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]
$1.93DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.01HC CATH PRIMO MALE 16" 12FR COUDE
$4.43HC CBC WITHOUT DIFFERENTIAL
$10.40HC 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]
$0.41INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$1.37MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.04ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.04PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.80PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$11.34TROPICAMIDE 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
-$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]
$91.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.54FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$53.08HC CBC WITHOUT DIFFERENTIAL
$6.47HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$7.86INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$7.98MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$109.28ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$4.69PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$53.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$73.55TROPICAMIDE 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]
$220.39DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$393.53FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.19HC CATH PRIMO MALE 16" 12FR COUDE
$13.45HC CBC WITHOUT DIFFERENTIAL
$31.58HC GLUCOSE TESTING POC
$7.89HC INTRODUCER 3FR TEARAWAY
$51.62HC WIRE ABBOTT PROWATER
$264.18INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.02IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.01ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.02PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.40PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.09This 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
-$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]
$1.26DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.56FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$60.64HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$9.71HC 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]
$19.68INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$366.18IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.34ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$102.00PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.82PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$13.46TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.21This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.05HC CATH PRIMO MALE 16" 12FR COUDE
$12.18HC CBC WITHOUT DIFFERENTIAL
$7.12HC 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]
$2.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$4.20IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.40ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$66.00PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$536.41PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$74.45DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$14.11FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$22.50HC CATH PRIMO MALE 16" 12FR COUDE
$16.61HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$12.56INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.01IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$89.91MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$12.56ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.47PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$18.64PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$14.89TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.98This 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
-$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]
$1.65DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.22FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.44HC CATH PRIMO MALE 16" 12FR COUDE
$10.72HC CBC WITHOUT DIFFERENTIAL
$47.07HC 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]
$0.15INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.37IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$58.05MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.59ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.59PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$22.67PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$62.49TROPICAMIDE 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]
$0.86DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.32FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$4.36HC CATH PRIMO MALE 16" 12FR COUDE
$13.00HC CBC WITHOUT DIFFERENTIAL
$9.55HC 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]
$1.32INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.86IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.32MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$122.27ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.34PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.01PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 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
-$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]
$1.32DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.57FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.55HC CATH PRIMO MALE 16" 12FR COUDE
$13.53HC CBC WITHOUT DIFFERENTIAL
$31.56HC 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]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.15IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.37MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$4.04ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.67PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$5.52PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$105.95This 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]
$45.60DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.50FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$24.43HC CATH PRIMO MALE 16" 12FR COUDE
$8.83HC CBC WITHOUT DIFFERENTIAL
$20.64HC 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]
$2.64INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.52IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.10MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.42ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.01PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.14PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.01TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.18This 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]
$11.89DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$11.52FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$13.34HC CATH PRIMO MALE 16" 12FR COUDE
$9.96HC CBC WITHOUT DIFFERENTIAL
$23.40HC 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]
$1.38INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$26.40IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.34MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$60.59ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.83PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.97PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.22TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.96DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.88FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.18HC CATH PRIMO MALE 16" 12FR COUDE
$17.71HC CBC WITHOUT DIFFERENTIAL
$41.60HC 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]
$23.19INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$3.02IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.44MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.73ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.10PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.68PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$16.41TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.08This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$22.97DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$13.17FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$267.12HC CATH PRIMO MALE 16" 12FR COUDE
$14.17HC CBC WITHOUT DIFFERENTIAL
$33.28HC 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]
$2.32INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.69IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.40MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.46ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.92PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.07PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$25.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$126.07This 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]
$146.15DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$598.75FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$18.83HC CATH PRIMO MALE 16" 12FR COUDE
$16.38HC CBC WITHOUT DIFFERENTIAL
$38.48HC 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]
$0.52INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$10.63IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.45MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.96ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.21PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$18.83TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$109.98This 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
-$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]
$0.01DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$73.95FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.12HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$9.71HC 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]
$0.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.09IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$5.84MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.06ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$12.37PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.61PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$61.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$36.80This 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
-$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]
$5.41DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.28HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$7.12HC 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]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.24IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.47MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.50ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$9.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$76.47PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.67TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$4.63DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$85.00FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.18HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$1.60INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$76.50IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.52MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.03ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$76.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.97PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$197.68TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.23This 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]
$1.01DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.88FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$5.95HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC CBC WITHOUT DIFFERENTIAL
$8.73HC 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]
$7.63INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.10IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$3.10MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.96PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.32PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.10TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.21This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$5.42DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.06FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.30HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$47.70INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$6.66IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.24MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.48ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.13PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.49PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$56.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.06DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$727.06FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$177.46HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$44.20HC 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]
