Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$36,903.99

Service Code	APR-DRG 1202
Min. Negotiated Rate	$23,307.78
Max. Negotiated Rate	$36,903.99
Rate for Payer: Adventist Health Medi-Cal	$23,307.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,775.10
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$36,903.99

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$30,416.28

Service Code	APR-DRG 1201
Min. Negotiated Rate	$19,210.28
Max. Negotiated Rate	$30,416.28
Rate for Payer: Adventist Health Medi-Cal	$19,210.28
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,892.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,416.28

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$85,484.23

Service Code	APR-DRG 1204
Min. Negotiated Rate	$53,990.04
Max. Negotiated Rate	$85,484.23
Rate for Payer: Adventist Health Medi-Cal	$53,990.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$64,338.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$85,484.23

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$52,602.58

Service Code	APR-DRG 1203
Min. Negotiated Rate	$33,222.68
Max. Negotiated Rate	$52,602.58
Rate for Payer: Adventist Health Medi-Cal	$33,222.68
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$39,590.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$52,602.58

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$15,189.00

Service Code	APR-DRG 1373
Min. Negotiated Rate	$9,593.05
Max. Negotiated Rate	$15,189.00
Rate for Payer: Adventist Health Medi-Cal	$9,593.05
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,431.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,189.00

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$9,654.01

Service Code	APR-DRG 1371
Min. Negotiated Rate	$6,097.27
Max. Negotiated Rate	$9,654.01
Rate for Payer: Adventist Health Medi-Cal	$6,097.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,265.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,654.01

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$28,244.98

Service Code	APR-DRG 1374
Min. Negotiated Rate	$17,838.94
Max. Negotiated Rate	$28,244.98
Rate for Payer: Adventist Health Medi-Cal	$17,838.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,258.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,244.98

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$10,687.29

Service Code	APR-DRG 1372
Min. Negotiated Rate	$6,749.87
Max. Negotiated Rate	$10,687.29
Rate for Payer: Adventist Health Medi-Cal	$6,749.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,043.59
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,687.29

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$47,542.64

Service Code	MSDRG 507
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$47,542.64
Rate for Payer: Aetna of CA HMO/PPO	$47,542.64
Rate for Payer: Anthem Blue Cross of CA Exchange	$30,710.61
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$42,995.93
Rate for Payer: EPIC Health Plan Commercial	$42,595.67
Rate for Payer: EPIC Health Plan Senior	$28,397.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,815.56
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$36,141.78
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$34,592.85
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$25,815.56
Rate for Payer: Prime Health Services Medicare	$27,364.49
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 SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$39,857.49

Service Code	MSDRG 508
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$39,857.49
Rate for Payer: Aetna of CA HMO/PPO	$39,857.49
Rate for Payer: Anthem Blue Cross of CA Exchange	$25,746.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$36,045.75
Rate for Payer: EPIC Health Plan Commercial	$35,950.65
Rate for Payer: EPIC Health Plan Senior	$23,967.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,788.27
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$30,503.58
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$29,196.28
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$21,788.27
Rate for Payer: Prime Health Services Medicare	$23,095.57
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 SKIN DISORDERS

Facility

$10,580.55

Service Code	APR-DRG 3812
Min. Negotiated Rate	$6,682.45
Max. Negotiated Rate	$10,580.55
Rate for Payer: Adventist Health Medi-Cal	$6,682.45
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,963.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,580.55

MAJOR SKIN DISORDERS

Facility

$35,286.59

Service Code	APR-DRG 3814
Min. Negotiated Rate	$22,286.27
Max. Negotiated Rate	$35,286.59
Rate for Payer: Adventist Health Medi-Cal	$22,286.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,557.80
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$35,286.59

MAJOR SKIN DISORDERS

Facility

$6,191.62

Service Code	APR-DRG 3811
Min. Negotiated Rate	$3,910.50
Max. Negotiated Rate	$6,191.62
Rate for Payer: Adventist Health Medi-Cal	$3,910.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,660.01
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$6,191.62

MAJOR SKIN DISORDERS

Facility

$17,569.78

Service Code	APR-DRG 3813
Min. Negotiated Rate	$11,096.70
Max. Negotiated Rate	$17,569.78
Rate for Payer: Adventist Health Medi-Cal	$11,096.70
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,223.57
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,569.78

