Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 963
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 MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 965
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 3512
Min. Negotiated Rate	$5,986.82
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,986.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$7,134.30

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 3513
Min. Negotiated Rate	$9,268.67
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$9,268.67
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$11,045.16

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 3514
Min. Negotiated Rate	$16,281.48
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$16,281.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$19,402.10

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility IP

$34,005.88

Service Code	APR-DRG 3511
Min. Negotiated Rate	$4,722.25
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,722.25
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,627.35

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 565
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 564
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 566
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 516
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 515
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 517
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 MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3202
Min. Negotiated Rate	$14,562.16
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,562.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$17,353.24

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility IP

$43,128.83

Service Code	APR-DRG 3204
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$43,128.83
Rate for Payer: Adventist Health Medi-Cal	$36,192.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$43,128.83

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3201
Min. Negotiated Rate	$10,510.84
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,510.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$12,525.41

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3203
Min. Negotiated Rate	$21,213.19
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$21,213.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$25,279.05

OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 844
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 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 843
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 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 845
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 NERVOUS SYSTEM AND RELATED PROCEDURES

Facility IP

$52,995.39

Service Code	APR-DRG 0264
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$52,995.39
Rate for Payer: Adventist Health Medi-Cal	$44,471.65
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$52,995.39

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0263
Min. Negotiated Rate	$23,819.62
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$23,819.62
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$28,385.04

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0262
Min. Negotiated Rate	$15,579.19
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,579.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,565.20

OTHER NERVOUS SYSTEM AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0261
Min. Negotiated Rate	$12,297.36
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$12,297.36
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$14,654.35

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4253
Min. Negotiated Rate	$7,129.31
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,129.31
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,495.76

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4254
Min. Negotiated Rate	$14,095.09
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$14,095.09
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$16,796.65

Price Transparency.

All Charges