Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$12,292.60

Service Code	APR-DRG 4612
Min. Negotiated Rate	$7,763.75
Max. Negotiated Rate	$12,292.60
Rate for Payer: Adventist Health Medi-Cal	$7,763.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,251.80
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,292.60

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$9,728.53

Service Code	APR-DRG 4611
Min. Negotiated Rate	$6,144.34
Max. Negotiated Rate	$9,728.53
Rate for Payer: Adventist Health Medi-Cal	$6,144.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,322.00
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,728.53

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$27,577.05

Service Code	MSDRG 687
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$27,577.05
Rate for Payer: Aetna of CA HMO/PPO	$27,577.05
Rate for Payer: Anthem Blue Cross of CA Exchange	$17,813.65
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$24,939.74
Rate for Payer: EPIC Health Plan Commercial	$25,332.30
Rate for Payer: EPIC Health Plan Senior	$16,888.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,352.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$21,494.07
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$20,572.90
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,352.91
Rate for Payer: Prime Health Services Medicare	$16,274.08
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

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$47,471.58

Service Code	MSDRG 686
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$47,471.58
Rate for Payer: Aetna of CA HMO/PPO	$47,471.58
Rate for Payer: Anthem Blue Cross of CA Exchange	$30,664.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$42,931.67
Rate for Payer: EPIC Health Plan Commercial	$42,534.21
Rate for Payer: EPIC Health Plan Senior	$28,356.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,778.31
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$36,089.63
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$34,542.94
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$25,778.31
Rate for Payer: Prime Health Services Medicare	$27,325.01
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

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$20,799.91

Service Code	MSDRG 688
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$20,799.91
Rate for Payer: Aetna of CA HMO/PPO	$20,799.91
Rate for Payer: Anthem Blue Cross of CA Exchange	$13,435.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$18,810.72
Rate for Payer: EPIC Health Plan Commercial	$19,472.39
Rate for Payer: EPIC Health Plan Senior	$12,981.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,801.45
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$16,522.03
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$15,813.94
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,801.45
Rate for Payer: Prime Health Services Medicare	$12,509.54
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

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$38,221.27

Service Code	APR-DRG 4423
Min. Negotiated Rate	$24,139.75
Max. Negotiated Rate	$38,221.27
Rate for Payer: Adventist Health Medi-Cal	$24,139.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,766.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$38,221.27

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$26,208.64

Service Code	APR-DRG 4422
Min. Negotiated Rate	$16,552.82
Max. Negotiated Rate	$26,208.64
Rate for Payer: Adventist Health Medi-Cal	$16,552.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,725.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$26,208.64

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$65,996.96

Service Code	APR-DRG 4424
Min. Negotiated Rate	$41,682.29
Max. Negotiated Rate	$65,996.96
Rate for Payer: Adventist Health Medi-Cal	$41,682.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$49,671.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$65,996.96

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$22,528.72

Service Code	APR-DRG 4421
Min. Negotiated Rate	$14,228.66
Max. Negotiated Rate	$22,528.72
Rate for Payer: Adventist Health Medi-Cal	$14,228.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,955.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,528.72

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$23,948.72

Service Code	APR-DRG 4432
Min. Negotiated Rate	$15,125.51
Max. Negotiated Rate	$23,948.72
Rate for Payer: Adventist Health Medi-Cal	$15,125.51
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,024.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,948.72

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$19,273.79

Service Code	APR-DRG 4431
Min. Negotiated Rate	$12,172.92
Max. Negotiated Rate	$19,273.79
Rate for Payer: Adventist Health Medi-Cal	$12,172.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,506.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,273.79

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$53,780.89

Service Code	APR-DRG 4434
Min. Negotiated Rate	$33,966.88
Max. Negotiated Rate	$53,780.89
Rate for Payer: Adventist Health Medi-Cal	$33,966.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$40,477.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$53,780.89

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$32,396.24

Service Code	APR-DRG 4433
Min. Negotiated Rate	$20,460.78
Max. Negotiated Rate	$32,396.24
Rate for Payer: Adventist Health Medi-Cal	$20,460.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,382.43
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$32,396.24

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$30,103.67

Service Code	MSDRG 695
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$30,103.67
Rate for Payer: Aetna of CA HMO/PPO	$30,103.67
Rate for Payer: Anthem Blue Cross of CA Exchange	$19,445.74
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$27,224.73
Rate for Payer: EPIC Health Plan Commercial	$27,516.93
Rate for Payer: EPIC Health Plan Senior	$18,344.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,676.93
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,347.70
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$22,347.09
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$16,676.93
Rate for Payer: Prime Health Services Medicare	$17,677.55
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

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$18,133.79

Service Code	MSDRG 696
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$18,133.79
Rate for Payer: Aetna of CA HMO/PPO	$18,133.79
Rate for Payer: Anthem Blue Cross of CA Exchange	$11,713.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$16,399.58
Rate for Payer: EPIC Health Plan Commercial	$17,167.14
Rate for Payer: EPIC Health Plan Senior	$11,444.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,404.33
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,566.06
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$13,941.80
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$10,404.33
Rate for Payer: Prime Health Services Medicare	$11,028.59
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

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 001
Min. Negotiated Rate	$282,500.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Heritage Provider Network Transplant	$282,500.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 002
Min. Negotiated Rate	$282,500.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Heritage Provider Network Transplant	$282,500.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 652
Min. Negotiated Rate	$282,500.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Heritage Provider Network Transplant	$282,500.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 651
Min. Negotiated Rate	$282,500.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Heritage Provider Network Transplant	$282,500.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 650
Min. Negotiated Rate	$282,500.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Heritage Provider Network Transplant	$282,500.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 651
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00
Rate for Payer: Heritage Provider Network Transplant	$226,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 650
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00
Rate for Payer: Heritage Provider Network Transplant	$226,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 005
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00
Rate for Payer: Heritage Provider Network Transplant	$226,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 006
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00
Rate for Payer: Heritage Provider Network Transplant	$226,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 652
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00
Rate for Payer: Heritage Provider Network Transplant	$226,000.00

Know your out-of-pocket cost for care.

All Charges