Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 29.00: CORONARY BYPASS W CARDIAC CATH W MCC

Facility

$134,979.63

Service Code	MSDRG 233
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$134,979.63
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: CORONARY BYPASS W CARDIAC CATH W/O MCC

Facility

$91,873.32

Service Code	MSDRG 234
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$91,873.32
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: CORONARY BYPASS W/O CARDIAC CATH W MCC

Facility

$101,612.91

Service Code	MSDRG 235
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$101,612.91
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: CORONARY BYPASS W/O CARDIAC CATH W/O MCC

Facility

$86,939.00

Service Code	MSDRG 236
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$86,939.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: CORONARY BYPASS W PTCA W MCC

Facility

$146,333.85

Service Code	MSDRG 231
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$146,333.85
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: CORONARY BYPASS W PTCA W/O MCC

Facility

$105,489.75

Service Code	MSDRG 232
Min. Negotiated Rate	$23,752.00
Max. Negotiated Rate	$105,489.75
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC

Facility

$28,638.53

Service Code	MSDRG 418
Min. Negotiated Rate	$14,580.00
Max. Negotiated Rate	$28,638.53
Rate for Payer: Cigna of CA HMO/PPO	$14,580.00

MS-DRG 29.00: LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC

Facility

$41,039.23

Service Code	MSDRG 417
Min. Negotiated Rate	$14,580.00
Max. Negotiated Rate	$41,039.23
Rate for Payer: Cigna of CA HMO/PPO	$14,580.00

MS-DRG 29.00: LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC

Facility

$22,753.34

Service Code	MSDRG 419
Min. Negotiated Rate	$14,580.00
Max. Negotiated Rate	$22,753.34
Rate for Payer: Cigna of CA HMO/PPO	$14,580.00

MS-DRG 29.00: MAJOR CARDIOVASC PROCEDURES W MCC

Facility

$32,400.00

Service Code	MSDRG 237
Min. Negotiated Rate	$32,400.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: MAJOR CARDIOVASC PROCEDURES W/O MCC

Facility

$32,400.00

Service Code	MSDRG 238
Min. Negotiated Rate	$32,400.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC

Facility

$56,446.43

Service Code	MSDRG 469
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$56,446.43
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC

Facility

$32,560.27

Service Code	MSDRG 470
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$32,560.27
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W CC

Facility

$27,578.23

Service Code	MSDRG 620
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$27,578.23
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W MCC

Facility

$47,083.31

Service Code	MSDRG 619
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$47,083.31
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W/O CC/MCC

Facility

$25,243.49

Service Code	MSDRG 621
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$25,243.49
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W CC

Facility

$86,939.00

Service Code	MSDRG 229
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$86,939.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W MCC

Facility

$86,939.00

Service Code	MSDRG 228
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$86,939.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC

Facility

$32,400.00

Service Code	MSDRG 230
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC

Facility

$53,401.95

Service Code	MSDRG 515
Min. Negotiated Rate	$13,500.00
Max. Negotiated Rate	$53,401.95
Rate for Payer: Cigna of CA HMO/PPO	$13,500.00

MS-DRG 29.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS

Facility

$11,000.00

Service Code	MSDRG 246
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC

Facility

$11,000.00

Service Code	MSDRG 247
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W MCC OR 4+ VES/STENTS

Facility

$11,000.00

Service Code	MSDRG 248
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC

Facility

$11,000.00

Service Code	MSDRG 249
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC

Facility

$39,935.76

Service Code	MSDRG 250
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$39,935.76
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

Know your out-of-pocket cost for care.

All Charges