Loma Linda University Medical Center

All Charges

Charge

Type

Price

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility IP

$41,401.65

Service Code	APR-DRG 3234
Min. Negotiated Rate	$34,742.64
Max. Negotiated Rate	$41,401.65
Rate for Payer: Adventist Health Medi-Cal	$34,742.64
Rate for Payer: IEHP medi-cal	$41,401.65

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility IP

$19,861.26

Service Code	APR-DRG 3231
Min. Negotiated Rate	$16,666.79
Max. Negotiated Rate	$19,861.26
Rate for Payer: Adventist Health Medi-Cal	$16,666.79
Rate for Payer: IEHP medi-cal	$19,861.26

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility IP

$22,302.54

Service Code	APR-DRG 3232
Min. Negotiated Rate	$18,715.42
Max. Negotiated Rate	$22,302.54
Rate for Payer: Adventist Health Medi-Cal	$18,715.42
Rate for Payer: IEHP medi-cal	$22,302.54

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$24,679.76

Service Code	APR-DRG 3251
Min. Negotiated Rate	$20,710.28
Max. Negotiated Rate	$24,679.76
Rate for Payer: Adventist Health Medi-Cal	$20,710.28
Rate for Payer: IEHP medi-cal	$24,679.76

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$28,729.42

Service Code	APR-DRG 3252
Min. Negotiated Rate	$24,108.60
Max. Negotiated Rate	$28,729.42
Rate for Payer: Adventist Health Medi-Cal	$24,108.60
Rate for Payer: IEHP medi-cal	$28,729.42

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$37,920.58

Service Code	APR-DRG 3253
Min. Negotiated Rate	$31,821.47
Max. Negotiated Rate	$37,920.58
Rate for Payer: Adventist Health Medi-Cal	$31,821.47
Rate for Payer: IEHP medi-cal	$37,920.58

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$52,785.83

Service Code	APR-DRG 3254
Min. Negotiated Rate	$44,295.80
Max. Negotiated Rate	$52,785.83
Rate for Payer: Adventist Health Medi-Cal	$44,295.80
Rate for Payer: IEHP medi-cal	$52,785.83

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$10,074.78

Service Code	APR-DRG 7941
Min. Negotiated Rate	$8,454.36
Max. Negotiated Rate	$10,074.78
Rate for Payer: Adventist Health Medi-Cal	$8,454.36
Rate for Payer: IEHP medi-cal	$10,074.78

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$33,720.09

Service Code	APR-DRG 7944
Min. Negotiated Rate	$28,296.58
Max. Negotiated Rate	$33,720.09
Rate for Payer: Adventist Health Medi-Cal	$28,296.58
Rate for Payer: IEHP medi-cal	$33,720.09

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$12,949.87

Service Code	APR-DRG 7942
Min. Negotiated Rate	$10,867.02
Max. Negotiated Rate	$12,949.87
Rate for Payer: Adventist Health Medi-Cal	$10,867.02
Rate for Payer: IEHP medi-cal	$12,949.87

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$18,840.16

Service Code	APR-DRG 7943
Min. Negotiated Rate	$15,809.93
Max. Negotiated Rate	$18,840.16
Rate for Payer: Adventist Health Medi-Cal	$15,809.93
Rate for Payer: IEHP medi-cal	$18,840.16

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$14,643.67

Service Code	APR-DRG 9522
Min. Negotiated Rate	$12,288.40
Max. Negotiated Rate	$14,643.67
Rate for Payer: Adventist Health Medi-Cal	$12,288.40
Rate for Payer: IEHP medi-cal	$14,643.67

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$23,328.98

Service Code	APR-DRG 9523
Min. Negotiated Rate	$19,576.76
Max. Negotiated Rate	$23,328.98
Rate for Payer: Adventist Health Medi-Cal	$19,576.76
Rate for Payer: IEHP medi-cal	$23,328.98

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$41,033.25

Service Code	APR-DRG 9524
Min. Negotiated Rate	$34,433.50
Max. Negotiated Rate	$41,033.25
Rate for Payer: Adventist Health Medi-Cal	$34,433.50
Rate for Payer: IEHP medi-cal	$41,033.25

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$10,632.71

Service Code	APR-DRG 9521
Min. Negotiated Rate	$8,922.55
Max. Negotiated Rate	$10,632.71
Rate for Payer: Adventist Health Medi-Cal	$8,922.55
Rate for Payer: IEHP medi-cal	$10,632.71

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$5,472.52

Service Code	APR-DRG 4261
Min. Negotiated Rate	$4,592.33
Max. Negotiated Rate	$5,472.52
Rate for Payer: Adventist Health Medi-Cal	$4,592.33
Rate for Payer: IEHP medi-cal	$5,472.52

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$10,594.01

Service Code	APR-DRG 4263
Min. Negotiated Rate	$8,890.08
Max. Negotiated Rate	$10,594.01
Rate for Payer: Adventist Health Medi-Cal	$8,890.08
Rate for Payer: IEHP medi-cal	$10,594.01

