Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$85,610.44

Service Code	MSDRG 260
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$85,610.44
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

MS-DRG 40.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility

$51,377.00

Service Code	MSDRG 262
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

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$173,055.32

Service Code	MSDRG 217
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$173,055.32
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$126,798.00
Rate for Payer: United Healthcare All Other HMO	$126,798.00
Rate for Payer: United Healthcare HMO Rider	$97,715.00
Rate for Payer: United Healthcare Select/Navigate/Core	$89,522.00

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$257,473.51

Service Code	MSDRG 216
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$257,473.51
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$155,615.00
Rate for Payer: United Healthcare All Other HMO	$155,615.00
Rate for Payer: United Healthcare HMO Rider	$119,917.00
Rate for Payer: United Healthcare Select/Navigate/Core	$109,864.00

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$173,055.32

Service Code	MSDRG 218
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$173,055.32
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$164,634.00
Rate for Payer: United Healthcare All Other HMO	$164,634.00
Rate for Payer: United Healthcare HMO Rider	$88,410.00
Rate for Payer: United Healthcare Select/Navigate/Core	$80,997.00

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

$140,353.96

Service Code	MSDRG 220
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$140,353.96
Rate for Payer: United Healthcare HMO Rider	$111,169.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$117,371.00
Rate for Payer: United Healthcare All Other HMO	$117,371.00
Rate for Payer: United Healthcare Select/Navigate/Core	$101,848.00

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$202,085.18

Service Code	MSDRG 219
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$202,085.18
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$147,690.00
Rate for Payer: United Healthcare All Other HMO	$147,690.00
Rate for Payer: United Healthcare HMO Rider	$111,169.00
Rate for Payer: United Healthcare Select/Navigate/Core	$101,848.00

MS-DRG 40.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$171,252.00

Service Code	MSDRG 221
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$171,252.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$30,123.00
Rate for Payer: United Healthcare All Other Commercial	$171,252.00
Rate for Payer: United Healthcare All Other HMO	$171,252.00
Rate for Payer: United Healthcare HMO Rider	$111,169.00
Rate for Payer: United Healthcare Select/Navigate/Core	$101,848.00

MS-DRG 40.00: CERVICAL SPINAL FUSION WITH CC

Facility

$77,538.41

Service Code	MSDRG 472
Min. Negotiated Rate	$22,650.00
Max. Negotiated Rate	$77,538.41
Rate for Payer: Heritage Provider Network Commercial/Senior	$24,564.00
Rate for Payer: United Healthcare All Other Commercial	$30,096.00
Rate for Payer: United Healthcare All Other HMO	$30,096.00
Rate for Payer: United Healthcare HMO Rider	$24,721.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,650.00

MS-DRG 40.00: CERVICAL SPINAL FUSION WITH MCC

Facility

$127,086.56

Service Code	MSDRG 471
Min. Negotiated Rate	$24,564.00
Max. Negotiated Rate	$127,086.56
Rate for Payer: Heritage Provider Network Commercial/Senior	$24,564.00
Rate for Payer: United Healthcare All Other Commercial	$42,108.00
Rate for Payer: United Healthcare All Other HMO	$42,108.00
Rate for Payer: United Healthcare HMO Rider	$34,591.00
Rate for Payer: United Healthcare Select/Navigate/Core	$31,692.00

MS-DRG 40.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC

Facility

$64,252.57

Service Code	MSDRG 473
Min. Negotiated Rate	$22,963.00
Max. Negotiated Rate	$64,252.57
Rate for Payer: Heritage Provider Network Commercial/Senior	$24,564.00
Rate for Payer: United Healthcare All Other Commercial	$42,292.00
Rate for Payer: United Healthcare All Other HMO	$42,292.00
Rate for Payer: United Healthcare HMO Rider	$25,065.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,963.00

MS-DRG 40.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$58,238.68

Service Code	MSDRG 286
Min. Negotiated Rate	$4,504.00
Max. Negotiated Rate	$58,238.68
Rate for Payer: Heritage Provider Network Commercial/Senior	$4,504.00
Rate for Payer: United Healthcare All Other Commercial	$20,829.00
Rate for Payer: United Healthcare All Other HMO	$20,829.00
Rate for Payer: United Healthcare HMO Rider	$15,202.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,927.00

