Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 31.00: CORONARY BYPASS W CARDIAC CATH W/O MCC

Facility

$143,772.80

Service Code	MSDRG 234
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$143,772.80
Rate for Payer: United Healthcare All Other Commercial	$103,054.00
Rate for Payer: United Healthcare All Other HMO	$103,054.00
Rate for Payer: United Healthcare HMO Rider	$74,111.00
Rate for Payer: United Healthcare Select/Navigate/Core	$67,897.00

MS-DRG 31.00: CORONARY BYPASS W/O CARDIAC CATH W MCC

Facility

$154,455.68

Service Code	MSDRG 235
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$154,455.68
Rate for Payer: United Healthcare All Other Commercial	$83,791.00
Rate for Payer: United Healthcare All Other HMO	$83,791.00
Rate for Payer: United Healthcare HMO Rider	$56,388.00
Rate for Payer: United Healthcare Select/Navigate/Core	$51,660.00

MS-DRG 31.00: CORONARY BYPASS W/O CARDIAC CATH W/O MCC

Facility

$110,245.03

Service Code	MSDRG 236
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$110,245.03
Rate for Payer: United Healthcare All Other Commercial	$76,448.00
Rate for Payer: United Healthcare All Other HMO	$76,448.00
Rate for Payer: United Healthcare HMO Rider	$52,096.00
Rate for Payer: United Healthcare Select/Navigate/Core	$47,726.00

MS-DRG 31.00: CORONARY BYPASS W PTCA W MCC

Facility

$221,866.54

Service Code	MSDRG 231
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$221,866.54
Rate for Payer: United Healthcare All Other Commercial	$107,429.00
Rate for Payer: United Healthcare All Other HMO	$107,429.00
Rate for Payer: United Healthcare HMO Rider	$94,080.00
Rate for Payer: United Healthcare Select/Navigate/Core	$86,191.00

MS-DRG 31.00: CORONARY BYPASS W PTCA W/O MCC

Facility

$159,561.57

Service Code	MSDRG 232
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$159,561.57
Rate for Payer: United Healthcare All Other Commercial	$94,061.00
Rate for Payer: United Healthcare All Other HMO	$94,061.00
Rate for Payer: United Healthcare HMO Rider	$79,841.00
Rate for Payer: United Healthcare Select/Navigate/Core	$73,147.00

MS-DRG 31.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC

Facility

$74,534.00

Service Code	MSDRG 481
Min. Negotiated Rate	$21,830.00
Max. Negotiated Rate	$74,534.00
Rate for Payer: United Healthcare All Other Commercial	$74,534.00
Rate for Payer: United Healthcare All Other HMO	$74,534.00
Rate for Payer: United Healthcare HMO Rider	$23,828.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,830.00

MS-DRG 31.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC

Facility

$76,648.82

Service Code	MSDRG 480
Min. Negotiated Rate	$24,564.00
Max. Negotiated Rate	$76,648.82
Rate for Payer: United Healthcare All Other Commercial	$56,679.00
Rate for Payer: United Healthcare All Other HMO	$56,679.00
Rate for Payer: United Healthcare HMO Rider	$30,970.00
Rate for Payer: United Healthcare Select/Navigate/Core	$28,371.00

MS-DRG 31.00: HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC

Facility

$60,760.00

Service Code	MSDRG 482
Min. Negotiated Rate	$18,472.00
Max. Negotiated Rate	$60,760.00
Rate for Payer: United Healthcare All Other Commercial	$60,760.00
Rate for Payer: United Healthcare All Other HMO	$60,760.00
Rate for Payer: United Healthcare HMO Rider	$20,163.00
Rate for Payer: United Healthcare Select/Navigate/Core	$18,472.00

MS-DRG 31.00: LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$99,038.40

Service Code	MSDRG 956
Min. Negotiated Rate	$25,608.00
Max. Negotiated Rate	$99,038.40
Rate for Payer: United Healthcare All Other Commercial	$91,491.00
Rate for Payer: United Healthcare All Other HMO	$91,491.00
Rate for Payer: United Healthcare HMO Rider	$44,920.00
Rate for Payer: United Healthcare Select/Navigate/Core	$41,155.00

MS-DRG 31.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC

Facility

$66,747.62

Service Code	MSDRG 493
Min. Negotiated Rate	$17,710.00
Max. Negotiated Rate	$66,747.62
Rate for Payer: United Healthcare All Other Commercial	$36,150.00
Rate for Payer: United Healthcare All Other HMO	$36,150.00
Rate for Payer: United Healthcare HMO Rider	$19,332.00
Rate for Payer: United Healthcare Select/Navigate/Core	$17,710.00

MS-DRG 31.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC

Facility

$96,632.84

Service Code	MSDRG 492
Min. Negotiated Rate	$21,433.00
Max. Negotiated Rate	$96,632.84
Rate for Payer: United Healthcare All Other Commercial	$37,370.00
Rate for Payer: United Healthcare All Other HMO	$37,370.00
Rate for Payer: United Healthcare HMO Rider	$28,889.00
Rate for Payer: United Healthcare Select/Navigate/Core	$26,467.00

MS-DRG 31.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC

Facility

$52,809.07

Service Code	MSDRG 494
Min. Negotiated Rate	$15,056.00
Max. Negotiated Rate	$52,809.07
Rate for Payer: United Healthcare All Other Commercial	$29,464.00
Rate for Payer: United Healthcare All Other HMO	$29,464.00
Rate for Payer: United Healthcare HMO Rider	$16,434.00
Rate for Payer: United Healthcare Select/Navigate/Core	$15,056.00

