Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$44,011.07

Service Code	APR-DRG 2014
Min. Negotiated Rate	$35,150.95
Max. Negotiated Rate	$44,011.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,150.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$44,011.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,378.32

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$9,737.29

Service Code	APR-DRG 2011
Min. Negotiated Rate	$7,777.02
Max. Negotiated Rate	$9,737.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,777.02
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,737.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,712.31

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$19,341.35

Service Code	APR-DRG 2013
Min. Negotiated Rate	$15,447.63
Max. Negotiated Rate	$19,341.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,447.63
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,341.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,305.42

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$92,304.46

Service Code	MSDRG 309
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$92,304.46
Rate for Payer: Aetna of CA HMO/PPO	$22,303.48
Rate for Payer: EPIC Health Plan Commercial	$92,304.46
Rate for Payer: EPIC Health Plan Senior	$61,536.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$55,942.10
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$78,318.94
Rate for Payer: Molina Healthcare of CA Medicare	$74,962.41
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC

Facility

$100,614.39

Service Code	MSDRG 308
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$100,614.39
Rate for Payer: Aetna of CA HMO/PPO	$36,500.46
Rate for Payer: EPIC Health Plan Commercial	$100,614.39
Rate for Payer: EPIC Health Plan Senior	$67,076.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,978.42
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$85,369.79
Rate for Payer: Molina Healthcare of CA Medicare	$81,711.08
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC

Facility

$89,294.95

Service Code	MSDRG 310
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$89,294.95
Rate for Payer: Aetna of CA HMO/PPO	$17,161.89
Rate for Payer: EPIC Health Plan Commercial	$89,294.95
Rate for Payer: EPIC Health Plan Senior	$59,529.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$54,118.15
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$75,765.41
Rate for Payer: Molina Healthcare of CA Medicare	$72,518.32
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$62,269.69

Service Code	APR-DRG 1914
Min. Negotiated Rate	$49,733.82
Max. Negotiated Rate	$62,269.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,733.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$62,269.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,714.98

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$31,294.77

Service Code	APR-DRG 1913
Min. Negotiated Rate	$24,994.64
Max. Negotiated Rate	$31,294.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,994.64
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$31,294.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,000.58

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$23,694.73

Service Code	APR-DRG 1912
Min. Negotiated Rate	$18,924.61
Max. Negotiated Rate	$23,694.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,924.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,694.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,200.55

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$20,026.59

Service Code	APR-DRG 1911
Min. Negotiated Rate	$15,994.92
Max. Negotiated Rate	$20,026.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,994.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,026.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,918.53

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$27,691.89

Service Code	APR-DRG 1922
Min. Negotiated Rate	$22,117.08
Max. Negotiated Rate	$27,691.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,117.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,691.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,776.96

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$84,056.68

Service Code	APR-DRG 1924
Min. Negotiated Rate	$67,134.75
Max. Negotiated Rate	$84,056.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$67,134.75
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$84,056.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$75,208.61

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$21,785.88

Service Code	APR-DRG 1921
Min. Negotiated Rate	$17,400.03
Max. Negotiated Rate	$21,785.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,400.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,785.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,492.62

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$39,454.96

Service Code	APR-DRG 1923
Min. Negotiated Rate	$31,512.06
Max. Negotiated Rate	$39,454.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$31,512.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$39,454.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$35,301.81

CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC

Facility

$107,211.92

Service Code	MSDRG 306
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$107,211.92
Rate for Payer: Aetna of CA HMO/PPO	$47,771.95
Rate for Payer: EPIC Health Plan Commercial	$107,211.92
Rate for Payer: EPIC Health Plan Senior	$71,474.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,976.92
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$90,967.69
Rate for Payer: Molina Healthcare of CA Medicare	$87,069.07
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Facility

$95,454.18

Service Code	MSDRG 307
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$95,454.18
Rate for Payer: Aetna of CA HMO/PPO	$27,684.57
Rate for Payer: EPIC Health Plan Commercial	$95,454.18
Rate for Payer: EPIC Health Plan Senior	$63,636.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$57,851.02
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$80,991.43
Rate for Payer: Molina Healthcare of CA Medicare	$77,520.37
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC

Facility

$216,165.21

Service Code	MSDRG 275
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$216,165.21
Rate for Payer: Aetna of CA HMO/PPO	$216,165.21
Rate for Payer: EPIC Health Plan Commercial	$205,777.31
Rate for Payer: EPIC Health Plan Senior	$137,184.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$124,713.52
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$174,598.93
Rate for Payer: Molina Healthcare of CA Medicare	$167,116.12
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR

Facility

$185,835.67

Service Code	MSDRG 276
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$185,835.67
Rate for Payer: Aetna of CA HMO/PPO	$182,096.09
Rate for Payer: EPIC Health Plan Commercial	$185,835.67
Rate for Payer: EPIC Health Plan Senior	$123,890.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$112,627.68
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$157,678.75
Rate for Payer: Molina Healthcare of CA Medicare	$150,921.09
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC

Facility

$161,204.11

Service Code	MSDRG 277
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$161,204.11
Rate for Payer: Aetna of CA HMO/PPO	$140,014.45
Rate for Payer: EPIC Health Plan Commercial	$161,204.11
Rate for Payer: EPIC Health Plan Senior	$107,469.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$97,699.46
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$136,779.24
Rate for Payer: Molina Healthcare of CA Medicare	$130,917.28
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$24,983.61

Service Code	APR-DRG 1771
Min. Negotiated Rate	$19,954.02
Max. Negotiated Rate	$24,983.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,954.02
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,983.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,353.76

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$37,548.83

Service Code	APR-DRG 1772
Min. Negotiated Rate	$29,989.65
Max. Negotiated Rate	$37,548.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$29,989.65
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$37,548.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,596.32

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$94,433.78

Service Code	APR-DRG 1774
Min. Negotiated Rate	$75,422.77
Max. Negotiated Rate	$94,433.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,422.77
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$94,433.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,493.38

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$47,481.91

Service Code	APR-DRG 1773
Min. Negotiated Rate	$37,923.05
Max. Negotiated Rate	$47,481.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,923.05
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$47,481.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,483.82

CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$135,005.64

Service Code	MSDRG 258
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$135,005.64
Rate for Payer: Aetna of CA HMO/PPO	$95,255.90
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: EPIC Health Plan Commercial	$135,005.64
Rate for Payer: EPIC Health Plan Senior	$90,003.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$81,821.60
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$114,550.24
Rate for Payer: Molina Healthcare of CA Medicare	$109,640.94
Rate for Payer: United Healthcare All Other Commercial	$38,532.00
Rate for Payer: United Healthcare All Other HMO	$38,532.00
Rate for Payer: United Healthcare HMO Rider	$23,768.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,774.00

CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$115,131.44

Service Code	MSDRG 259
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$115,131.44
Rate for Payer: Aetna of CA HMO/PPO	$61,301.98
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: EPIC Health Plan Commercial	$115,131.44
Rate for Payer: EPIC Health Plan Senior	$76,754.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,776.63
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$97,687.28
Rate for Payer: Molina Healthcare of CA Medicare	$93,500.68
Rate for Payer: United Healthcare All Other Commercial	$38,532.00
Rate for Payer: United Healthcare All Other HMO	$38,532.00
Rate for Payer: United Healthcare HMO Rider	$23,768.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,774.00

Know your out-of-pocket cost for care.

All Charges