Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

HEADACHES WITHOUT MCC

Facility

$22,010.58

Service Code	MSDRG 103
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$22,010.58
Rate for Payer: Aetna of CA HMO/PPO	$22,010.58
Rate for Payer: Anthem Blue Cross of CA Exchange	$14,217.94
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$19,905.61
Rate for Payer: EPIC Health Plan Commercial	$20,519.24
Rate for Payer: EPIC Health Plan Senior	$13,679.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,435.90
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$17,410.26
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,664.11
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$12,435.90
Rate for Payer: Prime Health Services Medicare	$13,182.05
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

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$37,125.54

Service Code	APR-DRG 0554
Min. Negotiated Rate	$23,447.71
Max. Negotiated Rate	$37,125.54
Rate for Payer: Adventist Health Medi-Cal	$23,447.71
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,941.86
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$37,125.54

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$13,773.02

Service Code	APR-DRG 0552
Min. Negotiated Rate	$8,698.75
Max. Negotiated Rate	$13,773.02
Rate for Payer: Adventist Health Medi-Cal	$8,698.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,366.01
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,773.02

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$21,279.92

Service Code	APR-DRG 0553
Min. Negotiated Rate	$13,439.95
Max. Negotiated Rate	$21,279.92
Rate for Payer: Adventist Health Medi-Cal	$13,439.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,015.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,279.92

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$9,686.24

Service Code	APR-DRG 0551
Min. Negotiated Rate	$6,117.62
Max. Negotiated Rate	$9,686.24
Rate for Payer: Adventist Health Medi-Cal	$6,117.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,290.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,686.24

HEART AND/OR LUNG TRANSPLANT

Facility

$192,894.95

Service Code	APR-DRG 0022
Min. Negotiated Rate	$121,828.39
Max. Negotiated Rate	$192,894.95
Rate for Payer: Adventist Health Medi-Cal	$121,828.39
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$145,178.83
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$192,894.95

HEART AND/OR LUNG TRANSPLANT

Facility

$147,867.73

Service Code	APR-DRG 0021
Min. Negotiated Rate	$93,390.14
Max. Negotiated Rate	$147,867.73
Rate for Payer: Adventist Health Medi-Cal	$93,390.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$111,289.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$147,867.73

HEART AND/OR LUNG TRANSPLANT

Facility

$249,908.61

Service Code	APR-DRG 0023
Min. Negotiated Rate	$157,837.02
Max. Negotiated Rate	$249,908.61
Rate for Payer: Adventist Health Medi-Cal	$157,837.02
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$188,089.12
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$249,908.61

HEART AND/OR LUNG TRANSPLANT

Facility

$462,139.77

Service Code	APR-DRG 0024
Min. Negotiated Rate	$291,877.75
Max. Negotiated Rate	$462,139.77
Rate for Payer: Adventist Health Medi-Cal	$291,877.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$347,820.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$462,139.77

HEART FAILURE

Facility

$33,371.11

Service Code	APR-DRG 1944
Min. Negotiated Rate	$21,076.49
Max. Negotiated Rate	$33,371.11
Rate for Payer: Adventist Health Medi-Cal	$21,076.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$25,116.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$33,371.11

HEART FAILURE

Facility

$8,429.39

Service Code	APR-DRG 1941
Min. Negotiated Rate	$5,323.82
Max. Negotiated Rate	$8,429.39
Rate for Payer: Adventist Health Medi-Cal	$5,323.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,344.22
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,429.39

HEART FAILURE

Facility

$17,533.52

Service Code	APR-DRG 1943
Min. Negotiated Rate	$11,073.80
Max. Negotiated Rate	$17,533.52
Rate for Payer: Adventist Health Medi-Cal	$11,073.80
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,196.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,533.52

HEART FAILURE

Facility

$11,378.15

Service Code	APR-DRG 1942
Min. Negotiated Rate	$7,186.20
Max. Negotiated Rate	$11,378.15
Rate for Payer: Adventist Health Medi-Cal	$7,186.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,563.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,378.15

HEART FAILURE AND SHOCK WITH CC

Facility

$22,344.83

Service Code	MSDRG 292
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$22,344.83
Rate for Payer: Aetna of CA HMO/PPO	$22,344.83
Rate for Payer: Anthem Blue Cross of CA Exchange	$14,433.85
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$20,207.90
Rate for Payer: EPIC Health Plan Commercial	$20,808.23
Rate for Payer: EPIC Health Plan Senior	$13,872.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,611.05
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$17,655.47
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,898.81
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$12,611.05
Rate for Payer: Prime Health Services Medicare	$13,367.71
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

