Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

CARDIAC ARREST AND SHOCK

Facility

$14,177.88

Service Code	APR-DRG 1963
Min. Negotiated Rate	$8,954.45
Max. Negotiated Rate	$14,177.88
Rate for Payer: Adventist Health Medi-Cal	$8,954.45
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,670.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,177.88

CARDIAC ARREST AND SHOCK

Facility

$6,860.33

Service Code	APR-DRG 1961
Min. Negotiated Rate	$4,332.84
Max. Negotiated Rate	$6,860.33
Rate for Payer: Adventist Health Medi-Cal	$4,332.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,163.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$6,860.33

CARDIAC ARREST AND SHOCK

Facility

$26,855.19

Service Code	APR-DRG 1964
Min. Negotiated Rate	$16,961.17
Max. Negotiated Rate	$26,855.19
Rate for Payer: Adventist Health Medi-Cal	$16,961.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,212.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$26,855.19

CARDIAC ARREST, UNEXPLAINED WITH CC

Facility

$16,409.90

Service Code	MSDRG 297
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$16,409.90
Rate for Payer: Aetna of CA HMO/PPO	$16,409.90
Rate for Payer: Anthem Blue Cross of CA Exchange	$10,600.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,840.55
Rate for Payer: EPIC Health Plan Commercial	$15,915.49
Rate for Payer: EPIC Health Plan Senior	$10,610.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,645.75
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$13,504.05
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$12,925.31
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$9,645.75
Rate for Payer: Prime Health Services Medicare	$10,224.50
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 ARREST, UNEXPLAINED WITH MCC

Facility

$41,107.65

Service Code	MSDRG 296
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$41,107.65
Rate for Payer: Aetna of CA HMO/PPO	$41,107.65
Rate for Payer: Anthem Blue Cross of CA Exchange	$26,553.86
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$37,176.34
Rate for Payer: EPIC Health Plan Commercial	$37,031.61
Rate for Payer: EPIC Health Plan Senior	$24,687.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,443.40
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$31,420.76
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$30,074.16
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$22,443.40
Rate for Payer: Prime Health Services Medicare	$23,790.00
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 ARREST, UNEXPLAINED WITHOUT CC/MCC

Facility

$11,977.78

Service Code	MSDRG 298
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$11,977.78
Rate for Payer: Aetna of CA HMO/PPO	$11,977.78
Rate for Payer: Anthem Blue Cross of CA Exchange	$7,737.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,832.29
Rate for Payer: EPIC Health Plan Commercial	$11,844.29
Rate for Payer: EPIC Health Plan Senior	$7,896.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,178.36
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$10,049.70
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$9,619.00
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$7,178.36
Rate for Payer: Prime Health Services Medicare	$7,609.06
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

Facility

$7,212.82

Service Code	APR-DRG 2011
Min. Negotiated Rate	$4,555.46
Max. Negotiated Rate	$7,212.82
Rate for Payer: Adventist Health Medi-Cal	$4,555.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,428.59
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,212.82

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$25,149.18

Service Code	APR-DRG 2014
Min. Negotiated Rate	$15,883.69
Max. Negotiated Rate	$25,149.18
Rate for Payer: Adventist Health Medi-Cal	$15,883.69
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,928.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,149.18

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$9,730.55

Service Code	APR-DRG 2012
Min. Negotiated Rate	$6,145.61
Max. Negotiated Rate	$9,730.55
Rate for Payer: Adventist Health Medi-Cal	$6,145.61
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,323.52
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,730.55

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$14,326.93

Service Code	APR-DRG 2013
Min. Negotiated Rate	$9,048.59
Max. Negotiated Rate	$14,326.93
Rate for Payer: Adventist Health Medi-Cal	$9,048.59
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,782.90
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,326.93

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$19,362.89

Service Code	MSDRG 309
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$19,362.89
Rate for Payer: Aetna of CA HMO/PPO	$19,362.89
Rate for Payer: Anthem Blue Cross of CA Exchange	$12,507.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$17,511.13
Rate for Payer: EPIC Health Plan Commercial	$18,229.86
Rate for Payer: EPIC Health Plan Senior	$12,153.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,048.40
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$15,467.76
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$14,804.86
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,048.40
Rate for Payer: Prime Health Services Medicare	$11,711.30
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

$31,688.08

Service Code	MSDRG 308
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$31,688.08
Rate for Payer: Aetna of CA HMO/PPO	$31,688.08
Rate for Payer: Anthem Blue Cross of CA Exchange	$20,469.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$28,657.61
Rate for Payer: EPIC Health Plan Commercial	$28,886.93
Rate for Payer: EPIC Health Plan Senior	$19,257.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,507.23
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$24,510.12
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$23,459.69
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$17,507.23
Rate for Payer: Prime Health Services Medicare	$18,557.66
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

