Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MAJOR CHEST PROCEDURES WITH MCC

Facility

$117,956.49

Service Code	MSDRG 163
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$117,956.49
Rate for Payer: Aetna of CA HMO/PPO	$117,956.49
Rate for Payer: Anthem Blue Cross of CA Exchange	$76,195.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$106,675.80
Rate for Payer: EPIC Health Plan Commercial	$103,479.40
Rate for Payer: EPIC Health Plan Senior	$68,986.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$62,714.79
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$87,800.71
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$84,037.82
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$62,714.79
Rate for Payer: Prime Health Services Medicare	$66,477.68
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

MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility

$50,379.83

Service Code	MSDRG 165
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$50,379.83
Rate for Payer: Aetna of CA HMO/PPO	$50,379.83
Rate for Payer: Anthem Blue Cross of CA Exchange	$32,543.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$45,561.79
Rate for Payer: EPIC Health Plan Commercial	$45,048.88
Rate for Payer: EPIC Health Plan Senior	$30,032.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,302.35
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$38,223.29
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$36,585.15
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$27,302.35
Rate for Payer: Prime Health Services Medicare	$28,940.49
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

MAJOR CHEST TRAUMA WITH CC

Facility

$28,006.05

Service Code	MSDRG 184
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$28,006.05
Rate for Payer: Aetna of CA HMO/PPO	$28,006.05
Rate for Payer: Anthem Blue Cross of CA Exchange	$18,090.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$25,327.71
Rate for Payer: EPIC Health Plan Commercial	$25,703.24
Rate for Payer: EPIC Health Plan Senior	$17,135.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,577.72
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$21,808.81
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$20,874.14
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,577.72
Rate for Payer: Prime Health Services Medicare	$16,512.38
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

MAJOR CHEST TRAUMA WITH MCC

Facility

$40,265.44

Service Code	MSDRG 183
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$40,265.44
Rate for Payer: Aetna of CA HMO/PPO	$40,265.44
Rate for Payer: Anthem Blue Cross of CA Exchange	$26,009.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$36,414.68
Rate for Payer: EPIC Health Plan Commercial	$36,303.40
Rate for Payer: EPIC Health Plan Senior	$24,202.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,002.06
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$30,802.88
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$29,482.76
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$22,002.06
Rate for Payer: Prime Health Services Medicare	$23,322.18
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

MAJOR CHEST TRAUMA WITHOUT CC/MCC

Facility

$20,699.89

Service Code	MSDRG 185
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$20,699.89
Rate for Payer: Aetna of CA HMO/PPO	$20,699.89
Rate for Payer: Anthem Blue Cross of CA Exchange	$13,371.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$18,720.27
Rate for Payer: EPIC Health Plan Commercial	$19,385.95
Rate for Payer: EPIC Health Plan Senior	$12,923.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,749.06
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$16,448.68
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$15,743.74
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,749.06
Rate for Payer: Prime Health Services Medicare	$12,454.00
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

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$23,346.48

Service Code	APR-DRG 0891
Min. Negotiated Rate	$14,745.14
Max. Negotiated Rate	$23,346.48
Rate for Payer: Adventist Health Medi-Cal	$14,745.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,571.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,346.48

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$87,089.54

Service Code	APR-DRG 0894
Min. Negotiated Rate	$55,003.92
Max. Negotiated Rate	$87,089.54
Rate for Payer: Adventist Health Medi-Cal	$55,003.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,546.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$87,089.54

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$60,739.92

Service Code	APR-DRG 0893
Min. Negotiated Rate	$38,362.06
Max. Negotiated Rate	$60,739.92
Rate for Payer: Adventist Health Medi-Cal	$38,362.06
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$45,714.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$60,739.92

MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$32,261.28

Service Code	APR-DRG 0892
Min. Negotiated Rate	$20,375.54
Max. Negotiated Rate	$32,261.28
Rate for Payer: Adventist Health Medi-Cal	$20,375.54
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,280.86
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$32,261.28

MAJOR ESOPHAGEAL DISORDERS

Facility

$9,901.75

Service Code	APR-DRG 2421
Min. Negotiated Rate	$6,253.74
Max. Negotiated Rate	$9,901.75
Rate for Payer: Adventist Health Medi-Cal	$6,253.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,452.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,901.75

MAJOR ESOPHAGEAL DISORDERS

Facility

$12,624.95

Service Code	APR-DRG 2422
Min. Negotiated Rate	$7,973.65
Max. Negotiated Rate	$12,624.95
Rate for Payer: Adventist Health Medi-Cal	$7,973.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,501.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,624.95

MAJOR ESOPHAGEAL DISORDERS

Facility

$34,509.11

Service Code	APR-DRG 2424
Min. Negotiated Rate	$21,795.23
Max. Negotiated Rate	$34,509.11
Rate for Payer: Adventist Health Medi-Cal	$21,795.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$25,972.65
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$34,509.11

MAJOR ESOPHAGEAL DISORDERS

Facility

$18,292.88

Service Code	APR-DRG 2423
Min. Negotiated Rate	$11,553.40
Max. Negotiated Rate	$18,292.88
Rate for Payer: Adventist Health Medi-Cal	$11,553.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,767.80
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$18,292.88

