Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 40.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT 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 40.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH 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 40.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH 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 40.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT 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 40.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH 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 40.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH 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 40.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT 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 40.00: AICD GENERATOR PROCEDURES

Facility

$120,077.81

Service Code	MSDRG 245
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$120,077.81
Rate for Payer: Heritage Provider Network Commercial/Senior	$9,547.00

MS-DRG 40.00: AICD LEAD PROCEDURES

Facility

$95,227.41

Service Code	MSDRG 265
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$95,227.41
Rate for Payer: Heritage Provider Network Commercial/Senior	$9,547.00

MS-DRG 40.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC

Facility

$181,019.45

Service Code	MSDRG 268
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$181,019.45
Rate for Payer: Heritage Provider Network Commercial/Senior	$25,651.00
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 HMO Rider	$84,927.00
Rate for Payer: United Healthcare Select/Navigate/Core	$77,806.00

MS-DRG 40.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC

Facility

$111,150.40

Service Code	MSDRG 269
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$111,150.40
Rate for Payer: Heritage Provider Network Commercial/Senior	$25,651.00
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 40.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH 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 40.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR

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 40.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT 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 40.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH 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

MS-DRG 40.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC

Facility

$70,008.54

Service Code	MSDRG 462
Min. Negotiated Rate	$36,596.00
Max. Negotiated Rate	$70,008.54
Rate for Payer: United Healthcare All Other Commercial	$52,127.00
Rate for Payer: United Healthcare All Other HMO	$52,127.00
Rate for Payer: United Healthcare HMO Rider	$39,944.00
Rate for Payer: United Healthcare Select/Navigate/Core	$36,596.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC

Facility

$124,263.00

Service Code	MSDRG 222
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$124,263.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$124,263.00
Rate for Payer: United Healthcare HMO Rider	$119,757.00
Rate for Payer: United Healthcare Select/Navigate/Core	$109,717.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC

Facility

$106,570.00

Service Code	MSDRG 223
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$106,570.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$106,570.00
Rate for Payer: United Healthcare HMO Rider	$94,546.00
Rate for Payer: United Healthcare Select/Navigate/Core	$86,620.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC

Facility

$113,336.00

Service Code	MSDRG 224
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$113,336.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$113,336.00
Rate for Payer: United Healthcare HMO Rider	$101,501.00
Rate for Payer: United Healthcare Select/Navigate/Core	$92,990.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC

Facility

$101,501.00

Service Code	MSDRG 225
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$101,501.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$97,504.00
Rate for Payer: United Healthcare HMO Rider	$101,501.00
Rate for Payer: United Healthcare Select/Navigate/Core	$92,990.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$92,297.00

Service Code	MSDRG 226
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$92,297.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$92,297.00
Rate for Payer: United Healthcare HMO Rider	$91,296.00
Rate for Payer: United Healthcare Select/Navigate/Core	$83,643.00

MS-DRG 40.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$91,296.00

Service Code	MSDRG 227
Min. Negotiated Rate	$12,764.00
Max. Negotiated Rate	$91,296.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$12,764.00
Rate for Payer: United Healthcare All Other HMO	$78,692.00
Rate for Payer: United Healthcare HMO Rider	$91,296.00
Rate for Payer: United Healthcare Select/Navigate/Core	$83,643.00

MS-DRG 40.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$82,696.93

Service Code	MSDRG 258
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$82,696.93
Rate for Payer: Heritage Provider Network Commercial/Senior	$7,978.00
Rate for Payer: United Healthcare All Other Commercial	$38,532.00
Rate for Payer: United Healthcare All Other HMO	$38,532.00
Rate for Payer: United Healthcare HMO Rider	$23,768.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,774.00

MS-DRG 40.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$53,219.65

Service Code	MSDRG 259
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$53,219.65
Rate for Payer: Heritage Provider Network Commercial/Senior	$7,978.00
Rate for Payer: United Healthcare All Other Commercial	$38,532.00
Rate for Payer: United Healthcare All Other HMO	$38,532.00
Rate for Payer: United Healthcare HMO Rider	$23,768.00
Rate for Payer: United Healthcare Select/Navigate/Core	$21,774.00

MS-DRG 40.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility

$51,377.00

Service Code	MSDRG 261
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$51,377.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$7,978.00
Rate for Payer: United Healthcare All Other Commercial	$51,377.00
Rate for Payer: United Healthcare All Other HMO	$51,377.00
Rate for Payer: United Healthcare HMO Rider	$31,691.00
Rate for Payer: United Healthcare Select/Navigate/Core	$29,035.00

Know your out-of-pocket cost for care.

All Charges