Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$59,642.18

Service Code	APR-DRG 1804
Min. Negotiated Rate	$37,668.74
Max. Negotiated Rate	$59,642.18
Rate for Payer: Adventist Health Medi-Cal	$37,668.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$44,888.59
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$59,642.18

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 COMPLICATIONS OF TREATMENT

Facility

$8,542.17

Service Code	APR-DRG 8131
Min. Negotiated Rate	$5,395.06
Max. Negotiated Rate	$8,542.17
Rate for Payer: Adventist Health Medi-Cal	$5,395.06
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,429.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,542.17

OTHER COMPLICATIONS OF TREATMENT

Facility

$16,214.24

Service Code	APR-DRG 8133
Min. Negotiated Rate	$10,240.57
Max. Negotiated Rate	$16,214.24
Rate for Payer: Adventist Health Medi-Cal	$10,240.57
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,203.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,214.24

OTHER COMPLICATIONS OF TREATMENT

Facility

$27,695.12

Service Code	APR-DRG 8134
Min. Negotiated Rate	$17,491.66
Max. Negotiated Rate	$27,695.12
Rate for Payer: Adventist Health Medi-Cal	$17,491.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,844.22
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,695.12

OTHER COMPLICATIONS OF TREATMENT

Facility

$11,317.73

Service Code	APR-DRG 8132
Min. Negotiated Rate	$7,148.04
Max. Negotiated Rate	$11,317.73
Rate for Payer: Adventist Health Medi-Cal	$7,148.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,518.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,317.73

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$17,892.05

Service Code	APR-DRG 2291
Min. Negotiated Rate	$11,300.24
Max. Negotiated Rate	$17,892.05
Rate for Payer: Adventist Health Medi-Cal	$11,300.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,466.12
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,892.05

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$25,048.46

Service Code	APR-DRG 2292
Min. Negotiated Rate	$15,820.08
Max. Negotiated Rate	$25,048.46
Rate for Payer: Adventist Health Medi-Cal	$15,820.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,852.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,048.46

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$61,477.10

Service Code	APR-DRG 2294
Min. Negotiated Rate	$38,827.64
Max. Negotiated Rate	$61,477.10
Rate for Payer: Adventist Health Medi-Cal	$38,827.64
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,269.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$61,477.10

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$38,199.12

Service Code	APR-DRG 2293
Min. Negotiated Rate	$24,125.76
Max. Negotiated Rate	$38,199.12
Rate for Payer: Adventist Health Medi-Cal	$24,125.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,749.86
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$38,199.12

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$27,366.80

Service Code	APR-DRG 2544
Min. Negotiated Rate	$17,284.30
Max. Negotiated Rate	$27,366.80
Rate for Payer: Adventist Health Medi-Cal	$17,284.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,597.12
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$27,366.80

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$8,276.31

Service Code	APR-DRG 2541
Min. Negotiated Rate	$5,227.14
Max. Negotiated Rate	$8,276.31
Rate for Payer: Adventist Health Medi-Cal	$5,227.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,229.01
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,276.31

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$11,400.32

Service Code	APR-DRG 2542
Min. Negotiated Rate	$7,200.20
Max. Negotiated Rate	$11,400.32
Rate for Payer: Adventist Health Medi-Cal	$7,200.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,580.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,400.32

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$16,419.69

Service Code	APR-DRG 2543
Min. Negotiated Rate	$10,370.33
Max. Negotiated Rate	$16,419.69
Rate for Payer: Adventist Health Medi-Cal	$10,370.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,357.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,419.69

OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility

$24,626.69

Service Code	MSDRG 394
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$24,626.69
Rate for Payer: Aetna of CA HMO/PPO	$24,626.69
Rate for Payer: Anthem Blue Cross of CA Exchange	$15,907.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$22,271.53
Rate for Payer: EPIC Health Plan Commercial	$22,781.25
Rate for Payer: EPIC Health Plan Senior	$15,187.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,806.82
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$19,329.55
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$18,501.14
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$13,806.82
Rate for Payer: Prime Health Services Medicare	$14,635.23
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 DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility

