Loma Linda University Medical Center

All Charges

Charge

Type

Price

INPATIENT MS-DRG 336: PERITONEAL ADHESIOLYSIS WITH CC

Facility IP

$34,713.77

Service Code	MS-DRG 336
Min. Negotiated Rate	$23,911.01
Max. Negotiated Rate	$34,713.77
Rate for Payer: EPIC Health Plan Medicare	$23,911.01
Rate for Payer: Humana Medicare	$23,911.01
Rate for Payer: IEHP Medicare Advantage	$23,911.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,214.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,127.87
Rate for Payer: Molina Healthcare of CA Medicare	$30,127.87
Rate for Payer: Multiplan WC	$34,713.77

INPATIENT MS-DRG 337: PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC

Facility IP

$25,713.00

Service Code	MS-DRG 337
Min. Negotiated Rate	$17,054.52
Max. Negotiated Rate	$25,713.00
Rate for Payer: EPIC Health Plan Medicare	$17,054.52
Rate for Payer: Humana Medicare	$17,054.52
Rate for Payer: IEHP Medicare Advantage	$17,054.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,124.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,488.70
Rate for Payer: Molina Healthcare of CA Medicare	$21,488.70
Rate for Payer: Multiplan WC	$25,713.00

INPATIENT MS-DRG 344: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility IP

$42,963.79

Service Code	MS-DRG 344
Min. Negotiated Rate	$31,062.52
Max. Negotiated Rate	$42,963.79
Rate for Payer: EPIC Health Plan Medicare	$31,062.52
Rate for Payer: Humana Medicare	$31,062.52
Rate for Payer: IEHP Medicare Advantage	$31,062.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$36,653.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,138.78
Rate for Payer: Molina Healthcare of CA Medicare	$39,138.78
Rate for Payer: Multiplan WC	$42,963.79

INPATIENT MS-DRG 345: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility IP

$25,321.30

Service Code	MS-DRG 345
Min. Negotiated Rate	$17,552.24
Max. Negotiated Rate	$25,321.30
Rate for Payer: EPIC Health Plan Medicare	$17,552.24
Rate for Payer: Humana Medicare	$17,552.24
Rate for Payer: IEHP Medicare Advantage	$17,552.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,711.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,115.82
Rate for Payer: Molina Healthcare of CA Medicare	$22,115.82
Rate for Payer: Multiplan WC	$25,321.30

INPATIENT MS-DRG 346: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility IP

$20,412.09

Service Code	MS-DRG 346
Min. Negotiated Rate	$14,705.59
Max. Negotiated Rate	$20,412.09
Rate for Payer: EPIC Health Plan Medicare	$14,705.59
Rate for Payer: Humana Medicare	$14,705.59
Rate for Payer: IEHP Medicare Advantage	$14,705.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,352.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,529.04
Rate for Payer: Molina Healthcare of CA Medicare	$18,529.04
Rate for Payer: Multiplan WC	$20,412.09

INPATIENT MS-DRG 347: ANAL AND STOMAL PROCEDURES WITH MCC

Facility IP

$41,424.77

Service Code	MS-DRG 347
Min. Negotiated Rate	$28,908.38
Max. Negotiated Rate	$41,424.77
Rate for Payer: EPIC Health Plan Medicare	$28,908.38
Rate for Payer: Humana Medicare	$28,908.38
Rate for Payer: IEHP Medicare Advantage	$28,908.38
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$34,111.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,424.56
Rate for Payer: Molina Healthcare of CA Medicare	$36,424.56
Rate for Payer: Multiplan WC	$41,424.77

INPATIENT MS-DRG 348: ANAL AND STOMAL PROCEDURES WITH CC

Facility IP

$22,538.65

Service Code	MS-DRG 348
Min. Negotiated Rate	$14,858.74
Max. Negotiated Rate	$22,538.65
Rate for Payer: EPIC Health Plan Medicare	$14,858.74
Rate for Payer: Humana Medicare	$14,858.74
Rate for Payer: IEHP Medicare Advantage	$14,858.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,533.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,722.01
Rate for Payer: Molina Healthcare of CA Medicare	$18,722.01
Rate for Payer: Multiplan WC	$22,538.65

INPATIENT MS-DRG 349: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC

Facility IP

$16,274.83

Service Code	MS-DRG 349
Min. Negotiated Rate	$11,192.33
Max. Negotiated Rate	$16,274.83
Rate for Payer: EPIC Health Plan Medicare	$11,192.33
Rate for Payer: Humana Medicare	$11,192.33
Rate for Payer: IEHP Medicare Advantage	$11,192.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,206.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,102.34
Rate for Payer: Molina Healthcare of CA Medicare	$14,102.34
Rate for Payer: Multiplan WC	$16,274.83