$0.92INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.03IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$6.60MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.68ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.28PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.92PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.55TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$20.11This 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
-$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]
$4.32DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.37FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.01HC CATH PRIMO MALE 16" 12FR COUDE
$13.28HC CBC WITHOUT DIFFERENTIAL
$31.20HC 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]
$0.04INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.47IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$4.66MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.08ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$5.48PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.40PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$5.03TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.07This 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]
$0.29DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.17FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$37.80HC CATH PRIMO MALE 16" 12FR COUDE
$19.93HC CBC WITHOUT DIFFERENTIAL
$46.80HC 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]
$0.35INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.36IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$107.89MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$702.77ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.11PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$4.82PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.36TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$13.67This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$436.96FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$15.04HC CBC WITHOUT DIFFERENTIAL
$10.61HC GLUCOSE TESTING POC
$5.38INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$436.96INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$436.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$436.96ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$436.96PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$436.96PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$436.96TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$9.61This 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
-$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]
$9.04DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.49FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.12HC CBC WITHOUT DIFFERENTIAL
$9.82HC GLUCOSE TESTING POC
$3.44HC INTRODUCER 3FR TEARAWAY
$0.02INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$0.49INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.78IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.41MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$32.42ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$150.41PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.12PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.12TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.78This 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
-$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]
$0.44FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$78.47HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$0.44ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$55.48PHENYLEPHRINE 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]
$5.86This 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
-$4,497.50Price 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]
$8.03DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.24FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.29HC CATH PRIMO MALE 16" 12FR COUDE
$14.77HC CBC WITHOUT DIFFERENTIAL
$34.68HC 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]
$2.64INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.57IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$79.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$21.89ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.19PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$7.96PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$58.03TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.45This 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
-$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]
$0.13DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$19.27FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$20.96HC CATH PRIMO MALE 16" 12FR COUDE
$8.44HC CBC WITHOUT DIFFERENTIAL
$10.85HC 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]
$0.08INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$173.71IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.32MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$254.01ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$16.93PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.10PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.15TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.17This 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
-$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]
$1.85DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.61FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.05HC CATH PRIMO MALE 16" 12FR COUDE
$13.70HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$22.27INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.12IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.97MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.90ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.33PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$64.40PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.04TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.25This 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
-$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]
$2.64DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.48FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.76HC CATH PRIMO MALE 16" 12FR COUDE
$4.43HC CBC WITHOUT DIFFERENTIAL
$10.40HC 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]
$0.75INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$126.84IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.96MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$6.74ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.15PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.10PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.03TROPICAMIDE 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
-$7,633.77Price 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]
$0.50DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.99HC CATH PRIMO MALE 16" 12FR COUDE
$15.50HC CBC WITHOUT DIFFERENTIAL
$8.67HC 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]
$20.29INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$38.66IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.41MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$2.10ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.67PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$38.66PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.34TROPICAMIDE 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
-$7,633.77Price 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]
$8.40DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.18FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.43HC CATH PRIMO MALE 16" 12FR COUDE
$15.50HC CBC WITHOUT DIFFERENTIAL
$8.67HC 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]
$4.00INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.85IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$5.43MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$44.58ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$38.58PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.59TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.87This 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]
$0.02DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.18FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.80HC CATH PRIMO MALE 16" 12FR COUDE
$16.61HC CBC WITHOUT DIFFERENTIAL
$39.00HC 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]
$0.32INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.26IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.46MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$360.00ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.89PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$84.25PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$13.50TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$36.00This 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
-$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]
$6.60DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.38FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.17HC CATH PRIMO MALE 16" 12FR COUDE
$14.39HC CBC WITHOUT DIFFERENTIAL
$33.80HC 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]
$0.22INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.11IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$5.04MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$1.08ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$260.29PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.11PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.11TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.23This 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]
$7.98DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.61FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.61HC CBC WITHOUT DIFFERENTIAL
$6.47HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$7.98INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.61MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.61ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.61PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$1.03PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.61TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$18.03This 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]
$0.52DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.09HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$44.20HC 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]
$0.01INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$31.91IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.20ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.14PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$2.14PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.92TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$1.99This 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
-$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]
$114.51DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$114.51FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$8.46HC CBC WITHOUT DIFFERENTIAL
$6.86HC GLUCOSE TESTING POC
$3.48INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$115.84INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$114.51MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$4.46ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$114.51PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$8.46PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$114.51TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$8.46This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.
