Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$13,325.88

Service Code	APR-DRG 0981
Min. Negotiated Rate	$8,416.34
Max. Negotiated Rate	$13,325.88
Rate for Payer: Adventist Health Medi-Cal	$8,416.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,029.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,325.88

OTHER ENDOCRINE DISORDERS

Facility

$11,364.05

Service Code	APR-DRG 4242
Min. Negotiated Rate	$7,177.30
Max. Negotiated Rate	$11,364.05
Rate for Payer: Adventist Health Medi-Cal	$7,177.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,552.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,364.05

OTHER ENDOCRINE DISORDERS

Facility

$7,901.66

Service Code	APR-DRG 4241
Min. Negotiated Rate	$4,990.52
Max. Negotiated Rate	$7,901.66
Rate for Payer: Adventist Health Medi-Cal	$4,990.52
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,947.04
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,901.66

OTHER ENDOCRINE DISORDERS

Facility

$29,244.02

Service Code	APR-DRG 4244
Min. Negotiated Rate	$18,469.91
Max. Negotiated Rate	$29,244.02
Rate for Payer: Adventist Health Medi-Cal	$18,469.91
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,009.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,244.02

OTHER ENDOCRINE DISORDERS

Facility

$17,221.33

Service Code	APR-DRG 4243
Min. Negotiated Rate	$10,876.63
Max. Negotiated Rate	$17,221.33
Rate for Payer: Adventist Health Medi-Cal	$10,876.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,961.32
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,221.33

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$57,343.84

Service Code	MSDRG 629
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$57,343.84
Rate for Payer: Aetna of CA HMO/PPO	$57,343.84
Rate for Payer: Anthem Blue Cross of CA Exchange	$37,041.78
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$51,859.80
Rate for Payer: EPIC Health Plan Commercial	$51,070.34
Rate for Payer: EPIC Health Plan Senior	$34,046.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,951.72
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$43,332.41
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$41,475.30
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$30,951.72
Rate for Payer: Prime Health Services Medicare	$32,808.82
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 ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$98,085.65

Service Code	MSDRG 628
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$98,085.65
Rate for Payer: Aetna of CA HMO/PPO	$98,085.65
Rate for Payer: Anthem Blue Cross of CA Exchange	$63,359.33
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$88,705.29
Rate for Payer: EPIC Health Plan Commercial	$86,297.97
Rate for Payer: EPIC Health Plan Senior	$57,531.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$52,301.80
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$73,222.52
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$70,084.41
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$52,301.80
Rate for Payer: Prime Health Services Medicare	$55,439.91
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 ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$38,412.58

Service Code	MSDRG 630
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$38,412.58
Rate for Payer: Aetna of CA HMO/PPO	$38,412.58
Rate for Payer: Anthem Blue Cross of CA Exchange	$24,812.96
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,739.02
Rate for Payer: EPIC Health Plan Commercial	$34,701.30
Rate for Payer: EPIC Health Plan Senior	$23,134.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,031.09
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$29,443.53
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$28,181.66
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$21,031.09
Rate for Payer: Prime Health Services Medicare	$22,292.96
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 ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$117,459.07

Service Code	MSDRG 319
Min. Negotiated Rate	$56,595.00
Max. Negotiated Rate	$117,459.07
Rate for Payer: Aetna of CA HMO/PPO	$117,459.07
Rate for Payer: Anthem Blue Cross of CA Exchange	$75,873.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$106,225.95
Rate for Payer: EPIC Health Plan Commercial	$103,049.28
Rate for Payer: EPIC Health Plan Senior	$68,699.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$62,454.11
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$87,435.75
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$83,688.51
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$62,454.11
Rate for Payer: Prime Health Services Medicare	$66,201.36
Rate for Payer: United Healthcare All Other Commercial	$86,080.00
Rate for Payer: United Healthcare All Other HMO	$86,080.00
Rate for Payer: United Healthcare HMO Rider	$61,775.00
Rate for Payer: United Healthcare Select/Navigate/Core	$56,595.00

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$63,305.09

Service Code	MSDRG 320
Min. Negotiated Rate	$32,402.00
Max. Negotiated Rate	$63,305.09
Rate for Payer: Aetna of CA HMO/PPO	$63,305.09
Rate for Payer: Anthem Blue Cross of CA Exchange	$40,892.51
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$57,250.95
Rate for Payer: EPIC Health Plan Commercial	$56,224.72
Rate for Payer: EPIC Health Plan Senior	$37,483.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$34,075.59
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$47,705.83
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$45,661.29
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$34,075.59
Rate for Payer: Prime Health Services Medicare	$36,120.13
Rate for Payer: United Healthcare All Other Commercial	$49,280.00
Rate for Payer: United Healthcare All Other HMO	$49,280.00
Rate for Payer: United Healthcare HMO Rider	$35,366.00
Rate for Payer: United Healthcare Select/Navigate/Core	$32,402.00

