Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 33.00: CERVICAL SPINAL FUSION W CC

Facility

$87,831.52

Service Code	MSDRG 472
Min. Negotiated Rate	$22,650.00
Max. Negotiated Rate	$87,831.52
Rate for Payer: United Healthcare All Other Commercial	$30,096.00
Rate for Payer: United Healthcare All Other HMO	$42,113.00
Rate for Payer: United Healthcare HMO Rider	$24,721.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,650.00

MS-DRG 33.00: CERVICAL SPINAL FUSION W MCC

Facility

$147,253.91

Service Code	MSDRG 471
Min. Negotiated Rate	$24,564.00
Max. Negotiated Rate	$147,253.91
Rate for Payer: United Healthcare All Other Commercial	$42,108.00
Rate for Payer: United Healthcare All Other HMO	$38,993.00
Rate for Payer: United Healthcare HMO Rider	$34,591.00
Rate for Payer: United Healthcare Select/Navigate/Core	$31,692.00

MS-DRG 33.00: CERVICAL SPINAL FUSION W/O CC/MCC

Facility

$71,770.10

Service Code	MSDRG 473
Min. Negotiated Rate	$22,963.00
Max. Negotiated Rate	$71,770.10
Rate for Payer: United Healthcare All Other Commercial	$42,292.00
Rate for Payer: United Healthcare All Other HMO	$32,996.00
Rate for Payer: United Healthcare HMO Rider	$25,065.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,963.00

MS-DRG 33.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC

Facility

$67,098.40

Service Code	MSDRG 286
Min. Negotiated Rate	$4,504.00
Max. Negotiated Rate	$67,098.40
Rate for Payer: United Healthcare All Other Commercial	$20,829.00
Rate for Payer: United Healthcare All Other HMO	$20,011.00
Rate for Payer: United Healthcare HMO Rider	$15,202.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,927.00

MS-DRG 33.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC

Facility

$40,330.48

Service Code	MSDRG 287
Min. Negotiated Rate	$4,504.00
Max. Negotiated Rate	$40,330.48
Rate for Payer: United Healthcare All Other Commercial	$27,003.00
Rate for Payer: United Healthcare All Other HMO	$19,364.00
Rate for Payer: United Healthcare HMO Rider	$14,707.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,475.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC

Facility

$128,918.00

Service Code	MSDRG 454
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$128,918.00
Rate for Payer: United Healthcare All Other Commercial	$128,918.00
Rate for Payer: United Healthcare All Other HMO	$99,335.00
Rate for Payer: United Healthcare HMO Rider	$75,453.00
Rate for Payer: United Healthcare Select/Navigate/Core	$69,126.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC

Facility

$152,808.00

Service Code	MSDRG 453
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$152,808.00
Rate for Payer: United Healthcare All Other Commercial	$152,808.00
Rate for Payer: United Healthcare All Other HMO	$127,264.00
Rate for Payer: United Healthcare HMO Rider	$96,665.00
Rate for Payer: United Healthcare Select/Navigate/Core	$88,562.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC

Facility

$111,708.00

Service Code	MSDRG 455
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$111,708.00
Rate for Payer: United Healthcare All Other Commercial	$111,708.00
Rate for Payer: United Healthcare All Other HMO	$83,450.00
Rate for Payer: United Healthcare HMO Rider	$63,390.00
Rate for Payer: United Healthcare Select/Navigate/Core	$58,075.00

MS-DRG 33.00: CORONARY BYPASS W CARDIAC CATH W MCC

Facility

$236,961.98

Service Code	MSDRG 233
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$236,961.98
Rate for Payer: United Healthcare All Other Commercial	$143,136.00
Rate for Payer: United Healthcare All Other HMO	$106,219.00
Rate for Payer: United Healthcare HMO Rider	$80,682.00
Rate for Payer: United Healthcare Select/Navigate/Core	$73,919.00

MS-DRG 33.00: CORONARY BYPASS W CARDIAC CATH W/O MCC

Facility

$161,287.18

Service Code	MSDRG 234
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$161,287.18
Rate for Payer: United Healthcare All Other Commercial	$103,054.00
Rate for Payer: United Healthcare All Other HMO	$97,568.00
Rate for Payer: United Healthcare HMO Rider	$74,111.00
Rate for Payer: United Healthcare Select/Navigate/Core	$67,897.00

MS-DRG 33.00: CORONARY BYPASS W/O CARDIAC CATH W MCC

Facility

$178,385.41

Service Code	MSDRG 235
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$178,385.41
Rate for Payer: United Healthcare All Other Commercial	$83,791.00
Rate for Payer: United Healthcare All Other HMO	$74,237.00
Rate for Payer: United Healthcare HMO Rider	$56,388.00
Rate for Payer: United Healthcare Select/Navigate/Core	$51,660.00

MS-DRG 33.00: CORONARY BYPASS W/O CARDIAC CATH W/O MCC

Facility

$124,662.42

Service Code	MSDRG 236
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$124,662.42
Rate for Payer: United Healthcare All Other Commercial	$76,448.00
Rate for Payer: United Healthcare All Other HMO	$68,582.00
Rate for Payer: United Healthcare HMO Rider	$52,096.00
Rate for Payer: United Healthcare Select/Navigate/Core	$47,726.00

