Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 4251
Min. Negotiated Rate	$4,301.11
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,301.11
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,125.49

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 OPEN CRANIOTOMY

Facility IP

$34,005.88

Service Code	APR-DRG 0272
Min. Negotiated Rate	$19,032.40
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$19,032.40
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$22,680.27

OTHER OPEN CRANIOTOMY

Facility IP

$34,005.88

Service Code	APR-DRG 0271
Min. Negotiated Rate	$16,349.81
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$16,349.81
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$19,483.52

OTHER OPEN CRANIOTOMY

Facility IP

$60,759.70

Service Code	APR-DRG 0274
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$60,759.70
Rate for Payer: Adventist Health Medi-Cal	$50,987.16
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$60,759.70

OTHER OPEN CRANIOTOMY

Facility IP

$36,851.44

Service Code	APR-DRG 0273
Min. Negotiated Rate	$30,924.29
Max. Negotiated Rate	$36,851.44
Rate for Payer: Adventist Health Medi-Cal	$30,924.29
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$36,851.44

OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 908
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 O.R. PROCEDURES FOR INJURIES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 907
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 O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 909
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 O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility IP

$34,005.88

Service Code	APR-DRG 6812
Min. Negotiated Rate	$15,118.84
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,118.84
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,016.61

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility IP

$34,005.88

Service Code	APR-DRG 6811
Min. Negotiated Rate	$11,520.02
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$11,520.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$13,728.03

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility IP

$34,005.88

Service Code	APR-DRG 6813
Min. Negotiated Rate	$25,950.01
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$25,950.01
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$30,923.76

OTHER O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility IP

$65,795.76

Service Code	APR-DRG 6814
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$65,795.76
Rate for Payer: Adventist Health Medi-Cal	$55,213.22
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$65,795.76

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 958
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 O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 957
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 O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 959
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 O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 803
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 O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 802
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 O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 804
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 PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0291
Min. Negotiated Rate	$18,523.88
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$18,523.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$22,074.30

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$49,259.40

Service Code	APR-DRG 0294
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$49,259.40
Rate for Payer: Adventist Health Medi-Cal	$41,336.56
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$49,259.40

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0292
Min. Negotiated Rate	$19,450.19
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$19,450.19
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$23,178.14

OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 0293
Min. Negotiated Rate	$25,027.07
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$25,027.07
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$29,823.92

OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 1823
Min. Negotiated Rate	$24,309.10
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$24,309.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$28,968.34

OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES

Facility IP

$51,888.88

Service Code	APR-DRG 1824
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$51,888.88
Rate for Payer: Adventist Health Medi-Cal	$43,543.12
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$51,888.88

Price Transparency.

All Charges