Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility IP

$34,005.88

Service Code	APR-DRG 7244
Min. Negotiated Rate	$22,305.28
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$22,305.28
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$26,580.45

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility IP

$34,005.88

Service Code	APR-DRG 7243
Min. Negotiated Rate	$11,069.75
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$11,069.75
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$13,191.45

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility IP

$34,005.88

Service Code	APR-DRG 7241
Min. Negotiated Rate	$5,537.68
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,537.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,599.06

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 868
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 INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 867
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 INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 869
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 INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 8154
Min. Negotiated Rate	$18,703.09
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$18,703.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$22,287.85

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 8153
Min. Negotiated Rate	$8,905.75
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,905.75
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,612.69

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 8152
Min. Negotiated Rate	$5,435.75
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,435.75
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,477.60

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 8151
Min. Negotiated Rate	$3,817.24
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$3,817.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$4,548.87

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 922
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 INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 923
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 KIDNEY AND URINARY TRACT DIAGNOSES AGE 0-17

Facility IP

$34,005.88

Service Code	TRIS-DRG 211
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 KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 699
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 KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 698
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 KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 700
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 KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility IP

$34,005.88

Service Code	APR-DRG 4683
Min. Negotiated Rate	$8,942.72
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,942.72
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,656.75

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility IP

$34,005.88

Service Code	APR-DRG 4681
Min. Negotiated Rate	$4,554.24
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,554.24
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,427.14

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility IP

$34,005.88

Service Code	APR-DRG 4684
Min. Negotiated Rate	$15,675.52
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,675.52
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,679.99

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility IP

$34,005.88

Service Code	APR-DRG 4682
Min. Negotiated Rate	$6,263.48
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,263.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,463.99

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 674
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 KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 673
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 KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 675
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 KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4471
Min. Negotiated Rate	$12,398.16
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$12,398.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$14,774.47

OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility IP

$50,899.82

Service Code	APR-DRG 4474
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$50,899.82
Rate for Payer: Adventist Health Medi-Cal	$42,713.14
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$50,899.82

Price Transparency.

All Charges