Loma Linda University Medical Center

All Charges

Charge

Type

Price

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$34,005.88

Service Code	APR-DRG 3251
Min. Negotiated Rate	$20,710.28
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$20,710.28
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$24,679.76

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$52,785.83

Service Code	APR-DRG 3254
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$52,785.83
Rate for Payer: Adventist Health Medi-Cal	$44,295.80
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$52,785.83

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility IP

$34,005.88

Service Code	APR-DRG 3252
Min. Negotiated Rate	$24,108.60
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$24,108.60
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
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: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$37,920.58

NON-EXTENSIVE BURNS

Facility IP

$34,005.88

Service Code	TRIS-DRG 935
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

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

Facility IP

$34,005.88

Service Code	APR-DRG 7942
Min. Negotiated Rate	$10,867.02
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,867.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$12,949.87

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

Facility IP

$34,005.88

Service Code	APR-DRG 7944
Min. Negotiated Rate	$28,296.58
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$28,296.58
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$33,720.09

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

Facility IP

$34,005.88

Service Code	APR-DRG 7943
Min. Negotiated Rate	$15,809.93
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,809.93
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,840.16

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

Facility IP

$34,005.88

Service Code	APR-DRG 7941
Min. Negotiated Rate	$8,454.36
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,454.36
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,074.78

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 988
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 987
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 989
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

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

Facility IP

$41,033.25

Service Code	APR-DRG 9524
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$41,033.25
Rate for Payer: Adventist Health Medi-Cal	$34,433.50
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$41,033.25

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

Facility IP

$34,005.88

Service Code	APR-DRG 9522
Min. Negotiated Rate	$12,288.40
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$12,288.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$14,643.67

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

Facility IP

$34,005.88

Service Code	APR-DRG 9521
Min. Negotiated Rate	$8,922.55
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,922.55
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,632.71

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

Facility IP

$34,005.88

Service Code	APR-DRG 9523
Min. Negotiated Rate	$19,576.76
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$19,576.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$23,328.98

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4263
Min. Negotiated Rate	$8,890.08
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,890.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,594.01

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4264
Min. Negotiated Rate	$15,762.89
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,762.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,784.11

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4261
Min. Negotiated Rate	$4,592.33
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,592.33
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,472.52

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4262
Min. Negotiated Rate	$6,082.03
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,082.03
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,247.75

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 600
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 601
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 071
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 070
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 072
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88

Price Transparency.

All Charges