Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 31.00: SPINAL PROCEDURES W MCC

Facility

$158,132.45

Service Code	MSDRG 028
Min. Negotiated Rate	$25,608.00
Max. Negotiated Rate	$158,132.45
Rate for Payer: United Healthcare All Other Commercial	$58,958.00
Rate for Payer: United Healthcare All Other HMO	$58,958.00
Rate for Payer: United Healthcare HMO Rider	$54,569.00
Rate for Payer: United Healthcare Select/Navigate/Core	$49,994.00

MS-DRG 31.00: SPINAL PROCEDURES W/O CC/MCC

Facility

$58,958.00

Service Code	MSDRG 030
Min. Negotiated Rate	$20,798.00
Max. Negotiated Rate	$58,958.00
Rate for Payer: United Healthcare All Other Commercial	$58,958.00
Rate for Payer: United Healthcare All Other HMO	$58,958.00
Rate for Payer: United Healthcare HMO Rider	$22,701.00
Rate for Payer: United Healthcare Select/Navigate/Core	$20,798.00

MS-DRG 31.00: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC

Facility

$48,290.10

Service Code	MSDRG 742
Min. Negotiated Rate	$22,398.00
Max. Negotiated Rate	$48,290.10
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: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC

Facility

$32,653.98

Service Code	MSDRG 743
Min. Negotiated Rate	$18,013.39
Max. Negotiated Rate	$32,653.98
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: UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC

Facility

$37,533.53

Service Code	MSDRG 741
Min. Negotiated Rate	$20,570.44
Max. Negotiated Rate	$37,533.53
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: WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC

Facility

$112,353.00

Service Code	MSDRG 464
Min. Negotiated Rate	$34,033.00
Max. Negotiated Rate	$112,353.00
Rate for Payer: United Healthcare All Other Commercial	$112,353.00
Rate for Payer: United Healthcare All Other HMO	$112,353.00
Rate for Payer: United Healthcare HMO Rider	$37,147.00
Rate for Payer: United Healthcare Select/Navigate/Core	$34,033.00

MS-DRG 31.00: WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC

Facility

$150,005.14

Service Code	MSDRG 463
Min. Negotiated Rate	$46,778.00
Max. Negotiated Rate	$150,005.14
Rate for Payer: United Healthcare All Other Commercial	$112,353.00
Rate for Payer: United Healthcare All Other HMO	$112,353.00
Rate for Payer: United Healthcare HMO Rider	$51,058.00
Rate for Payer: United Healthcare Select/Navigate/Core	$46,778.00

MS-DRG 31.00: WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC

Facility

$112,353.00

Service Code	MSDRG 465
Min. Negotiated Rate	$26,054.17
Max. Negotiated Rate	$112,353.00
Rate for Payer: United Healthcare All Other Commercial	$112,353.00
Rate for Payer: United Healthcare All Other HMO	$112,353.00
Rate for Payer: United Healthcare HMO Rider	$30,180.00
Rate for Payer: United Healthcare Select/Navigate/Core	$27,650.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC

Facility

$26,466.00

Service Code	MSDRG 281
Min. Negotiated Rate	$13,577.88
Max. Negotiated Rate	$26,466.00
Rate for Payer: United Healthcare All Other Commercial	$26,466.00
Rate for Payer: United Healthcare All Other HMO	$26,466.00
Rate for Payer: United Healthcare HMO Rider	$16,920.00
Rate for Payer: United Healthcare Select/Navigate/Core	$15,502.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC

Facility

$42,218.31

Service Code	MSDRG 280
Min. Negotiated Rate	$20,535.00
Max. Negotiated Rate	$42,218.31
Rate for Payer: United Healthcare All Other Commercial	$27,038.00
Rate for Payer: United Healthcare All Other HMO	$27,038.00
Rate for Payer: United Healthcare HMO Rider	$22,413.00
Rate for Payer: United Healthcare Select/Navigate/Core	$20,535.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC

Facility

$28,087.00

Service Code	MSDRG 282
Min. Negotiated Rate	$10,874.63
Max. Negotiated Rate	$28,087.00
Rate for Payer: United Healthcare All Other Commercial	$28,087.00
Rate for Payer: United Healthcare All Other HMO	$28,087.00
Rate for Payer: United Healthcare HMO Rider	$13,685.00
Rate for Payer: United Healthcare Select/Navigate/Core	$12,537.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC

Facility

$28,275.00

Service Code	MSDRG 284
Min. Negotiated Rate	$10,448.46
Max. Negotiated Rate	$28,275.00
Rate for Payer: United Healthcare All Other Commercial	$28,275.00
Rate for Payer: United Healthcare All Other HMO	$28,275.00
Rate for Payer: United Healthcare HMO Rider	$15,558.00
Rate for Payer: United Healthcare Select/Navigate/Core	$14,254.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC

Facility

$52,132.68

Service Code	MSDRG 283
Min. Negotiated Rate	$18,641.00
Max. Negotiated Rate	$52,132.68
Rate for Payer: United Healthcare All Other Commercial	$29,007.00
Rate for Payer: United Healthcare All Other HMO	$29,007.00
Rate for Payer: United Healthcare HMO Rider	$20,346.00
Rate for Payer: United Healthcare Select/Navigate/Core	$18,641.00

