Loma Linda University Medical Center

All Charges

Charge

Type

Price

INPATIENT MS-DRG 376: DIGESTIVE MALIGNANCY WITHOUT CC/MCC

Facility IP

$14,326.16

Service Code	MS-DRG 376
Min. Negotiated Rate	$10,241.96
Max. Negotiated Rate	$14,326.16
Rate for Payer: EPIC Health Plan Medicare	$10,241.96
Rate for Payer: Humana Medicare	$10,241.96
Rate for Payer: IEHP Medicare Advantage	$10,241.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,085.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,904.87
Rate for Payer: Molina Healthcare of CA Medicare	$12,904.87
Rate for Payer: Multiplan WC	$14,326.16

INPATIENT MS-DRG 377: GASTROINTESTINAL HEMORRHAGE WITH MCC

Facility IP

$29,017.90

Service Code	MS-DRG 377
Min. Negotiated Rate	$20,363.95
Max. Negotiated Rate	$29,017.90
Rate for Payer: EPIC Health Plan Medicare	$20,363.95
Rate for Payer: Humana Medicare	$20,363.95
Rate for Payer: IEHP Medicare Advantage	$20,363.95
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,029.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,658.58
Rate for Payer: Molina Healthcare of CA Medicare	$25,658.58
Rate for Payer: Multiplan WC	$29,017.90

INPATIENT MS-DRG 378: GASTROINTESTINAL HEMORRHAGE WITH CC

Facility IP

$16,075.72

Service Code	MS-DRG 378
Min. Negotiated Rate	$11,282.41
Max. Negotiated Rate	$16,075.72
Rate for Payer: EPIC Health Plan Medicare	$11,282.41
Rate for Payer: Humana Medicare	$11,282.41
Rate for Payer: IEHP Medicare Advantage	$11,282.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,313.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,215.84
Rate for Payer: Molina Healthcare of CA Medicare	$14,215.84
Rate for Payer: Multiplan WC	$16,075.72

INPATIENT MS-DRG 379: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC

Facility IP

$10,343.95

Service Code	MS-DRG 379
Min. Negotiated Rate	$7,334.50
Max. Negotiated Rate	$10,343.95
Rate for Payer: EPIC Health Plan Medicare	$7,334.50
Rate for Payer: Humana Medicare	$7,334.50
Rate for Payer: IEHP Medicare Advantage	$7,334.50
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,654.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,241.47
Rate for Payer: Molina Healthcare of CA Medicare	$9,241.47
Rate for Payer: Multiplan WC	$10,343.95

INPATIENT MS-DRG 380: COMPLICATED PEPTIC ULCER WITH MCC

Facility IP

$31,075.92

Service Code	MS-DRG 380
Min. Negotiated Rate	$22,145.37
Max. Negotiated Rate	$31,075.92
Rate for Payer: EPIC Health Plan Medicare	$22,145.37
Rate for Payer: Humana Medicare	$22,145.37
Rate for Payer: IEHP Medicare Advantage	$22,145.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,131.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,903.17
Rate for Payer: Molina Healthcare of CA Medicare	$27,903.17
Rate for Payer: Multiplan WC	$31,075.92

INPATIENT MS-DRG 381: COMPLICATED PEPTIC ULCER WITH CC

Facility IP

$17,226.31

Service Code	MS-DRG 381
Min. Negotiated Rate	$12,286.85
Max. Negotiated Rate	$17,226.31
Rate for Payer: EPIC Health Plan Medicare	$12,286.85
Rate for Payer: Humana Medicare	$12,286.85
Rate for Payer: IEHP Medicare Advantage	$12,286.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,498.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,481.43
Rate for Payer: Molina Healthcare of CA Medicare	$15,481.43
Rate for Payer: Multiplan WC	$17,226.31

INPATIENT MS-DRG 382: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC

Facility IP

$12,563.54

Service Code	MS-DRG 382
Min. Negotiated Rate	$8,729.67
Max. Negotiated Rate	$12,563.54
Rate for Payer: EPIC Health Plan Medicare	$8,729.67
Rate for Payer: Humana Medicare	$8,729.67
Rate for Payer: IEHP Medicare Advantage	$8,729.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,301.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,999.38
Rate for Payer: Molina Healthcare of CA Medicare	$10,999.38
Rate for Payer: Multiplan WC	$12,563.54

INPATIENT MS-DRG 383: UNCOMPLICATED PEPTIC ULCER WITH MCC

Facility IP

$22,195.92

Service Code	MS-DRG 383
Min. Negotiated Rate	$15,948.74
Max. Negotiated Rate	$22,195.92
Rate for Payer: EPIC Health Plan Medicare	$15,948.74
Rate for Payer: Humana Medicare	$15,948.74
Rate for Payer: IEHP Medicare Advantage	$15,948.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,819.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,095.41
Rate for Payer: Molina Healthcare of CA Medicare	$20,095.41
Rate for Payer: Multiplan WC	$22,195.92