HEART FAILURE AND SHOCK WITH MCC

Facility

$33,788.33

Service Code	MSDRG 291
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$33,788.33
Rate for Payer: Aetna of CA HMO/PPO	$33,788.33
Rate for Payer: Anthem Blue Cross of CA Exchange	$21,825.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,557.01
Rate for Payer: EPIC Health Plan Commercial	$30,702.90
Rate for Payer: EPIC Health Plan Senior	$20,468.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,607.82
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$26,050.95
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$24,934.48
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$18,607.82
Rate for Payer: Prime Health Services Medicare	$19,724.29
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

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$14,896.55

Service Code	MSDRG 293
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$14,896.55
Rate for Payer: Aetna of CA HMO/PPO	$14,896.55
Rate for Payer: Anthem Blue Cross of CA Exchange	$9,622.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,471.93
Rate for Payer: EPIC Health Plan Commercial	$14,368.03
Rate for Payer: EPIC Health Plan Senior	$9,578.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,707.90
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$12,191.06
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,668.59
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$8,707.90
Rate for Payer: Prime Health Services Medicare	$9,230.37
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

Heart Transplant

Facility

$110,000.00

Service Code	MSDRG 001
Min. Negotiated Rate	$110,000.00
Max. Negotiated Rate	$110,000.00
Rate for Payer: Networks By Design Commercial	$110,000.00

Heart Transplant

Facility

$110,000.00

Service Code	MSDRG 002
Min. Negotiated Rate	$110,000.00
Max. Negotiated Rate	$110,000.00
Rate for Payer: Networks By Design Commercial	$110,000.00

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$737,561.02

Service Code	MSDRG 001
Min. Negotiated Rate	$125,000.00
Max. Negotiated Rate	$737,561.02
Rate for Payer: Aetna of CA HMO/PPO	$737,561.02
Rate for Payer: Anthem Blue Cross of CA Exchange	$476,434.32
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$667,024.87
Rate for Payer: Blue Distinction Transplant	$252,280.00
Rate for Payer: Blue Shield of California Transplant	$140,000.00
Rate for Payer: CareMore Health Medicare Advantage	$387,408.57
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant	$252,000.00
Rate for Payer: EPIC Health Plan Commercial	$639,224.14
Rate for Payer: EPIC Health Plan Senior	$426,149.43
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$125,000.00
Rate for Payer: Heritage Provider Network Transplant	$242,950.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$387,408.57
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$542,372.00
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$519,127.48
Rate for Payer: OptumHealth Care Solutions (URN) Commercial	$272,333.00
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$387,408.57
Rate for Payer: Prime Health Services Medicare	$410,653.08
Rate for Payer: United Healthcare All Other Commercial	$352,597.00
Rate for Payer: United Healthcare All Other HMO	$311,084.00
Rate for Payer: United Healthcare HMO Rider	$236,295.00
Rate for Payer: United Healthcare Select/Navigate/Core	$216,484.00

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$298,241.64

Service Code	MSDRG 002
Min. Negotiated Rate	$125,000.00
Max. Negotiated Rate	$298,241.64
Rate for Payer: Aetna of CA HMO/PPO	$298,241.64
Rate for Payer: Anthem Blue Cross of CA Exchange	$192,651.93
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$269,719.50
Rate for Payer: Blue Distinction Transplant	$252,280.00
Rate for Payer: Blue Shield of California Transplant	$140,000.00
Rate for Payer: CareMore Health Medicare Advantage	$157,190.33
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant	$252,000.00
Rate for Payer: EPIC Health Plan Commercial	$259,364.04
Rate for Payer: EPIC Health Plan Senior	$172,909.36
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$125,000.00
Rate for Payer: Heritage Provider Network Transplant	$242,950.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$157,190.33
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$220,066.46
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$210,635.04
Rate for Payer: OptumHealth Care Solutions (URN) Commercial	$272,333.00
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$157,190.33
Rate for Payer: Prime Health Services Medicare	$166,621.75
Rate for Payer: United Healthcare All Other Commercial	$248,271.00
Rate for Payer: United Healthcare All Other HMO	$255,229.00
Rate for Payer: United Healthcare HMO Rider	$193,871.00
Rate for Payer: United Healthcare Select/Navigate/Core	$177,614.00

HEMIN 350 MG INTRAVENOUS POWDER FOR SOLUTION [218818]

