Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$20,852.92

Service Code	APR-DRG 7564
Min. Negotiated Rate	$13,170.26
Max. Negotiated Rate	$20,852.92
Rate for Payer: Adventist Health Medi-Cal	$13,170.26
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,694.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,852.92

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$20,748.17

Service Code	APR-DRG 1454
Min. Negotiated Rate	$13,104.11
Max. Negotiated Rate	$20,748.17
Rate for Payer: Adventist Health Medi-Cal	$13,104.11
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,615.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,748.17

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$7,325.60

Service Code	APR-DRG 1451
Min. Negotiated Rate	$4,626.70
Max. Negotiated Rate	$7,325.60
Rate for Payer: Adventist Health Medi-Cal	$4,626.70
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,513.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,325.60

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$9,259.23

Service Code	APR-DRG 1452
Min. Negotiated Rate	$5,847.94
Max. Negotiated Rate	$9,259.23
Rate for Payer: Adventist Health Medi-Cal	$5,847.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,968.79
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,259.23

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$12,886.79

Service Code	APR-DRG 1453
Min. Negotiated Rate	$8,139.02
Max. Negotiated Rate	$12,886.79
Rate for Payer: Adventist Health Medi-Cal	$8,139.02
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,699.00
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,886.79

ACUTE KIDNEY INJURY

Facility

$16,884.96

Service Code	APR-DRG 4693
Min. Negotiated Rate	$10,664.18
Max. Negotiated Rate	$16,884.96
Rate for Payer: Adventist Health Medi-Cal	$10,664.18
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,708.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,884.96

ACUTE KIDNEY INJURY

Facility

$7,625.73

Service Code	APR-DRG 4691
Min. Negotiated Rate	$4,816.25
Max. Negotiated Rate	$7,625.73
Rate for Payer: Adventist Health Medi-Cal	$4,816.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,739.36
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,625.73

ACUTE KIDNEY INJURY

Facility

$10,381.14

Service Code	APR-DRG 4692
Min. Negotiated Rate	$6,556.51
Max. Negotiated Rate	$10,381.14
Rate for Payer: Adventist Health Medi-Cal	$6,556.51
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,813.18
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,381.14

ACUTE KIDNEY INJURY

Facility

$32,434.50

Service Code	APR-DRG 4694
Min. Negotiated Rate	$20,484.95
Max. Negotiated Rate	$32,434.50
Rate for Payer: Adventist Health Medi-Cal	$20,484.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,411.23
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$32,434.50

ACUTE LEUKEMIA

Facility

$48,918.64

Service Code	APR-DRG 6903
Min. Negotiated Rate	$30,895.98
Max. Negotiated Rate	$48,918.64
Rate for Payer: Adventist Health Medi-Cal	$30,895.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$36,817.71
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$48,918.64

ACUTE LEUKEMIA

Facility

$28,901.60

Service Code	APR-DRG 6902
Min. Negotiated Rate	$18,253.64
Max. Negotiated Rate	$28,901.60
Rate for Payer: Adventist Health Medi-Cal	$18,253.64
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,752.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,901.60

ACUTE LEUKEMIA

Facility

$85,649.40

Service Code	APR-DRG 6904
Min. Negotiated Rate	$54,094.36
Max. Negotiated Rate	$85,649.40
Rate for Payer: Adventist Health Medi-Cal	$54,094.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$64,462.44
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$85,649.40

ACUTE LEUKEMIA

Facility

$16,329.04

Service Code	APR-DRG 6901
Min. Negotiated Rate	$10,313.08
Max. Negotiated Rate	$16,329.04
Rate for Payer: Adventist Health Medi-Cal	$10,313.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,289.75
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,329.04

ACUTE LEUKEMIA WITH CC

Facility

$54,896.17

Service Code	MSDRG 835
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$54,896.17
Rate for Payer: Aetna of CA HMO/PPO	$54,896.17
Rate for Payer: Anthem Blue Cross of CA Exchange	$35,460.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$49,646.21
Rate for Payer: EPIC Health Plan Commercial	$48,953.93
Rate for Payer: EPIC Health Plan Senior	$32,635.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,669.05
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$41,536.67
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$39,756.53
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$29,669.05
Rate for Payer: Prime Health Services Medicare	$31,449.19
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

ACUTE LEUKEMIA WITH MCC

Facility

$144,488.68

Service Code	MSDRG 834
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$144,488.68
Rate for Payer: Aetna of CA HMO/PPO	$144,488.68
Rate for Payer: Anthem Blue Cross of CA Exchange	$93,333.79
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$130,670.60
Rate for Payer: EPIC Health Plan Commercial	$126,420.62
Rate for Payer: EPIC Health Plan Senior	$84,280.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$76,618.56
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$107,265.98
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$102,668.87
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$76,618.56
Rate for Payer: Prime Health Services Medicare	$81,215.67
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

