Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$79,869.92

Service Code	APR-DRG 0041
Min. Negotiated Rate	$50,444.16
Max. Negotiated Rate	$79,869.92
Rate for Payer: Adventist Health Medi-Cal	$50,444.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$60,112.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$79,869.92

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$110,348.62

Service Code	APR-DRG 0042
Min. Negotiated Rate	$69,693.86
Max. Negotiated Rate	$110,348.62
Rate for Payer: Adventist Health Medi-Cal	$69,693.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$83,051.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$110,348.62

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$256,441.78

Service Code	APR-DRG 0044
Min. Negotiated Rate	$161,963.23
Max. Negotiated Rate	$256,441.78
Rate for Payer: Adventist Health Medi-Cal	$161,963.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$193,006.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$256,441.78

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$124,683.72

Service Code	APR-DRG 0053
Min. Negotiated Rate	$78,747.61
Max. Negotiated Rate	$124,683.72
Rate for Payer: Adventist Health Medi-Cal	$78,747.61
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$93,840.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$124,683.72

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$176,075.53

Service Code	APR-DRG 0054
Min. Negotiated Rate	$111,205.60
Max. Negotiated Rate	$176,075.53
Rate for Payer: Adventist Health Medi-Cal	$111,205.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$132,520.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$176,075.53

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$69,807.98

Service Code	APR-DRG 0051
Min. Negotiated Rate	$44,089.25
Max. Negotiated Rate	$69,807.98
Rate for Payer: Adventist Health Medi-Cal	$44,089.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,539.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,807.98

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$82,709.17

Service Code	APR-DRG 0052
Min. Negotiated Rate	$52,237.37
Max. Negotiated Rate	$82,709.17
Rate for Payer: Adventist Health Medi-Cal	$52,237.37
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$62,249.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$82,709.17

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$26,515.54

Service Code	APR-DRG 0474
Min. Negotiated Rate	$16,746.66
Max. Negotiated Rate	$26,515.54
Rate for Payer: Adventist Health Medi-Cal	$16,746.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,956.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,515.54

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$12,391.53

Service Code	APR-DRG 0472
Min. Negotiated Rate	$7,826.23
Max. Negotiated Rate	$12,391.53
Rate for Payer: Adventist Health Medi-Cal	$7,826.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,326.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,391.53

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$10,811.23

Service Code	APR-DRG 0471
Min. Negotiated Rate	$6,828.14
Max. Negotiated Rate	$10,811.23
Rate for Payer: Adventist Health Medi-Cal	$6,828.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,136.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,811.23

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$15,633.96

Service Code	APR-DRG 0473
Min. Negotiated Rate	$9,874.08
Max. Negotiated Rate	$15,633.96
Rate for Payer: Adventist Health Medi-Cal	$9,874.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,766.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,633.96

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$11,851.46

Service Code	APR-DRG 4821
Min. Negotiated Rate	$7,485.13
Max. Negotiated Rate	$11,851.46
Rate for Payer: Adventist Health Medi-Cal	$7,485.13
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,919.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,851.46

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$26,715.22

Service Code	APR-DRG 4823
Min. Negotiated Rate	$16,872.77
Max. Negotiated Rate	$26,715.22
Rate for Payer: Adventist Health Medi-Cal	$16,872.77
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,106.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,715.22

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$14,671.69

Service Code	APR-DRG 4822
Min. Negotiated Rate	$9,266.33
Max. Negotiated Rate	$14,671.69
Rate for Payer: Adventist Health Medi-Cal	$9,266.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,042.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,671.69

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$44,895.57

Service Code	APR-DRG 4824
Min. Negotiated Rate	$28,355.10
Max. Negotiated Rate	$44,895.57
Rate for Payer: Adventist Health Medi-Cal	$28,355.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,789.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,895.57

APR-DRG 41.00: URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$26,372.91

Service Code	APR-DRG 4463
Min. Negotiated Rate	$16,656.58
Max. Negotiated Rate	$26,372.91
Rate for Payer: Adventist Health Medi-Cal	$16,656.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,849.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,372.91

APR-DRG 41.00: URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$16,723.63

Service Code	APR-DRG 4462
Min. Negotiated Rate	$10,562.29
Max. Negotiated Rate	$16,723.63
Rate for Payer: Adventist Health Medi-Cal	$10,562.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,586.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,723.63

APR-DRG 41.00: URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$46,145.00

Service Code	APR-DRG 4464
Min. Negotiated Rate	$29,144.21
Max. Negotiated Rate	$46,145.00
Rate for Payer: Adventist Health Medi-Cal	$29,144.21
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$34,730.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,145.00

APR-DRG 41.00: URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$13,774.09

Service Code	APR-DRG 4461
Min. Negotiated Rate	$8,699.42
Max. Negotiated Rate	$13,774.09
Rate for Payer: Adventist Health Medi-Cal	$8,699.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,366.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,774.09

APR-DRG 41.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$16,771.19

Service Code	APR-DRG 4653
Min. Negotiated Rate	$10,592.33
Max. Negotiated Rate	$16,771.19
Rate for Payer: Adventist Health Medi-Cal	$10,592.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,622.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,771.19

APR-DRG 41.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$28,249.90

Service Code	APR-DRG 4654
Min. Negotiated Rate	$17,842.04
Max. Negotiated Rate	$28,249.90
Rate for Payer: Adventist Health Medi-Cal	$17,842.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,261.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,249.90

APR-DRG 41.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$8,432.18

Service Code	APR-DRG 4651
Min. Negotiated Rate	$5,325.59
Max. Negotiated Rate	$8,432.18
Rate for Payer: Adventist Health Medi-Cal	$5,325.59
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,346.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,432.18

APR-DRG 41.00: URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$10,149.42

Service Code	APR-DRG 4652
Min. Negotiated Rate	$6,410.16
Max. Negotiated Rate	$10,149.42
Rate for Payer: Adventist Health Medi-Cal	$6,410.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,638.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,149.42

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$19,433.58

Service Code	APR-DRG 5192
Min. Negotiated Rate	$12,273.84
Max. Negotiated Rate	$19,433.58
Rate for Payer: Adventist Health Medi-Cal	$12,273.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,626.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,433.58

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$15,200.36

Service Code	APR-DRG 5191
Min. Negotiated Rate	$9,600.23
Max. Negotiated Rate	$15,200.36
Rate for Payer: Adventist Health Medi-Cal	$9,600.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,440.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,200.36

Know your out-of-pocket cost for care.

All Charges