Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 320
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 ESOPHAGEAL DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 2434
Min. Negotiated Rate	$17,423.96
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$17,423.96
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,763.56

OTHER ESOPHAGEAL DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 2432
Min. Negotiated Rate	$6,636.48
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,636.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,908.47

OTHER ESOPHAGEAL DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 2431
Min. Negotiated Rate	$5,160.20
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,160.20
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,149.24

OTHER ESOPHAGEAL DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 2433
Min. Negotiated Rate	$9,674.14
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,674.14
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$11,528.35

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility IP

$34,005.88

Service Code	TRIS-DRG 951
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 FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 5182
Min. Negotiated Rate	$11,750.76
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$11,750.76
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$14,002.99

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 5181
Min. Negotiated Rate	$8,097.06
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,097.06
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$9,649.00

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$43,191.56

Service Code	APR-DRG 5184
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$43,191.56
Rate for Payer: Adventist Health Medi-Cal	$36,244.67
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$43,191.56

OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 5183
Min. Negotiated Rate	$19,762.69
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$19,762.69
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$23,550.54

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 749
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 FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 750
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 GASTROENTERITIS, NAUSEA AND VOMITING

Facility IP

$34,005.88

Service Code	APR-DRG 2491
Min. Negotiated Rate	$4,403.04
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,403.04
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,246.96

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility IP

$34,005.88

Service Code	APR-DRG 2492
Min. Negotiated Rate	$5,504.08
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,504.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,559.02

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility IP

$34,005.88

Service Code	APR-DRG 2493
Min. Negotiated Rate	$7,959.29
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,959.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$9,484.82

OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility IP

$34,005.88

Service Code	APR-DRG 2494
Min. Negotiated Rate	$14,650.64
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,650.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,458.68

OTHER HEART ASSIST SYSTEM IMPLANT

Facility IP

$34,005.88

Service Code	TRIS-DRG 215
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 HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 424
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 HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 423
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 HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 425
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 HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2643
Min. Negotiated Rate	$20,979.10
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$20,979.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$25,000.09

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2641
Min. Negotiated Rate	$13,193.42
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$13,193.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$15,722.16

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2642
Min. Negotiated Rate	$14,434.48
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,434.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,201.08

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility IP

$53,135.54

Service Code	APR-DRG 2644
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$53,135.54
Rate for Payer: Adventist Health Medi-Cal	$44,589.26
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$53,135.54

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility IP

$34,005.88

Service Code	APR-DRG 7242
Min. Negotiated Rate	$6,635.35
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,635.35
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,907.13

Price Transparency.

All Charges