MS-DRG 33.00: CORONARY BYPASS W PTCA W MCC

Facility

$256,894.75

Service Code	MSDRG 231
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$256,894.75
Rate for Payer: United Healthcare All Other Commercial	$107,429.00
Rate for Payer: United Healthcare All Other HMO	$102,631.00
Rate for Payer: United Healthcare HMO Rider	$94,080.00
Rate for Payer: United Healthcare Select/Navigate/Core	$86,191.00

MS-DRG 33.00: CORONARY BYPASS W PTCA W/O MCC

Facility

$185,191.35

Service Code	MSDRG 232
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$185,191.35
Rate for Payer: United Healthcare All Other Commercial	$94,061.00
Rate for Payer: United Healthcare All Other HMO	$87,101.00
Rate for Payer: United Healthcare HMO Rider	$79,841.00
Rate for Payer: United Healthcare Select/Navigate/Core	$73,147.00

MS-DRG 33.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC

Facility

$216,703.00

Service Code	MSDRG 266
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$216,703.00
Rate for Payer: United Healthcare All Other Commercial	$216,703.00
Rate for Payer: United Healthcare All Other HMO	$204,544.00
Rate for Payer: United Healthcare HMO Rider	$155,367.00
Rate for Payer: United Healthcare Select/Navigate/Core	$142,342.00

MS-DRG 33.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC

Facility

$162,712.00

Service Code	MSDRG 267
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$162,712.00
Rate for Payer: United Healthcare All Other Commercial	$162,712.00
Rate for Payer: United Healthcare All Other HMO	$153,580.00
Rate for Payer: United Healthcare HMO Rider	$116,659.00
Rate for Payer: United Healthcare Select/Navigate/Core	$106,879.00

MS-DRG 33.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC

Facility

$74,534.00

Service Code	MSDRG 481
Min. Negotiated Rate	$21,830.00
Max. Negotiated Rate	$74,534.00
Rate for Payer: United Healthcare All Other Commercial	$74,534.00
Rate for Payer: United Healthcare All Other HMO	$31,364.00
Rate for Payer: United Healthcare HMO Rider	$23,828.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,830.00

MS-DRG 33.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC

Facility

$89,159.36

Service Code	MSDRG 480
Min. Negotiated Rate	$24,564.00
Max. Negotiated Rate	$89,159.36
Rate for Payer: United Healthcare All Other Commercial	$56,679.00
Rate for Payer: United Healthcare All Other HMO	$40,772.00
Rate for Payer: United Healthcare HMO Rider	$30,970.00
Rate for Payer: United Healthcare Select/Navigate/Core	$28,371.00

MS-DRG 33.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC

Facility

$60,760.00

Service Code	MSDRG 482
Min. Negotiated Rate	$18,472.00
Max. Negotiated Rate	$60,760.00
Rate for Payer: United Healthcare All Other Commercial	$60,760.00
Rate for Payer: United Healthcare All Other HMO	$26,545.00
Rate for Payer: United Healthcare HMO Rider	$20,163.00
Rate for Payer: United Healthcare Select/Navigate/Core	$18,472.00

MS-DRG 33.00: KIDNEY TRANSPLANT

Facility

$322,497.00

Service Code	MSDRG 652
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$322,497.00
Rate for Payer: Networks By Design Commercial	$85,000.00

MS-DRG 33.00: LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$115,879.88

Service Code	MSDRG 956
Min. Negotiated Rate	$25,608.00
Max. Negotiated Rate	$115,879.88
Rate for Payer: United Healthcare All Other Commercial	$91,491.00
Rate for Payer: United Healthcare All Other HMO	$59,139.00
Rate for Payer: United Healthcare HMO Rider	$44,920.00
Rate for Payer: United Healthcare Select/Navigate/Core	$41,155.00

MS-DRG 33.00: LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT

Facility

$322,847.21

Service Code	MSDRG 005
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$322,847.21
Rate for Payer: Networks By Design Commercial	$120,000.00

MS-DRG 33.00: LIVER TRANSPLANT W/O MCC

Facility

$243,955.00

Service Code	MSDRG 006
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$243,955.00
Rate for Payer: Networks By Design Commercial	$120,000.00

MS-DRG 33.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC

Facility

$72,788.72

Service Code	MSDRG 493
Min. Negotiated Rate	$17,710.00
Max. Negotiated Rate	$72,788.72
Rate for Payer: United Healthcare All Other Commercial	$36,150.00
Rate for Payer: United Healthcare All Other HMO	$25,455.00
Rate for Payer: United Healthcare HMO Rider	$19,332.00
Rate for Payer: United Healthcare Select/Navigate/Core	$17,710.00

MS-DRG 33.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC

Facility

$107,658.18

Service Code	MSDRG 492
Min. Negotiated Rate	$21,433.00
Max. Negotiated Rate	$107,658.18
Rate for Payer: United Healthcare All Other Commercial	$37,370.00
Rate for Payer: United Healthcare All Other HMO	$38,031.00
Rate for Payer: United Healthcare HMO Rider	$28,889.00
Rate for Payer: United Healthcare Select/Navigate/Core	$26,467.00

Know your out-of-pocket cost for care.

All Charges