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]
$11.77DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$9.60FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$4.09HC 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 PROWATER
$87.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$26.77INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.64IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$11.87ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$42.40PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.48PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.28This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$53.08DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$25.05FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.26HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.44MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.98ONDANSETRON 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]
$0.26TROPICAMIDE 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
$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]
$12.72DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$170.65FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$440.77HC CATH PRIMO MALE 16" 12FR COUDE
$13.45HC GLUCOSE TESTING POC
$7.89HC INTRODUCER 3FR TEARAWAY
$51.62HC WIRE ABBOTT PROWATER
$264.18INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$36.77INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.19IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.14ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.07PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$7.29TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$32.43This 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
$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]
$311.10DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.45FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$87.11HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.31INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.12IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$73.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.44PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$158.87TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$2.15DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.36FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$142.54HC 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 PROWATER
$239.25INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$86.11INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.01IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.92ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$15.59PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.69PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.38TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$3.84DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.29HC 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 PROWATER
$326.25INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.51INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.84IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.46MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$84.25ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.41PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.74PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$9.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$11.21DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$11.82FENTANYL-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 PROWATER
$210.63INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$11.82INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.40IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.27MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$5.61ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.33PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$3.79PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$1.25DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.37FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.08HC 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 PROWATER
$255.48INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.57INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.89IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.82MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.13ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.66PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.89PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.71This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$5.37DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.03FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.58HC 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 PROWATER
$265.79INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$2.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$4.84IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.74MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$2.31ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.70PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.66TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.31This 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
-$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]
$228.16DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.52HC 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 PROWATER
$173.56INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$43.19INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$30.16IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.35MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.78ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.26PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.26TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.11This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$13,506.00Insurance Discount
-$7,428.30Price Negotiated by Insurer
$6,077.70Deductible 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.
ACETAMINOPHEN 100 MG/10 ML (10 MG/ML) INTRAVENOUS SYRINGE [4080108021]
$5.39DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$11.04FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$27.72HC CATH PRIMO MALE 16" 12FR COUDE
$9.96HC GLUCOSE TESTING POC
$5.85HC INTRODUCER 3FR TEARAWAY
$38.25HC STENT METAL URETERAL
$1,755.00HC WIRE ABBOTT PROWATER
$195.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$2.08INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$59.40IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.21ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.36PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$25.78PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.68TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$17.38This 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
-$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]
$6.82DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.78FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$19.41HC 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 PROWATER
$348.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$11.34INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.26IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$95.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.07ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.31PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$15.22PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$317.72TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.88This 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]
$0.38DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$13.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.90HC 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 PROWATER
$278.40INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.39MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$41.99ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.63PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$313.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$8.75TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$7.58This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$61.52DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.22FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.08HC 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 PROWATER
$321.90INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$16.80INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.88IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.41MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$14.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.15PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$3.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.46TROPICAMIDE 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
-$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]
$0.58DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.24FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.28HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$78.54INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.55IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.75MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.53ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.98PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.37PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$20.40TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.05This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.18DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$11.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.88HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$11.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.49IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.67ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.18PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$480.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$6.45TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.88This 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]
$71.40DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$9.18FENTANYL-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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$45.39ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$22.44PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$159.37PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.53This 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.
