Supplies, drugs & other prices at Loma Linda University Children's Hospital

Loma Linda, CA · every code in this section with a posted price and a Medicare benchmark.

82 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) $9,983.25 $22,185 0.7×
Admin influenza virus vac (G0008) $45 $100 0.7×
Admin pneumococcal vaccine (G0009)
range across 2 matching MRF lines		 $49.50–$66.60 $110–$148 varies
Ca screen;pelvic/breast exam (G0101) $126.90 $282 1.0×
Catheterize for urine spec (P9612) $75.15 $167 8.0×
Diab manage trn per indiv (G0108) $151.20 $336 2.7×
Diab manage trn ind/group (G0109) $66.15 $147 4.1×
Direct refer hospital observ (G0379) $396.90 $882 0.5×
Drug test def 1-7 classes (G0480)
range across 2 matching MRF lines		 $40.50–$98.89 $40.50–$98.89 varies
Drug test def 15-21 classes (G0482) $64.75 $64.75 0.3×
Elec stim other than wound (G0283)
range across 2 matching MRF lines		 $104.85–$125.10 $233–$278 varies
Elec stim unattend for press (G0281) $51.75 $115 4.4×
Electrophysiologic eval ccm-d leads at 1st impl (0930T) $1,491.75 $3,315 1.0×
Electrophysiologic eval ccm-d leads separate (0931T) $1,491.75 $3,315 1.0×
Electrophysiologic Eval Icds W/Ss Electrode (0577T) $1,639.35 $3,643 1.0×
Endovascular Venous Arterialization Tibl/Prnl Vn (0620T)
unusually low: confirm this is the full procedure		 $21,793.50 $48,430 0.4×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $13,442.40 $29,872 0.9×
Group mnt 2 or more 30 mins (G0271) $21.60 $48 1.3×
Hbot, full body chamber, 30m (G0277) $651.60 $1,448 3.7×
Histotripsy mal hepatocellular tiss w/img gdn (0686T) $24,785.10 $55,078 1.1×
Hiv combination assay (G0475) $13.05 $29 0.5×
Hospital outpt clinic visit (G0463)
range across 11 matching MRF lines		 $119.25–$312.75 $265–$695 varies
Insertion of substernal implantable defibrillator electrode (0572T) $35,039.25 $77,865 3.3×
Insertion perm ccm-d system pulse generator only (0916T) $27,584.10 $61,298 1.0×
Insj perm ccm-d sys 1 transvns lead only (0917T) $10,170.45 $22,601 1.0×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $10,170.45 $22,601 1.0×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) $39,400.20 $87,556 1.0×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $35,039.25 $77,865 0.9×
Ire Abltj 1+Tum Organ Perq (0600T) $9,983.25 $22,185 0.7×
Mnt subs tx for change dx (G0270) $37.80 $84 1.2×
N-Invas Detcj Heart Failure Drv Augmnt Alys Echo (0932T) $368.55 $819 0.9×
Opps service,sched team conf (G0175) $333.90 $742 0.6×
Pathogen test for platelets (P9100) $61 $61 0.8×
Perc d-e cor revasc chro sin (C9607) $17,078.40 $37,952 0.7×
Perc d-e cor revasc t cabg s (C9604) $15,452.10 $34,338 1.0×
Perc d-e cor stent ather s (C9602) $15,452.10 $34,338 0.7×
Perc drug-el cor stent sing (C9600) $20,331.45 $45,181 1.4×
Perq Sacral Augmt Bilat Inj (0201T) $13,863.15 $30,807 1.5×
Perq Sacral Augmt Unilat Inj (0200T) $7,467.30 $16,594 0.8×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)
unusually low: confirm this is the full procedure		 $7,006.50 $15,570 0.5×
Perq Tcat Thrm Abltj Nerves Innervating P-Art (0793T) $21,424.05 $47,609 0.9×
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone… (0220T)
likely a partial charge, not the full procedure		 $2,327.85 $5,173 0.1×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $62.55 $139 1.3×
Prostate biopsy, any mthd (G0416) $425.25 $945 0.9×
Relocation skin pocket implanted ccm-d pg (0925T) $2,247.75 $4,995 0.8×
Rem auton alg nsln cal setup (0740T) $66.60 $148 0.9×
Rem auton alg nsln data coll (0741T) $40.50 $90 0.8×
Removal perm ccm-d system pulse generator only (0919T) $4,472.10 $9,938 0.9×
Removal Ss Dfb Electrode (0573T) $35,039.25 $77,865 7.3×
Repos prev impl ss impltbl dfb pacing eltrd (0574T) $35,039.25 $77,865 7.3×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $759.60 $1,688 0.9×
Revasc lith-sten-ath tib/per (C9775) $21,817.80 $48,484 0.9×
Revasc lithotr-ather tib/per (C9774) $26,524.80 $58,944 1.1×
Revasc lithotr-stent tib/per (C9773) $26,524.80 $58,944 1.1×
Revasc lithotrip tibi/perone (C9772) $16,703.55 $37,119 1.1×
Rmvl perm ccm-d sys 1 transvns dfb lead only (0921T) $4,472.10 $9,938 0.9×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $4,472.10 $9,938 0.9×
Rmvl perm ccm-d sys dual transvns leads only (0922T) $4,472.10 $9,938 0.9×
Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) $2,619.90 $5,822 0.5×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $27,584.10 $61,298 1.0×
Screen pap by tech w md supv (P3000)
range across 2 matching MRF lines		 $17.55–$43.20 $39–$96 varies
Tcat implt wrls l atr prs snr l-t l atr prs mntr (0933T) $3,952.35 $8,783 0.9×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $19,666.80 $43,704 0.8×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $19,666.80 $43,704 0.8×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $19,666.80 $43,704 0.8×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $19,666.80 $43,704 0.8×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $3,217.05 $7,149 0.8×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $3,217.05 $7,149 0.8×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $3,217.05 $7,149 0.8×
Tcat Rmvl Perm Dual Chamber Ldls Pm Compl Sys (0798T) $3,217.05 $7,149 0.8×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $19,666.80 $43,704 0.8×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) $19,666.80 $43,704 0.8×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $19,666.80 $43,704 0.8×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $19,666.80 $43,704 0.8×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $6,189.75 $13,755 0.8×
Transcatheter Renal Sympath Denervation Bilat (0339T) $8,138.25 $18,085 1.1×
Transcatheter renal sympath denervation unilat (0338T) $5,425.20 $12,056 0.7×
Trluml perip athrc abd aorta (0236T) $14,236.65 $31,637 1.0×
Trluml Perip Athrc Brchiocph (0237T) $14,236.65 $31,637 1.0×
Trluml Perip Athrc Iliac Art (0238T) $14,236.65 $31,637 0.6×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $14,236.65 $31,637 1.0×
Vasc emb/occ w/prs cath (C9797) $15,993.45 $35,541 0.7×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.