Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC

Facility

$80,332.60

Service Code	MSDRG 277
Min. Negotiated Rate	$52,142.62
Max. Negotiated Rate	$80,332.60
Rate for Payer: EPIC Health Plan Medicare	$52,142.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$52,142.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$59,964.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$65,699.70
Rate for Payer: Molina Healthcare of CA Medicare	$65,699.70
Rate for Payer: Multiplan WC	$80,332.60

MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$48,447.54

Service Code	MSDRG 258
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$48,447.54
Rate for Payer: Aetna of CA Gatekeeper	$28,979.00
Rate for Payer: EPIC Health Plan Medicare	$31,573.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$31,573.26
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$36,309.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,782.31
Rate for Payer: Molina Healthcare of CA Medicare	$39,782.31
Rate for Payer: Multiplan WC	$48,447.54

MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$30,353.32

Service Code	MSDRG 259
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$30,353.32
Rate for Payer: Aetna of CA Gatekeeper	$28,979.00
Rate for Payer: EPIC Health Plan Medicare	$19,900.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,900.48
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,885.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,074.60
Rate for Payer: Molina Healthcare of CA Medicare	$25,074.60
Rate for Payer: Multiplan WC	$30,353.32

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility

$32,769.22

Service Code	MSDRG 261
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$32,769.22
Rate for Payer: Aetna of CA Gatekeeper	$28,979.00
Rate for Payer: EPIC Health Plan Medicare	$21,459.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,459.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,677.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,038.35
Rate for Payer: Molina Healthcare of CA Medicare	$27,038.35
Rate for Payer: Multiplan WC	$32,769.22

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC

Facility

$58,820.89

Service Code	MSDRG 260
Min. Negotiated Rate	$8,850.00
Max. Negotiated Rate	$58,820.89
Rate for Payer: Aetna of CA Gatekeeper	$28,979.00
Rate for Payer: EPIC Health Plan Medicare	$38,265.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$38,265.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$44,004.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,214.16
Rate for Payer: Molina Healthcare of CA Medicare	$48,214.16
Rate for Payer: Multiplan WC	$58,820.89

MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT 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: Aetna of CA Gatekeeper	$28,979.00
Rate for Payer: EPIC Health Plan Medicare	$17,227.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,227.95
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,812.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,707.22
Rate for Payer: Molina Healthcare of CA Medicare	$21,707.22
Rate for Payer: Multiplan WC	$26,210.54

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$111,520.00

Service Code	MSDRG 217
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$111,520.00
Rate for Payer: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$72,261.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$72,261.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$83,101.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$91,050.03
Rate for Payer: Molina Healthcare of CA Medicare	$91,050.03
Rate for Payer: Multiplan WC	$111,520.00

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$166,662.64

Service Code	MSDRG 216
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$166,662.64
Rate for Payer: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$107,835.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$107,835.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$124,010.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$135,872.11
Rate for Payer: Molina Healthcare of CA Medicare	$135,872.11
Rate for Payer: Multiplan WC	$166,662.64

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT 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: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$66,596.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$66,596.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$76,585.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$83,910.96
Rate for Payer: Molina Healthcare of CA Medicare	$83,910.96
Rate for Payer: Multiplan WC	$102,737.10

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

$91,467.51

Service Code	MSDRG 220
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$91,467.51
Rate for Payer: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$59,325.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,325.86
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$68,224.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$74,750.58
Rate for Payer: Molina Healthcare of CA Medicare	$74,750.58
Rate for Payer: Multiplan WC	$91,467.51

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$133,617.12

Service Code	MSDRG 219
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$133,617.12
Rate for Payer: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$86,517.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$86,517.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$99,494.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$109,011.43
Rate for Payer: Molina Healthcare of CA Medicare	$109,011.43
Rate for Payer: Multiplan WC	$133,617.12

MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT 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: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$51,482.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$51,482.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$59,204.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$64,867.32
Rate for Payer: Molina Healthcare of CA Medicare	$64,867.32
Rate for Payer: Multiplan WC	$79,308.56

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH 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 Medicare	$25,661.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,661.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,510.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,333.00
Rate for Payer: Molina Healthcare of CA Medicare	$32,333.00
Rate for Payer: Multiplan WC	$39,283.01

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH 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 Medicare	$43,640.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$43,640.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$50,186.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$54,986.90
Rate for Payer: Molina Healthcare of CA Medicare	$54,986.90
Rate for Payer: Multiplan WC	$67,153.07

MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT 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 Medicare	$20,740.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,740.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,851.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,132.98
Rate for Payer: Molina Healthcare of CA Medicare	$26,132.98
Rate for Payer: Multiplan WC	$31,655.38

MS-DRG 42.00: CELLULITIS WITH MCC

Facility

$25,371.28

Service Code	MSDRG 602
Min. Negotiated Rate	$16,686.54
Max. Negotiated Rate	$25,371.28
Rate for Payer: EPIC Health Plan Medicare	$16,686.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,686.54
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,189.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,025.04
Rate for Payer: Molina Healthcare of CA Medicare	$21,025.04
Rate for Payer: Multiplan WC	$25,371.28

