Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$6,437.30

Service Code	APR-DRG 1141
Min. Negotiated Rate	$4,065.66
Max. Negotiated Rate	$6,437.30
Rate for Payer: Adventist Health Medi-Cal	$4,065.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,844.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,437.30

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$13,304.37

Service Code	APR-DRG 1143
Min. Negotiated Rate	$8,402.76
Max. Negotiated Rate	$13,304.37
Rate for Payer: Adventist Health Medi-Cal	$8,402.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,013.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,304.37

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$9,035.03

Service Code	APR-DRG 1142
Min. Negotiated Rate	$5,706.34
Max. Negotiated Rate	$9,035.03
Rate for Payer: Adventist Health Medi-Cal	$5,706.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,800.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,035.03

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$5,265.83

Service Code	APR-DRG 7541
Min. Negotiated Rate	$3,325.79
Max. Negotiated Rate	$5,265.83
Rate for Payer: Adventist Health Medi-Cal	$3,325.79
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,963.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,265.83

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$11,404.56

Service Code	APR-DRG 7543
Min. Negotiated Rate	$7,202.88
Max. Negotiated Rate	$11,404.56
Rate for Payer: Adventist Health Medi-Cal	$7,202.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,583.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,404.56

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$26,800.79

Service Code	APR-DRG 7544
Min. Negotiated Rate	$16,926.82
Max. Negotiated Rate	$26,800.79
Rate for Payer: Adventist Health Medi-Cal	$16,926.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,171.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,800.79

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$7,093.38

Service Code	APR-DRG 7542
Min. Negotiated Rate	$4,480.03
Max. Negotiated Rate	$7,093.38
Rate for Payer: Adventist Health Medi-Cal	$4,480.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,338.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,093.38

APR-DRG 41.00: DIABETES

Facility

$28,149.11

Service Code	APR-DRG 4204
Min. Negotiated Rate	$17,778.38
Max. Negotiated Rate	$28,149.11
Rate for Payer: Adventist Health Medi-Cal	$17,778.38
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,185.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,149.11

APR-DRG 41.00: DIABETES

Facility

$9,259.42

Service Code	APR-DRG 4202
Min. Negotiated Rate	$5,848.06
Max. Negotiated Rate	$9,259.42
Rate for Payer: Adventist Health Medi-Cal	$5,848.06
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,968.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,259.42

APR-DRG 41.00: DIABETES

Facility

$7,342.49

Service Code	APR-DRG 4201
Min. Negotiated Rate	$4,637.36
Max. Negotiated Rate	$7,342.49
Rate for Payer: Adventist Health Medi-Cal	$4,637.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,526.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,342.49

APR-DRG 41.00: DIABETES

Facility

$13,766.49

Service Code	APR-DRG 4203
Min. Negotiated Rate	$8,694.62
Max. Negotiated Rate	$13,766.49
Rate for Payer: Adventist Health Medi-Cal	$8,694.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,361.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,766.49

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$11,653.69

Service Code	APR-DRG 2401
Min. Negotiated Rate	$7,360.22
Max. Negotiated Rate	$11,653.69
Rate for Payer: Adventist Health Medi-Cal	$7,360.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,770.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,653.69

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$13,964.26

Service Code	APR-DRG 2402
Min. Negotiated Rate	$8,819.53
Max. Negotiated Rate	$13,964.26
Rate for Payer: Adventist Health Medi-Cal	$8,819.53
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,509.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,964.26

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$18,659.58

Service Code	APR-DRG 2403
Min. Negotiated Rate	$11,785.00
Max. Negotiated Rate	$18,659.58
Rate for Payer: Adventist Health Medi-Cal	$11,785.00
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,043.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,659.58

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$30,528.15

Service Code	APR-DRG 2404
Min. Negotiated Rate	$19,280.94
Max. Negotiated Rate	$30,528.15
Rate for Payer: Adventist Health Medi-Cal	$19,280.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,976.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,528.15

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$23,176.14

Service Code	APR-DRG 5173
Min. Negotiated Rate	$14,637.56
Max. Negotiated Rate	$23,176.14
Rate for Payer: Adventist Health Medi-Cal	$14,637.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,443.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,176.14

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$40,945.72

Service Code	APR-DRG 5174
Min. Negotiated Rate	$25,860.46
Max. Negotiated Rate	$40,945.72
Rate for Payer: Adventist Health Medi-Cal	$25,860.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$30,817.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,945.72

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$14,371.22

Service Code	APR-DRG 5172
Min. Negotiated Rate	$9,076.56
Max. Negotiated Rate	$14,371.22
Rate for Payer: Adventist Health Medi-Cal	$9,076.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,816.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,371.22

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$11,625.15

Service Code	APR-DRG 5171
Min. Negotiated Rate	$7,342.20
Max. Negotiated Rate	$11,625.15
Rate for Payer: Adventist Health Medi-Cal	$7,342.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,749.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,625.15

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$10,674.30

Service Code	APR-DRG 2841
Min. Negotiated Rate	$6,741.66
Max. Negotiated Rate	$10,674.30
Rate for Payer: Adventist Health Medi-Cal	$6,741.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,033.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,674.30

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$13,907.20

Service Code	APR-DRG 2842
Min. Negotiated Rate	$8,783.50
Max. Negotiated Rate	$13,907.20
Rate for Payer: Adventist Health Medi-Cal	$8,783.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,467.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,907.20

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$19,479.22

Service Code	APR-DRG 2843
Min. Negotiated Rate	$12,302.66
Max. Negotiated Rate	$19,479.22
Rate for Payer: Adventist Health Medi-Cal	$12,302.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,660.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,479.22

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$33,160.11

Service Code	APR-DRG 2844
Min. Negotiated Rate	$20,943.23
Max. Negotiated Rate	$33,160.11
Rate for Payer: Adventist Health Medi-Cal	$20,943.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,957.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,160.11

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$8,726.95

Service Code	APR-DRG 2821
Min. Negotiated Rate	$5,511.76
Max. Negotiated Rate	$8,726.95
Rate for Payer: Adventist Health Medi-Cal	$5,511.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,568.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,726.95

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$11,288.55

Service Code	APR-DRG 2822
Min. Negotiated Rate	$7,129.61
Max. Negotiated Rate	$11,288.55
Rate for Payer: Adventist Health Medi-Cal	$7,129.61
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,496.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,288.55

Know your out-of-pocket cost for care.

All Charges