Total estimated charges
$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]
$0.70DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$2.58FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.12HC CATH PRIMO MALE 16" 12FR COUDE
$8.86HC CBC WITHOUT DIFFERENTIAL
$7.12HC 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]
$2.58INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.12IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$1.92MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.12ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$2.58PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$14.40PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.12TROPICAMIDE 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]
$0.07DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$1.01FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$41.04HC CATH PRIMO MALE 16" 12FR COUDE
$13.28HC CBC WITHOUT DIFFERENTIAL
$31.20HC 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]
$0.44INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.04IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$2.88MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.22ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.11PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.76PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$1.90TROPICAMIDE 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
-$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]
$0.75DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.40FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.22HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC CBC WITHOUT DIFFERENTIAL
$5.24HC 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]
$0.14INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$1.19IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$59.94MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$63.75ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.10PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.09PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.63TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$7.88This 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
$13,506.00Price 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]
$4.31DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.26FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$110.91HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC CBC WITHOUT DIFFERENTIAL
$5.24HC 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]
$0.20INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.01IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$59.94MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.07ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.86PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.20PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.10TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$86.80This 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
-$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]
$0.49DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$12.01HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC CBC WITHOUT DIFFERENTIAL
$5.24HC 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]
$0.61INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$5.84IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.31MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.04ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$3.50PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.08PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$45.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$24.53This 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
-$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]
$0.27DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$220.43FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$0.43HC CATH PRIMO MALE 16" 12FR COUDE
$11.07HC CBC WITHOUT DIFFERENTIAL
$5.24HC 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]
$6.98INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.61IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.44MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$17.17ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$1.22PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.74PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.43TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$3.16This 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]
$9.17DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$94.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$9.17HC CBC WITHOUT DIFFERENTIAL
$6.47HC GLUCOSE TESTING POC
$3.28INTRAOP GENTAMICIN 80 MG/2 ML INJECTION [4083426]
$94.15INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$237.10MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$237.10ONDANSETRON 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]
$9.17TROPICAMIDE 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]
$98.08DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$10.15FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$98.08HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$9.71HC 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]
$0.26INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.16IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$0.48MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.02ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$119.41PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$0.60PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$3.20TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.79This 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
-$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]
$111.94DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.61FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$2.07HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$7.12HC 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]
$0.07INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$28.49IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$28.49ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$99.65PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$28.49PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$2.07TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$2.53This 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
-$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]
$0.68DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SYRINGE [114048]
$0.29FENTANYL-ROPIVACAINE-NACL (PF) 2.5 MCG/ML-0.15% EPIDURAL [4081421]
$1.78HC CATH PRIMO MALE 16" 12FR COUDE
$18.82HC CBC WITHOUT DIFFERENTIAL
$6.47HC 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]
$5.42INTRAOP ONLY CEFAZOLIN POWDER 1 G [4081027]
$0.59IOPAMIDOL 76% INTRAVENOUS SOLUTION MULTIDOSE [40810328]
$101.90MIDAZOLAM CONTINUOUS INFUSION (STRAIGHT DRUG) 5 MG/ML [4081034]
$0.11ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION [106349]
$0.59PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION FOR DRIPS [4086242]
$5.16PROPOFOL INFUSION 10 MG/ML CONTINUOUS [40840026]
$0.60TROPICAMIDE 1 %-PROPARACAINE 0.5 %-PE 2.5 %-KETOROLAC 0.5 % EYE DROPS [223020]
$0.59This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Loma Linda University Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Loma Linda University Medical Center directly.