$14,899.19

Service Code	MSDRG 310
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$14,899.19
Rate for Payer: Aetna of CA HMO/PPO	$14,899.19
Rate for Payer: Anthem Blue Cross of CA Exchange	$9,624.27
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,474.31
Rate for Payer: EPIC Health Plan Commercial	$14,370.33
Rate for Payer: EPIC Health Plan Senior	$9,580.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,709.29
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$12,193.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,670.45
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$8,709.29
Rate for Payer: Prime Health Services Medicare	$9,231.85
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

$23,181.31

Service Code	APR-DRG 1913
Min. Negotiated Rate	$14,640.83
Max. Negotiated Rate	$23,181.31
Rate for Payer: Adventist Health Medi-Cal	$14,640.83
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,446.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,181.31

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$14,834.52

Service Code	APR-DRG 1911
Min. Negotiated Rate	$9,369.17
Max. Negotiated Rate	$14,834.52
Rate for Payer: Adventist Health Medi-Cal	$9,369.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,164.93
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,834.52

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$17,551.65

Service Code	APR-DRG 1912
Min. Negotiated Rate	$11,085.25
Max. Negotiated Rate	$17,551.65
Rate for Payer: Adventist Health Medi-Cal	$11,085.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,209.93
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,551.65

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$35,582.69

Service Code	APR-DRG 1914
Min. Negotiated Rate	$22,473.28
Max. Negotiated Rate	$35,582.69
Rate for Payer: Adventist Health Medi-Cal	$22,473.28
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,780.65
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$35,582.69

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$16,137.69

Service Code	APR-DRG 1921
Min. Negotiated Rate	$10,192.22
Max. Negotiated Rate	$16,137.69
Rate for Payer: Adventist Health Medi-Cal	$10,192.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,145.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,137.69

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$29,225.90

Service Code	APR-DRG 1923
Min. Negotiated Rate	$18,458.46
Max. Negotiated Rate	$29,225.90
Rate for Payer: Adventist Health Medi-Cal	$18,458.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,996.33
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,225.90

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$20,512.51

Service Code	APR-DRG 1922
Min. Negotiated Rate	$12,955.27
Max. Negotiated Rate	$20,512.51
Rate for Payer: Adventist Health Medi-Cal	$12,955.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,438.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,512.51

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$48,032.38

Service Code	APR-DRG 1924
Min. Negotiated Rate	$30,336.24
Max. Negotiated Rate	$48,032.38
Rate for Payer: Adventist Health Medi-Cal	$30,336.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$36,150.69
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$48,032.38

CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC

Facility

$41,473.48

Service Code	MSDRG 306
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$41,473.48
Rate for Payer: Aetna of CA HMO/PPO	$41,473.48
Rate for Payer: Anthem Blue Cross of CA Exchange	$26,790.18
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$37,507.19
Rate for Payer: EPIC Health Plan Commercial	$37,347.90
Rate for Payer: EPIC Health Plan Senior	$24,898.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,635.09
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$31,689.13
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$30,331.02
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$22,635.09
Rate for Payer: Prime Health Services Medicare	$23,993.20
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

$24,034.51

Service Code	MSDRG 307
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$24,034.51
Rate for Payer: Aetna of CA HMO/PPO	$24,034.51
Rate for Payer: Anthem Blue Cross of CA Exchange	$15,525.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$21,735.99
Rate for Payer: EPIC Health Plan Commercial	$22,269.22
Rate for Payer: EPIC Health Plan Senior	$14,846.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,496.50
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$18,895.10
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$18,085.31
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$13,496.50
Rate for Payer: Prime Health Services Medicare	$14,306.29
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

$187,665.00

Service Code	MSDRG 275
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$187,665.00
Rate for Payer: Aetna of CA HMO/PPO	$187,665.00
Rate for Payer: Anthem Blue Cross of CA Exchange	$121,223.93
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$169,717.78
Rate for Payer: EPIC Health Plan Commercial	$163,753.28
Rate for Payer: EPIC Health Plan Senior	$109,168.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$99,244.41
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$138,942.17
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$132,987.51
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$99,244.41
Rate for Payer: Prime Health Services Medicare	$105,199.07
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

$158,087.71

Service Code	MSDRG 276
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$158,087.71
Rate for Payer: Aetna of CA HMO/PPO	$158,087.71
Rate for Payer: Anthem Blue Cross of CA Exchange	$102,118.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$142,969.09
Rate for Payer: EPIC Health Plan Commercial	$138,179.10
Rate for Payer: EPIC Health Plan Senior	$92,119.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$83,744.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$117,242.87
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$112,218.18
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$83,744.91
Rate for Payer: Prime Health Services Medicare	$88,769.60
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

Know your out-of-pocket cost for care.

All Charges