Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 33.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC

Facility

$93,464.03

Service Code	MSDRG 492
Min. Negotiated Rate	$21,433.00
Max. Negotiated Rate	$93,464.03
Rate for Payer: United Healthcare All Other Commercial	$37,370.00
Rate for Payer: United Healthcare All Other HMO	$38,031.00
Rate for Payer: United Healthcare HMO Rider	$28,889.00
Rate for Payer: United Healthcare Select/Navigate/Core	$26,467.00

MS-DRG 33.00: LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC

Facility

$49,621.84

Service Code	MSDRG 494
Min. Negotiated Rate	$15,056.00
Max. Negotiated Rate	$49,621.84
Rate for Payer: United Healthcare All Other Commercial	$29,464.00
Rate for Payer: United Healthcare All Other HMO	$21,638.00
Rate for Payer: United Healthcare HMO Rider	$16,434.00
Rate for Payer: United Healthcare Select/Navigate/Core	$15,056.00

MS-DRG 33.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC

Facility

$86,028.92

Service Code	MSDRG 469
Min. Negotiated Rate	$23,506.00
Max. Negotiated Rate	$86,028.92
Rate for Payer: United Healthcare All Other Commercial	$41,904.00
Rate for Payer: United Healthcare All Other HMO	$38,803.00
Rate for Payer: United Healthcare HMO Rider	$34,363.00
Rate for Payer: United Healthcare Select/Navigate/Core	$31,483.00

MS-DRG 33.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC

Facility

$53,685.00

Service Code	MSDRG 470
Min. Negotiated Rate	$23,467.00
Max. Negotiated Rate	$53,685.00
Rate for Payer: United Healthcare All Other Commercial	$53,685.00
Rate for Payer: United Healthcare All Other HMO	$33,721.00
Rate for Payer: United Healthcare HMO Rider	$25,615.00
Rate for Payer: United Healthcare Select/Navigate/Core	$23,467.00

MS-DRG 33.00: MAJOR MALE PELVIC PROCEDURES W CC/MCC

Facility

$51,074.65

Service Code	MSDRG 707
Min. Negotiated Rate	$22,398.00
Max. Negotiated Rate	$51,074.65
Rate for Payer: United Healthcare All Other Commercial	$24,996.00
Rate for Payer: United Healthcare All Other HMO	$24,494.00
Rate for Payer: United Healthcare HMO Rider	$24,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,398.00

MS-DRG 33.00: MAJOR MALE PELVIC PROCEDURES W/O CC/MCC

Facility

$39,017.92

Service Code	MSDRG 708
Min. Negotiated Rate	$21,000.28
Max. Negotiated Rate	$39,017.92
Rate for Payer: United Healthcare All Other Commercial	$24,996.00
Rate for Payer: United Healthcare All Other HMO	$24,494.00
Rate for Payer: United Healthcare HMO Rider	$24,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,398.00

MS-DRG 33.00: MEDICAL BACK PROBLEMS W MCC

Facility

$59,884.00

Service Code	MSDRG 551
Min. Negotiated Rate	$13,734.00
Max. Negotiated Rate	$59,884.00
Rate for Payer: United Healthcare All Other Commercial	$59,884.00
Rate for Payer: United Healthcare All Other HMO	$19,739.00
Rate for Payer: United Healthcare HMO Rider	$14,990.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,734.00

MS-DRG 33.00: MEDICAL BACK PROBLEMS W/O MCC

Facility

$59,884.00

Service Code	MSDRG 552
Min. Negotiated Rate	$13,778.00
Max. Negotiated Rate	$59,884.00
Rate for Payer: United Healthcare All Other Commercial	$59,884.00
Rate for Payer: United Healthcare All Other HMO	$19,797.00
Rate for Payer: United Healthcare HMO Rider	$15,038.00
Rate for Payer: United Healthcare Select/Navigate/Core	$13,778.00

MS-DRG 33.00: O.R. PROCEDURES FOR OBESITY W CC

Facility

$42,031.44

Service Code	MSDRG 620
Min. Negotiated Rate	$12,116.00
Max. Negotiated Rate	$42,031.44
Rate for Payer: Networks By Design Commercial	$20,000.00
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,337.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 33.00: O.R. PROCEDURES FOR OBESITY W MCC

Facility

$71,758.75

Service Code	MSDRG 619
Min. Negotiated Rate	$12,116.00
Max. Negotiated Rate	$71,758.75
Rate for Payer: Networks By Design Commercial	$20,000.00
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,337.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 33.00: O.R. PROCEDURES FOR OBESITY W/O CC/MCC

Facility

$38,473.11

Service Code	MSDRG 621
Min. Negotiated Rate	$12,116.00
Max. Negotiated Rate	$38,473.11
Rate for Payer: Networks By Design Commercial	$20,000.00
Rate for Payer: United Healthcare All Other Commercial	$28,919.00
Rate for Payer: United Healthcare All Other HMO	$28,337.00
Rate for Payer: United Healthcare HMO Rider	$28,283.00
Rate for Payer: United Healthcare Select/Navigate/Core	$25,912.00

MS-DRG 33.00: OTHER CARDIOTHORACIC PROCEDURES W CC

Facility

$81,754.71

Service Code	MSDRG 229
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$81,754.71
Rate for Payer: United Healthcare All Other Commercial	$71,243.00
Rate for Payer: United Healthcare All Other HMO	$65,974.00
Rate for Payer: United Healthcare HMO Rider	$68,556.00
Rate for Payer: United Healthcare Select/Navigate/Core	$62,809.00

