Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Facility

$12,854.88

Service Code	MSDRG 726
Min. Negotiated Rate	$8,612.07
Max. Negotiated Rate	$12,854.88
Rate for Payer: EPIC Health Plan Medicare	$8,612.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,612.07
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,903.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,851.21
Rate for Payer: Molina Healthcare of CA Medicare	$10,851.21
Rate for Payer: Multiplan WC	$12,854.88

MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH 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 Medicare	$68,683.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$68,683.69
Rate for Payer: Kaiser Permanente of CA Commercial	$9,944.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$78,986.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$86,541.45
Rate for Payer: Molina Healthcare of CA Medicare	$86,541.45
Rate for Payer: Multiplan WC	$105,973.27

MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT 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 Medicare	$32,222.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,222.73
Rate for Payer: Kaiser Permanente of CA Commercial	$9,944.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,056.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,600.64
Rate for Payer: Molina Healthcare of CA Medicare	$40,600.64
Rate for Payer: Multiplan WC	$49,454.31

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$36,203.98

Service Code	MSDRG 409
Min. Negotiated Rate	$23,674.81
Max. Negotiated Rate	$36,203.98
Rate for Payer: EPIC Health Plan Medicare	$23,674.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,674.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,226.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,830.26
Rate for Payer: Molina Healthcare of CA Medicare	$29,830.26
Rate for Payer: Multiplan WC	$36,203.98

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$60,463.15

Service Code	MSDRG 408
Min. Negotiated Rate	$39,324.65
Max. Negotiated Rate	$60,463.15
Rate for Payer: EPIC Health Plan Medicare	$39,324.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,324.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,223.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,549.06
Rate for Payer: Molina Healthcare of CA Medicare	$49,549.06
Rate for Payer: Multiplan WC	$60,463.15

MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$26,785.60

Service Code	MSDRG 410
Min. Negotiated Rate	$17,598.93
Max. Negotiated Rate	$26,785.60
Rate for Payer: EPIC Health Plan Medicare	$17,598.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,598.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,238.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,174.65
Rate for Payer: Molina Healthcare of CA Medicare	$22,174.65
Rate for Payer: Multiplan WC	$26,785.60

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$40,384.75

Service Code	MSDRG 478
Min. Negotiated Rate	$26,371.86
Max. Negotiated Rate	$40,384.75
Rate for Payer: EPIC Health Plan Medicare	$26,371.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,371.86
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,327.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,228.54
Rate for Payer: Molina Healthcare of CA Medicare	$33,228.54
Rate for Payer: Multiplan WC	$40,384.75

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$59,387.30

Service Code	MSDRG 477
Min. Negotiated Rate	$38,630.63
Max. Negotiated Rate	$59,387.30
Rate for Payer: EPIC Health Plan Medicare	$38,630.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$38,630.63
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$44,425.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,674.59
Rate for Payer: Molina Healthcare of CA Medicare	$48,674.59
Rate for Payer: Multiplan WC	$59,387.30

MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$30,665.89

Service Code	MSDRG 479
Min. Negotiated Rate	$20,102.12
Max. Negotiated Rate	$30,665.89
Rate for Payer: EPIC Health Plan Medicare	$20,102.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,102.12
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,117.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,328.67
Rate for Payer: Molina Healthcare of CA Medicare	$25,328.67
Rate for Payer: Multiplan WC	$30,665.89

MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$22,553.01

Service Code	MSDRG 553
Min. Negotiated Rate	$14,868.44
Max. Negotiated Rate	$22,553.01
Rate for Payer: EPIC Health Plan Medicare	$14,868.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,868.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,098.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,734.23
Rate for Payer: Molina Healthcare of CA Medicare	$18,734.23
Rate for Payer: Multiplan WC	$22,553.01

MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Facility

$14,412.52

Service Code	MSDRG 554
Min. Negotiated Rate	$9,616.92
Max. Negotiated Rate	$14,412.52
Rate for Payer: EPIC Health Plan Medicare	$9,616.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,616.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,059.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,117.32
Rate for Payer: Molina Healthcare of CA Medicare	$12,117.32
Rate for Payer: Multiplan WC	$14,412.52

MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC

Facility

$35,356.09

Service Code	MSDRG 584
Min. Negotiated Rate	$23,127.83
Max. Negotiated Rate	$35,356.09
Rate for Payer: EPIC Health Plan Medicare	$23,127.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,127.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,597.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,141.07
Rate for Payer: Molina Healthcare of CA Medicare	$29,141.07
Rate for Payer: Multiplan WC	$35,356.09

MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC

Facility

$34,280.24

Service Code	MSDRG 585
Min. Negotiated Rate	$22,433.79
Max. Negotiated Rate	$34,280.24
Rate for Payer: EPIC Health Plan Medicare	$22,433.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,433.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,798.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,266.58
Rate for Payer: Molina Healthcare of CA Medicare	$28,266.58
Rate for Payer: Multiplan WC	$34,280.24

