Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$25,279.40

Service Code	MSDRG 756
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$25,279.40
Rate for Payer: Aetna of CA HMO/PPO	$25,279.40
Rate for Payer: Anthem Blue Cross of CA Exchange	$16,329.46
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$22,861.82
Rate for Payer: EPIC Health Plan Commercial	$23,345.65
Rate for Payer: EPIC Health Plan Senior	$15,563.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,148.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$19,808.43
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$18,959.50
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$14,148.88
Rate for Payer: Prime Health Services Medicare	$14,997.81
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, MALE REPRODUCTIVE SYSTEM

Facility

$17,430.81

Service Code	APR-DRG 5003
Min. Negotiated Rate	$11,008.93
Max. Negotiated Rate	$17,430.81
Rate for Payer: Adventist Health Medi-Cal	$11,008.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,118.98
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,430.81

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$8,546.20

Service Code	APR-DRG 5001
Min. Negotiated Rate	$5,397.60
Max. Negotiated Rate	$8,546.20
Rate for Payer: Adventist Health Medi-Cal	$5,397.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,432.14
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,546.20

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$26,516.82

Service Code	APR-DRG 5004
Min. Negotiated Rate	$16,747.46
Max. Negotiated Rate	$26,516.82
Rate for Payer: Adventist Health Medi-Cal	$16,747.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,957.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$26,516.82

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$11,358.01

Service Code	APR-DRG 5002
Min. Negotiated Rate	$7,173.48
Max. Negotiated Rate	$11,358.01
Rate for Payer: Adventist Health Medi-Cal	$7,173.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,548.40
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,358.01

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$30,074.72

Service Code	MSDRG 723
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$30,074.72
Rate for Payer: Aetna of CA HMO/PPO	$30,074.72
Rate for Payer: Anthem Blue Cross of CA Exchange	$19,427.04
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$27,198.55
Rate for Payer: EPIC Health Plan Commercial	$27,491.92
Rate for Payer: EPIC Health Plan Senior	$18,327.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,661.77
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,326.48
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$22,326.77
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$16,661.77
Rate for Payer: Prime Health Services Medicare	$17,661.48
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, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$47,629.49

Service Code	MSDRG 722
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$47,629.49
Rate for Payer: Aetna of CA HMO/PPO	$47,629.49
Rate for Payer: Anthem Blue Cross of CA Exchange	$30,766.71
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$43,074.48
Rate for Payer: EPIC Health Plan Commercial	$42,670.75
Rate for Payer: EPIC Health Plan Senior	$28,447.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,861.06
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$36,205.48
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$34,653.82
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$25,861.06
Rate for Payer: Prime Health Services Medicare	$27,412.72
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, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$16,409.33

Service Code	MSDRG 724
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$16,409.33
Rate for Payer: Aetna of CA HMO/PPO	$16,099.33
Rate for Payer: Anthem Blue Cross of CA Exchange	$10,399.51
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,559.68
Rate for Payer: EPIC Health Plan Commercial	$16,409.33
Rate for Payer: EPIC Health Plan Senior	$10,939.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,945.05
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$13,923.07
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$13,326.37
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$9,945.05
Rate for Payer: Prime Health Services Medicare	$10,541.75
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 OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$14,226.23

Service Code	APR-DRG 2812
Min. Negotiated Rate	$8,984.99
Max. Negotiated Rate	$14,226.23
Rate for Payer: Adventist Health Medi-Cal	$8,984.99
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,707.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,226.23

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$19,092.51

Service Code	APR-DRG 2813
Min. Negotiated Rate	$12,058.43
Max. Negotiated Rate	$19,092.51
Rate for Payer: Adventist Health Medi-Cal	$12,058.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,369.63
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,092.51

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$29,098.99

Service Code	APR-DRG 2814
Min. Negotiated Rate	$18,378.31
Max. Negotiated Rate	$29,098.99
Rate for Payer: Adventist Health Medi-Cal	$18,378.31
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,900.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,098.99

MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS

Facility

$10,300.57

Service Code	APR-DRG 2811
Min. Negotiated Rate	$6,505.62
Max. Negotiated Rate	$10,300.57
Rate for Payer: Adventist Health Medi-Cal	$6,505.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,752.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,300.57

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$29,769.42

Service Code	MSDRG 436
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$29,769.42
Rate for Payer: Aetna of CA HMO/PPO	$29,769.42
Rate for Payer: Anthem Blue Cross of CA Exchange	$19,229.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$26,922.44
Rate for Payer: EPIC Health Plan Commercial	$27,227.94
Rate for Payer: EPIC Health Plan Senior	$18,151.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,501.78
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,102.49
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$22,112.39
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$16,501.78
Rate for Payer: Prime Health Services Medicare	$17,491.89
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 OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$48,340.11