MS-DRG 33.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED W/O CC/MCC

Facility

$27,865.00

Service Code	MSDRG 285
Min. Negotiated Rate	$9,161.66
Max. Negotiated Rate	$27,865.00
Rate for Payer: United Healthcare All Other Commercial	$27,865.00
Rate for Payer: United Healthcare All Other HMO	$27,865.00
Rate for Payer: United Healthcare HMO Rider	$13,432.00
Rate for Payer: United Healthcare Select/Navigate/Core	$12,305.00

MS-DRG 33.00: ACUTE & SUBACUTE ENDOCARDITIS W CC

Facility

$44,923.90

Service Code	MSDRG 289
Min. Negotiated Rate	$24,443.24
Max. Negotiated Rate	$44,923.90
Rate for Payer: United Healthcare All Other Commercial	$33,040.00
Rate for Payer: United Healthcare All Other HMO	$33,040.00
Rate for Payer: United Healthcare HMO Rider	$29,741.00
Rate for Payer: United Healthcare Select/Navigate/Core	$27,248.00

MS-DRG 33.00: ACUTE & SUBACUTE ENDOCARDITIS W MCC

Facility

$71,224.48

Service Code	MSDRG 288
Min. Negotiated Rate	$34,413.00
Max. Negotiated Rate	$71,224.48
Rate for Payer: United Healthcare All Other Commercial	$37,549.00
Rate for Payer: United Healthcare All Other HMO	$37,549.00
Rate for Payer: United Healthcare HMO Rider	$37,563.00
Rate for Payer: United Healthcare Select/Navigate/Core	$34,413.00

MS-DRG 33.00: ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC

Facility

$33,040.00

Service Code	MSDRG 290
Min. Negotiated Rate	$13,724.07
Max. Negotiated Rate	$33,040.00
Rate for Payer: United Healthcare All Other Commercial	$33,040.00
Rate for Payer: United Healthcare All Other HMO	$33,040.00
Rate for Payer: United Healthcare HMO Rider	$25,436.00
Rate for Payer: United Healthcare Select/Navigate/Core	$23,302.00

MS-DRG 33.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC

Facility

$181,019.45

Service Code	MSDRG 268
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$181,019.45
Rate for Payer: United Healthcare HMO Rider	$84,927.00
Rate for Payer: United Healthcare All Other Commercial	$127,168.00
Rate for Payer: United Healthcare All Other HMO	$127,168.00
Rate for Payer: United Healthcare Select/Navigate/Core	$77,806.00

MS-DRG 33.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC

Facility

$111,150.40

Service Code	MSDRG 269
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$111,150.40
Rate for Payer: United Healthcare All Other Commercial	$79,046.00
Rate for Payer: United Healthcare All Other HMO	$79,046.00
Rate for Payer: United Healthcare HMO Rider	$52,792.00
Rate for Payer: United Healthcare Select/Navigate/Core	$48,365.00

MS-DRG 33.00: AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC

Facility

$158,516.00

Service Code	MSDRG 016
Min. Negotiated Rate	$82,684.31
Max. Negotiated Rate	$158,516.00
Rate for Payer: Networks By Design Commercial	$110,000.00

MS-DRG 33.00: AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC

Facility

$158,516.00

Service Code	MSDRG 017
Min. Negotiated Rate	$75,824.14
Max. Negotiated Rate	$158,516.00
Rate for Payer: Networks By Design Commercial	$110,000.00

MS-DRG 33.00: BACK & NECK PROC EXC SPINAL FUSION W CC

Facility

$52,643.26

Service Code	MSDRG 519
Min. Negotiated Rate	$14,908.00
Max. Negotiated Rate	$52,643.26
Rate for Payer: United Healthcare All Other Commercial	$18,257.00
Rate for Payer: United Healthcare All Other HMO	$18,257.00
Rate for Payer: United Healthcare HMO Rider	$16,273.00
Rate for Payer: United Healthcare Select/Navigate/Core	$14,908.00

MS-DRG 33.00: BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM

Facility

$98,362.00

Service Code	MSDRG 518
Min. Negotiated Rate	$14,908.00
Max. Negotiated Rate	$98,362.00
Rate for Payer: United Healthcare All Other Commercial	$18,257.00
Rate for Payer: United Healthcare All Other HMO	$18,257.00
Rate for Payer: United Healthcare HMO Rider	$16,273.00
Rate for Payer: United Healthcare Select/Navigate/Core	$14,908.00

MS-DRG 33.00: BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC

Facility

$39,317.95

Service Code	MSDRG 520
Min. Negotiated Rate	$11,314.00
Max. Negotiated Rate	$39,317.95
Rate for Payer: United Healthcare All Other Commercial	$21,329.00
Rate for Payer: United Healthcare All Other HMO	$21,329.00
Rate for Payer: United Healthcare HMO Rider	$12,349.00
Rate for Payer: United Healthcare Select/Navigate/Core	$11,314.00

MS-DRG 33.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC

Facility

$141,085.63

Service Code	MSDRG 461
Min. Negotiated Rate	$45,279.00
Max. Negotiated Rate	$141,085.63
Rate for Payer: United Healthcare All Other Commercial	$64,494.00
Rate for Payer: United Healthcare All Other HMO	$64,494.00
Rate for Payer: United Healthcare HMO Rider	$49,424.00
Rate for Payer: United Healthcare Select/Navigate/Core	$45,279.00

Know your out-of-pocket cost for care.

All Charges