Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$31,226.08

Service Code	APR-DRG 2223
Min. Negotiated Rate	$19,721.74
Max. Negotiated Rate	$31,226.08
Rate for Payer: Adventist Health Medi-Cal	$19,721.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,501.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,226.08

APR-DRG 41.00: OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$12,216.58

Service Code	APR-DRG 2221
Min. Negotiated Rate	$7,715.74
Max. Negotiated Rate	$12,216.58
Rate for Payer: Adventist Health Medi-Cal	$7,715.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,194.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,216.58

APR-DRG 41.00: OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$21,198.36

Service Code	APR-DRG 2222
Min. Negotiated Rate	$13,388.44
Max. Negotiated Rate	$21,198.36
Rate for Payer: Adventist Health Medi-Cal	$13,388.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,954.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,198.36

APR-DRG 41.00: PANCREAS TRANSPLANT

Facility

$127,524.87

Service Code	APR-DRG 0062
Min. Negotiated Rate	$80,542.02
Max. Negotiated Rate	$127,524.87
Rate for Payer: Adventist Health Medi-Cal	$80,542.02
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$95,979.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$127,524.87

APR-DRG 41.00: PANCREAS TRANSPLANT

Facility

$105,934.75

Service Code	APR-DRG 0061
Min. Negotiated Rate	$66,906.16
Max. Negotiated Rate	$105,934.75
Rate for Payer: Adventist Health Medi-Cal	$66,906.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$79,729.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$105,934.75

APR-DRG 41.00: PANCREAS TRANSPLANT

Facility

$196,096.72

Service Code	APR-DRG 0064
Min. Negotiated Rate	$123,850.56
Max. Negotiated Rate	$196,096.72
Rate for Payer: Adventist Health Medi-Cal	$123,850.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$147,588.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$196,096.72

APR-DRG 41.00: PANCREAS TRANSPLANT

Facility

$155,247.99

Service Code	APR-DRG 0063
Min. Negotiated Rate	$98,051.36
Max. Negotiated Rate	$155,247.99
Rate for Payer: Adventist Health Medi-Cal	$98,051.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$116,844.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$155,247.99

APR-DRG 41.00: PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT

Facility

$5,990.40

Service Code	APR-DRG 8441
Min. Negotiated Rate	$3,783.41
Max. Negotiated Rate	$5,990.40
Rate for Payer: Adventist Health Medi-Cal	$3,783.41
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,508.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,990.40

APR-DRG 41.00: PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT

Facility

$38,220.57

Service Code	APR-DRG 8444
Min. Negotiated Rate	$24,139.31
Max. Negotiated Rate	$38,220.57
Rate for Payer: Adventist Health Medi-Cal	$24,139.31
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,766.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,220.57

APR-DRG 41.00: PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT

Facility

$10,010.61

Service Code	APR-DRG 8442
Min. Negotiated Rate	$6,322.49
Max. Negotiated Rate	$10,010.61
Rate for Payer: Adventist Health Medi-Cal	$6,322.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,534.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,010.61

APR-DRG 41.00: PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT

Facility

$17,488.13

Service Code	APR-DRG 8443
Min. Negotiated Rate	$11,045.14
Max. Negotiated Rate	$17,488.13
Rate for Payer: Adventist Health Medi-Cal	$11,045.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,162.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,488.13

APR-DRG 41.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES

Facility

$41,035.10

Service Code	APR-DRG 5103
Min. Negotiated Rate	$25,916.90
Max. Negotiated Rate	$41,035.10
Rate for Payer: Adventist Health Medi-Cal	$25,916.90
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$30,884.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,035.10

APR-DRG 41.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES

Facility

$21,865.87

Service Code	APR-DRG 5101
Min. Negotiated Rate	$13,810.02
Max. Negotiated Rate	$21,865.87
Rate for Payer: Adventist Health Medi-Cal	$13,810.02
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,456.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,865.87

APR-DRG 41.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES

Facility

$25,889.88

Service Code	APR-DRG 5102
Min. Negotiated Rate	$16,351.50
Max. Negotiated Rate	$25,889.88
Rate for Payer: Adventist Health Medi-Cal	$16,351.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,485.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,889.88

APR-DRG 41.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES

Facility

$79,938.38

Service Code	APR-DRG 5104
Min. Negotiated Rate	$50,487.40
Max. Negotiated Rate	$79,938.38
Rate for Payer: Adventist Health Medi-Cal	$50,487.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$60,164.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$79,938.38

APR-DRG 41.00: PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$14,962.65

Service Code	APR-DRG 4831
Min. Negotiated Rate	$9,450.10
Max. Negotiated Rate	$14,962.65
Rate for Payer: Adventist Health Medi-Cal	$9,450.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,261.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,962.65

APR-DRG 41.00: PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$52,367.38

Service Code	APR-DRG 4834
Min. Negotiated Rate	$33,074.14
Max. Negotiated Rate	$52,367.38
Rate for Payer: Adventist Health Medi-Cal	$33,074.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$39,413.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,367.38

APR-DRG 41.00: PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$30,803.90

Service Code	APR-DRG 4833
Min. Negotiated Rate	$19,455.10
Max. Negotiated Rate	$30,803.90
Rate for Payer: Adventist Health Medi-Cal	$19,455.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,183.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,803.90

APR-DRG 41.00: PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$20,333.08

Service Code	APR-DRG 4832
Min. Negotiated Rate	$12,841.94
Max. Negotiated Rate	$20,333.08
Rate for Payer: Adventist Health Medi-Cal	$12,841.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,303.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,333.08

APR-DRG 41.00: PEPTIC ULCER AND GASTRITIS

Facility

$12,463.81

Service Code	APR-DRG 2412
Min. Negotiated Rate	$7,871.88
Max. Negotiated Rate	$12,463.81
Rate for Payer: Adventist Health Medi-Cal	$7,871.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,380.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,463.81

APR-DRG 41.00: PEPTIC ULCER AND GASTRITIS

Facility

$35,295.73

Service Code	APR-DRG 2414
Min. Negotiated Rate	$22,292.04
Max. Negotiated Rate	$35,295.73
Rate for Payer: Adventist Health Medi-Cal	$22,292.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,564.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,295.73

APR-DRG 41.00: PEPTIC ULCER AND GASTRITIS

Facility

$10,065.74

Service Code	APR-DRG 2411
Min. Negotiated Rate	$6,357.31
Max. Negotiated Rate	$10,065.74
Rate for Payer: Adventist Health Medi-Cal	$6,357.31
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,575.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,065.74

APR-DRG 41.00: PEPTIC ULCER AND GASTRITIS

Facility

$18,313.47

Service Code	APR-DRG 2413
Min. Negotiated Rate	$11,566.40
Max. Negotiated Rate	$18,313.47
Rate for Payer: Adventist Health Medi-Cal	$11,566.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,783.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,313.47

APR-DRG 41.00: PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$63,039.78

Service Code	APR-DRG 1744
Min. Negotiated Rate	$39,814.60
Max. Negotiated Rate	$63,039.78
Rate for Payer: Adventist Health Medi-Cal	$39,814.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,445.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$63,039.78

APR-DRG 41.00: PERCUTANEOUS CARDIAC INTERVENTION WITH AMI

Facility

$43,912.38

Service Code	APR-DRG 1743
Min. Negotiated Rate	$27,734.14
Max. Negotiated Rate	$43,912.38
Rate for Payer: Adventist Health Medi-Cal	$27,734.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,049.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,912.38

Know your out-of-pocket cost for care.

All Charges