INPATIENT MS-DRG 384: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC

Facility IP

$14,714.59

Service Code	MS-DRG 384
Min. Negotiated Rate	$10,065.17
Max. Negotiated Rate	$14,714.59
Rate for Payer: EPIC Health Plan Medicare	$10,065.17
Rate for Payer: Humana Medicare	$10,065.17
Rate for Payer: IEHP Medicare Advantage	$10,065.17
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,876.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,682.11
Rate for Payer: Molina Healthcare of CA Medicare	$12,682.11
Rate for Payer: Multiplan WC	$14,714.59

INPATIENT MS-DRG 385: INFLAMMATORY BOWEL DISEASE WITH MCC

Facility IP

$26,581.25

Service Code	MS-DRG 385
Min. Negotiated Rate	$17,848.39
Max. Negotiated Rate	$26,581.25
Rate for Payer: EPIC Health Plan Medicare	$17,848.39
Rate for Payer: Humana Medicare	$17,848.39
Rate for Payer: IEHP Medicare Advantage	$17,848.39
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,061.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,488.97
Rate for Payer: Molina Healthcare of CA Medicare	$22,488.97
Rate for Payer: Multiplan WC	$26,581.25

INPATIENT MS-DRG 386: INFLAMMATORY BOWEL DISEASE WITH CC

Facility IP

$16,154.06

Service Code	MS-DRG 386
Min. Negotiated Rate	$11,145.05
Max. Negotiated Rate	$16,154.06
Rate for Payer: EPIC Health Plan Medicare	$11,145.05
Rate for Payer: Humana Medicare	$11,145.05
Rate for Payer: IEHP Medicare Advantage	$11,145.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,151.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,042.76
Rate for Payer: Molina Healthcare of CA Medicare	$14,042.76
Rate for Payer: Multiplan WC	$16,154.06

INPATIENT MS-DRG 387: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility IP

$11,287.28

Service Code	MS-DRG 387
Min. Negotiated Rate	$7,907.65
Max. Negotiated Rate	$11,287.28
Rate for Payer: EPIC Health Plan Medicare	$7,907.65
Rate for Payer: Humana Medicare	$7,907.65
Rate for Payer: IEHP Medicare Advantage	$7,907.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,331.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,963.64
Rate for Payer: Molina Healthcare of CA Medicare	$9,963.64
Rate for Payer: Multiplan WC	$11,287.28

INPATIENT MS-DRG 388: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility IP

$23,948.74

Service Code	MS-DRG 388
Min. Negotiated Rate	$16,571.45
Max. Negotiated Rate	$23,948.74
Rate for Payer: EPIC Health Plan Medicare	$16,571.45
Rate for Payer: Humana Medicare	$16,571.45
Rate for Payer: IEHP Medicare Advantage	$16,571.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,554.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,880.03
Rate for Payer: Molina Healthcare of CA Medicare	$20,880.03
Rate for Payer: Multiplan WC	$23,948.74

INPATIENT MS-DRG 389: GASTROINTESTINAL OBSTRUCTION WITH CC

Facility IP

$13,172.30

Service Code	MS-DRG 389
Min. Negotiated Rate	$9,172.21
Max. Negotiated Rate	$13,172.30
Rate for Payer: EPIC Health Plan Medicare	$9,172.21
Rate for Payer: Humana Medicare	$9,172.21
Rate for Payer: IEHP Medicare Advantage	$9,172.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,823.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,556.98
Rate for Payer: Molina Healthcare of CA Medicare	$11,556.98
Rate for Payer: Multiplan WC	$13,172.30

INPATIENT MS-DRG 390: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility IP

$9,229.26

Service Code	MS-DRG 390
Min. Negotiated Rate	$6,498.98
Max. Negotiated Rate	$9,229.26
Rate for Payer: EPIC Health Plan Medicare	$6,498.98
Rate for Payer: Humana Medicare	$6,498.98
Rate for Payer: IEHP Medicare Advantage	$6,498.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,668.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,188.71
Rate for Payer: Molina Healthcare of CA Medicare	$8,188.71
Rate for Payer: Multiplan WC	$9,229.26

INPATIENT MS-DRG 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC

Facility IP

$20,955.56

Service Code	MS-DRG 391
Min. Negotiated Rate	$14,569.34
Max. Negotiated Rate	$20,955.56
Rate for Payer: EPIC Health Plan Medicare	$14,569.34
Rate for Payer: Humana Medicare	$14,569.34
Rate for Payer: IEHP Medicare Advantage	$14,569.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,191.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,357.37
Rate for Payer: Molina Healthcare of CA Medicare	$18,357.37
Rate for Payer: Multiplan WC	$20,955.56

