Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

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

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

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

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

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS

Facility

$18,576.00

Service Code	MSDRG 065
Min. Negotiated Rate	$11,647.74
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC

Facility

$34,351.04

Service Code	MSDRG 064
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$34,351.04
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC

Facility

$18,576.00

Service Code	MSDRG 066
Min. Negotiated Rate	$7,987.06
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

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

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

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

MS-DRG 33.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC

Facility

$34,739.59

Service Code	MSDRG 516
Min. Negotiated Rate	$22,730.06
Max. Negotiated Rate	$34,739.59
Rate for Payer: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC

Facility

$27,318.00

Service Code	MSDRG 517
Min. Negotiated Rate	$16,948.27
Max. Negotiated Rate	$27,318.00
Rate for Payer: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC

Facility

$26,984.18

Service Code	MSDRG 251
Min. Negotiated Rate	$9,725.00
Max. Negotiated Rate	$26,984.18
Rate for Payer: EPIC Health Plan Commercial	$9,725.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

Know your out-of-pocket cost for care.

All Charges