MAJOR SKIN DISORDERS WITH MCC

Facility

$55,814.70

Service Code	MSDRG 595
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$55,814.70
Rate for Payer: Aetna of CA HMO/PPO	$55,814.70
Rate for Payer: Anthem Blue Cross of CA Exchange	$36,054.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$50,476.90
Rate for Payer: EPIC Health Plan Commercial	$49,748.14
Rate for Payer: EPIC Health Plan Senior	$33,165.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,150.39
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$42,210.55
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$40,401.52
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$30,150.39
Rate for Payer: Prime Health Services Medicare	$31,959.41
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 SKIN DISORDERS WITHOUT MCC

Facility

$28,490.32

Service Code	MSDRG 596
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$28,490.32
Rate for Payer: Aetna of CA HMO/PPO	$28,490.32
Rate for Payer: Anthem Blue Cross of CA Exchange	$18,403.58
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$25,765.67
Rate for Payer: EPIC Health Plan Commercial	$26,121.97
Rate for Payer: EPIC Health Plan Senior	$17,414.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,831.50
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$22,164.10
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$21,214.21
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,831.50
Rate for Payer: Prime Health Services Medicare	$16,781.39
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 SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$63,091.91

Service Code	MSDRG 330
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$63,091.91
Rate for Payer: Aetna of CA HMO/PPO	$63,091.91
Rate for Payer: Anthem Blue Cross of CA Exchange	$40,754.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$57,058.15
Rate for Payer: EPIC Health Plan Commercial	$56,040.43
Rate for Payer: EPIC Health Plan Senior	$37,360.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$33,963.90
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$47,549.46
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$45,511.63
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$33,963.90
Rate for Payer: Prime Health Services Medicare	$36,001.73
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 SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$120,975.28

Service Code	MSDRG 329
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$120,975.28
Rate for Payer: Aetna of CA HMO/PPO	$120,975.28
Rate for Payer: Anthem Blue Cross of CA Exchange	$78,145.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$109,405.89
Rate for Payer: EPIC Health Plan Commercial	$106,089.60
Rate for Payer: EPIC Health Plan Senior	$70,726.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,296.73
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$90,015.42
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$86,157.62
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$64,296.73
Rate for Payer: Prime Health Services Medicare	$68,154.53
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 SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$44,292.25

Service Code	MSDRG 331
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$44,292.25
Rate for Payer: Aetna of CA HMO/PPO	$44,292.25
Rate for Payer: Anthem Blue Cross of CA Exchange	$28,610.98
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$40,056.39
Rate for Payer: EPIC Health Plan Commercial	$39,785.20
Rate for Payer: EPIC Health Plan Senior	$26,523.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,112.24
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$33,757.14
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$32,310.40
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$24,112.24
Rate for Payer: Prime Health Services Medicare	$25,558.97
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 SMALL BOWEL PROCEDURES

Facility

$19,104.60

Service Code	APR-DRG 2301
Min. Negotiated Rate	$12,066.06
Max. Negotiated Rate	$19,104.60
Rate for Payer: Adventist Health Medi-Cal	$12,066.06
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,378.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,104.60

MAJOR SMALL BOWEL PROCEDURES

Facility

$45,558.96

Service Code	APR-DRG 2303
Min. Negotiated Rate	$28,774.08
Max. Negotiated Rate	$45,558.96
Rate for Payer: Adventist Health Medi-Cal	$28,774.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$34,289.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$45,558.96

MAJOR SMALL BOWEL PROCEDURES

Facility

$30,986.30

Service Code	APR-DRG 2302
Min. Negotiated Rate	$19,570.30
Max. Negotiated Rate	$30,986.30
Rate for Payer: Adventist Health Medi-Cal	$19,570.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,321.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,986.30

MAJOR SMALL BOWEL PROCEDURES

Facility

$74,178.58

Service Code	APR-DRG 2304
Min. Negotiated Rate	$46,849.63
Max. Negotiated Rate	$74,178.58
Rate for Payer: Adventist Health Medi-Cal	$46,849.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$55,829.14
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$74,178.58

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$86,731.03

Service Code	APR-DRG 2204
Min. Negotiated Rate	$54,777.49
Max. Negotiated Rate	$86,731.03
Rate for Payer: Adventist Health Medi-Cal	$54,777.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,276.51
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$86,731.03

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$49,055.61

Service Code	APR-DRG 2203
Min. Negotiated Rate	$30,982.49
Max. Negotiated Rate	$49,055.61
Rate for Payer: Adventist Health Medi-Cal	$30,982.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$36,920.80
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,055.61

Know your out-of-pocket cost for care.

All Charges