INPATIENT MS-DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC

Facility IP

$12,854.05

Service Code	MS-DRG 392
Min. Negotiated Rate	$9,050.59
Max. Negotiated Rate	$12,854.05
Rate for Payer: EPIC Health Plan Medicare	$9,050.59
Rate for Payer: Humana Medicare	$9,050.59
Rate for Payer: IEHP Medicare Advantage	$9,050.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,679.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,403.74
Rate for Payer: Molina Healthcare of CA Medicare	$11,403.74
Rate for Payer: Multiplan WC	$12,854.05

INPATIENT MS-DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility IP

$26,297.27

Service Code	MS-DRG 393
Min. Negotiated Rate	$18,441.79
Max. Negotiated Rate	$26,297.27
Rate for Payer: EPIC Health Plan Medicare	$18,441.79
Rate for Payer: Humana Medicare	$18,441.79
Rate for Payer: IEHP Medicare Advantage	$18,441.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,761.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,236.66
Rate for Payer: Molina Healthcare of CA Medicare	$23,236.66
Rate for Payer: Multiplan WC	$26,297.27

INPATIENT MS-DRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility IP

$15,390.25

Service Code	MS-DRG 394
Min. Negotiated Rate	$10,754.28
Max. Negotiated Rate	$15,390.25
Rate for Payer: EPIC Health Plan Medicare	$10,754.28
Rate for Payer: Humana Medicare	$10,754.28
Rate for Payer: IEHP Medicare Advantage	$10,754.28
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,690.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,550.39
Rate for Payer: Molina Healthcare of CA Medicare	$13,550.39
Rate for Payer: Multiplan WC	$15,390.25

INPATIENT MS-DRG 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility IP

$10,525.11

Service Code	MS-DRG 395
Min. Negotiated Rate	$7,495.52
Max. Negotiated Rate	$10,525.11
Rate for Payer: EPIC Health Plan Medicare	$7,495.52
Rate for Payer: Humana Medicare	$7,495.52
Rate for Payer: IEHP Medicare Advantage	$7,495.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,844.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,444.36
Rate for Payer: Molina Healthcare of CA Medicare	$9,444.36
Rate for Payer: Multiplan WC	$10,525.11

INPATIENT MS-DRG 397: APPENDIX PROCEDURES WITH MCC

Facility IP

$32,132.66

Service Code	MS-DRG 397
Min. Negotiated Rate	$25,502.11
Max. Negotiated Rate	$32,132.66
Rate for Payer: EPIC Health Plan Medicare	$25,502.11
Rate for Payer: Humana Medicare	$25,502.11
Rate for Payer: IEHP Medicare Advantage	$25,502.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,092.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,132.66
Rate for Payer: Molina Healthcare of CA Medicare	$32,132.66

INPATIENT MS-DRG 398: APPENDIX PROCEDURES WITH CC

Facility IP

$21,728.47

Service Code	MS-DRG 398
Min. Negotiated Rate	$17,244.82
Max. Negotiated Rate	$21,728.47
Rate for Payer: EPIC Health Plan Medicare	$17,244.82
Rate for Payer: Humana Medicare	$17,244.82
Rate for Payer: IEHP Medicare Advantage	$17,244.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,348.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,728.47
Rate for Payer: Molina Healthcare of CA Medicare	$21,728.47

INPATIENT MS-DRG 399: APPENDIX PROCEDURES WITHOUT CC/MCC

Facility IP

$16,050.38

Service Code	MS-DRG 399
Min. Negotiated Rate	$12,738.40
Max. Negotiated Rate	$16,050.38
Rate for Payer: EPIC Health Plan Medicare	$12,738.40
Rate for Payer: Humana Medicare	$12,738.40
Rate for Payer: IEHP Medicare Advantage	$12,738.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,031.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,050.38
Rate for Payer: Molina Healthcare of CA Medicare	$16,050.38

INPATIENT MS-DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility IP

$90,446.74

Service Code	MS-DRG 405
Min. Negotiated Rate	$62,195.42
Max. Negotiated Rate	$90,446.74
Rate for Payer: EPIC Health Plan Medicare	$62,195.42
Rate for Payer: Humana Medicare	$62,195.42
Rate for Payer: IEHP Medicare Advantage	$62,195.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$73,390.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$78,366.23
Rate for Payer: Molina Healthcare of CA Medicare	$78,366.23
Rate for Payer: Multiplan WC	$90,446.74

INPATIENT MS-DRG 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility IP

$47,814.25

Service Code	MS-DRG 406
Min. Negotiated Rate	$32,717.82
Max. Negotiated Rate	$47,814.25
Rate for Payer: EPIC Health Plan Medicare	$32,717.82
Rate for Payer: Humana Medicare	$32,717.82
Rate for Payer: IEHP Medicare Advantage	$32,717.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,607.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,224.45
Rate for Payer: Molina Healthcare of CA Medicare	$41,224.45
Rate for Payer: Multiplan WC	$47,814.25

Price Transparency.

All Charges