How many shoppable procedure prices are published for Loma Linda University Children's Hospital?

Loma Linda University Children's Hospital in Loma Linda, CA currently has 105 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Loma Linda University Children's Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Loma Linda University Children's Hospital's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is Loma Linda University Children's Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Loma Linda University Children's Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Church 364 Beds · urban Updated: 2026-09-02

Loma Linda University Children's Hospital

11234 Anderson Street Suite A, Loma Linda, CA 92354 · 105 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.39×vs. Fair Market Price

Typical commercial prices here are +39% above the fair benchmark (1.39×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 51% of the Time

File Completeness60

Price Logic79

Peer Alignment73

Clean Billing86

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.39× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Loma Linda University Children's Hospital maintains elevated commercial insurance contracts (1.39× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 51% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#183 of 240 in CA · 75th State Percentile#2,428 of 3,385 in U.S. · 71st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.06× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 51% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (73/100 safety score) with 75% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (40.1% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
Commercial insurance median sits at 1.25× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.48×) jump +18% above the median procedure ratio (Q50 1.25×)
Unnegotiated chargemaster list prices average 14.9× Medicare (16¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.71× Divergence

1.2× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+18% Upper Tail

Q25 1.06× · Q50 1.25× · Q75 1.48×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.3× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.7× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

51% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 73/100Fair

Procedure Prices at Loma Linda University Children's Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 105 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$58,477	$19,432	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$10,108	$6,109	1.7×
Breast lump removal CPT Code: `19120`	—	$6,547	$3,875	1.7×
Inguinal hernia repair CPT Code: `49505`	—	$5,986	$3,629	1.6×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,574	$3,372	1.7×
C-section delivery (full package) CPT Code: `59510`	$10,026	$4,410	$2,975	1.5×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,304	$2,540	1.7×
Vaginal delivery (full package) CPT Code: `59400`	$2,102	$2,102	$2,680	0.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,482	$2,062	$1,256	1.6×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,482	$1,603	$981	1.6×
Upper endoscopy with biopsy CPT Code: `43239`	$2,614	$1,598	$987	1.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,042	$773	$583	1.3×
Blood transfusion CPT Code: `36430`	$1,128	$670	$498	1.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,243	$591	$511	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,330	$565	$448	1.3×
MRI, knee or other leg joint CPT Code: `73721`	$2,164	$430	$369	1.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,008	$387	$303	1.3×
MRI, lower back (no contrast) CPT Code: `72148`	$2,758	$387	$338	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$2,741	$387	$343	1.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$383	$322	$148	2.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,402	$338	$272	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$249	$310	$201	1.5×
Rabies immune globulin HCPCS Code: `90375`	$375	$330	$322	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$207	$297	$181	1.6×
Neurobehavioral status check CPT Code: `96116`	$460	$305	$231	1.3×
Family therapy session CPT Code: `90847`	$140	$297	$173	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$269	$269	$123	2.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,120	$282	$258	1.1×
Speech therapy (language evaluation) CPT Code: `92507`	$289	$289	$86	unverified
CT scan, head (with contrast) CPT Code: `70460`	$3,003	$248	$242	1.0×
X-ray, lower back CPT Code: `72110`	$506	$180	$112	1.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$960	$175	$126	1.4×
Ultrasound, pelvis CPT Code: `76856`	$1,147	$175	$130	1.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$801	$175	$132	1.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,269	$175	$134	1.3×
CT scan, pelvis CPT Code: `72192`	$2,133	$188	$163	1.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$89	$171	$151	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$1,888	$188	$167	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,141	$188	$168	1.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,721	$188	$169	1.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$145	$145	$40	3.6×
X-ray, hip CPT Code: `73502`	$350	$150	$93	1.6×
Group therapy session CPT Code: `90853`	$181	$144	$100	1.4×
CT scan, head (no contrast) CPT Code: `70450`	$2,574	$169	$160	1.1×
CT scan, sinuses CPT Code: `70486`	$2,153	$169	$166	1.0×
