Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4473
Min. Negotiated Rate	$20,952.22
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$20,952.22
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$24,968.06

OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4472
Min. Negotiated Rate	$15,010.19
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,010.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,887.14

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 278
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 MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 277
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 MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 279
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 MAJOR HEAD AND NECK PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0912
Min. Negotiated Rate	$21,947.96
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$21,947.96
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$26,154.66

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility IP

$46,564.50

Service Code	APR-DRG 0913
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$46,564.50
Rate for Payer: Adventist Health Medi-Cal	$39,075.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$46,564.50

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility IP

$72,952.75

Service Code	APR-DRG 0914
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$72,952.75
Rate for Payer: Adventist Health Medi-Cal	$61,219.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$72,952.75

OTHER MAJOR HEAD AND NECK PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0911
Min. Negotiated Rate	$14,620.40
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,620.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,422.65

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$44,144.59

Service Code	APR-DRG 4844
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$44,144.59
Rate for Payer: Adventist Health Medi-Cal	$37,044.41
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$44,144.59

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4843
Min. Negotiated Rate	$16,805.68
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$16,805.68
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,026.76

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4842
Min. Negotiated Rate	$14,014.44
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,014.44
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$16,700.54

OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 4841
Min. Negotiated Rate	$10,965.59
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,965.59
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$13,067.33

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 729
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 MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 730
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 MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 717
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 MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 718
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 MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 715
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 MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 716
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 MENTAL DISORDER DIAGNOSES

Facility IP

$34,005.88

Service Code	TRIS-DRG 887
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 MENTAL HEALTH DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 7603
Min. Negotiated Rate	$8,820.64
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,820.64
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,511.26

OTHER MENTAL HEALTH DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 7604
Min. Negotiated Rate	$14,792.89
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,792.89
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,628.20

OTHER MENTAL HEALTH DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 7602
Min. Negotiated Rate	$6,303.82
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$6,303.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,512.05

OTHER MENTAL HEALTH DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 7601
Min. Negotiated Rate	$5,128.85
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,128.85
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,111.88

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 964
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