MS-DRG 33.00: OTHER CARDIOTHORACIC PROCEDURES W MCC

Facility

$131,155.47

Service Code	MSDRG 228
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$131,155.47
Rate for Payer: United Healthcare All Other Commercial	$120,397.00
Rate for Payer: United Healthcare All Other HMO	$83,596.00
Rate for Payer: United Healthcare HMO Rider	$86,872.00
Rate for Payer: United Healthcare Select/Navigate/Core	$79,589.00

MS-DRG 33.00: OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC

Facility

$81,188.00

Service Code	MSDRG 230
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$81,188.00
Rate for Payer: United Healthcare All Other HMO	$81,188.00
Rate for Payer: United Healthcare HMO Rider	$61,670.00
Rate for Payer: United Healthcare Select/Navigate/Core	$56,499.00

MS-DRG 33.00: OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$278,844.54

Service Code	MSDRG 215
Min. Negotiated Rate	$144,650.00
Max. Negotiated Rate	$278,844.54
Rate for Payer: United Healthcare All Other Commercial	$200,732.00
Rate for Payer: United Healthcare All Other HMO	$207,861.00
Rate for Payer: United Healthcare HMO Rider	$157,887.00
Rate for Payer: United Healthcare Select/Navigate/Core	$144,650.00

MS-DRG 33.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC

Facility

$90,653.16

Service Code	MSDRG 271
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$90,653.16
Rate for Payer: United Healthcare All Other Commercial	$63,629.00
Rate for Payer: United Healthcare All Other HMO	$55,944.00
Rate for Payer: United Healthcare HMO Rider	$42,494.00
Rate for Payer: United Healthcare Select/Navigate/Core	$38,930.00

MS-DRG 33.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC

Facility

$135,095.43

Service Code	MSDRG 270
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$135,095.43
Rate for Payer: United Healthcare All Other Commercial	$95,869.00
Rate for Payer: United Healthcare All Other HMO	$84,289.00
Rate for Payer: United Healthcare HMO Rider	$64,025.00
Rate for Payer: United Healthcare Select/Navigate/Core	$58,657.00

MS-DRG 33.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC

Facility

$65,855.40

Service Code	MSDRG 272
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$65,855.40
Rate for Payer: United Healthcare All Other Commercial	$45,573.00
Rate for Payer: United Healthcare All Other HMO	$40,069.00
Rate for Payer: United Healthcare HMO Rider	$30,435.00
Rate for Payer: United Healthcare Select/Navigate/Core	$27,883.00

MS-DRG 33.00: OTHER VASCULAR PROCEDURES W CC

Facility

$67,192.41

Service Code	MSDRG 253
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$67,192.41
Rate for Payer: United Healthcare All Other Commercial	$43,936.00
Rate for Payer: United Healthcare All Other HMO	$38,236.00
Rate for Payer: United Healthcare HMO Rider	$29,046.00
Rate for Payer: United Healthcare Select/Navigate/Core	$26,610.00

MS-DRG 33.00: OTHER VASCULAR PROCEDURES W MCC

Facility

$90,284.70

Service Code	MSDRG 252
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$90,284.70
Rate for Payer: United Healthcare All Other Commercial	$42,180.00
Rate for Payer: United Healthcare All Other HMO	$41,854.00
Rate for Payer: United Healthcare HMO Rider	$31,795.00
Rate for Payer: United Healthcare Select/Navigate/Core	$29,128.00

MS-DRG 33.00: OTHER VASCULAR PROCEDURES W/O CC/MCC

Facility

$56,697.00

Service Code	MSDRG 254
Min. Negotiated Rate	$19,823.00
Max. Negotiated Rate	$56,697.00
Rate for Payer: United Healthcare All Other Commercial	$56,697.00
Rate for Payer: United Healthcare All Other HMO	$28,481.00
Rate for Payer: United Healthcare HMO Rider	$21,636.00
Rate for Payer: United Healthcare Select/Navigate/Core	$19,823.00

MS-DRG 33.00: PANCREAS TRANSPLANT

Facility

$209,841.39

Service Code	MSDRG 010
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$209,841.39
Rate for Payer: Networks By Design Commercial	$60,000.00

MS-DRG 33.00: PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC

Facility

$31,948.63

Service Code	MSDRG 735
Min. Negotiated Rate	$17,337.80
Max. Negotiated Rate	$31,948.63
Rate for Payer: United Healthcare All Other Commercial	$24,996.00
Rate for Payer: United Healthcare All Other HMO	$24,494.00
Rate for Payer: United Healthcare HMO Rider	$24,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$22,398.00

MS-DRG 33.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS

Facility

$39,873.00

Service Code	MSDRG 246
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$39,873.00
Rate for Payer: United Healthcare All Other HMO	$39,873.00
Rate for Payer: United Healthcare HMO Rider	$30,287.00
Rate for Payer: United Healthcare Select/Navigate/Core	$27,748.00

MS-DRG 33.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC

Facility

$37,475.00

Service Code	MSDRG 247
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$37,475.00
Rate for Payer: United Healthcare All Other HMO	$37,475.00
Rate for Payer: United Healthcare HMO Rider	$28,460.00
Rate for Payer: United Healthcare Select/Navigate/Core	$26,075.00

Know your out-of-pocket cost for care.

All Charges