Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 33.00: CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC

Facility

$13,987.00

Service Code	MSDRG 226
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 DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC

Facility

$13,987.00

Service Code	MSDRG 227
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 PACEMAKER DEVICE REPLACEMENT W MCC

Facility

$48,447.54

Service Code	MSDRG 258
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$48,447.54
Rate for Payer: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC

Facility

$30,353.32

Service Code	MSDRG 259
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$30,353.32
Rate for Payer: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC

Facility

$32,769.22

Service Code	MSDRG 261
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$32,769.22
Rate for Payer: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC

Facility

$58,820.89

Service Code	MSDRG 260
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$58,820.89
Rate for Payer: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC

Facility

$28,979.00

Service Code	MSDRG 262
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$28,979.00
Rate for Payer: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC

Facility

$111,520.00

Service Code	MSDRG 217
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$111,520.00
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC

Facility

$166,662.64

Service Code	MSDRG 216
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$166,662.64
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC

Facility

$102,737.10

Service Code	MSDRG 218
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$102,737.10
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC

Facility

$91,467.51

Service Code	MSDRG 220
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$91,467.51
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC

Facility

$133,617.12

Service Code	MSDRG 219
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$133,617.12
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC

Facility

$86,939.00

Service Code	MSDRG 221
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$86,939.00
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CAROTID ARTERY STENT PROCEDURE W CC

Facility

$39,283.01

Service Code	MSDRG 035
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$39,283.01
Rate for Payer: EPIC Health Plan Commercial	$14,752.00

MS-DRG 33.00: CAROTID ARTERY STENT PROCEDURE W MCC

Facility

$67,153.07

Service Code	MSDRG 034
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$67,153.07
Rate for Payer: EPIC Health Plan Commercial	$14,752.00

MS-DRG 33.00: CAROTID ARTERY STENT PROCEDURE W/O CC/MCC

Facility

$31,655.38

Service Code	MSDRG 036
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$31,655.38
Rate for Payer: EPIC Health Plan Commercial	$14,752.00

MS-DRG 33.00: CERVICAL SPINAL FUSION W CC

Facility

$50,031.09

Service Code	MSDRG 472
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$50,031.09
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CERVICAL SPINAL FUSION W MCC

Facility

$83,879.61

Service Code	MSDRG 471
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$83,879.61
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CERVICAL SPINAL FUSION W/O CC/MCC

Facility

$40,882.09

Service Code	MSDRG 473
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$40,882.09
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC

Facility

$38,220.97

Service Code	MSDRG 286
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$38,220.97
Rate for Payer: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC

Facility

$18,817.78

Service Code	MSDRG 287
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$18,817.78
Rate for Payer: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC

Facility

$28,410.00

Service Code	MSDRG 454
Min. Negotiated Rate	$21,600.00
Max. Negotiated Rate	$28,410.00
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC

Facility

$28,410.00

Service Code	MSDRG 453
Min. Negotiated Rate	$21,600.00
Max. Negotiated Rate	$28,410.00
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC

Facility

$28,410.00

Service Code	MSDRG 455
Min. Negotiated Rate	$21,600.00
Max. Negotiated Rate	$28,410.00
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$28,410.00

Know your out-of-pocket cost for care.

All Charges