MS-DRG 42.00: CELLULITIS WITHOUT MCC

Facility

$15,210.33

Service Code	MSDRG 603
Min. Negotiated Rate	$10,131.59
Max. Negotiated Rate	$15,210.33
Rate for Payer: EPIC Health Plan Medicare	$10,131.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,131.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,651.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,765.80
Rate for Payer: Molina Healthcare of CA Medicare	$12,765.80
Rate for Payer: Multiplan WC	$15,210.33

MS-DRG 42.00: CERVICAL SPINAL FUSION WITH 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 Medicare	$32,594.82
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,594.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,484.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,069.47
Rate for Payer: Molina Healthcare of CA Medicare	$41,069.47
Rate for Payer: Multiplan WC	$50,031.09

MS-DRG 42.00: CERVICAL SPINAL FUSION WITH 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 Medicare	$54,430.83
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$54,430.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$62,595.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$68,582.85
Rate for Payer: Molina Healthcare of CA Medicare	$68,582.85
Rate for Payer: Multiplan WC	$83,879.61

MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT 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 Medicare	$26,692.71
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,692.71
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,696.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,632.81
Rate for Payer: Molina Healthcare of CA Medicare	$33,632.81
Rate for Payer: Multiplan WC	$40,882.09

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC

Facility

$18,335.99

Service Code	MSDRG 787
Min. Negotiated Rate	$7,879.00
Max. Negotiated Rate	$18,335.99
Rate for Payer: EPIC Health Plan Medicare	$12,147.99
Rate for Payer: Heritage Provider Network Commercial	$8,663.00
Rate for Payer: Heritage Provider Network Senior	$7,879.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,147.99
Rate for Payer: Kaiser Permanente of CA Commercial	$13,453.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,970.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,306.47
Rate for Payer: Molina Healthcare of CA Medicare	$15,306.47
Rate for Payer: Multiplan WC	$18,335.99
Rate for Payer: United Healthcare All Other HMO/non HMO	$12,088.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$10,167.00

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC

Facility

$27,904.61

Service Code	MSDRG 786
Min. Negotiated Rate	$7,879.00
Max. Negotiated Rate	$27,904.61
Rate for Payer: EPIC Health Plan Medicare	$18,320.81
Rate for Payer: Heritage Provider Network Commercial	$8,663.00
Rate for Payer: Heritage Provider Network Senior	$7,879.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,320.81
Rate for Payer: Kaiser Permanente of CA Commercial	$13,453.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,068.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,084.22
Rate for Payer: Molina Healthcare of CA Medicare	$23,084.22
Rate for Payer: Multiplan WC	$27,904.61
Rate for Payer: United Healthcare All Other HMO/non HMO	$12,088.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$10,167.00

MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

Facility

$15,623.06

Service Code	MSDRG 788
Min. Negotiated Rate	$7,879.00
Max. Negotiated Rate	$15,623.06
Rate for Payer: EPIC Health Plan Medicare	$10,397.85
Rate for Payer: Heritage Provider Network Commercial	$8,663.00
Rate for Payer: Heritage Provider Network Senior	$7,879.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,397.85
Rate for Payer: Kaiser Permanente of CA Commercial	$13,453.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,957.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,101.29
Rate for Payer: Molina Healthcare of CA Medicare	$13,101.29
Rate for Payer: Multiplan WC	$15,623.06
Rate for Payer: United Healthcare All Other HMO/non HMO	$12,088.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$10,167.00

MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC

Facility

$18,702.08

Service Code	MSDRG 784
Min. Negotiated Rate	$7,879.00
Max. Negotiated Rate	$18,702.08
Rate for Payer: EPIC Health Plan Medicare	$12,384.15
Rate for Payer: Heritage Provider Network Commercial	$8,663.00
Rate for Payer: Heritage Provider Network Senior	$7,879.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,384.15
Rate for Payer: Kaiser Permanente of CA Commercial	$13,453.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,241.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,604.03
Rate for Payer: Molina Healthcare of CA Medicare	$15,604.03
Rate for Payer: Multiplan WC	$18,702.08
Rate for Payer: United Healthcare All Other HMO/non HMO	$12,088.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$10,167.00

MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC

Facility

$31,810.81

Service Code	MSDRG 783
Min. Negotiated Rate	$7,879.00
Max. Negotiated Rate	$31,810.81
Rate for Payer: EPIC Health Plan Medicare	$20,840.73
Rate for Payer: Heritage Provider Network Commercial	$8,663.00
Rate for Payer: Heritage Provider Network Senior	$7,879.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,840.73
Rate for Payer: Kaiser Permanente of CA Commercial	$13,453.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,966.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,259.32
Rate for Payer: Molina Healthcare of CA Medicare	$26,259.32
Rate for Payer: Multiplan WC	$31,810.81
Rate for Payer: United Healthcare All Other HMO/non HMO	$12,088.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$10,167.00

Know your out-of-pocket cost for care.

All Charges