INPATIENT MS-DRG 350: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC

Facility IP

$38,467.49

Service Code	MS-DRG 350
Min. Negotiated Rate	$27,229.45
Max. Negotiated Rate	$38,467.49
Rate for Payer: EPIC Health Plan Medicare	$27,229.45
Rate for Payer: Humana Medicare	$27,229.45
Rate for Payer: IEHP Medicare Advantage	$27,229.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$32,130.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,309.11
Rate for Payer: Molina Healthcare of CA Medicare	$34,309.11
Rate for Payer: Multiplan WC	$38,467.49

INPATIENT MS-DRG 351: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC

Facility IP

$23,994.44

Service Code	MS-DRG 351
Min. Negotiated Rate	$16,595.11
Max. Negotiated Rate	$23,994.44
Rate for Payer: EPIC Health Plan Medicare	$16,595.11
Rate for Payer: Humana Medicare	$16,595.11
Rate for Payer: IEHP Medicare Advantage	$16,595.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,582.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,909.84
Rate for Payer: Molina Healthcare of CA Medicare	$20,909.84
Rate for Payer: Multiplan WC	$23,994.44

INPATIENT MS-DRG 352: INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC

Facility IP

$17,986.85

Service Code	MS-DRG 352
Min. Negotiated Rate	$12,692.23
Max. Negotiated Rate	$17,986.85
Rate for Payer: EPIC Health Plan Medicare	$12,692.23
Rate for Payer: Humana Medicare	$12,692.23
Rate for Payer: IEHP Medicare Advantage	$12,692.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,976.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,992.21
Rate for Payer: Molina Healthcare of CA Medicare	$15,992.21
Rate for Payer: Multiplan WC	$17,986.85

INPATIENT MS-DRG 353: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility IP

$46,804.01

Service Code	MS-DRG 353
Min. Negotiated Rate	$33,133.31
Max. Negotiated Rate	$46,804.01
Rate for Payer: EPIC Health Plan Medicare	$33,133.31
Rate for Payer: Humana Medicare	$33,133.31
Rate for Payer: IEHP Medicare Advantage	$33,133.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$39,097.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,747.97
Rate for Payer: Molina Healthcare of CA Medicare	$41,747.97
Rate for Payer: Multiplan WC	$46,804.01

INPATIENT MS-DRG 354: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility IP

$28,593.57

Service Code	MS-DRG 354
Min. Negotiated Rate	$19,547.59
Max. Negotiated Rate	$28,593.57
Rate for Payer: EPIC Health Plan Medicare	$19,547.59
Rate for Payer: Humana Medicare	$19,547.59
Rate for Payer: IEHP Medicare Advantage	$19,547.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,066.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,629.96
Rate for Payer: Molina Healthcare of CA Medicare	$24,629.96
Rate for Payer: Multiplan WC	$28,593.57

INPATIENT MS-DRG 355: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility IP

$22,396.67

Service Code	MS-DRG 355
Min. Negotiated Rate	$15,547.88
Max. Negotiated Rate	$22,396.67
Rate for Payer: EPIC Health Plan Medicare	$15,547.88
Rate for Payer: Humana Medicare	$15,547.88
Rate for Payer: IEHP Medicare Advantage	$15,547.88
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,346.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,590.33
Rate for Payer: Molina Healthcare of CA Medicare	$19,590.33
Rate for Payer: Multiplan WC	$22,396.67

INPATIENT MS-DRG 356: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility IP

$68,913.43

Service Code	MS-DRG 356
Min. Negotiated Rate	$48,384.47
Max. Negotiated Rate	$68,913.43
Rate for Payer: EPIC Health Plan Medicare	$48,384.47
Rate for Payer: Humana Medicare	$48,384.47
Rate for Payer: IEHP Medicare Advantage	$48,384.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$57,093.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,964.43
Rate for Payer: Molina Healthcare of CA Medicare	$60,964.43
Rate for Payer: Multiplan WC	$68,913.43

INPATIENT MS-DRG 357: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility IP

$36,659.17

Service Code	MS-DRG 357
Min. Negotiated Rate	$24,941.34
Max. Negotiated Rate	$36,659.17
Rate for Payer: EPIC Health Plan Medicare	$24,941.34
Rate for Payer: Humana Medicare	$24,941.34
Rate for Payer: IEHP Medicare Advantage	$24,941.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,430.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,426.09
Rate for Payer: Molina Healthcare of CA Medicare	$31,426.09
Rate for Payer: Multiplan WC	$36,659.17

INPATIENT MS-DRG 358: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$22,639.83

Service Code	MS-DRG 358
Min. Negotiated Rate	$14,630.14
Max. Negotiated Rate	$22,639.83
Rate for Payer: EPIC Health Plan Medicare	$14,630.14
Rate for Payer: Humana Medicare	$14,630.14
Rate for Payer: IEHP Medicare Advantage	$14,630.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,263.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,433.98
Rate for Payer: Molina Healthcare of CA Medicare	$18,433.98
Rate for Payer: Multiplan WC	$22,639.83

