CPT 52332
The standard charge for Ureteral stents inserted internally between the bladder and the kidney and will remain within the patient for a defined period of time is $13,506.00. 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
$13,506.00Insurance Discount
-$10,804.80Price Negotiated by Insurer
$2,701.20Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.49DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.48FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.04HC 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]
$0.14INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.31IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.12MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.08PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$7.34PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.58TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$33.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.44DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.61FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$75.93HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$312.03INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$835.80MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.98ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$7.98PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.61PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$312.03TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.61This 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
$13,506.00Insurance Discount
-$7,258.00Price Negotiated by Insurer
$6,248.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$5.67DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$7.51FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$227.01HC 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]
$3.43INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.25IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.17MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.01ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$85.99PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.40PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$471.84TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.25This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$6,932.61Price Negotiated by Insurer
$6,573.39Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.26DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$180.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.16HC 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]
$42.41INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$31.91IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.48MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.31ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.27PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$260.46TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$8,685.51Price Negotiated by Insurer
$4,820.49Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$32.11DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.04HC 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]
$0.02INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.06IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$65.93MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.98PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.69PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.05TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.96This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$36.96DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.46FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.31HC 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]
$1.53INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$53.08IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$89.91MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$29.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$343.23PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.04PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$63.38TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$205.31This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$8,770.00Price Negotiated by Insurer
$4,736.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.12DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.12HC 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]
$13.19INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.01IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$58.05MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$5.50ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$17.19PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$6.87PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.73TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$7,173.00Price Negotiated by Insurer
$6,333.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.08DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.06FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.31HC 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]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$16.87IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.82MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.86ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$44.77PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$58.92This 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
$13,506.00Insurance Discount
-$6,523.66Price Negotiated by Insurer
$6,982.34Deductible 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
$13,506.00Insurance Discount
-$9,260.70Price Negotiated by Insurer
$4,245.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.98DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.26FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$12.95HC CATH PRIMO MALE 16" 12FR COUDE
$13.53HC GLUCOSE TESTING POC
$7.89HC INTRODUCER 3FR TEARAWAY
$51.94HC STENT METAL URETERAL
$3,014.70HC WIRE ABBOTT ASAHI SION
$379.43INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.24ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$120.16PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$120.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 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
$13,506.00Insurance Discount
-$10,340.39Price Negotiated by Insurer
$3,165.61Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$402.26DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.78FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.16HC CATH PRIMO MALE 16" 12FR COUDE
$8.83HC GLUCOSE TESTING POC
$5.16HC INTRODUCER 3FR TEARAWAY
$33.91HC STENT METAL URETERAL
$1,965.60HC WIRE ABBOTT ASAHI SION
$247.78INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$92.57INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$24.61IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$47.83MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.42ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.32PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$3.66TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.19This 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
$13,506.00Insurance Discount
-$6,077.70Price Negotiated by Insurer
$7,428.30Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.15DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$66.00FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$66.00HC 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]
$1.11INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.16IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.37ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.32PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$47.31PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$60.06TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.99This 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
$13,506.00Insurance Discount
-$2,701.20Price Negotiated by Insurer
$10,804.80Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$2.70DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.66FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$23.39HC 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]
$0.85INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.60IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$95.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.88ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$37.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$86.40TROPICAMIDE 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
$13,506.00Insurance Discount
-$4,862.16Price Negotiated by Insurer
$8,643.84Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$4.96DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.35FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.03HC 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]
$6.85INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$6.85IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$76.72MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.81ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.16PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.18PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$108.07TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$15.12This 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
$13,506.00Insurance Discount
-$3,511.56Price Negotiated by Insurer
$9,994.44Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.46DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$84.00FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$5.46HC 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]
$134.40INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$37.92IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.41MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.58ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$6.97PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.11PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.39TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$5.42This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$6,932.61Price Negotiated by Insurer
$6,573.39Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$185.90DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.35FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.44HC 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]
$0.21INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.47IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.47MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.47PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$58.14PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.82TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$15.30This 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
$13,506.00Insurance Discount
-$8,685.51Price Negotiated by Insurer
$4,820.49Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.17DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.13FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$55.48HC 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]
$0.63INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.13IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.18ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.65PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.17PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.31FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.09HC 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]
$48.96INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.06IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$23.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.55PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$10.73PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$82.35This 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
$13,506.00Insurance Discount
-$7,589.95Price Negotiated by Insurer
$5,916.05Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$1.39DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.14HC 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]
$5.91INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.23MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.52ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.82PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.13PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$33.12TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.84FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.14HC 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]
$0.10INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.05IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$47.95MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$21.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$19.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$7.68TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$155.42This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$2,025.90Price Negotiated by Insurer
$11,480.10Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.03DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$727.06FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$123.99HC 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]
$0.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$507.35IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.08MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$48.33ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.12PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$13.48TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.57This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$5,402.40Price Negotiated by Insurer
$8,103.60Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.18DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.05HC 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]
$0.50INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$513.22IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.37MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.68PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$10.05TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$18.36This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$1,350.60Price Negotiated by Insurer
$12,155.40Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$20.47DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.09FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.32HC 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]
$48.10INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$30.55IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$107.89MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.43ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$42.12PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.27PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$5.59TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.78This 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
$13,506.00Insurance Discount
-$6,319.09Price Negotiated by Insurer
$7,186.91Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.60DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$15.04FENTANYL-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]
$15.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$15.04MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$87.05ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.04PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$87.05PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$237.61TROPICAMIDE 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
$13,506.00Insurance Discount
-$12,558.92Price Negotiated by Insurer
$947.08Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.06DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$174.80FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.06HC GLUCOSE TESTING POC
$3.44HC INTRODUCER 3FR TEARAWAY
