
-$13,906.40Price Negotiated by Insurer
$3,476.60Deductible 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]
$0.02FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.43HC CATH PRIMO MALE 16" 12FR COUDE
$4.43HC GLUCOSE TESTING POC
$2.60HC INTRODUCER 3FR TEARAWAY
$17.00HC STENT METAL URETERAL
$780.00HC WIRE ABBOTT ASAHI SION
$124.20INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.02INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.55PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$58.31PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$126.84TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$8,727.60Price Negotiated by Insurer
$8,655.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.43FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.81HC CATH PRIMO MALE 16" 12FR COUDE
$15.50HC GLUCOSE TESTING POC
$4.40HC INTRODUCER 3FR TEARAWAY
$59.50HC STENT METAL URETERAL
$2,730.00HC WIRE ABBOTT ASAHI SION
$434.70INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$99.77INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.22ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.02PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$64.05PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.69TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$24.15This 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
$17,383.00Insurance Discount
-$8,727.60Price Negotiated by Insurer
$8,655.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.16FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.18HC CATH PRIMO MALE 16" 12FR COUDE
$15.50HC GLUCOSE TESTING POC
$4.40HC INTRODUCER 3FR TEARAWAY
$59.50HC STENT METAL URETERAL
$2,730.00HC WIRE ABBOTT ASAHI SION
$434.70INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$37.88INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$28.32PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$6.26PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.50TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.14This 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
$17,383.00Insurance Discount
-$4,345.75Price Negotiated by Insurer
$13,037.25Deductible 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]
$0.21FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.62HC CATH PRIMO MALE 16" 12FR COUDE
$16.61HC GLUCOSE TESTING POC
$9.75HC INTRODUCER 3FR TEARAWAY
$63.75HC STENT METAL URETERAL
$2,925.00HC WIRE ABBOTT ASAHI SION
$465.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.21INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.35PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$3.33PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$6.00TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$4.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$7,091.33Price Negotiated by Insurer
$10,291.67Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$6,084.05Price Negotiated by Insurer
$11,298.95Deductible 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]
$0.60FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$104.66HC CATH PRIMO MALE 16" 12FR COUDE
$14.39HC GLUCOSE TESTING POC
$8.45HC INTRODUCER 3FR TEARAWAY
$55.25HC STENT METAL URETERAL
$1,950.00HC WIRE ABBOTT ASAHI SION
$403.65INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$183.00INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$43.95PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$29.85PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.37TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$13.45This 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$0.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.17HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.17PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$9.17PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$94.15TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$53.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$6,881.30Price Negotiated by Insurer
$10,501.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$2,607.45Price Negotiated by Insurer
$14,775.55Deductible 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]
$0.47FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$47.94HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$11.05HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$2.29INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.52ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.06PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.46PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.05TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$10,536.19Price Negotiated by Insurer
$6,846.81Deductible 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]
$0.27FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$58.81HC GLUCOSE TESTING POC
$3.48INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.47INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.47ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.47PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.46PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$58.81TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$58.81This 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
$17,383.00Insurance Discount
-$7,196.35Price Negotiated by Insurer
$10,186.65Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$10,277.82Price Negotiated by Insurer
$7,105.18Deductible 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]
$4.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.32HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC GLUCOSE TESTING POC
$3.61HC INTRODUCER 3FR TEARAWAY
$34.00HC STENT METAL URETERAL
$1,560.00HC WIRE ABBOTT ASAHI SION
$248.40INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$4.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.32ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.12PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.55PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$4.44TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$4.30This 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
$17,383.00Insurance Discount
-$6,953.20Price Negotiated by Insurer
$10,429.80Deductible 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]
$186.12FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$12.63HC CATH PRIMO MALE 16" 12FR COUDE
$13.28HC GLUCOSE TESTING POC
$7.80HC INTRODUCER 3FR TEARAWAY
$51.00HC STENT METAL URETERAL
$2,340.00HC WIRE ABBOTT ASAHI SION
$372.60INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.40INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$62.42PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.56This 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
$17,383.00Insurance Discount
-$8,691.50Price Negotiated by Insurer
$8,691.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.42FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$109.56HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC GLUCOSE TESTING POC
$2.65HC INTRODUCER 3FR TEARAWAY
$42.50HC STENT METAL URETERAL
$1,463.67HC WIRE ABBOTT ASAHI SION
$310.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$15.18INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.24ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$31.04PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.14TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$8,691.50Price Negotiated by Insurer
$8,691.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$16.11FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$4.98HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC GLUCOSE TESTING POC
$2.65HC INTRODUCER 3FR TEARAWAY
$42.50HC STENT METAL URETERAL
$1,424.67HC WIRE ABBOTT ASAHI SION
$310.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.12INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.68ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.63PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.52PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.52TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.21This 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
$17,383.00Insurance Discount
-$8,691.50Price Negotiated by Insurer
$8,691.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.17HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC GLUCOSE TESTING POC
$2.65HC INTRODUCER 3FR TEARAWAY
$42.50HC STENT METAL URETERAL
$1,393.86HC WIRE ABBOTT ASAHI SION
$310.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$134.94INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.19ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.04PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.89This 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
$17,383.00Insurance Discount
-$8,691.50Price Negotiated by Insurer
$8,691.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$12.29FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$6.55HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC GLUCOSE TESTING POC
$2.65HC INTRODUCER 3FR TEARAWAY
$42.50HC STENT METAL URETERAL
$1,277.25HC WIRE ABBOTT ASAHI SION
$310.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.12INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.99ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$6.39PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.55TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.10This 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$94.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.17HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$94.15INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$94.15ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.17PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$94.15PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$94.15TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$17,383.00Insurance Discount
-$7,694.12Price Negotiated by Insurer
$9,688.88Deductible 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]
$0.43FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.62HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$4.92HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.35INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.43ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.43PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.43PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.10TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.62This 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
$17,383.00Insurance Discount
-$10,277.82Price Negotiated by Insurer
$7,105.18Deductible 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]
$33.78FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$193.40HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$3.61HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.60INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$35.33ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.29PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.45PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$9.18TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$17,383.00Insurance Discount
-$10,923.75Price Negotiated by Insurer
$6,459.25Deductible 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]
$0.31FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.92HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC GLUCOSE TESTING POC
$3.28HC INTRODUCER 3FR TEARAWAY
$72.25HC STENT METAL URETERAL
$3,315.00HC WIRE ABBOTT ASAHI SION
$527.85INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.83INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.07ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.84PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.95PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$11.00TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.68This 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.