MS-DRG 31.00: MAJOR CARDIOVASC PROCEDURES W MCC

Facility

$79,185.00

Service Code	MSDRG 237
Min. Negotiated Rate	$14,790.00
Max. Negotiated Rate	$79,185.00
Rate for Payer: United Healthcare All Other HMO	$79,185.00
Rate for Payer: United Healthcare HMO Rider	$60,147.00
Rate for Payer: United Healthcare Select/Navigate/Core	$55,106.00

MS-DRG 31.00: MAJOR CARDIOVASC PROCEDURES W/O MCC

Facility

$68,582.00

Service Code	MSDRG 238
Min. Negotiated Rate	$14,790.00
Max. Negotiated Rate	$68,582.00
Rate for Payer: United Healthcare All Other HMO	$68,582.00
Rate for Payer: United Healthcare HMO Rider	$52,096.00
Rate for Payer: United Healthcare Select/Navigate/Core	$47,726.00

MS-DRG 31.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC

Facility

$79,830.79

Service Code	MSDRG 469
Min. Negotiated Rate	$23,506.00
Max. Negotiated Rate	$79,830.79
Rate for Payer: United Healthcare All Other Commercial	$41,904.00
Rate for Payer: United Healthcare All Other HMO	$41,904.00
Rate for Payer: United Healthcare HMO Rider	$34,363.00
Rate for Payer: United Healthcare Select/Navigate/Core	$31,483.00

MS-DRG 31.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC

Facility

$53,685.00

Service Code	MSDRG 470
Min. Negotiated Rate	$23,467.00
Max. Negotiated Rate	$53,685.00
Rate for Payer: United Healthcare All Other Commercial	$53,685.00
Rate for Payer: United Healthcare All Other HMO	$53,685.00
Rate for Payer: United Healthcare HMO Rider	$25,615.00
Rate for Payer: United Healthcare Select/Navigate/Core	$23,467.00

MS-DRG 31.00: MAJOR MALE PELVIC PROCEDURES W CC/MCC

Facility

$52,645.90

Service Code	MSDRG 707
Min. Negotiated Rate	$22,398.00
Max. Negotiated Rate	$52,645.90
Rate for Payer: United Healthcare All Other Commercial	$24,996.00
Rate for Payer: United Healthcare All Other HMO	$24,996.00
Rate for Payer: United Healthcare HMO Rider	$24,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,398.00

MS-DRG 31.00: MAJOR MALE PELVIC PROCEDURES W/O CC/MCC

Facility

$40,378.61

Service Code	MSDRG 708
Min. Negotiated Rate	$22,061.35
Max. Negotiated Rate	$40,378.61
Rate for Payer: United Healthcare All Other Commercial	$24,996.00
Rate for Payer: United Healthcare All Other HMO	$24,996.00
Rate for Payer: United Healthcare HMO Rider	$24,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,398.00

MS-DRG 31.00: MEDICAL BACK PROBLEMS W MCC

Facility

$59,884.00

Service Code	MSDRG 551
Min. Negotiated Rate	$13,734.00
Max. Negotiated Rate	$59,884.00
Rate for Payer: United Healthcare All Other Commercial	$59,884.00
Rate for Payer: United Healthcare All Other HMO	$59,884.00
Rate for Payer: United Healthcare HMO Rider	$14,990.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,734.00

MS-DRG 31.00: MEDICAL BACK PROBLEMS W/O MCC

Facility

$59,884.00

Service Code	MSDRG 552
Min. Negotiated Rate	$13,778.00
Max. Negotiated Rate	$59,884.00
Rate for Payer: United Healthcare All Other Commercial	$59,884.00
Rate for Payer: United Healthcare All Other HMO	$59,884.00
Rate for Payer: United Healthcare HMO Rider	$15,038.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,778.00

MS-DRG 31.00: O.R. PROCEDURES FOR OBESITY W CC

Facility

$42,118.30

Service Code	MSDRG 620
Min. Negotiated Rate	$12,166.00
Max. Negotiated Rate	$42,118.30
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,919.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 31.00: O.R. PROCEDURES FOR OBESITY W MCC

Facility

$75,993.48

Service Code	MSDRG 619
Min. Negotiated Rate	$12,166.00
Max. Negotiated Rate	$75,993.48
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,919.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 31.00: O.R. PROCEDURES FOR OBESITY W/O CC/MCC

Facility

$39,699.58

Service Code	MSDRG 621
Min. Negotiated Rate	$12,166.00
Max. Negotiated Rate	$39,699.58
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,919.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 31.00: OTHER CARDIOTHORACIC PROCEDURES W CC

Facility

$82,891.69

Service Code	MSDRG 229
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$82,891.69
Rate for Payer: United Healthcare All Other Commercial	$71,243.00
Rate for Payer: United Healthcare All Other HMO	$71,243.00
Rate for Payer: United Healthcare HMO Rider	$68,556.00
Rate for Payer: United Healthcare Select/Navigate/Core	$62,809.00

MS-DRG 31.00: OTHER CARDIOTHORACIC PROCEDURES W MCC

Facility

$130,210.62

Service Code	MSDRG 228
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$130,210.62
Rate for Payer: United Healthcare All Other Commercial	$120,397.00
Rate for Payer: United Healthcare All Other HMO	$120,397.00
Rate for Payer: United Healthcare HMO Rider	$86,872.00
Rate for Payer: United Healthcare Select/Navigate/Core	$79,589.00

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