OTHER ESOPHAGEAL DISORDERS

Facility

$8,598.58

Service Code	APR-DRG 2431
Min. Negotiated Rate	$5,430.68
Max. Negotiated Rate	$8,598.58
Rate for Payer: Adventist Health Medi-Cal	$5,430.68
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,471.57
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,598.58

OTHER ESOPHAGEAL DISORDERS

Facility

$30,192.71

Service Code	APR-DRG 2434
Min. Negotiated Rate	$19,069.08
Max. Negotiated Rate	$30,192.71
Rate for Payer: Adventist Health Medi-Cal	$19,069.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,723.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,192.71

OTHER ESOPHAGEAL DISORDERS

Facility

$16,552.61

Service Code	APR-DRG 2433
Min. Negotiated Rate	$10,454.28
Max. Negotiated Rate	$16,552.61
Rate for Payer: Adventist Health Medi-Cal	$10,454.28
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,458.02
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,552.61

OTHER ESOPHAGEAL DISORDERS

Facility

$11,480.88

Service Code	APR-DRG 2432
Min. Negotiated Rate	$7,251.08
Max. Negotiated Rate	$11,480.88
Rate for Payer: Adventist Health Medi-Cal	$7,251.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,640.88
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,480.88

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$14,633.36

Service Code	MSDRG 951
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$14,633.36
Rate for Payer: Aetna of CA HMO/PPO	$14,633.36
Rate for Payer: Anthem Blue Cross of CA Exchange	$9,452.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,233.91
Rate for Payer: EPIC Health Plan Commercial	$14,140.45
Rate for Payer: EPIC Health Plan Senior	$9,426.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,569.97
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$11,997.96
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,483.76
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$8,569.97
Rate for Payer: Prime Health Services Medicare	$9,084.17
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 FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$34,223.10

Service Code	APR-DRG 5183
Min. Negotiated Rate	$21,614.59
Max. Negotiated Rate	$34,223.10
Rate for Payer: Adventist Health Medi-Cal	$21,614.59
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$25,757.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$34,223.10

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$13,299.70

Service Code	APR-DRG 5181
Min. Negotiated Rate	$8,399.81
Max. Negotiated Rate	$13,299.70
Rate for Payer: Adventist Health Medi-Cal	$8,399.81
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,009.77
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,299.70

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$21,612.25

Service Code	APR-DRG 5182
Min. Negotiated Rate	$13,649.84
Max. Negotiated Rate	$21,612.25
Rate for Payer: Adventist Health Medi-Cal	$13,649.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,266.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,612.25

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$58,616.96

Service Code	APR-DRG 5184
Min. Negotiated Rate	$37,021.24
Max. Negotiated Rate	$58,616.96
Rate for Payer: Adventist Health Medi-Cal	$37,021.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$44,116.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$58,616.96

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$67,576.66

Service Code	MSDRG 749
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$67,576.66
Rate for Payer: Aetna of CA HMO/PPO	$67,576.66
Rate for Payer: Anthem Blue Cross of CA Exchange	$43,651.77
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$61,114.02
Rate for Payer: EPIC Health Plan Commercial	$59,918.22
Rate for Payer: EPIC Health Plan Senior	$39,945.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$36,314.07
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$50,839.70
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$48,660.85
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$36,314.07
Rate for Payer: Prime Health Services Medicare	$38,492.91
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 FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$38,841.58

Service Code	MSDRG 750
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$38,841.58
Rate for Payer: Aetna of CA HMO/PPO	$38,841.58
Rate for Payer: Anthem Blue Cross of CA Exchange	$25,090.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$35,126.99
Rate for Payer: EPIC Health Plan Commercial	$35,072.25
Rate for Payer: EPIC Health Plan Senior	$23,381.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,255.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$29,758.27
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$28,482.92
Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage	$21,255.91
Rate for Payer: Prime Health Services Medicare	$22,531.26
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 GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$23,968.86

Service Code	APR-DRG 2494
Min. Negotiated Rate	$15,138.23
Max. Negotiated Rate	$23,968.86
Rate for Payer: Adventist Health Medi-Cal	$15,138.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,039.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,968.86

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$9,374.05

Service Code	APR-DRG 2492
Min. Negotiated Rate	$5,920.45
Max. Negotiated Rate	$9,374.05
Rate for Payer: Adventist Health Medi-Cal	$5,920.45
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,055.21
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,374.05

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$13,539.38

Service Code	APR-DRG 2493
Min. Negotiated Rate	$8,551.19
Max. Negotiated Rate	$13,539.38
Rate for Payer: Adventist Health Medi-Cal	$8,551.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,190.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,539.38

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$7,434.38

Service Code	APR-DRG 2491
Min. Negotiated Rate	$4,695.40
Max. Negotiated Rate	$7,434.38
Rate for Payer: Adventist Health Medi-Cal	$4,695.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,595.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,434.38

Know your out-of-pocket cost for care.

All Charges