Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 35.00: PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC

Facility

$108,579.03

Service Code	MSDRG 273
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$108,579.03
Rate for Payer: United Healthcare All Other Commercial	$62,136.00
Rate for Payer: United Healthcare All Other HMO	$62,136.00
Rate for Payer: United Healthcare HMO Rider	$36,699.00
Rate for Payer: United Healthcare Select/Navigate/Core	$33,623.00

MS-DRG 35.00: PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC

Facility

$86,634.25

Service Code	MSDRG 274
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$86,634.25
Rate for Payer: United Healthcare All Other Commercial	$42,353.00
Rate for Payer: United Healthcare All Other HMO	$42,353.00
Rate for Payer: United Healthcare HMO Rider	$25,015.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,918.00

MS-DRG 35.00: PERMANENT CARDIAC PACEMAKER IMPLANT W CC

Facility

$56,083.16

Service Code	MSDRG 243
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$56,083.16
Rate for Payer: United Healthcare All Other Commercial	$29,923.00
Rate for Payer: United Healthcare All Other HMO	$29,923.00
Rate for Payer: United Healthcare HMO Rider	$24,583.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,521.00

MS-DRG 35.00: PERMANENT CARDIAC PACEMAKER IMPLANT W MCC

Facility

$84,031.30

Service Code	MSDRG 242
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$84,031.30
Rate for Payer: United Healthcare All Other Commercial	$38,262.00
Rate for Payer: United Healthcare All Other HMO	$38,262.00
Rate for Payer: United Healthcare HMO Rider	$36,089.00
Rate for Payer: United Healthcare Select/Navigate/Core	$33,062.00

MS-DRG 35.00: PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC

Facility

$47,571.59

Service Code	MSDRG 244
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$47,571.59
Rate for Payer: United Healthcare All Other Commercial	$25,087.00
Rate for Payer: United Healthcare All Other HMO	$25,087.00
Rate for Payer: United Healthcare HMO Rider	$20,612.00
Rate for Payer: United Healthcare Select/Navigate/Core	$18,884.00

MS-DRG 35.00: PROSTATECTOMY W/O CC/MCC

Facility

$29,114.08

Service Code	MSDRG 667
Min. Negotiated Rate	$16,158.37
Max. Negotiated Rate	$29,114.08
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 35.00: REVISION OF HIP OR KNEE REPLACEMENT W CC

Facility

$92,816.59

Service Code	MSDRG 467
Min. Negotiated Rate	$32,499.00
Max. Negotiated Rate	$92,816.59
Rate for Payer: United Healthcare All Other Commercial	$36,468.00
Rate for Payer: United Healthcare All Other HMO	$36,468.00
Rate for Payer: United Healthcare HMO Rider	$35,474.00
Rate for Payer: United Healthcare Select/Navigate/Core	$32,499.00

MS-DRG 35.00: REVISION OF HIP OR KNEE REPLACEMENT W MCC

Facility

$137,000.92

Service Code	MSDRG 466
Min. Negotiated Rate	$39,477.00
Max. Negotiated Rate	$137,000.92
Rate for Payer: United Healthcare All Other Commercial	$39,477.00
Rate for Payer: United Healthcare All Other HMO	$39,477.00
Rate for Payer: United Healthcare HMO Rider	$45,640.00
Rate for Payer: United Healthcare Select/Navigate/Core	$41,813.00

MS-DRG 35.00: REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC

Facility

$72,324.61

Service Code	MSDRG 468
Min. Negotiated Rate	$28,986.00
Max. Negotiated Rate	$72,324.61
Rate for Payer: United Healthcare All Other Commercial	$39,477.00
Rate for Payer: United Healthcare All Other HMO	$39,477.00
Rate for Payer: United Healthcare HMO Rider	$31,639.00
Rate for Payer: United Healthcare Select/Navigate/Core	$28,986.00

MS-DRG 35.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC

Facility

$156,942.83

Service Code	MSDRG 457
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$156,942.83
Rate for Payer: United Healthcare All Other Commercial	$90,575.00
Rate for Payer: United Healthcare All Other HMO	$90,575.00
Rate for Payer: United Healthcare HMO Rider	$62,293.00
Rate for Payer: United Healthcare Select/Navigate/Core	$57,072.00

MS-DRG 35.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC

Facility

$221,169.08

Service Code	MSDRG 456
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$221,169.08
Rate for Payer: United Healthcare All Other Commercial	$112,148.00
Rate for Payer: United Healthcare All Other HMO	$112,148.00
Rate for Payer: United Healthcare HMO Rider	$75,636.00
Rate for Payer: United Healthcare Select/Navigate/Core	$69,294.00

MS-DRG 35.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC

Facility

$109,818.66

Service Code	MSDRG 458
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$109,818.66
Rate for Payer: United Healthcare All Other Commercial	$81,933.00
Rate for Payer: United Healthcare All Other HMO	$81,933.00
Rate for Payer: United Healthcare HMO Rider	$53,969.00
Rate for Payer: United Healthcare Select/Navigate/Core	$49,445.00

MS-DRG 35.00: SPINAL FUSION EXCEPT CERVICAL W MCC

Facility

$76,782.00

Service Code	MSDRG 459
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$76,782.00
Rate for Payer: United Healthcare All Other Commercial	$76,782.00
Rate for Payer: United Healthcare All Other HMO	$76,782.00
Rate for Payer: United Healthcare HMO Rider	$52,096.00
Rate for Payer: United Healthcare Select/Navigate/Core	$47,726.00

MS-DRG 35.00: SPINAL FUSION EXCEPT CERVICAL W/O MCC

Facility

$81,808.00

Service Code	MSDRG 460
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$81,808.00
Rate for Payer: United Healthcare All Other Commercial	$81,808.00
Rate for Payer: United Healthcare All Other HMO	$81,808.00
Rate for Payer: United Healthcare HMO Rider	$32,713.00
Rate for Payer: United Healthcare Select/Navigate/Core	$29,970.00

MS-DRG 35.00: SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS

Facility

$89,789.90

Service Code	MSDRG 029
Min. Negotiated Rate	$25,608.00
Max. Negotiated Rate	$89,789.90
Rate for Payer: United Healthcare All Other Commercial	$76,644.00
Rate for Payer: United Healthcare All Other HMO	$76,644.00
Rate for Payer: United Healthcare HMO Rider	$36,551.00
Rate for Payer: United Healthcare Select/Navigate/Core	$33,485.00

MS-DRG 35.00: 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 35.00: 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 35.00: 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 35.00: 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 35.00: 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 35.00: 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 35.00: 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 35.00: 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 40.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH 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 40.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH 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

Know your out-of-pocket cost for care.

All Charges