Loma Linda University Medical Center

All Charges

Charge

Type

Price

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 167
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 RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 166
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 RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 168
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 SIGNIFICANT HIP AND FEMUR SURGERY

Facility IP

$48,869.64

Service Code	APR-DRG 3094
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$48,869.64
Rate for Payer: Adventist Health Medi-Cal	$41,009.48
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$48,869.64

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility IP

$34,005.88

Service Code	APR-DRG 3092
Min. Negotiated Rate	$18,026.57
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$18,026.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$21,481.66

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility IP

$34,005.88

Service Code	APR-DRG 3093
Min. Negotiated Rate	$25,637.51
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$25,637.51
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$30,551.36

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility IP

$34,005.88

Service Code	APR-DRG 3091
Min. Negotiated Rate	$13,554.08
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$13,554.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$16,151.95

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 3852
Min. Negotiated Rate	$5,565.67
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$5,565.67
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$6,632.43

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 3854
Min. Negotiated Rate	$17,336.60
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$17,336.60
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$20,659.45

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 3853
Min. Negotiated Rate	$8,641.42
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$8,641.42
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$10,297.69

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility IP

$34,005.88

Service Code	APR-DRG 3851
Min. Negotiated Rate	$4,219.34
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$4,219.34
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$5,028.05

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility IP

$34,005.88

Service Code	TRIS-DRG 580
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 SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 579
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 SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility IP

$34,005.88

Service Code	TRIS-DRG 581
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 SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3641
Min. Negotiated Rate	$7,459.73
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,459.73
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,889.51

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3643
Min. Negotiated Rate	$16,459.57
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$16,459.57
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$19,614.32

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility IP

$35,058.85

Service Code	APR-DRG 3644
Min. Negotiated Rate	$29,420.02
Max. Negotiated Rate	$35,058.85
Rate for Payer: Adventist Health Medi-Cal	$29,420.02
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$35,058.85

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 3642
Min. Negotiated Rate	$10,306.98
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,306.98
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$12,282.48

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2233
Min. Negotiated Rate	$21,919.97
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$21,919.97
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$26,121.30

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility IP

$46,097.34

Service Code	APR-DRG 2234
Min. Negotiated Rate	$34,005.88
Max. Negotiated Rate	$46,097.34
Rate for Payer: Adventist Health Medi-Cal	$38,683.08
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$46,097.34

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2232
Min. Negotiated Rate	$15,595.99
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$15,595.99
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$18,585.22

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2231
Min. Negotiated Rate	$10,309.21
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$10,309.21
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$12,285.14

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2221
Min. Negotiated Rate	$7,491.10
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$7,491.10
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$8,926.89

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2223
Min. Negotiated Rate	$18,877.82
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$18,877.82
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$22,496.07

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility IP

$34,005.88

Service Code	APR-DRG 2222
Min. Negotiated Rate	$12,637.86
Max. Negotiated Rate	$34,005.88
Rate for Payer: Adventist Health Medi-Cal	$12,637.86
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: IEHP medi-cal	$15,060.12

Price Transparency.

All Charges