Facility

$13,712.59

Service Code	HCPCS J1640
Hospital Charge Code	901700025
Hospital Revenue Code	636
Min. Negotiated Rate	$2,742.52
Max. Negotiated Rate	$12,341.33
Rate for Payer: Adventist Health Commercial	$2,742.52
Rate for Payer: Blue Shield of California Commercial	$10,997.50
Rate for Payer: Blue Shield of California EPN	$6,911.15
Rate for Payer: Cash Price	$6,170.67
Rate for Payer: Central Health Plan Commercial	$10,970.07
Rate for Payer: Cigna of CA HMO	$9,598.81
Rate for Payer: Cigna of CA PPO	$9,598.81
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant	$9,598.81
Rate for Payer: EPIC Health Plan Commercial	$5,485.04
Rate for Payer: EPIC Health Plan Senior	$5,485.04
Rate for Payer: Galaxy Health WC	$11,655.70
Rate for Payer: Global Benefits Group Commercial	$8,227.55
Rate for Payer: Health Management Network EPO/PPO	$12,341.33
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded	$8,707.49
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$8,090.43
Rate for Payer: LLUH Dept of Risk Management WC	$2,742.52
Rate for Payer: Multiplan Commercial	$10,284.44
Rate for Payer: Networks By Design Commercial	$6,856.30
Rate for Payer: Prime Health Services Commercial	$11,655.70
Rate for Payer: United Healthcare All Other Commercial	$5,146.34
Rate for Payer: United Healthcare All Other HMO	$5,009.21
Rate for Payer: United Healthcare HMO Rider	$4,900.88
Rate for Payer: United Healthcare Select/Navigate/Core	$4,490.87

HEMIN 350 MG INTRAVENOUS POWDER FOR SOLUTION [218818]

Facility

$13,712.59

Service Code	HCPCS J1640
Hospital Charge Code	901700025
Hospital Revenue Code	636
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$12,341.33
Rate for Payer: Adventist Health Commercial	$2,742.52
Rate for Payer: Adventist Health Medi-Cal	$35.82
Rate for Payer: Aetna of CA HMO/PPO	$204.93
Rate for Payer: Alpha Care Medical Group Commercial/Exchange	$44.77
Rate for Payer: Alpha Care Medical Group Medi-Cal	$39.40
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product	$39.40
Rate for Payer: Anthem Blue Cross of CA Exchange	$13.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$16.49
Rate for Payer: Blue Shield of California Commercial	$40.34
Rate for Payer: Blue Shield of California EPN	$36.67
Rate for Payer: Cash Price	$6,170.67
Rate for Payer: Cash Price	$6,170.67
Rate for Payer: Central Health Plan Commercial	$10,970.07
Rate for Payer: Cigna of CA HMO	$9,598.81
Rate for Payer: Cigna of CA PPO	$9,598.81
Rate for Payer: Dignity Health Commercial/Exchange	$44.77
Rate for Payer: Dignity Health Medi-Cal	$39.40
Rate for Payer: Dignity Health Medicare Advantage	$39.40
Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant	$9,598.81
Rate for Payer: EPIC Health Plan Commercial	$59.10
Rate for Payer: EPIC Health Plan Senior	$39.40
Rate for Payer: Galaxy Health WC	$11,655.70
Rate for Payer: Global Benefits Group Commercial	$8,227.55
Rate for Payer: Health Management Network EPO/PPO	$12,341.33
Rate for Payer: Heritage Provider Network Commercial/Senior	$58.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$35.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$35.82
Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded	$8,707.49
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$67.09
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$50.15
Rate for Payer: LLUH Dept of Risk Management WC	$2,742.52
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$48.00
Rate for Payer: Multiplan Commercial	$10,284.44
Rate for Payer: Networks By Design Commercial	$6,856.30
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$35.82
Rate for Payer: Prime Health Services Commercial	$11,655.70
Rate for Payer: Prime Health Services Medicare	$37.97
Rate for Payer: Riverside University Health System MISP	$39.40
Rate for Payer: Temecula Valley Physicians Medical Group Commercial	$8,227.55
Rate for Payer: TriValley Medical Group Commercial/Senior	$8,227.55
Rate for Payer: United Healthcare All Other Commercial	$5,146.34
Rate for Payer: United Healthcare All Other HMO	$5,009.21
Rate for Payer: United Healthcare HMO Rider	$4,900.88
Rate for Payer: United Healthcare Select/Navigate/Core	$4,490.87
Rate for Payer: Upland Medical Group Pediatric	$35.82
Rate for Payer: Vantage Medical Group Commercial/Exchange	$44.77
Rate for Payer: Vantage Medical Group Medi-Cal	$39.40
Rate for Payer: Vantage Medical Group Senior	$39.40

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$7,496.81

Service Code	APR-DRG 8101
Min. Negotiated Rate	$4,734.83
Max. Negotiated Rate	$7,496.81
Rate for Payer: Adventist Health Medi-Cal	$4,734.83
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,642.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,496.81

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$15,986.62

Service Code	APR-DRG 8103
Min. Negotiated Rate	$10,096.81
Max. Negotiated Rate	$15,986.62
Rate for Payer: Adventist Health Medi-Cal	$10,096.81
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,032.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,986.62

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$10,512.05

Service Code	APR-DRG 8102
Min. Negotiated Rate	$6,639.19
Max. Negotiated Rate	$10,512.05
Rate for Payer: Adventist Health Medi-Cal	$6,639.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,911.70
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,512.05

Know your out-of-pocket cost for care.

All Charges