Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

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 WITHOUT AMI

Facility

$46,810.58

Service Code	APR-DRG 1753
Min. Negotiated Rate	$29,564.58
Max. Negotiated Rate	$46,810.58
Rate for Payer: Adventist Health Medi-Cal	$29,564.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$35,231.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,810.58

APR-DRG 41.00: PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$70,152.18

Service Code	APR-DRG 1754
Min. Negotiated Rate	$44,306.64
Max. Negotiated Rate	$70,152.18
Rate for Payer: Adventist Health Medi-Cal	$44,306.64
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,798.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,152.18

APR-DRG 41.00: PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$37,547.36

Service Code	APR-DRG 1752
Min. Negotiated Rate	$23,714.12
Max. Negotiated Rate	$37,547.36
Rate for Payer: Adventist Health Medi-Cal	$23,714.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,259.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,547.36

APR-DRG 41.00: PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI

Facility

$33,416.84

Service Code	APR-DRG 1751
Min. Negotiated Rate	$21,105.37
Max. Negotiated Rate	$33,416.84
Rate for Payer: Adventist Health Medi-Cal	$21,105.37
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$25,150.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,416.84

APR-DRG 41.00: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$55,060.21

Service Code	APR-DRG 0303
Min. Negotiated Rate	$34,774.87
Max. Negotiated Rate	$55,060.21
Rate for Payer: Adventist Health Medi-Cal	$34,774.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$41,440.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$55,060.21

APR-DRG 41.00: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$30,463.50

Service Code	APR-DRG 0301
Min. Negotiated Rate	$19,240.10
Max. Negotiated Rate	$30,463.50
Rate for Payer: Adventist Health Medi-Cal	$19,240.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,927.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,463.50

APR-DRG 41.00: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$73,217.74

Service Code	APR-DRG 0304
Min. Negotiated Rate	$46,242.78
Max. Negotiated Rate	$73,217.74
Rate for Payer: Adventist Health Medi-Cal	$46,242.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$55,105.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$73,217.74

APR-DRG 41.00: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$40,318.15

Service Code	APR-DRG 0302
Min. Negotiated Rate	$25,464.10
Max. Negotiated Rate	$40,318.15
Rate for Payer: Adventist Health Medi-Cal	$25,464.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$30,344.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,318.15

APR-DRG 41.00: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$66,027.38

Service Code	APR-DRG 1832
Min. Negotiated Rate	$41,701.50
Max. Negotiated Rate	$66,027.38
Rate for Payer: Adventist Health Medi-Cal	$41,701.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$49,694.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$66,027.38

APR-DRG 41.00: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$64,622.00

Service Code	APR-DRG 1831
Min. Negotiated Rate	$40,813.90
Max. Negotiated Rate	$64,622.00
Rate for Payer: Adventist Health Medi-Cal	$40,813.90
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$48,636.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$64,622.00

APR-DRG 41.00: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$114,713.05

Service Code	APR-DRG 1834
Min. Negotiated Rate	$72,450.35
Max. Negotiated Rate	$114,713.05
Rate for Payer: Adventist Health Medi-Cal	$72,450.35
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$86,336.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$114,713.05

APR-DRG 41.00: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$76,621.79

Service Code	APR-DRG 1833
Min. Negotiated Rate	$48,392.71
Max. Negotiated Rate	$76,621.79
Rate for Payer: Adventist Health Medi-Cal	$48,392.71
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$57,667.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$76,621.79

APR-DRG 41.00: PERIPHERAL AND OTHER VASCULAR DISORDERS

Facility

$14,702.12

Service Code	APR-DRG 1973
Min. Negotiated Rate	$9,285.55
Max. Negotiated Rate	$14,702.12
Rate for Payer: Adventist Health Medi-Cal	$9,285.55
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,065.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,702.12

APR-DRG 41.00: PERIPHERAL AND OTHER VASCULAR DISORDERS

Facility

$25,861.36

Service Code	APR-DRG 1974
Min. Negotiated Rate	$16,333.49
Max. Negotiated Rate	$25,861.36
Rate for Payer: Adventist Health Medi-Cal	$16,333.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,464.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,861.36

APR-DRG 41.00: PERIPHERAL AND OTHER VASCULAR DISORDERS

Facility

$7,838.85

Service Code	APR-DRG 1971
Min. Negotiated Rate	$4,950.85
Max. Negotiated Rate	$7,838.85
Rate for Payer: Adventist Health Medi-Cal	$4,950.85
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,899.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,838.85

APR-DRG 41.00: PERIPHERAL AND OTHER VASCULAR DISORDERS

Facility

$10,409.97

Service Code	APR-DRG 1972
Min. Negotiated Rate	$6,574.72
Max. Negotiated Rate	$10,409.97
Rate for Payer: Adventist Health Medi-Cal	$6,574.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,834.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,409.97

APR-DRG 41.00: PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$10,119.00

Service Code	APR-DRG 0481
Min. Negotiated Rate	$6,390.95
Max. Negotiated Rate	$10,119.00
Rate for Payer: Adventist Health Medi-Cal	$6,390.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,615.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,119.00

APR-DRG 41.00: PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$11,646.07

Service Code	APR-DRG 0482
Min. Negotiated Rate	$7,355.41
Max. Negotiated Rate	$11,646.07
Rate for Payer: Adventist Health Medi-Cal	$7,355.41
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,765.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,646.07

APR-DRG 41.00: PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$30,590.91

Service Code	APR-DRG 0484
Min. Negotiated Rate	$19,320.58
Max. Negotiated Rate	$30,590.91
Rate for Payer: Adventist Health Medi-Cal	$19,320.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,023.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,590.91

APR-DRG 41.00: PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS

Facility

$15,883.09

Service Code	APR-DRG 0483
Min. Negotiated Rate	$10,031.42
Max. Negotiated Rate	$15,883.09
Rate for Payer: Adventist Health Medi-Cal	$10,031.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,954.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,883.09

APR-DRG 41.00: PERITONEAL ADHESIOLYSIS

Facility

$64,369.07

Service Code	APR-DRG 2244
Min. Negotiated Rate	$40,654.15
Max. Negotiated Rate	$64,369.07
Rate for Payer: Adventist Health Medi-Cal	$40,654.15
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$48,446.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$64,369.07

APR-DRG 41.00: PERITONEAL ADHESIOLYSIS

Facility

$37,115.68

Service Code	APR-DRG 2243
Min. Negotiated Rate	$23,441.48
Max. Negotiated Rate	$37,115.68
Rate for Payer: Adventist Health Medi-Cal	$23,441.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,934.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,115.68

APR-DRG 41.00: PERITONEAL ADHESIOLYSIS

Facility

$22,579.01

Service Code	APR-DRG 2241
Min. Negotiated Rate	$14,260.43
Max. Negotiated Rate	$22,579.01
Rate for Payer: Adventist Health Medi-Cal	$14,260.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,993.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,579.01

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All Charges