MAJOR ESOPHAGEAL DISORDERS WITH CC

Facility

$26,324.26

Service Code	MSDRG 369
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$26,324.26
Rate for Payer: Aetna of CA HMO/PPO	$26,324.26
Rate for Payer: Anthem Blue Cross of CA Exchange	$17,004.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$23,806.76
Rate for Payer: EPIC Health Plan Commercial	$24,249.04
Rate for Payer: EPIC Health Plan Senior	$16,166.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,696.39
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$20,574.95
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$19,693.16
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$14,696.39
Rate for Payer: Prime Health Services Medicare	$15,578.17
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

MAJOR ESOPHAGEAL DISORDERS WITH MCC

Facility

$41,897.22

Service Code	MSDRG 368
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$41,897.22
Rate for Payer: Aetna of CA HMO/PPO	$41,897.22
Rate for Payer: Anthem Blue Cross of CA Exchange	$27,063.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$37,890.40
Rate for Payer: EPIC Health Plan Commercial	$37,714.31
Rate for Payer: EPIC Health Plan Senior	$25,142.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,857.16
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$32,000.02
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$30,628.59
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$22,857.16
Rate for Payer: Prime Health Services Medicare	$24,228.59
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

MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC

Facility

$18,444.36

Service Code	MSDRG 370
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$18,444.36
Rate for Payer: Aetna of CA HMO/PPO	$18,444.36
Rate for Payer: Anthem Blue Cross of CA Exchange	$11,914.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$16,680.44
Rate for Payer: EPIC Health Plan Commercial	$17,435.67
Rate for Payer: EPIC Health Plan Senior	$11,623.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,567.07
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,793.90
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$14,159.87
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$10,567.07
Rate for Payer: Prime Health Services Medicare	$11,201.09
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

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$16,886.97

Service Code	APR-DRG 2483
Min. Negotiated Rate	$10,665.46
Max. Negotiated Rate	$16,886.97
Rate for Payer: Adventist Health Medi-Cal	$10,665.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,709.67
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,886.97

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$11,573.53

Service Code	APR-DRG 2482
Min. Negotiated Rate	$7,309.60
Max. Negotiated Rate	$11,573.53
Rate for Payer: Adventist Health Medi-Cal	$7,309.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,710.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,573.53

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$8,725.47

Service Code	APR-DRG 2481
Min. Negotiated Rate	$5,510.82
Max. Negotiated Rate	$8,725.47
Rate for Payer: Adventist Health Medi-Cal	$5,510.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,567.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,725.47

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$28,923.78

Service Code	APR-DRG 2484
Min. Negotiated Rate	$18,267.65
Max. Negotiated Rate	$28,923.78
Rate for Payer: Adventist Health Medi-Cal	$18,267.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,768.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,923.78

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC

Facility

$26,871.70

Service Code	MSDRG 372
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$26,871.70
Rate for Payer: Aetna of CA HMO/PPO	$26,871.70
Rate for Payer: Anthem Blue Cross of CA Exchange	$17,358.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$24,301.84
Rate for Payer: EPIC Health Plan Commercial	$24,722.40
Rate for Payer: EPIC Health Plan Senior	$16,481.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,983.27
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$20,976.58
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$20,077.58
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$14,983.27
Rate for Payer: Prime Health Services Medicare	$15,882.27
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

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC

Facility

$46,666.22

Service Code	MSDRG 371
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$46,666.22
Rate for Payer: Aetna of CA HMO/PPO	$46,666.22
Rate for Payer: Anthem Blue Cross of CA Exchange	$30,144.47
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$42,203.33
Rate for Payer: EPIC Health Plan Commercial	$41,837.86
Rate for Payer: EPIC Health Plan Senior	$27,891.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,356.28
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$35,498.79
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$33,977.42
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$25,356.28
Rate for Payer: Prime Health Services Medicare	$26,877.66
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

MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC

Facility

$19,144.44

Service Code	MSDRG 373
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$19,144.44
Rate for Payer: Aetna of CA HMO/PPO	$19,144.44
Rate for Payer: Anthem Blue Cross of CA Exchange	$12,366.53
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$17,313.57
Rate for Payer: EPIC Health Plan Commercial	$18,040.98
Rate for Payer: EPIC Health Plan Senior	$12,027.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,933.93
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$15,307.50
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$14,651.47
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$10,933.93
Rate for Payer: Prime Health Services Medicare	$11,589.97
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

MAJOR HEAD AND NECK PROCEDURES WITH CC

Facility

$57,404.37

Service Code	MSDRG 141
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$57,404.37
Rate for Payer: Aetna of CA HMO/PPO	$57,404.37
Rate for Payer: Anthem Blue Cross of CA Exchange	$37,080.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$51,914.54
Rate for Payer: EPIC Health Plan Commercial	$51,122.68
Rate for Payer: EPIC Health Plan Senior	$34,081.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,983.44
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$43,376.82
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$41,517.81
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$30,983.44
Rate for Payer: Prime Health Services Medicare	$32,842.45
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

MAJOR HEAD AND NECK PROCEDURES WITH MCC

Facility

$112,258.43

Service Code	MSDRG 140
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$112,258.43
Rate for Payer: Aetna of CA HMO/PPO	$112,258.43
Rate for Payer: Anthem Blue Cross of CA Exchange	$72,514.37
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$101,522.67
Rate for Payer: EPIC Health Plan Commercial	$98,552.57
Rate for Payer: EPIC Health Plan Senior	$65,701.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,728.83
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$83,620.36
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$80,036.63
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$59,728.83
Rate for Payer: Prime Health Services Medicare	$63,312.56
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