Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

OTHER BLADDER PROCEDURES

Facility

$21,620.31

Service Code	APR-DRG 4452
Min. Negotiated Rate	$13,654.93
Max. Negotiated Rate	$21,620.31
Rate for Payer: Adventist Health Medi-Cal	$13,654.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,272.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,620.31

OTHER BLADDER PROCEDURES

Facility

$30,222.92

Service Code	APR-DRG 4453
Min. Negotiated Rate	$19,088.16
Max. Negotiated Rate	$30,222.92
Rate for Payer: Adventist Health Medi-Cal	$19,088.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,746.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,222.92

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$37,953.37

Service Code	APR-DRG 1671
Min. Negotiated Rate	$23,970.55
Max. Negotiated Rate	$37,953.37
Rate for Payer: Adventist Health Medi-Cal	$23,970.55
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,564.91
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$37,953.37

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$63,714.87

Service Code	APR-DRG 1673
Min. Negotiated Rate	$40,240.97
Max. Negotiated Rate	$63,714.87
Rate for Payer: Adventist Health Medi-Cal	$40,240.97
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,953.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$63,714.87

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$102,655.21

Service Code	APR-DRG 1674
Min. Negotiated Rate	$64,834.87
Max. Negotiated Rate	$102,655.21
Rate for Payer: Adventist Health Medi-Cal	$64,834.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$77,261.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$102,655.21

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$48,568.16

Service Code	APR-DRG 1672
Min. Negotiated Rate	$30,674.63
Max. Negotiated Rate	$48,568.16
Rate for Payer: Adventist Health Medi-Cal	$30,674.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$36,553.93
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$48,568.16

OTHER CARDIOTHORACIC PROCEDURES WITH MCC

Facility

$130,210.62

Service Code	MSDRG 228
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$130,210.62
Rate for Payer: Aetna of CA HMO/PPO	$130,210.62
Rate for Payer: Anthem Blue Cross of CA Exchange	$84,110.75
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$117,758.01
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: EPIC Health Plan Commercial	$114,075.01
Rate for Payer: EPIC Health Plan Senior	$76,050.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,136.37
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$96,790.92
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$92,642.74
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$69,136.37
Rate for Payer: Prime Health Services Medicare	$73,284.55
Rate for Payer: United Healthcare All Other Commercial	$120,397.00
Rate for Payer: United Healthcare All Other HMO	$120,397.00
Rate for Payer: United Healthcare HMO Rider	$86,872.00
Rate for Payer: United Healthcare Select/Navigate/Core	$79,589.00

OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC

Facility

$82,891.69

Service Code	MSDRG 229
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$82,891.69
Rate for Payer: Aetna of CA HMO/PPO	$82,891.69
Rate for Payer: Anthem Blue Cross of CA Exchange	$53,544.65
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$74,964.40
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: EPIC Health Plan Commercial	$73,160.41
Rate for Payer: EPIC Health Plan Senior	$48,773.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$44,339.64
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$62,075.50
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$59,415.12
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$44,339.64
Rate for Payer: Prime Health Services Medicare	$47,000.02
Rate for Payer: United Healthcare All Other Commercial	$71,243.00
Rate for Payer: United Healthcare All Other HMO	$71,243.00
Rate for Payer: United Healthcare HMO Rider	$68,556.00
Rate for Payer: United Healthcare Select/Navigate/Core	$62,809.00

OTHER CEREBROVASCULAR DISORDERS WITH CC

Facility

$27,003.29

Service Code	MSDRG 071
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$27,003.29
Rate for Payer: Aetna of CA HMO/PPO	$27,003.29
Rate for Payer: Anthem Blue Cross of CA Exchange	$17,443.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$24,420.85
Rate for Payer: EPIC Health Plan Commercial	$24,836.18
Rate for Payer: EPIC Health Plan Senior	$16,557.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,052.23
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$21,073.12
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$20,169.99
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,052.23
Rate for Payer: Prime Health Services Medicare	$15,955.36
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CEREBROVASCULAR DISORDERS WITH MCC

Facility

$43,815.87

Service Code	MSDRG 070
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$43,815.87
Rate for Payer: Aetna of CA HMO/PPO	$43,815.87
Rate for Payer: Anthem Blue Cross of CA Exchange	$28,303.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$39,625.57
Rate for Payer: EPIC Health Plan Commercial	$39,373.29
Rate for Payer: EPIC Health Plan Senior	$26,248.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,862.60
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$33,407.64
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$31,975.88
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$23,862.60
Rate for Payer: Prime Health Services Medicare	$25,294.36
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$19,902.43

Service Code	MSDRG 072
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$19,902.43
Rate for Payer: Aetna of CA HMO/PPO	$19,902.43
Rate for Payer: Anthem Blue Cross of CA Exchange	$12,856.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$17,999.07
Rate for Payer: EPIC Health Plan Commercial	$18,696.38
Rate for Payer: EPIC Health Plan Senior	$12,464.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,331.14
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$15,863.60
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$15,183.73
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$11,331.14
Rate for Payer: Prime Health Services Medicare	$12,011.01
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CHEMOTHERAPY

