Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

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 THUMB OR JOINT PROCEDURES

Facility

$32,191.22

Service Code	MSDRG 506
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$32,191.22
Rate for Payer: EPIC Health Plan Senior	$21,460.81
Rate for Payer: Aetna of CA HMO/PPO	$31,572.27
Rate for Payer: Anthem Blue Cross of CA Exchange	$20,394.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$28,552.88
Rate for Payer: EPIC Health Plan Commercial	$32,191.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,509.83
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$27,313.76
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$26,143.17
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$19,509.83
Rate for Payer: Prime Health Services Medicare	$20,680.42
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

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$7,452.50

Service Code	APR-DRG 5011
Min. Negotiated Rate	$4,706.84
Max. Negotiated Rate	$7,452.50
Rate for Payer: Adventist Health Medi-Cal	$4,706.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,608.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,452.50

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$9,863.49

Service Code	APR-DRG 5012
Min. Negotiated Rate	$6,229.57
Max. Negotiated Rate	$9,863.49
Rate for Payer: Adventist Health Medi-Cal	$6,229.57
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,423.57
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,863.49

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$14,721.71

Service Code	APR-DRG 5013
Min. Negotiated Rate	$9,297.92
Max. Negotiated Rate	$14,721.71
Rate for Payer: Adventist Health Medi-Cal	$9,297.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,080.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,721.71

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$27,032.44

Service Code	APR-DRG 5014
Min. Negotiated Rate	$17,073.12
Max. Negotiated Rate	$27,032.44
Rate for Payer: Adventist Health Medi-Cal	$17,073.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,345.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,032.44

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$16,659.37

Service Code	APR-DRG 2523
Min. Negotiated Rate	$10,521.71
Max. Negotiated Rate	$16,659.37
Rate for Payer: Adventist Health Medi-Cal	$10,521.71
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,538.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,659.37

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$11,573.53

Service Code	APR-DRG 2522
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

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$9,102.12

Service Code	APR-DRG 2521
Min. Negotiated Rate	$5,748.71
Max. Negotiated Rate	$9,102.12
Rate for Payer: Adventist Health Medi-Cal	$5,748.71
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,850.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,102.12

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$29,932.88

Service Code	APR-DRG 2524
Min. Negotiated Rate	$18,904.98
Max. Negotiated Rate	$29,932.88
Rate for Payer: Adventist Health Medi-Cal	$18,904.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,528.43
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,932.88

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$32,577.51

Service Code	APR-DRG 2064
Min. Negotiated Rate	$20,575.27
Max. Negotiated Rate	$32,577.51
Rate for Payer: Adventist Health Medi-Cal	$20,575.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,518.87
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$32,577.51

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$9,077.95

Service Code	APR-DRG 2061
Min. Negotiated Rate	$5,733.44
Max. Negotiated Rate	$9,077.95
Rate for Payer: Adventist Health Medi-Cal	$5,733.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,832.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,077.95

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$17,469.08

Service Code	APR-DRG 2063
Min. Negotiated Rate	$11,033.10
Max. Negotiated Rate	$17,469.08
Rate for Payer: Adventist Health Medi-Cal	$11,033.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,147.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,469.08

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$11,503.04

Service Code	APR-DRG 2062
Min. Negotiated Rate	$7,265.08
Max. Negotiated Rate	$11,503.04
Rate for Payer: Adventist Health Medi-Cal	$7,265.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,657.55
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,503.04

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$28,148.31

Service Code	APR-DRG 4664
Min. Negotiated Rate	$17,777.88
Max. Negotiated Rate	$28,148.31
Rate for Payer: Adventist Health Medi-Cal	$17,777.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,185.31
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,148.31

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$16,333.07

Service Code	APR-DRG 4663
Min. Negotiated Rate	$10,315.62
Max. Negotiated Rate	$16,333.07
Rate for Payer: Adventist Health Medi-Cal	$10,315.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,292.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,333.07

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$10,973.30

Service Code	APR-DRG 4662
Min. Negotiated Rate	$6,930.50
Max. Negotiated Rate	$10,973.30
Rate for Payer: Adventist Health Medi-Cal	$6,930.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,258.85
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,973.30

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$8,413.28

Service Code	APR-DRG 4661
Min. Negotiated Rate	$5,313.65
Max. Negotiated Rate	$8,413.28
Rate for Payer: Adventist Health Medi-Cal	$5,313.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,332.10
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,413.28

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$17,682.58

Service Code	APR-DRG 3493
Min. Negotiated Rate	$11,167.94
Max. Negotiated Rate	$17,682.58
Rate for Payer: Adventist Health Medi-Cal	$11,167.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,308.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,682.58

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$12,230.17

Service Code	APR-DRG 3492
Min. Negotiated Rate	$7,724.32
Max. Negotiated Rate	$12,230.17
Rate for Payer: Adventist Health Medi-Cal	$7,724.32
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,204.81
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,230.17

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$29,761.68

Service Code	APR-DRG 3494
Min. Negotiated Rate	$18,796.85
Max. Negotiated Rate	$29,761.68
Rate for Payer: Adventist Health Medi-Cal	$18,796.85
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,399.58
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,761.68

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$8,741.58

Service Code	APR-DRG 3491
Min. Negotiated Rate	$5,521.00
Max. Negotiated Rate	$8,741.58
Rate for Payer: Adventist Health Medi-Cal	$5,521.00
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,579.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,741.58

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$28,629.81

Service Code	MSDRG 755
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$28,629.81
Rate for Payer: Aetna of CA HMO/PPO	$28,629.81
Rate for Payer: Anthem Blue Cross of CA Exchange	$18,493.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$25,891.82
Rate for Payer: EPIC Health Plan Commercial	$26,242.57
Rate for Payer: EPIC Health Plan Senior	$17,495.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,904.59
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$22,266.43
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$21,312.15
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,904.59
Rate for Payer: Prime Health Services Medicare	$16,858.87
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

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$48,471.70

Service Code	MSDRG 754
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$48,471.70
Rate for Payer: Aetna of CA HMO/PPO	$48,471.70
Rate for Payer: Anthem Blue Cross of CA Exchange	$31,310.74
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$43,836.14
Rate for Payer: EPIC Health Plan Commercial	$43,398.98
Rate for Payer: EPIC Health Plan Senior	$28,932.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,302.41
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$36,823.37
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$35,245.23
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$26,302.41
Rate for Payer: Prime Health Services Medicare	$27,880.55
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

Know your out-of-pocket cost for care.

All Charges