Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES

Facility

$5,717.63

Service Code	APR-DRG 7511
Min. Negotiated Rate	$3,611.14
Max. Negotiated Rate	$5,717.63
Rate for Payer: Adventist Health Medi-Cal	$3,611.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,303.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,717.63

MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES

Facility

$7,700.36

Service Code	APR-DRG 7512
Min. Negotiated Rate	$4,863.38
Max. Negotiated Rate	$7,700.36
Rate for Payer: Adventist Health Medi-Cal	$4,863.38
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,795.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,700.36

MAJOR ESOPHAGEAL DISORDERS

Facility

$8,675.76

Service Code	APR-DRG 2421
Min. Negotiated Rate	$5,479.43
Max. Negotiated Rate	$8,675.76
Rate for Payer: Adventist Health Medi-Cal	$5,479.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,529.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,675.76

MAJOR ESOPHAGEAL DISORDERS

Facility

$33,027.15

Service Code	APR-DRG 2424
Min. Negotiated Rate	$20,859.25
Max. Negotiated Rate	$33,027.15
Rate for Payer: Adventist Health Medi-Cal	$20,859.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,857.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,027.15

MAJOR ESOPHAGEAL DISORDERS

Facility

$16,094.16

Service Code	APR-DRG 2423
Min. Negotiated Rate	$10,164.73
Max. Negotiated Rate	$16,094.16
Rate for Payer: Adventist Health Medi-Cal	$10,164.73
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,112.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,094.16

MAJOR ESOPHAGEAL DISORDERS

Facility

$11,222.46

Service Code	APR-DRG 2422
Min. Negotiated Rate	$7,087.87
Max. Negotiated Rate	$11,222.46
Rate for Payer: Adventist Health Medi-Cal	$7,087.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,446.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,222.46

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$10,819.87

Service Code	APR-DRG 2482
Min. Negotiated Rate	$6,833.60
Max. Negotiated Rate	$10,819.87
Rate for Payer: Adventist Health Medi-Cal	$6,833.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,143.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,819.87

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$28,889.67

Service Code	APR-DRG 2484
Min. Negotiated Rate	$18,246.11
Max. Negotiated Rate	$28,889.67
Rate for Payer: Adventist Health Medi-Cal	$18,246.11
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,743.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,889.67

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$15,893.75

Service Code	APR-DRG 2483
Min. Negotiated Rate	$10,038.16
Max. Negotiated Rate	$15,893.75
Rate for Payer: Adventist Health Medi-Cal	$10,038.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,962.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,893.75

MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$8,218.22

Service Code	APR-DRG 2481
Min. Negotiated Rate	$5,190.46
Max. Negotiated Rate	$8,218.22
Rate for Payer: Adventist Health Medi-Cal	$5,190.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,185.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,218.22

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$17,417.15

Service Code	APR-DRG 6603
Min. Negotiated Rate	$11,000.30
Max. Negotiated Rate	$17,417.15
Rate for Payer: Adventist Health Medi-Cal	$11,000.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,108.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,417.15

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$11,172.80

Service Code	APR-DRG 6602
Min. Negotiated Rate	$7,056.50
Max. Negotiated Rate	$11,172.80
Rate for Payer: Adventist Health Medi-Cal	$7,056.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,409.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,172.80

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$9,507.52

Service Code	APR-DRG 6601
Min. Negotiated Rate	$6,004.75
Max. Negotiated Rate	$9,507.52
Rate for Payer: Adventist Health Medi-Cal	$6,004.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,155.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,507.52

MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$38,001.71

Service Code	APR-DRG 6604
Min. Negotiated Rate	$24,001.08
Max. Negotiated Rate	$38,001.71
Rate for Payer: Adventist Health Medi-Cal	$24,001.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,601.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,001.71

MAJOR LARGE BOWEL PROCEDURES

Facility

$23,773.24

Service Code	APR-DRG 2311
Min. Negotiated Rate	$15,014.68
Max. Negotiated Rate	$23,773.24
Rate for Payer: Adventist Health Medi-Cal	$15,014.68
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,892.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,773.24

MAJOR LARGE BOWEL PROCEDURES

Facility

$68,414.76

Service Code	APR-DRG 2314
Min. Negotiated Rate	$43,209.32
Max. Negotiated Rate	$68,414.76
Rate for Payer: Adventist Health Medi-Cal	$43,209.32
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$51,491.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$68,414.76

MAJOR LARGE BOWEL PROCEDURES

Facility

$29,191.14

Service Code	APR-DRG 2312
Min. Negotiated Rate	$18,436.51
Max. Negotiated Rate	$29,191.14
Rate for Payer: Adventist Health Medi-Cal	$18,436.51
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,970.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$29,191.14

MAJOR LARGE BOWEL PROCEDURES

Facility

$41,727.74

Service Code	APR-DRG 2313
Min. Negotiated Rate	$26,354.36
Max. Negotiated Rate	$41,727.74
Rate for Payer: Adventist Health Medi-Cal	$26,354.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$31,405.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,727.74

MAJOR MALE PELVIC PROCEDURES

Facility

$57,827.20

Service Code	APR-DRG 4804
Min. Negotiated Rate	$36,522.44
Max. Negotiated Rate	$57,827.20
Rate for Payer: Adventist Health Medi-Cal	$36,522.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$43,522.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$57,827.20

MAJOR MALE PELVIC PROCEDURES

Facility

$23,610.06

Service Code	APR-DRG 4802
Min. Negotiated Rate	$14,911.62
Max. Negotiated Rate	$23,610.06
Rate for Payer: Adventist Health Medi-Cal	$14,911.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,769.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,610.06

MAJOR MALE PELVIC PROCEDURES

Facility

$35,208.50

Service Code	APR-DRG 4803
Min. Negotiated Rate	$22,236.95
Max. Negotiated Rate	$35,208.50
Rate for Payer: Adventist Health Medi-Cal	$22,236.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,499.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,208.50

MAJOR MALE PELVIC PROCEDURES

Facility

$20,541.98

Service Code	APR-DRG 4801
Min. Negotiated Rate	$12,973.88
Max. Negotiated Rate	$20,541.98
Rate for Payer: Adventist Health Medi-Cal	$12,973.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,460.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,541.98

MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$102,521.95

Service Code	APR-DRG 6804
Min. Negotiated Rate	$64,750.70
Max. Negotiated Rate	$102,521.95
Rate for Payer: Adventist Health Medi-Cal	$64,750.70
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$77,161.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$102,521.95

MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$24,661.73

Service Code	APR-DRG 6801
Min. Negotiated Rate	$15,575.83
Max. Negotiated Rate	$24,661.73
Rate for Payer: Adventist Health Medi-Cal	$15,575.83
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,561.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,661.73

MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$32,539.44

Service Code	APR-DRG 6802
Min. Negotiated Rate	$20,551.22
Max. Negotiated Rate	$32,539.44
Rate for Payer: Adventist Health Medi-Cal	$20,551.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,490.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,539.44

Know your out-of-pocket cost for care.

All Charges