Speech therapy (group session) CPT Code: `92508`	$168	$168	$27	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$170	$170	$86	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$151	$141	$34	4.1×
Orthotic fitting and training CPT Code: `97760`	$135	$135	$51	2.6×
X-ray, chest (two views) CPT Code: `71046`	$319	$141	$93	1.5×
X-ray, chest (single view) CPT Code: `71045`	$318	$130	$92	1.4×
X-ray, pelvis CPT Code: `72170`	$291	$148	$110	1.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$149	$150	$35	unverified
X-ray, shoulder CPT Code: `73030`	$365	$123	$92	1.3×
X-ray, foot CPT Code: `73630`	$348	$123	$92	1.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$358	$123	$93	1.3×
X-ray, hand CPT Code: `73130`	$342	$123	$93	1.3×
X-ray, ankle CPT Code: `73610`	$356	$123	$93	1.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$111	$111	$166	unverified
Physical therapy (gait training) CPT Code: `97116`	$134	$132	$33	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$130	$130	$38	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$113	$113	$38	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$115	$115	$14	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$387	$83	$64	1.3×
Prosthetic fitting and training CPT Code: `97761`	$94	$94	$45	unverified
Typhoid vaccine HCPCS Code: `90675`	$239	$394	$347	1.1×
Hepatitis B vaccine HCPCS Code: `90744`	$42	$72	$37	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$52	$84	$56	1.5×
Flu vaccine injection HCPCS Code: `G0008`	$45	$68	$48	1.4×
Flu vaccine (high dose) HCPCS Code: `90656`	$27	$37	$25	1.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$32	$56	$39	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$58	$67	$49	1.4×
Drug screening test HCPCS Code: `G0480`	$70	$70	$116	0.6×
Office visit, established patient (20-29 min) CPT Code: `99213`	$233	$46	$87	0.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$58	$58	$203	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$78	$7	$6	1.2×
Blood test, lipase CPT Code: `83690`	$49	$8	$7	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$66	$9	$8	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$71	$11	$10	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$122	$15	$14	1.1×
Hepatitis C antibody test CPT Code: `86803`	$144	$16	$15	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$106	$20	$19	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$40	$40	$111	0.4×
Pneumococcal vaccine HCPCS Code: `90732`	$40	$40	$140	unverified
Blood test, calcium CPT Code: `82310`	$33	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$41	$6	$5	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$358	$12	$11	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$20	$15	$14	1.1×
Blood test, vitamin D CPT Code: `82306`	$71	$33	$31	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$100	$17	$16	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$203	$9	$9	1.0×
Blood test, liver function panel CPT Code: `80076`	$181	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$61	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$25	$7	$7	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$44	$4	$4	1.0×
Blood test, magnesium CPT Code: `83735`	$25	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$43	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$41	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$81	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$23	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$37	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$55	$5	$5	1.0×
Culture, blood CPT Code: `87040`	$176	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$157	$9	$9	1.0×
Blood antibody screen CPT Code: `86850`	$148	$11	$46	0.2×

Showing top 25 high-impact procedures of 105 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 40.1%

Audit a Bill or Quote at Loma Linda University Children's Hospital (Zero PHI Required)

CMS CCN: 050778

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash Request Quote

Insurer Median $58,477

1. Amount on Your Bill or Quote ($) Pre-filled with Loma Linda University Children's Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $56,334 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $56,334

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (40.1% of gross = $56,334).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Loma Linda University Children's Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$120,913 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($140,345) is $120,913 above the denoised Fair BaseRate ($19,432) and 10.0× the $14,044 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (40.1% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite73/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)76%

Median ER Wait222 min

Left ER Before Seen6%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (754 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Loma Linda University Children's Hospital.

Price Index: 1.67× regional baseline

Quality: 62/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

UnitedHealthcare

-41.1%

Median Household Income$82,184U.S. Census ACS

Local Uninsured Share8.5%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 050778

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 050778) ↗ CMS HCRIS Cost Reports ↗

Published MRF Fileexport

Publication / Vintage2026-09-02 · 230.97 MB

Validated Rate Rows6,889 (CMS v3.0.0)

File Integrity DigestVerified · CCN 050778

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy