Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$31,014.99

Service Code	APR-DRG 5193
Min. Negotiated Rate	$19,588.42
Max. Negotiated Rate	$31,014.99
Rate for Payer: Adventist Health Medi-Cal	$19,588.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,342.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,014.99

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$62,570.06

Service Code	APR-DRG 5194
Min. Negotiated Rate	$39,517.93
Max. Negotiated Rate	$62,570.06
Rate for Payer: Adventist Health Medi-Cal	$39,517.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,092.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,570.06

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$19,330.88

Service Code	APR-DRG 5132
Min. Negotiated Rate	$12,208.98
Max. Negotiated Rate	$19,330.88
Rate for Payer: Adventist Health Medi-Cal	$12,208.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$14,549.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,330.88

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$30,370.30

Service Code	APR-DRG 5133
Min. Negotiated Rate	$19,181.24
Max. Negotiated Rate	$30,370.30
Rate for Payer: Adventist Health Medi-Cal	$19,181.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,857.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,370.30

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$52,424.44

Service Code	APR-DRG 5134
Min. Negotiated Rate	$33,110.17
Max. Negotiated Rate	$52,424.44
Rate for Payer: Adventist Health Medi-Cal	$33,110.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$39,456.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,424.44

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$16,059.94

Service Code	APR-DRG 5131
Min. Negotiated Rate	$10,143.12
Max. Negotiated Rate	$16,059.94
Rate for Payer: Adventist Health Medi-Cal	$10,143.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,087.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,059.94

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$70,941.38

Service Code	APR-DRG 5124
Min. Negotiated Rate	$44,805.08
Max. Negotiated Rate	$70,941.38
Rate for Payer: Adventist Health Medi-Cal	$44,805.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$53,392.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,941.38

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$37,642.44

Service Code	APR-DRG 5123
Min. Negotiated Rate	$23,774.17
Max. Negotiated Rate	$37,642.44
Rate for Payer: Adventist Health Medi-Cal	$23,774.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,330.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,642.44

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$20,932.13

Service Code	APR-DRG 5121
Min. Negotiated Rate	$13,220.29
Max. Negotiated Rate	$20,932.13
Rate for Payer: Adventist Health Medi-Cal	$13,220.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,754.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,932.13

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$24,239.19

Service Code	APR-DRG 5122
Min. Negotiated Rate	$15,308.96
Max. Negotiated Rate	$24,239.19
Rate for Payer: Adventist Health Medi-Cal	$15,308.96
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,243.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,239.19

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$22,620.85

Service Code	APR-DRG 5111
Min. Negotiated Rate	$14,286.85
Max. Negotiated Rate	$22,620.85
Rate for Payer: Adventist Health Medi-Cal	$14,286.85
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,025.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,620.85

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$27,378.92

Service Code	APR-DRG 5112
Min. Negotiated Rate	$17,291.95
Max. Negotiated Rate	$27,378.92
Rate for Payer: Adventist Health Medi-Cal	$17,291.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,606.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,378.92

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$39,011.67

Service Code	APR-DRG 5113
Min. Negotiated Rate	$24,638.95
Max. Negotiated Rate	$39,011.67
Rate for Payer: Adventist Health Medi-Cal	$24,638.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$29,361.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$39,011.67

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$76,644.61

Service Code	APR-DRG 5114
Min. Negotiated Rate	$48,407.12
Max. Negotiated Rate	$76,644.61
Rate for Payer: Adventist Health Medi-Cal	$48,407.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$57,685.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$76,644.61

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$6,138.14

Service Code	APR-DRG 5601
Min. Negotiated Rate	$3,876.72
Max. Negotiated Rate	$6,138.14
Rate for Payer: Adventist Health Medi-Cal	$3,876.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$4,619.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,138.14

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$16,030.09

Service Code	APR-DRG 5604
Min. Negotiated Rate	$10,124.27
Max. Negotiated Rate	$16,030.09
Rate for Payer: Adventist Health Medi-Cal	$10,124.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$12,064.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,030.09

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$7,013.01

Service Code	APR-DRG 5602
Min. Negotiated Rate	$4,429.27
Max. Negotiated Rate	$7,013.01
Rate for Payer: Adventist Health Medi-Cal	$4,429.27
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,278.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,013.01

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$9,155.82

Service Code	APR-DRG 5603
Min. Negotiated Rate	$5,782.62
Max. Negotiated Rate	$9,155.82
Rate for Payer: Adventist Health Medi-Cal	$5,782.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,890.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,155.82

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$35,823.46

Service Code	APR-DRG 5424
Min. Negotiated Rate	$22,625.34
Max. Negotiated Rate	$35,823.46
Rate for Payer: Adventist Health Medi-Cal	$22,625.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,961.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,823.46

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$11,981.99

Service Code	APR-DRG 5423
Min. Negotiated Rate	$7,567.57
Max. Negotiated Rate	$11,981.99
Rate for Payer: Adventist Health Medi-Cal	$7,567.57
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,018.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,981.99

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$8,067.29

Service Code	APR-DRG 5422
Min. Negotiated Rate	$5,095.13
Max. Negotiated Rate	$8,067.29
Rate for Payer: Adventist Health Medi-Cal	$5,095.13
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,071.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,067.29

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$7,093.65

Service Code	APR-DRG 5421
Min. Negotiated Rate	$4,480.20
Max. Negotiated Rate	$7,093.65
Rate for Payer: Adventist Health Medi-Cal	$4,480.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,338.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,093.65

APR-DRG 41.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$11,286.53

Service Code	APR-DRG 5412
Min. Negotiated Rate	$7,128.34
Max. Negotiated Rate	$11,286.53
Rate for Payer: Adventist Health Medi-Cal	$7,128.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,494.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,286.53

APR-DRG 41.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$10,768.48

Service Code	APR-DRG 5411
Min. Negotiated Rate	$6,801.14
Max. Negotiated Rate	$10,768.48
Rate for Payer: Adventist Health Medi-Cal	$6,801.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,104.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,768.48

APR-DRG 41.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$14,189.31

Service Code	APR-DRG 5413
Min. Negotiated Rate	$8,961.67
Max. Negotiated Rate	$14,189.31
Rate for Payer: Adventist Health Medi-Cal	$8,961.67
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,679.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,189.31

Know your out-of-pocket cost for care.

All Charges