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]
$40.99DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$7.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$10.47HC 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 PROWATER
$174.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.96INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.28IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.24MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$14.39ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$71.66PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.10PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.08TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$18.01This 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
$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]
$0.84DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$5.86FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$5.18HC 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 PROWATER
$174.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.16INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$78.46IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.12MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.31ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$155.71PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.44PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.48TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.02This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$1.96DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$10.03FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.10HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$239.70INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.16IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.94ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.98PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$20.62PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.02TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$11.38This 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]
$65.18DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.39FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.20HC 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 PROWATER
$261.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.53INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.23IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$71.93MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.32PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$144.00PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$7.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.91This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$450.00DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.24FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$3.24HC 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 PROWATER
$391.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$14.03INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.32IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$107.89MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.23ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.60PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.61PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$702.77TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.30This 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
-$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]
$15.04DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$15.04FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$15.04HC 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]
$15.04ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.72PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$87.05PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$87.05TROPICAMIDE 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]
$2.21DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.47FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$5.79HC GLUCOSE TESTING POC
$3.44HC INTRODUCER 3FR TEARAWAY
$0.02INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$13.88INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.79IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.14MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.03ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.47PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.47PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.47TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.21This 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
$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]
$56.01DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$12.24FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$12.24HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$7.98INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$55.48MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$175.82ONDANSETRON 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]
$0.44TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.74This 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
$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]
$0.56DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.66FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.42HC 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 PROWATER
$217.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.18INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.27IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$59.94MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.41PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$75.64PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.70TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$159.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$4.87DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$68.09FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.81HC 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 PROWATER
$290.14INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$48.02INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.13IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$79.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$238.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.05PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.83TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.13This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$8.55DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$6.31FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.31HC 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 PROWATER
$165.74INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$82.63INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$20.96IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.32MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$8.55ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$286.46PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$49.93PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.74TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.55This 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]
$1.43DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$68.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.51HC 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 PROWATER
$269.26INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.89INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.41IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$30.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.07PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.26PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.89TROPICAMIDE 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
$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]
$0.12FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.16HC 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 PROWATER
$87.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$5.64INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.15IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.12MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$126.84ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.03PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.80PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.16TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.24This 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]
$0.09DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.35FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$64.83HC 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 PROWATER
$304.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$10.08INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.03IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.62MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.13ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.31PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$3.00PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.21TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.97This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.59DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.05FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.01HC 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 PROWATER
$304.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$3.00INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.68IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$5.43MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$7.85ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.68PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.59PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.06TROPICAMIDE 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
-$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]
$0.77DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.80FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$360.00HC 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 PROWATER
$326.25INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$121.67INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$19.53IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$5.15MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.02ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$21.10PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.23PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$3.98TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$27.81This 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
$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]
$7.23DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$222.03FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.35HC 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 PROWATER
$282.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$7.23INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$317.10IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.36MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$408.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.72PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$72.94TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.74This 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
$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]
$28.85DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$108.03FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$108.03HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$28.85INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.44MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.26ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.44PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$108.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$108.03TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$108.03This 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
-$6,381.16Price 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]
$0.21DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$61.20FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.22HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$317.73INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$127.50IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$48.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.26PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.22PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.82TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$99.80DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$33.05FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.13HC GLUCOSE TESTING POC
$3.48INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$10.56INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$34.98MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$6.14ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.66PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.28PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.28TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.13This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.54DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.29FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.02HC 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 PROWATER
$174.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$23.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.02IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$1.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.54ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.09PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.29PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$10.09TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$10.09This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$125.27DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$24.27FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$3.07HC 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 PROWATER
$261.00INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.72INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.12IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$71.93MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$3.30ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$11.75PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.82PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$576.00TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$35.61This 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
-$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]
$31.07DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.12FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.03HC 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 PROWATER
$217.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.03INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.24IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.65MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.84ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.84PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.34PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.63TROPICAMIDE 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
$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]
$1.69DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.53FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.50HC 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 PROWATER
$217.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$2.41IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.88MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.32ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$10.52PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.81PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.69TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.52This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$4.86DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$57.98FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$28.31HC 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 PROWATER
$217.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$226.66INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$13.42IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.31MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$4.53ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.46PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.53PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.07TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$9.11This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.11DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$3.93FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.46HC 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 PROWATER
$217.50INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$1.10INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$14.06IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.29MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.83ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.14PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.19PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.27TROPICAMIDE 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
$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]
$312.03INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$312.03MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$9.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$312.03PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$312.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$312.03TROPICAMIDE 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]
$2.87DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.06FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$4.08HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.54INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.01IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.08MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.69ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.15PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.02PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.55TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.55This 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]
$1.08DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$22.13FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$8.80HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.67INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.79IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.75MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.24ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.11PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.79PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.67TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$480.16This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University 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]
$110.13DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.35FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$6.77HC 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 PROWATER
$369.75INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$40.80INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$10.88IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.99ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$118.83PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.41TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$32.56This 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.