Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER CHEMOTHERAPY

Facility IP

$34,005.88

Service Code	APR-DRG 6964
Min. Negotiated Rate	$24,211.64
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$24,211.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$28,852.21

OTHER CHEMOTHERAPY

Facility IP

$34,005.88

Service Code	APR-DRG 6963
Min. Negotiated Rate	$12,180.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$12,180.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$14,515.54

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2074
Min. Negotiated Rate	$15,504.14
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,504.14
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,475.77

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2071
Min. Negotiated Rate	$5,249.82
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,249.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,256.04

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2072
Min. Negotiated Rate	$6,578.23
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,578.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,839.06

OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2073
Min. Negotiated Rate	$9,148.81
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,148.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,902.33

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 315
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

OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 314
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

OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 316
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

OTHER CIRCULATORY SYSTEM O.R. PROCEDURES

Facility IP

$34,005.88

Service Code	TRIS-DRG 264
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

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 1801
Min. Negotiated Rate	$11,616.35
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$11,616.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$13,842.81

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$43,951.05

Service Code	APR-DRG 1804
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$43,951.05
Rate for Payer: Adventist Health Medi-Cal	$36,882.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$43,951.05

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 1802
Min. Negotiated Rate	$14,501.68
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,501.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,281.16

OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 1803
Min. Negotiated Rate	$20,038.24
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$20,038.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$23,878.90

OTHER COMPLICATIONS OF TREATMENT

Facility IP

$34,005.88

Service Code	APR-DRG 8134
Min. Negotiated Rate	$17,482.21
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$17,482.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,832.97

OTHER COMPLICATIONS OF TREATMENT

Facility IP

$34,005.88

Service Code	APR-DRG 8131
Min. Negotiated Rate	$5,459.27
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,459.27
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,505.63

OTHER COMPLICATIONS OF TREATMENT

Facility IP

$34,005.88

Service Code	APR-DRG 8133
Min. Negotiated Rate	$9,753.66
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,753.66
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$11,623.11

OTHER COMPLICATIONS OF TREATMENT

Facility IP

$34,005.88

Service Code	APR-DRG 8132
Min. Negotiated Rate	$6,724.96
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,724.96
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,013.91

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2292
Min. Negotiated Rate	$15,439.19
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,439.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,398.37

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility IP

$47,937.98

Service Code	APR-DRG 2294
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$47,937.98
Rate for Payer: Adventist Health Medi-Cal	$40,227.67
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$47,937.98

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2291
Min. Negotiated Rate	$11,198.56
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$11,198.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$13,344.95

OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2293
Min. Negotiated Rate	$23,312.22
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$23,312.22
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$27,780.40

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2541
Min. Negotiated Rate	$4,853.30
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,853.30
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,783.52

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2543
Min. Negotiated Rate	$9,742.45
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,742.45
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$11,609.76

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2544
Min. Negotiated Rate	$17,119.31
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$17,119.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,400.51

Price Transparency.

All Charges