MS-DRG 40.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$28,163.96

Service Code	MSDRG 287
Min. Negotiated Rate	$4,504.00
Max. Negotiated Rate	$28,163.96
Rate for Payer: Heritage Provider Network Commercial/Senior	$4,504.00
Rate for Payer: United Healthcare All Other Commercial	$27,003.00
Rate for Payer: United Healthcare All Other HMO	$27,003.00
Rate for Payer: United Healthcare HMO Rider	$14,707.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,475.00

MS-DRG 40.00: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC

Facility

$128,918.00

Service Code	MSDRG 454
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$128,918.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$29,434.00
Rate for Payer: United Healthcare All Other Commercial	$128,918.00
Rate for Payer: United Healthcare All Other HMO	$128,918.00
Rate for Payer: United Healthcare HMO Rider	$75,453.00
Rate for Payer: United Healthcare Select/Navigate/Core	$69,126.00

MS-DRG 40.00: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC

Facility

$152,808.00

Service Code	MSDRG 453
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$152,808.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$29,434.00
Rate for Payer: United Healthcare All Other Commercial	$152,808.00
Rate for Payer: United Healthcare All Other HMO	$152,808.00
Rate for Payer: United Healthcare HMO Rider	$96,665.00
Rate for Payer: United Healthcare Select/Navigate/Core	$88,562.00

MS-DRG 40.00: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC

Facility

$111,708.00

Service Code	MSDRG 455
Min. Negotiated Rate	$29,434.00
Max. Negotiated Rate	$111,708.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$29,434.00
Rate for Payer: United Healthcare All Other Commercial	$111,708.00
Rate for Payer: United Healthcare All Other HMO	$111,708.00
Rate for Payer: United Healthcare HMO Rider	$63,390.00
Rate for Payer: United Healthcare Select/Navigate/Core	$58,075.00

MS-DRG 40.00: CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$65,315.86

Service Code	MSDRG 545
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$65,315.86
Rate for Payer: Heritage Provider Network Commercial/Senior	$17,258.00

MS-DRG 40.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC

Facility

$201,214.02

Service Code	MSDRG 233
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$201,214.02
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
Rate for Payer: United Healthcare All Other Commercial	$143,136.00
Rate for Payer: United Healthcare All Other HMO	$143,136.00
Rate for Payer: United Healthcare HMO Rider	$80,682.00
Rate for Payer: United Healthcare Select/Navigate/Core	$73,919.00

MS-DRG 40.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC

Facility

$143,772.80

Service Code	MSDRG 234
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$143,772.80
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
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 40.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$154,455.68

Service Code	MSDRG 235
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$154,455.68
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
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 40.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$110,245.03

Service Code	MSDRG 236
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$110,245.03
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
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 40.00: CORONARY BYPASS WITH PTCA WITH 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 HMO Rider	$94,080.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
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 Select/Navigate/Core	$86,191.00

MS-DRG 40.00: CORONARY BYPASS WITH PTCA WITHOUT MCC

Facility

$159,561.57

Service Code	MSDRG 232
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$159,561.57
Rate for Payer: Heritage Provider Network Commercial/Senior	$33,409.00
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 40.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC

Facility

$216,703.00

Service Code	MSDRG 266
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$216,703.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$25,651.00
Rate for Payer: United Healthcare All Other Commercial	$216,703.00
Rate for Payer: United Healthcare All Other HMO	$216,703.00
Rate for Payer: United Healthcare HMO Rider	$155,367.00
Rate for Payer: United Healthcare Select/Navigate/Core	$142,342.00

MS-DRG 40.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC

Facility

$162,712.00

Service Code	MSDRG 267
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$162,712.00
Rate for Payer: Heritage Provider Network Commercial/Senior	$25,651.00
Rate for Payer: United Healthcare All Other Commercial	$162,712.00
Rate for Payer: United Healthcare All Other HMO	$162,712.00
Rate for Payer: United Healthcare HMO Rider	$116,659.00
Rate for Payer: United Healthcare Select/Navigate/Core	$106,879.00

Know your out-of-pocket cost for care.

All Charges