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$227,909.38

Service Code	MSDRG 850
Min. Negotiated Rate	$120,333.84
Max. Negotiated Rate	$227,909.38
Rate for Payer: Aetna of CA HMO/PPO	$227,909.38
Rate for Payer: Anthem Blue Cross of CA Exchange	$147,220.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$206,113.42
Rate for Payer: EPIC Health Plan Commercial	$198,550.84
Rate for Payer: EPIC Health Plan Senior	$132,367.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$120,333.84
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$168,467.38
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$161,247.35
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$120,333.84
Rate for Payer: Prime Health Services Medicare	$127,553.87

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$32,096.02

Service Code	MSDRG 836
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$32,096.02
Rate for Payer: Aetna of CA HMO/PPO	$32,096.02
Rate for Payer: Anthem Blue Cross of CA Exchange	$20,732.72
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$29,026.54
Rate for Payer: EPIC Health Plan Commercial	$29,239.65
Rate for Payer: EPIC Health Plan Senior	$19,493.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,721.00
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$24,809.40
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$23,746.14
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$17,721.00
Rate for Payer: Prime Health Services Medicare	$18,784.26
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

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$30,616.89

Service Code	MSDRG 121
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$30,616.89
Rate for Payer: Aetna of CA HMO/PPO	$30,616.89
Rate for Payer: Anthem Blue Cross of CA Exchange	$19,777.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$27,688.87
Rate for Payer: EPIC Health Plan Commercial	$27,960.70
Rate for Payer: EPIC Health Plan Senior	$18,640.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,945.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,724.23
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$22,707.48
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$16,945.88
Rate for Payer: Prime Health Services Medicare	$17,962.63
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

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$20,681.47

Service Code	MSDRG 122
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$20,681.47
Rate for Payer: Aetna of CA HMO/PPO	$20,681.47
Rate for Payer: Anthem Blue Cross of CA Exchange	$13,359.39
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$18,703.61
Rate for Payer: EPIC Health Plan Commercial	$19,369.99
Rate for Payer: EPIC Health Plan Senior	$12,913.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,739.39
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$16,435.15
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$15,730.78
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,739.39
Rate for Payer: Prime Health Services Medicare	$12,443.75
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

ACUTE MYOCARDIAL INFARCTION

Facility

$28,760.62

Service Code	APR-DRG 1904
Min. Negotiated Rate	$18,164.60
Max. Negotiated Rate	$28,760.62
Rate for Payer: Adventist Health Medi-Cal	$18,164.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,646.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,760.62

ACUTE MYOCARDIAL INFARCTION

Facility

$12,614.88

Service Code	APR-DRG 1901
Min. Negotiated Rate	$7,967.29
Max. Negotiated Rate	$12,614.88
Rate for Payer: Adventist Health Medi-Cal	$7,967.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,494.36
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,614.88

ACUTE MYOCARDIAL INFARCTION

Facility

$13,901.94

Service Code	APR-DRG 1902
Min. Negotiated Rate	$8,780.17
Max. Negotiated Rate	$13,901.94
Rate for Payer: Adventist Health Medi-Cal	$8,780.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,463.04
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,901.94

ACUTE MYOCARDIAL INFARCTION

Facility

$18,037.08

Service Code	APR-DRG 1903
Min. Negotiated Rate	$11,391.84
Max. Negotiated Rate	$18,037.08
Rate for Payer: Adventist Health Medi-Cal	$11,391.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,575.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$18,037.08

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$26,466.00

Service Code	MSDRG 281
Min. Negotiated Rate	$13,577.88
Max. Negotiated Rate	$26,466.00
Rate for Payer: Aetna of CA HMO/PPO	$24,189.79
Rate for Payer: Anthem Blue Cross of CA Exchange	$15,625.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$21,876.42
Rate for Payer: EPIC Health Plan Commercial	$22,403.50
Rate for Payer: EPIC Health Plan Senior	$14,935.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,577.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$19,009.03
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$18,194.36
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$13,577.88
Rate for Payer: Prime Health Services Medicare	$14,392.55
Rate for Payer: United Healthcare All Other Commercial	$26,466.00
Rate for Payer: United Healthcare All Other HMO	$26,466.00
Rate for Payer: United Healthcare HMO Rider	$16,920.00
Rate for Payer: United Healthcare Select/Navigate/Core	$15,502.00

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$42,218.31

Service Code	MSDRG 280
Min. Negotiated Rate	$20,535.00
Max. Negotiated Rate	$42,218.31
Rate for Payer: Aetna of CA HMO/PPO	$42,218.31
Rate for Payer: Anthem Blue Cross of CA Exchange	$27,271.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$38,180.79
Rate for Payer: EPIC Health Plan Commercial	$37,991.94
Rate for Payer: EPIC Health Plan Senior	$25,327.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,025.42
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$32,235.59
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$30,854.06
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$23,025.42
Rate for Payer: Prime Health Services Medicare	$24,406.95
Rate for Payer: United Healthcare All Other Commercial	$27,038.00
Rate for Payer: United Healthcare All Other HMO	$27,038.00
Rate for Payer: United Healthcare HMO Rider	$22,413.00
Rate for Payer: United Healthcare Select/Navigate/Core	$20,535.00

Know your out-of-pocket cost for care.

All Charges