$42,091.98

Service Code	MSDRG 393
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$42,091.98
Rate for Payer: Aetna of CA HMO/PPO	$42,091.98
Rate for Payer: Anthem Blue Cross of CA Exchange	$27,189.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$38,066.54
Rate for Payer: EPIC Health Plan Commercial	$37,882.70
Rate for Payer: EPIC Health Plan Senior	$25,255.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,959.21
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$32,142.89
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$30,765.34
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$22,959.21
Rate for Payer: Prime Health Services Medicare	$24,336.76
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 DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$17,081.03

Service Code	MSDRG 395
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$17,081.03
Rate for Payer: Aetna of CA HMO/PPO	$17,081.03
Rate for Payer: Anthem Blue Cross of CA Exchange	$11,033.65
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$15,447.50
Rate for Payer: EPIC Health Plan Commercial	$16,256.84
Rate for Payer: EPIC Health Plan Senior	$10,837.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,852.63
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$13,793.68
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$13,202.52
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$9,852.63
Rate for Payer: Prime Health Services Medicare	$10,443.79
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility

$61,204.83

Service Code	MSDRG 357
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$61,204.83
Rate for Payer: Aetna of CA HMO/PPO	$61,204.83
Rate for Payer: Anthem Blue Cross of CA Exchange	$39,535.83
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$55,351.55
Rate for Payer: EPIC Health Plan Commercial	$54,408.77
Rate for Payer: EPIC Health Plan Senior	$36,272.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,975.01
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$46,165.01
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$44,186.51
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$32,975.01
Rate for Payer: Prime Health Services Medicare	$34,953.51
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility

$115,614.10

Service Code	MSDRG 356
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$115,614.10
Rate for Payer: Aetna of CA HMO/PPO	$115,614.10
Rate for Payer: Anthem Blue Cross of CA Exchange	$74,681.99
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$104,557.43
Rate for Payer: EPIC Health Plan Commercial	$101,454.06
Rate for Payer: EPIC Health Plan Senior	$67,636.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$61,487.31
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$86,082.23
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$82,393.00
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$61,487.31
Rate for Payer: Prime Health Services Medicare	$65,176.55
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$36,791.33

Service Code	MSDRG 358
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$36,791.33
Rate for Payer: Aetna of CA HMO/PPO	$36,791.33
Rate for Payer: Anthem Blue Cross of CA Exchange	$23,765.70
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$33,272.82
Rate for Payer: EPIC Health Plan Commercial	$33,299.46
Rate for Payer: EPIC Health Plan Senior	$22,199.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,181.49
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$28,254.09
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$27,043.20
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$20,181.49
Rate for Payer: Prime Health Services Medicare	$21,392.38
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 DISORDERS OF NERVOUS SYSTEM

Facility

$30,521.03

Service Code	APR-DRG 0584
Min. Negotiated Rate	$19,276.44
Max. Negotiated Rate	$30,521.03
Rate for Payer: Adventist Health Medi-Cal	$19,276.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,971.09
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,521.03

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$22,947.67

Service Code	APR-DRG 0583
Min. Negotiated Rate	$14,493.26
Max. Negotiated Rate	$22,947.67
Rate for Payer: Adventist Health Medi-Cal	$14,493.26
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,271.14
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,947.67

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$16,345.15

Service Code	APR-DRG 0582
Min. Negotiated Rate	$10,323.25
Max. Negotiated Rate	$16,345.15
Rate for Payer: Adventist Health Medi-Cal	$10,323.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,301.88
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,345.15

OTHER DISORDERS OF NERVOUS SYSTEM

Facility

$10,912.88

Service Code	APR-DRG 0581
Min. Negotiated Rate	$6,892.34
Max. Negotiated Rate	$10,912.88
Rate for Payer: Adventist Health Medi-Cal	$6,892.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,213.38
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,912.88

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$26,924.34

Service Code	MSDRG 092
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$26,924.34
Rate for Payer: Aetna of CA HMO/PPO	$26,924.34
Rate for Payer: Anthem Blue Cross of CA Exchange	$17,392.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$24,349.45
Rate for Payer: EPIC Health Plan Commercial	$24,767.95
Rate for Payer: EPIC Health Plan Senior	$16,511.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,010.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$21,015.23
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$20,114.58
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$15,010.88
Rate for Payer: Prime Health Services Medicare	$15,911.53
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

Know your out-of-pocket cost for care.

All Charges