$0.02INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$9.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$9.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.14MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.39PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$9.04PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.06TROPICAMIDE 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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$194.32DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.41FENTANYL-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]
$28.27INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$91.02MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$82.86PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$55.48PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.44TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.45This 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
$13,506.00Insurance Discount
-$6,932.61Price Negotiated by Insurer
$6,573.39Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.17DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.33FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.01HC 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]
$0.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.88IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.29MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$10.47ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.27PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$17.34PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.17TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$163.93This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$4,497.50Price Negotiated by Insurer
$9,008.50Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$6.64DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$4.00FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.14HC 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]
$87.84INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.76IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$79.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.92ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.39PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$12.73PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$67.40TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$56.99This 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
$13,506.00Insurance Discount
-$12,459.80Price Negotiated by Insurer
$1,046.20Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.09DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$9.33FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$72.73HC 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]
$0.61INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$9.50IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.32MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$9.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$417.94PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$8.99PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$9.40TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$100.85This 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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.34DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.46FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
HC 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]
$68.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$63.38IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.38MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.16ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.49PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$55.48TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$5.57This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$10,804.80Price Negotiated by Insurer
$2,701.20Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$6.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$10.68FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.15HC 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]
$0.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.07IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.01ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$48.00PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$11.28PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$14.40TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$36.98This 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
$13,506.00Insurance Discount
-$7,633.77Price Negotiated by Insurer
$5,872.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.43DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$3.22HC 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]
$0.43INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.43MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.43ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.01PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.65TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$11.25This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$7,633.77Price Negotiated by Insurer
$5,872.23Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$16.80DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$8.89HC 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]
$0.50INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$12.60IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$83.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.10ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$6.26PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$98.11PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.22TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.84This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$3,376.50Price Negotiated by Insurer
$10,129.50Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$3.90DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.57FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.50HC 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]
$21.86INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$10.80IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.46MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.21ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.33PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$5.36PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$51.30TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$6,523.66Price Negotiated by Insurer
$6,982.34Deductible 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
$13,506.00Insurance Discount
-$4,727.10Price Negotiated by Insurer
$8,778.90Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.01DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.28FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.04HC 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]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$15.60IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.57MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.16ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$14.06PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.58TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$91.80This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$9.17DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$9.17FENTANYL-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]
$9.17INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.44MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.44ONDANSETRON 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]
$0.44TROPICAMIDE 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
$13,506.00Insurance Discount
-$6,381.16Price Negotiated by Insurer
$7,124.84Deductible 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
$13,506.00Insurance Discount
-$2,025.90Price Negotiated by Insurer
$11,480.10Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$178.50DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.57FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$39.78HC 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]
$0.31INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.13IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$669.80ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$24.55PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.04PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$6.60TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$10.14This 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
$13,506.00Insurance Discount
-$8,860.80Price Negotiated by Insurer
$4,645.20Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$56.26DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$8.46FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.21HC GLUCOSE TESTING POC
$3.48INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$8.33INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.27MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$4.50ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$8.33PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$205.97PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.13TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.33This 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
$13,506.00Insurance Discount
-$6,594.91Price Negotiated by Insurer
$6,911.09Deductible 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
$13,506.00Insurance Discount
-$8,685.51Price Negotiated by Insurer
$4,820.49Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$4.44DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.39FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.30HC 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]
$72.00INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.44IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.24MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$58.38ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$58.38PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$58.38This 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
$13,506.00Insurance Discount
-$5,402.40Price Negotiated by Insurer
$8,103.60Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$146.88DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$53.86FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.02HC 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]
$16.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.79IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.35MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$12.63PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$53.86PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.25TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.79This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$1,522.00Price Negotiated by Insurer
$11,984.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.45DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.90FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.21HC 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]
$1.25INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$59.94MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$28.64ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$28.64PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.05PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.38TROPICAMIDE 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
$13,506.00Price Negotiated by Insurer
$16,122.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.08DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$245.88FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.14HC 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]
$0.35INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.24IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.31MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$243.79ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.44PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.35TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$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
$13,506.00Insurance Discount
-$3,341.00Price Negotiated by Insurer
$10,165.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.12DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$5.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.49HC 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]
$0.87INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$109.71IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.40MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$19.36ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.03PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.24PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.42This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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
$13,506.00Insurance Discount
-$4,194.00Price Negotiated by Insurer
$9,312.00Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$2.54DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.08FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.73HC 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]
$0.37INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.85IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$59.94MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.16ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.45PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.98TROPICAMIDE 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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$9.17DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$32.09FENTANYL-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]
$32.09MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$32.09ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$94.15PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$94.15PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$32.09TROPICAMIDE 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
$13,506.00Insurance Discount
-$6,932.61Price Negotiated by Insurer
$6,573.39Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.43DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.60FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.26HC 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]
$378.65INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.21IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$6.60MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$79.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.90PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.50TROPICAMIDE 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
$13,506.00Insurance Discount
-$8,685.51Price Negotiated by Insurer
$4,820.49Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$0.20DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$44.57HC 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]
$16.83INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.29IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.60ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.35PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.29TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.04This 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
$13,506.00Insurance Discount
-$9,123.74Price Negotiated by Insurer
$4,382.26Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$2.95DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.72FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.67HC 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]
$0.29INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.72IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$34.13ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.49PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$5.10PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.72TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.53This 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.