INPATIENT MS-DRG 368: MAJOR ESOPHAGEAL DISORDERS WITH MCC

Facility IP

$28,629.48

Service Code	MS-DRG 368
Min. Negotiated Rate	$18,806.64
Max. Negotiated Rate	$28,629.48
Rate for Payer: EPIC Health Plan Medicare	$18,806.64
Rate for Payer: Humana Medicare	$18,806.64
Rate for Payer: IEHP Medicare Advantage	$18,806.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,191.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,696.37
Rate for Payer: Molina Healthcare of CA Medicare	$23,696.37
Rate for Payer: Multiplan WC	$28,629.48

INPATIENT MS-DRG 369: MAJOR ESOPHAGEAL DISORDERS WITH CC

Facility IP

$16,681.21

Service Code	MS-DRG 369
Min. Negotiated Rate	$11,333.09
Max. Negotiated Rate	$16,681.21
Rate for Payer: EPIC Health Plan Medicare	$11,333.09
Rate for Payer: Humana Medicare	$11,333.09
Rate for Payer: IEHP Medicare Advantage	$11,333.09
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,373.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,279.69
Rate for Payer: Molina Healthcare of CA Medicare	$14,279.69
Rate for Payer: Multiplan WC	$16,681.21

INPATIENT MS-DRG 370: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC

Facility IP

$12,219.18

Service Code	MS-DRG 370
Min. Negotiated Rate	$8,578.77
Max. Negotiated Rate	$12,219.18
Rate for Payer: EPIC Health Plan Medicare	$8,578.77
Rate for Payer: Humana Medicare	$8,578.77
Rate for Payer: IEHP Medicare Advantage	$8,578.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,122.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,809.25
Rate for Payer: Molina Healthcare of CA Medicare	$10,809.25
Rate for Payer: Multiplan WC	$12,219.18

INPATIENT MS-DRG 371: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC

Facility IP

$27,611.07

Service Code	MS-DRG 371
Min. Negotiated Rate	$19,884.27
Max. Negotiated Rate	$27,611.07
Rate for Payer: EPIC Health Plan Medicare	$19,884.27
Rate for Payer: Humana Medicare	$19,884.27
Rate for Payer: IEHP Medicare Advantage	$19,884.27
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,463.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,054.18
Rate for Payer: Molina Healthcare of CA Medicare	$25,054.18
Rate for Payer: Multiplan WC	$27,611.07

INPATIENT MS-DRG 372: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC

Facility IP

$16,614.29

Service Code	MS-DRG 372
Min. Negotiated Rate	$11,941.15
Max. Negotiated Rate	$16,614.29
Rate for Payer: EPIC Health Plan Medicare	$11,941.15
Rate for Payer: Humana Medicare	$11,941.15
Rate for Payer: IEHP Medicare Advantage	$11,941.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,090.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,045.85
Rate for Payer: Molina Healthcare of CA Medicare	$15,045.85
Rate for Payer: Multiplan WC	$16,614.29

INPATIENT MS-DRG 373: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC

Facility IP

$11,848.70

Service Code	MS-DRG 373
Min. Negotiated Rate	$8,272.49
Max. Negotiated Rate	$11,848.70
Rate for Payer: EPIC Health Plan Medicare	$8,272.49
Rate for Payer: Humana Medicare	$8,272.49
Rate for Payer: IEHP Medicare Advantage	$8,272.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,761.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,423.34
Rate for Payer: Molina Healthcare of CA Medicare	$10,423.34
Rate for Payer: Multiplan WC	$11,848.70

INPATIENT MS-DRG 374: DIGESTIVE MALIGNANCY WITH MCC

Facility IP

$32,531.71

Service Code	MS-DRG 374
Min. Negotiated Rate	$23,840.05
Max. Negotiated Rate	$32,531.71
Rate for Payer: EPIC Health Plan Medicare	$23,840.05
Rate for Payer: Humana Medicare	$23,840.05
Rate for Payer: IEHP Medicare Advantage	$23,840.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,131.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,038.46
Rate for Payer: Molina Healthcare of CA Medicare	$30,038.46
Rate for Payer: Multiplan WC	$32,531.71

INPATIENT MS-DRG 375: DIGESTIVE MALIGNANCY WITH CC

Facility IP

$19,659.71

Service Code	MS-DRG 375
Min. Negotiated Rate	$13,697.79
Max. Negotiated Rate	$19,659.71
Rate for Payer: EPIC Health Plan Medicare	$13,697.79
Rate for Payer: Humana Medicare	$13,697.79
Rate for Payer: IEHP Medicare Advantage	$13,697.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,163.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,259.22
Rate for Payer: Molina Healthcare of CA Medicare	$17,259.22
Rate for Payer: Multiplan WC	$19,659.71

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