Service Code	MSDRG 435
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$48,340.11
Rate for Payer: Aetna of CA HMO/PPO	$48,340.11
Rate for Payer: Anthem Blue Cross of CA Exchange	$31,225.74
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$43,717.13
Rate for Payer: EPIC Health Plan Commercial	$43,285.19
Rate for Payer: EPIC Health Plan Senior	$28,856.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,233.45
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$36,726.83
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$35,152.82
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$26,233.45
Rate for Payer: Prime Health Services Medicare	$27,807.46
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 OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$22,458.00

Service Code	MSDRG 437
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$22,458.00
Rate for Payer: Aetna of CA HMO/PPO	$22,458.00
Rate for Payer: Anthem Blue Cross of CA Exchange	$14,506.95
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$20,310.25
Rate for Payer: EPIC Health Plan Commercial	$20,906.08
Rate for Payer: EPIC Health Plan Senior	$13,937.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,670.35
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$17,738.49
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,978.27
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$12,670.35
Rate for Payer: Prime Health Services Medicare	$13,430.57
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

MALIGNANT BREAST DISORDERS

Facility

$11,913.93

Service Code	APR-DRG 3822
Min. Negotiated Rate	$7,524.59
Max. Negotiated Rate	$11,913.93
Rate for Payer: Adventist Health Medi-Cal	$7,524.59
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,966.80
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,913.93

MALIGNANT BREAST DISORDERS

Facility

$8,644.91

Service Code	APR-DRG 3821
Min. Negotiated Rate	$5,459.94
Max. Negotiated Rate	$8,644.91
Rate for Payer: Adventist Health Medi-Cal	$5,459.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,506.43
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,644.91

MALIGNANT BREAST DISORDERS

Facility

$16,578.79

Service Code	APR-DRG 3823
Min. Negotiated Rate	$10,470.82
Max. Negotiated Rate	$16,578.79
Rate for Payer: Adventist Health Medi-Cal	$10,470.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,477.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,578.79

MALIGNANT BREAST DISORDERS

Facility

$28,035.51

Service Code	APR-DRG 3824
Min. Negotiated Rate	$17,706.64
Max. Negotiated Rate	$28,035.51
Rate for Payer: Adventist Health Medi-Cal	$17,706.64
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,100.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,035.51

MALIGNANT BREAST DISORDERS WITH CC

Facility

$29,774.68

Service Code	MSDRG 598
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$29,774.68
Rate for Payer: Aetna of CA HMO/PPO	$29,774.68
Rate for Payer: Anthem Blue Cross of CA Exchange	$19,233.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$26,927.20
Rate for Payer: EPIC Health Plan Commercial	$27,232.49
Rate for Payer: EPIC Health Plan Senior	$18,154.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,504.54
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,106.36
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$22,116.08
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$16,504.54
Rate for Payer: Prime Health Services Medicare	$17,494.81
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

MALIGNANT BREAST DISORDERS WITH MCC

Facility

$43,876.40

Service Code	MSDRG 597
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$43,876.40
Rate for Payer: Aetna of CA HMO/PPO	$43,876.40
Rate for Payer: Anthem Blue Cross of CA Exchange	$28,342.37
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$39,680.31
Rate for Payer: EPIC Health Plan Commercial	$39,425.61
Rate for Payer: EPIC Health Plan Senior	$26,283.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,894.31
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$33,452.03
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$32,018.38
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$23,894.31
Rate for Payer: Prime Health Services Medicare	$25,327.97
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

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$19,297.09

Service Code	MSDRG 599
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$19,297.09
Rate for Payer: Aetna of CA HMO/PPO	$19,297.09
Rate for Payer: Anthem Blue Cross of CA Exchange	$12,465.13
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$17,451.63
Rate for Payer: EPIC Health Plan Commercial	$18,996.78
Rate for Payer: EPIC Health Plan Senior	$12,664.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,513.20
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$16,118.48
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$15,427.69
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,513.20
Rate for Payer: Prime Health Services Medicare	$12,203.99
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

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$27,602.46

Service Code	APR-DRG 4214
Min. Negotiated Rate	$17,433.13
Max. Negotiated Rate	$27,602.46
Rate for Payer: Adventist Health Medi-Cal	$17,433.13
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,774.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,602.46

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$6,044.58

Service Code	APR-DRG 4211
Min. Negotiated Rate	$3,817.63
Max. Negotiated Rate	$6,044.58
Rate for Payer: Adventist Health Medi-Cal	$3,817.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,549.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$6,044.58

MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS

Facility

$15,815.43

Service Code	APR-DRG 4213
Min. Negotiated Rate	$9,988.69
Max. Negotiated Rate	$15,815.43
Rate for Payer: Adventist Health Medi-Cal	$9,988.69
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,903.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,815.43

Know your out-of-pocket cost for care.

All Charges