Facility

$9,992.40

Service Code	APR-DRG 6961
Min. Negotiated Rate	$6,310.99
Max. Negotiated Rate	$9,992.40
Rate for Payer: Adventist Health Medi-Cal	$6,310.99
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,520.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,992.40

OTHER CHEMOTHERAPY

Facility

$19,235.52

Service Code	APR-DRG 6963
Min. Negotiated Rate	$12,148.75
Max. Negotiated Rate	$19,235.52
Rate for Payer: Adventist Health Medi-Cal	$12,148.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,477.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,235.52

OTHER CHEMOTHERAPY

Facility

$12,769.96

Service Code	APR-DRG 6962
Min. Negotiated Rate	$8,065.24
Max. Negotiated Rate	$12,769.96
Rate for Payer: Adventist Health Medi-Cal	$8,065.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,611.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,769.96

OTHER CHEMOTHERAPY

Facility

$36,023.79

Service Code	APR-DRG 6964
Min. Negotiated Rate	$22,751.87
Max. Negotiated Rate	$36,023.79
Rate for Payer: Adventist Health Medi-Cal	$22,751.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,112.64
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$36,023.79

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$27,942.86

Service Code	APR-DRG 2074
Min. Negotiated Rate	$17,648.12
Max. Negotiated Rate	$27,942.86
Rate for Payer: Adventist Health Medi-Cal	$17,648.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,030.68
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,942.86

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$15,168.86

Service Code	APR-DRG 2073
Min. Negotiated Rate	$9,580.33
Max. Negotiated Rate	$15,168.86
Rate for Payer: Adventist Health Medi-Cal	$9,580.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,416.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,168.86

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$8,149.40

Service Code	APR-DRG 2071
Min. Negotiated Rate	$5,146.99
Max. Negotiated Rate	$8,149.40
Rate for Payer: Adventist Health Medi-Cal	$5,146.99
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,133.50
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,149.40

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$10,655.07

Service Code	APR-DRG 2072
Min. Negotiated Rate	$6,729.52
Max. Negotiated Rate	$10,655.07
Rate for Payer: Adventist Health Medi-Cal	$6,729.52
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,019.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,655.07

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$25,353.09

Service Code	MSDRG 315
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$25,353.09
Rate for Payer: Aetna of CA HMO/PPO	$25,353.09
Rate for Payer: Anthem Blue Cross of CA Exchange	$16,377.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$22,928.47
Rate for Payer: EPIC Health Plan Commercial	$23,409.36
Rate for Payer: EPIC Health Plan Senior	$15,606.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,187.49
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$19,862.49
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$19,011.24
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$14,187.49
Rate for Payer: Prime Health Services Medicare	$15,038.74
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$54,880.38

Service Code	MSDRG 314
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$54,880.38
Rate for Payer: Aetna of CA HMO/PPO	$54,880.38
Rate for Payer: Anthem Blue Cross of CA Exchange	$35,450.49
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$49,631.93
Rate for Payer: EPIC Health Plan Commercial	$48,940.29
Rate for Payer: EPIC Health Plan Senior	$32,626.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,660.78
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$41,525.09
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$39,745.45
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$29,660.78
Rate for Payer: Prime Health Services Medicare	$31,440.43
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$17,952.19

Service Code	MSDRG 316
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$17,952.19
Rate for Payer: Aetna of CA HMO/PPO	$17,952.19
Rate for Payer: Anthem Blue Cross of CA Exchange	$11,596.38
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$16,235.34
Rate for Payer: EPIC Health Plan Commercial	$17,010.10
Rate for Payer: EPIC Health Plan Senior	$11,340.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,309.15
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,432.81
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$13,814.26
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$10,309.15
Rate for Payer: Prime Health Services Medicare	$10,927.70
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility

$87,921.25

Service Code	MSDRG 264
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$87,921.25
Rate for Payer: Aetna of CA HMO/PPO	$87,921.25
Rate for Payer: Anthem Blue Cross of CA Exchange	$56,793.54
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$79,512.96
Rate for Payer: EPIC Health Plan Commercial	$77,509.26
Rate for Payer: EPIC Health Plan Senior	$51,672.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$46,975.31
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$65,765.43
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$62,946.92
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$46,975.31
Rate for Payer: Prime Health Services Medicare	$49,793.83
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$19,835.73

Service Code	APR-DRG 1801
Min. Negotiated Rate	$12,527.83
Max. Negotiated Rate	$19,835.73
Rate for Payer: Adventist Health Medi-Cal	$12,527.83
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,929.00
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,835.73

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$34,158.66

Service Code	APR-DRG 1803
Min. Negotiated Rate	$21,573.89
Max. Negotiated Rate	$34,158.66
Rate for Payer: Adventist Health Medi-Cal	$21,573.89
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$25,708.88
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$34,158.66

Know your out-of-pocket cost for care.

All Charges