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$7,247.75

Service Code	APR-DRG 4262
Min. Negotiated Rate	$6,082.03
Max. Negotiated Rate	$7,247.75
Rate for Payer: Adventist Health Medi-Cal	$6,082.03
Rate for Payer: IEHP medi-cal	$7,247.75

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$18,784.11

Service Code	APR-DRG 4264
Min. Negotiated Rate	$15,762.89
Max. Negotiated Rate	$18,784.11
Rate for Payer: Adventist Health Medi-Cal	$15,762.89
Rate for Payer: IEHP medi-cal	$18,784.11

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility IP

$9,551.56

Service Code	APR-DRG 0462
Min. Negotiated Rate	$8,015.29
Max. Negotiated Rate	$9,551.56
Rate for Payer: Adventist Health Medi-Cal	$8,015.29
Rate for Payer: IEHP medi-cal	$9,551.56

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility IP

$7,576.11

Service Code	APR-DRG 0461
Min. Negotiated Rate	$6,357.58
Max. Negotiated Rate	$7,576.11
Rate for Payer: Adventist Health Medi-Cal	$6,357.58
Rate for Payer: IEHP medi-cal	$7,576.11

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility IP

$11,800.63

Service Code	APR-DRG 0463
Min. Negotiated Rate	$9,902.63
Max. Negotiated Rate	$11,800.63
Rate for Payer: Adventist Health Medi-Cal	$9,902.63
Rate for Payer: IEHP medi-cal	$11,800.63

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility IP

$20,710.16

Service Code	APR-DRG 0464
Min. Negotiated Rate	$17,379.16
Max. Negotiated Rate	$20,710.16
Rate for Payer: Adventist Health Medi-Cal	$17,379.16
Rate for Payer: IEHP medi-cal	$20,710.16

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION [10734]

Facility OP

$5.41

Service Code	NDC 70121-1576-7
Hospital Charge Code	1720130
Hospital Revenue Code	250
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$4.87
Rate for Payer: Aetna of CA HMO/PPO	$3.29
Rate for Payer: AlphaCare Medical Group Commercial/Exchange	$4.60
Rate for Payer: AlphaCare Medical Group Medi-Cal	$2.98
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product	$2.98
Rate for Payer: Anthem Blue Cross of CA Exchange	$2.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3.20
Rate for Payer: BCBS Transplant Transplant	$3.25
Rate for Payer: Blue Shield of California Commercial	$3.40
Rate for Payer: Blue Shield of California EPN	$2.65
Rate for Payer: Cash Price	$2.43
Rate for Payer: Cash Price	$2.43
Rate for Payer: Central Health Plan Commercial	$4.33
Rate for Payer: Cigna of CA HMO	$3.46
Rate for Payer: Cigna of CA PPO	$4.00
Rate for Payer: Dignity Health Commercial/Exchange	$4.60
Rate for Payer: EPIC Health Plan Commercial	$2.16
Rate for Payer: EPIC Health Plan Transplant	$2.16
Rate for Payer: Galaxy Health WC	$4.60
Rate for Payer: Global Benefits Group Commercial	$3.25
Rate for Payer: Health Management Network EPO/PPO	$4.87
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other	$4.06
Rate for Payer: IEHP medi-cal	$1.89
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded	$3.61
Rate for Payer: LLUH Dept of Risk Management WC	$1.08
Rate for Payer: Multiplan Commercial	$4.06
Rate for Payer: Networks By Design Commercial	$3.52
Rate for Payer: Prime Health Services Commercial	$4.60
Rate for Payer: Riverside University Health MISP	$2.16
Rate for Payer: Temecula Valley Physicians Medical Group Commercial	$3.25
Rate for Payer: TriValley Medical Group Commercial/Senior	$3.25
Rate for Payer: United Healthcare All Other Commercial	$2.70
Rate for Payer: United Healthcare All Other HMO	$2.70
Rate for Payer: United Healthcare HMO Rider	$2.70
Rate for Payer: United Healthcare Select/Navigate/Core	$2.70
Rate for Payer: Vantage Medical Group Medi-Cal	$4.60
Rate for Payer: Vantage Medical Group Senior	$4.60

NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION [10734]

Facility IP

$6.74

Service Code	NDC 0409-3375-14
Hospital Charge Code	1720130
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$6.07
Rate for Payer: Blue Shield of California Commercial	$5.06
Rate for Payer: Blue Shield of California EPN	$3.60
Rate for Payer: Cash Price	$3.03
Rate for Payer: Central Health Plan Commercial	$5.39
Rate for Payer: EPIC Health Plan Commercial	$2.70
Rate for Payer: Galaxy Health WC	$5.73
Rate for Payer: Global Benefits Group Commercial	$4.04
Rate for Payer: Health Management Network EPO/PPO	$6.07
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded	$4.50
Rate for Payer: LLUH Dept of Risk Management WC	$1.35
Rate for Payer: Multiplan Commercial	$5.06
Rate for Payer: Networks By Design Commercial	$4.38
Rate for Payer: Prime Health Services Commercial	$5.73

Price Transparency.

All Charges