Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W CC

Facility

$38,903.09

Service Code	MSDRG 243
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$38,903.09
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W MCC

Facility

$58,575.68

Service Code	MSDRG 242
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$58,575.68
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC

Facility

$31,164.95

Service Code	MSDRG 244
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$31,164.95
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W CC

Facility

$59,149.00

Service Code	MSDRG 467
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$59,149.00
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W MCC

Facility

$87,977.49

Service Code	MSDRG 466
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$87,977.49
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC

Facility

$45,301.17

Service Code	MSDRG 468
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$45,301.17
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC

Facility

$99,112.39

Service Code	MSDRG 457
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$99,112.39
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

MS-DRG 29.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC

Facility

$146,252.68

Service Code	MSDRG 456
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$146,252.68
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

MS-DRG 29.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC

Facility

$74,566.55

Service Code	MSDRG 458
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$74,566.55
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

MS-DRG 29.00: SPINAL FUSION EXCEPT CERVICAL W MCC

Facility

$28,410.00

Service Code	MSDRG 459
Min. Negotiated Rate	$21,600.00
Max. Negotiated Rate	$28,410.00
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

MS-DRG 29.00: SPINAL FUSION EXCEPT CERVICAL W/O MCC

Facility

$28,410.00

Service Code	MSDRG 460
Min. Negotiated Rate	$21,600.00
Max. Negotiated Rate	$28,410.00
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

MS-DRG 29.00: VAGINAL DELIVERY W COMPLICATING DIAGNOSES

Facility

$4,895.00

Service Code	MSDRG 774
Min. Negotiated Rate	$4,895.00
Max. Negotiated Rate	$4,895.00
Rate for Payer: Cigna of CA HMO/PPO	$4,895.00

MS-DRG 29.00: VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES

Facility

$4,895.00

Service Code	MSDRG 775
Min. Negotiated Rate	$4,895.00
Max. Negotiated Rate	$4,895.00
Rate for Payer: Cigna of CA HMO/PPO	$4,895.00

MS-DRG 29.00: VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C

Facility

$18,931.76

Service Code	MSDRG 768
Min. Negotiated Rate	$4,895.00
Max. Negotiated Rate	$18,931.76
Rate for Payer: Cigna of CA HMO/PPO	$4,895.00

MS-DRG 29.00: VAGINAL DELIVERY W STERILIZATION &/OR D&C

Facility

$4,895.00

Service Code	MSDRG 767
Min. Negotiated Rate	$4,895.00
Max. Negotiated Rate	$4,895.00
Rate for Payer: Cigna of CA HMO/PPO	$4,895.00

MS-DRG 33.00: ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC

Facility

$30,753.96

Service Code	MSDRG 062
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$30,753.96
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC

Facility

$24,259.17

Service Code	MSDRG 063
Min. Negotiated Rate	$15,969.06
Max. Negotiated Rate	$24,259.17
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: AICD GENERATOR PROCEDURES

Facility

$84,389.03

Service Code	MSDRG 245
Min. Negotiated Rate	$10,312.00
Max. Negotiated Rate	$84,389.03
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

MS-DRG 33.00: AICD LEAD PROCEDURES

Facility

$61,601.16

Service Code	MSDRG 265
Min. Negotiated Rate	$10,312.00
Max. Negotiated Rate	$61,601.16
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

MS-DRG 33.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC

Facility

$105,973.27

Service Code	MSDRG 461
Min. Negotiated Rate	$9,944.00
Max. Negotiated Rate	$105,973.27
Rate for Payer: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC

Facility

$49,454.31

Service Code	MSDRG 462
Min. Negotiated Rate	$9,944.00
Max. Negotiated Rate	$49,454.31
Rate for Payer: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC

Facility

$13,987.00

Service Code	MSDRG 222
Min. Negotiated Rate	$13,987.00
Max. Negotiated Rate	$13,987.00
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

MS-DRG 33.00: CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC

Facility

$13,987.00

Service Code	MSDRG 223
Min. Negotiated Rate	$11,000.00
Max. Negotiated Rate	$13,987.00
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

MS-DRG 33.00: CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC

Facility

$13,987.00

Service Code	MSDRG 224
Min. Negotiated Rate	$11,000.00
Max. Negotiated Rate	$13,987.00
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

MS-DRG 33.00: CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC

Facility

$13,987.00

Service Code	MSDRG 225
Min. Negotiated Rate	$11,000.00
Max. Negotiated Rate	$13,987.00
Rate for Payer: EPIC Health Plan Commercial	$13,987.00

Know your out-of-pocket cost for care.

All Charges