Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$6,728.24

Service Code	APR-DRG 5321
Min. Negotiated Rate	$4,249.42
Max. Negotiated Rate	$6,728.24
Rate for Payer: Adventist Health Medi-Cal	$4,249.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,063.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,728.24

APR-DRG 41.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$13,163.64

Service Code	APR-DRG 5323
Min. Negotiated Rate	$8,313.88
Max. Negotiated Rate	$13,163.64
Rate for Payer: Adventist Health Medi-Cal	$8,313.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,907.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,163.64

APR-DRG 41.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$23,058.23

Service Code	APR-DRG 5324
Min. Negotiated Rate	$14,563.09
Max. Negotiated Rate	$23,058.23
Rate for Payer: Adventist Health Medi-Cal	$14,563.09
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,354.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,058.23

APR-DRG 41.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$40,238.28

Service Code	APR-DRG 7403
Min. Negotiated Rate	$25,413.65
Max. Negotiated Rate	$40,238.28
Rate for Payer: Adventist Health Medi-Cal	$25,413.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$30,284.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,238.28

APR-DRG 41.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$82,186.21

Service Code	APR-DRG 7404
Min. Negotiated Rate	$51,907.08
Max. Negotiated Rate	$82,186.21
Rate for Payer: Adventist Health Medi-Cal	$51,907.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$61,855.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$82,186.21

APR-DRG 41.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$23,303.56

Service Code	APR-DRG 7402
Min. Negotiated Rate	$14,718.04
Max. Negotiated Rate	$23,303.56
Rate for Payer: Adventist Health Medi-Cal	$14,718.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,538.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,303.56

APR-DRG 41.00: MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$14,705.92

Service Code	APR-DRG 7401
Min. Negotiated Rate	$9,287.95
Max. Negotiated Rate	$14,705.92
Rate for Payer: Adventist Health Medi-Cal	$9,287.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,068.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,705.92

APR-DRG 41.00: MIGRAINE AND OTHER HEADACHES

Facility

$9,272.74

Service Code	APR-DRG 0541
Min. Negotiated Rate	$5,856.47
Max. Negotiated Rate	$9,272.74
Rate for Payer: Adventist Health Medi-Cal	$5,856.47
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,978.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,272.74

APR-DRG 41.00: MIGRAINE AND OTHER HEADACHES

Facility

$11,083.17

Service Code	APR-DRG 0542
Min. Negotiated Rate	$6,999.90
Max. Negotiated Rate	$11,083.17
Rate for Payer: Adventist Health Medi-Cal	$6,999.90
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,341.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,083.17

APR-DRG 41.00: MIGRAINE AND OTHER HEADACHES

Facility

$13,973.76

Service Code	APR-DRG 0543
Min. Negotiated Rate	$8,825.53
Max. Negotiated Rate	$13,973.76
Rate for Payer: Adventist Health Medi-Cal	$8,825.53
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,517.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,973.76

APR-DRG 41.00: MIGRAINE AND OTHER HEADACHES

Facility

$22,879.48

Service Code	APR-DRG 0544
Min. Negotiated Rate	$14,450.20
Max. Negotiated Rate	$22,879.48
Rate for Payer: Adventist Health Medi-Cal	$14,450.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,219.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,879.48

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$16,697.01

Service Code	APR-DRG 7931
Min. Negotiated Rate	$10,545.48
Max. Negotiated Rate	$16,697.01
Rate for Payer: Adventist Health Medi-Cal	$10,545.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,566.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,697.01

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$21,835.43

Service Code	APR-DRG 7932
Min. Negotiated Rate	$13,790.80
Max. Negotiated Rate	$21,835.43
Rate for Payer: Adventist Health Medi-Cal	$13,790.80
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,434.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,835.43

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$61,651.54

Service Code	APR-DRG 7934
Min. Negotiated Rate	$38,937.82
Max. Negotiated Rate	$61,651.54
Rate for Payer: Adventist Health Medi-Cal	$38,937.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,400.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,651.54

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$32,192.16

Service Code	APR-DRG 7933
Min. Negotiated Rate	$20,331.89
Max. Negotiated Rate	$32,192.16
Rate for Payer: Adventist Health Medi-Cal	$20,331.89
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,228.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,192.16

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$18,513.14

Service Code	APR-DRG 9511
Min. Negotiated Rate	$11,692.51
Max. Negotiated Rate	$18,513.14
Rate for Payer: Adventist Health Medi-Cal	$11,692.51
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,933.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,513.14

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$36,598.41

Service Code	APR-DRG 9513
Min. Negotiated Rate	$23,114.78
Max. Negotiated Rate	$36,598.41
Rate for Payer: Adventist Health Medi-Cal	$23,114.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,545.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,598.41

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$65,664.15

Service Code	APR-DRG 9514
Min. Negotiated Rate	$41,472.10
Max. Negotiated Rate	$65,664.15
Rate for Payer: Adventist Health Medi-Cal	$41,472.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$49,420.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$65,664.15

APR-DRG 41.00: MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$24,505.44

Service Code	APR-DRG 9512
Min. Negotiated Rate	$15,477.12
Max. Negotiated Rate	$24,505.44
Rate for Payer: Adventist Health Medi-Cal	$15,477.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,443.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,505.44

APR-DRG 41.00: MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$18,174.64

Service Code	APR-DRG 0432
Min. Negotiated Rate	$11,478.72
Max. Negotiated Rate	$18,174.64
Rate for Payer: Adventist Health Medi-Cal	$11,478.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,678.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,174.64

APR-DRG 41.00: MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$26,903.49

Service Code	APR-DRG 0433
Min. Negotiated Rate	$16,991.68
Max. Negotiated Rate	$26,903.49
Rate for Payer: Adventist Health Medi-Cal	$16,991.68
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,248.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,903.49

APR-DRG 41.00: MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$52,395.92

Service Code	APR-DRG 0434
Min. Negotiated Rate	$33,092.16
Max. Negotiated Rate	$52,395.92
Rate for Payer: Adventist Health Medi-Cal	$33,092.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$39,434.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,395.92

APR-DRG 41.00: MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$13,570.60

Service Code	APR-DRG 0431
Min. Negotiated Rate	$8,570.90
Max. Negotiated Rate	$13,570.60
Rate for Payer: Adventist Health Medi-Cal	$8,570.90
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,213.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,570.60

APR-DRG 41.00: MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$23,999.58

Service Code	APR-DRG 9303
Min. Negotiated Rate	$15,157.63
Max. Negotiated Rate	$23,999.58
Rate for Payer: Adventist Health Medi-Cal	$15,157.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,062.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,999.58

APR-DRG 41.00: MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$15,046.33

Service Code	APR-DRG 9302
Min. Negotiated Rate	$9,502.94
Max. Negotiated Rate	$15,046.33
Rate for Payer: Adventist Health Medi-Cal	$9,502.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,324.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,046.33

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