MS-DRG 42.00: BRONCHITIS AND ASTHMA WITH CC/MCC

Facility

$16,693.72

Service Code	MSDRG 202
Min. Negotiated Rate	$11,088.54
Max. Negotiated Rate	$16,693.72
Rate for Payer: EPIC Health Plan Medicare	$11,088.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,088.54
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,751.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,971.56
Rate for Payer: Molina Healthcare of CA Medicare	$13,971.56
Rate for Payer: Multiplan WC	$16,693.72

MS-DRG 42.00: BRONCHITIS AND ASTHMA WITHOUT CC/MCC

Facility

$12,029.43

Service Code	MSDRG 203
Min. Negotiated Rate	$8,079.56
Max. Negotiated Rate	$12,029.43
Rate for Payer: EPIC Health Plan Medicare	$8,079.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,079.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,291.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,180.25
Rate for Payer: Molina Healthcare of CA Medicare	$10,180.25
Rate for Payer: Multiplan WC	$12,029.43

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH CC

Facility

$12,164.12

Service Code	MSDRG 297
Min. Negotiated Rate	$8,166.46
Max. Negotiated Rate	$12,164.12
Rate for Payer: EPIC Health Plan Medicare	$8,166.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,166.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,391.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,289.74
Rate for Payer: Molina Healthcare of CA Medicare	$10,289.74
Rate for Payer: Multiplan WC	$12,164.12

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH MCC

Facility

$28,293.16

Service Code	MSDRG 296
Min. Negotiated Rate	$18,571.46
Max. Negotiated Rate	$28,293.16
Rate for Payer: EPIC Health Plan Medicare	$18,571.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,571.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,357.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,400.04
Rate for Payer: Molina Healthcare of CA Medicare	$23,400.04
Rate for Payer: Multiplan WC	$28,293.16

MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC

Facility

$7,627.61

Service Code	MSDRG 298
Min. Negotiated Rate	$5,239.90
Max. Negotiated Rate	$7,627.61
Rate for Payer: EPIC Health Plan Medicare	$5,239.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$5,239.90
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$6,025.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,602.27
Rate for Payer: Molina Healthcare of CA Medicare	$6,602.27
Rate for Payer: Multiplan WC	$7,627.61

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$12,766.80

Service Code	MSDRG 309
Min. Negotiated Rate	$8,555.26
Max. Negotiated Rate	$12,766.80
Rate for Payer: EPIC Health Plan Medicare	$8,555.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,555.26
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,838.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,779.63
Rate for Payer: Molina Healthcare of CA Medicare	$10,779.63
Rate for Payer: Multiplan WC	$12,766.80

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC

Facility

$20,824.41

Service Code	MSDRG 308
Min. Negotiated Rate	$13,753.29
Max. Negotiated Rate	$20,824.41
Rate for Payer: EPIC Health Plan Medicare	$13,753.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,753.29
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,816.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,329.15
Rate for Payer: Molina Healthcare of CA Medicare	$17,329.15
Rate for Payer: Multiplan WC	$20,824.41

MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC

Facility

$9,661.88

Service Code	MSDRG 310
Min. Negotiated Rate	$6,552.23
Max. Negotiated Rate	$9,661.88
Rate for Payer: EPIC Health Plan Medicare	$6,552.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,552.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,535.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,255.81
Rate for Payer: Molina Healthcare of CA Medicare	$8,255.81
Rate for Payer: Multiplan WC	$9,661.88

MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC

Facility

$25,858.26

Service Code	MSDRG 306
Min. Negotiated Rate	$17,000.68
Max. Negotiated Rate	$25,858.26
Rate for Payer: EPIC Health Plan Medicare	$17,000.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,000.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,550.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,420.86
Rate for Payer: Molina Healthcare of CA Medicare	$21,420.86
Rate for Payer: Multiplan WC	$25,858.26

MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Facility

$15,997.79

Service Code	MSDRG 307
Min. Negotiated Rate	$10,639.60
Max. Negotiated Rate	$15,997.79
Rate for Payer: EPIC Health Plan Medicare	$10,639.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,639.60
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,235.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,405.90
Rate for Payer: Molina Healthcare of CA Medicare	$13,405.90
Rate for Payer: Multiplan WC	$15,997.79

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC

Facility

$122,038.41

Service Code	MSDRG 275
Min. Negotiated Rate	$79,047.47
Max. Negotiated Rate	$122,038.41
Rate for Payer: EPIC Health Plan Medicare	$79,047.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$79,047.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$90,904.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$99,599.81
Rate for Payer: Molina Healthcare of CA Medicare	$99,599.81
Rate for Payer: Multiplan WC	$122,038.41

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR

Facility

$106,969.69

Service Code	MSDRG 276
Min. Negotiated Rate	$69,326.47
Max. Negotiated Rate	$106,969.69
Rate for Payer: EPIC Health Plan Medicare	$69,326.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,326.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$79,725.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$87,351.35
Rate for Payer: Molina Healthcare of CA Medicare	$87,351.35
Rate for Payer: Multiplan WC	$106,969.69

Know your out-of-pocket cost for care.

All Charges