Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 2542
Min. Negotiated Rate	$6,775.37
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,775.37
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,073.98

OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17

Facility IP

$34,005.88

Service Code	TRIS-DRG 160
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 DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 394
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 DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 393
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 DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 395
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 357
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 356
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 DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 358
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 DISORDERS OF NERVOUS SYSTEM

Facility IP

$34,005.88

Service Code	APR-DRG 0583
Min. Negotiated Rate	$13,498.08
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$13,498.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$16,085.21

OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$34,005.88

Service Code	APR-DRG 0584
Min. Negotiated Rate	$18,783.74
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$18,783.74
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$22,383.96

OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$34,005.88

Service Code	APR-DRG 0581
Min. Negotiated Rate	$7,678.15
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,678.15
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$9,149.80

OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$34,005.88

Service Code	APR-DRG 0582
Min. Negotiated Rate	$10,303.62
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,303.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$12,278.48

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 092
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 DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 091
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 DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 093
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 DISORDERS OF THE EYE AGE 0-17

Facility IP

$34,005.88

Service Code	TRIS-DRG 109
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 DISORDERS OF THE EYE AGE >17 WITH MCC OR THROMBOLYTIC AGENT

Facility IP

$34,005.88

Service Code	TRIS-DRG 124
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 DISORDERS OF THE EYE AGE >17 WITHOUT MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 125
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 DISORDERS OF THE LIVER

Facility IP

$34,005.88

Service Code	APR-DRG 2834
Min. Negotiated Rate	$17,261.56
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$17,261.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,570.02

OTHER DISORDERS OF THE LIVER

Facility IP

$34,005.88

Service Code	APR-DRG 2832
Min. Negotiated Rate	$6,327.34
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,327.34
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,540.08

OTHER DISORDERS OF THE LIVER

Facility IP

$34,005.88

Service Code	APR-DRG 2831
Min. Negotiated Rate	$4,944.04
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,944.04
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,891.64

OTHER DISORDERS OF THE LIVER

Facility IP

$34,005.88

Service Code	APR-DRG 2833
Min. Negotiated Rate	$9,205.93
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,205.93
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,970.40

OTHER DRUG ABUSE AND DEPENDENCE

Facility IP

$34,005.88

Service Code	APR-DRG 7762
Min. Negotiated Rate	$4,302.23
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,302.23
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,126.82

OTHER DRUG ABUSE AND DEPENDENCE

Facility IP

$34,005.88

Service Code	APR-DRG 7763
Min. Negotiated Rate	$7,522.45
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,522.45
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,964.26

OTHER DRUG ABUSE AND DEPENDENCE

Facility IP

$34,005.88

Service Code	APR-DRG 7761
Min. Negotiated Rate	$3,924.76
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$3,924.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$4,677.00

Price Transparency.

All Charges