Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC

Facility

$18,000.96

Service Code	MSDRG 074
Min. Negotiated Rate	$11,931.86
Max. Negotiated Rate	$18,000.96
Rate for Payer: EPIC Health Plan Medicare	$11,931.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,931.86
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,721.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,034.14
Rate for Payer: Molina Healthcare of CA Medicare	$15,034.14
Rate for Payer: Multiplan WC	$18,000.96

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC

Facility

$52,818.27

Service Code	MSDRG 026
Min. Negotiated Rate	$34,392.85
Max. Negotiated Rate	$52,818.27
Rate for Payer: EPIC Health Plan Medicare	$34,392.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$34,392.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$39,551.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,334.99
Rate for Payer: Molina Healthcare of CA Medicare	$43,334.99
Rate for Payer: Multiplan WC	$52,818.27

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC

Facility

$77,231.12

Service Code	MSDRG 025
Min. Negotiated Rate	$50,141.84
Max. Negotiated Rate	$77,231.12
Rate for Payer: EPIC Health Plan Medicare	$50,141.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$50,141.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$57,663.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$63,178.72
Rate for Payer: Molina Healthcare of CA Medicare	$63,178.72
Rate for Payer: Multiplan WC	$77,231.12

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$42,615.88

Service Code	MSDRG 027
Min. Negotiated Rate	$27,811.18
Max. Negotiated Rate	$42,615.88
Rate for Payer: EPIC Health Plan Medicare	$27,811.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,811.18
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,982.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$35,042.09
Rate for Payer: Molina Healthcare of CA Medicare	$35,042.09
Rate for Payer: Multiplan WC	$42,615.88

MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$117,916.35

Service Code	MSDRG 955
Min. Negotiated Rate	$76,388.30
Max. Negotiated Rate	$117,916.35
Rate for Payer: EPIC Health Plan Medicare	$76,388.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$76,388.30
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$87,846.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$96,249.26
Rate for Payer: Molina Healthcare of CA Medicare	$96,249.26
Rate for Payer: Multiplan WC	$117,916.35

MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR

Facility

$98,520.08

Service Code	MSDRG 023
Min. Negotiated Rate	$63,875.55
Max. Negotiated Rate	$98,520.08
Rate for Payer: EPIC Health Plan Medicare	$63,875.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$63,875.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$73,456.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$80,483.19
Rate for Payer: Molina Healthcare of CA Medicare	$80,483.19
Rate for Payer: Multiplan WC	$98,520.08

MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC

Facility

$65,650.69

Service Code	MSDRG 024
Min. Negotiated Rate	$42,671.19
Max. Negotiated Rate	$65,650.69
Rate for Payer: EPIC Health Plan Medicare	$42,671.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$42,671.19
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$49,071.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$53,765.70
Rate for Payer: Molina Healthcare of CA Medicare	$53,765.70
Rate for Payer: Multiplan WC	$65,650.69

MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC

Facility

$33,743.18

Service Code	MSDRG 744
Min. Negotiated Rate	$22,087.33
Max. Negotiated Rate	$33,743.18
Rate for Payer: EPIC Health Plan Medicare	$22,087.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,087.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,400.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,830.04
Rate for Payer: Molina Healthcare of CA Medicare	$27,830.04
Rate for Payer: Multiplan WC	$33,743.18

MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC

Facility

$17,697.04

Service Code	MSDRG 745
Min. Negotiated Rate	$11,735.79
Max. Negotiated Rate	$17,697.04
Rate for Payer: EPIC Health Plan Medicare	$11,735.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,735.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,496.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,787.10
Rate for Payer: Molina Healthcare of CA Medicare	$14,787.10
Rate for Payer: Multiplan WC	$17,697.04

MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC

Facility

$21,206.05

Service Code	MSDRG 294
Min. Negotiated Rate	$13,999.49
Max. Negotiated Rate	$21,206.05
Rate for Payer: EPIC Health Plan Medicare	$13,999.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,999.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,099.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,639.36
Rate for Payer: Molina Healthcare of CA Medicare	$17,639.36
Rate for Payer: Multiplan WC	$21,206.05

MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC

Facility

$13,638.88

Service Code	MSDRG 295
Min. Negotiated Rate	$9,117.84
Max. Negotiated Rate	$13,638.88
Rate for Payer: EPIC Health Plan Medicare	$9,117.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,117.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,485.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,488.48
Rate for Payer: Molina Healthcare of CA Medicare	$11,488.48
Rate for Payer: Multiplan WC	$13,638.88

MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC

Facility

$43,242.74

Service Code	MSDRG 056
Min. Negotiated Rate	$28,215.58
Max. Negotiated Rate	$43,242.74
Rate for Payer: EPIC Health Plan Medicare	$28,215.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$28,215.58
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$32,447.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$35,551.63
Rate for Payer: Molina Healthcare of CA Medicare	$35,551.63
Rate for Payer: Multiplan WC	$43,242.74

MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC

Facility

$23,043.45

Service Code	MSDRG 057
Min. Negotiated Rate	$15,184.82
Max. Negotiated Rate	$23,043.45
Rate for Payer: EPIC Health Plan Medicare	$15,184.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,184.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,462.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,132.87
Rate for Payer: Molina Healthcare of CA Medicare	$19,132.87
Rate for Payer: Multiplan WC	$23,043.45

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC

Facility

$16,243.01

Service Code	MSDRG 158
Min. Negotiated Rate	$10,797.78
Max. Negotiated Rate	$16,243.01
Rate for Payer: EPIC Health Plan Medicare	$10,797.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,797.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,417.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,605.20
Rate for Payer: Molina Healthcare of CA Medicare	$13,605.20
Rate for Payer: Multiplan WC	$16,243.01

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC

Facility

$28,277.62

Service Code	MSDRG 157
Min. Negotiated Rate	$18,561.42
Max. Negotiated Rate	$28,277.62
Rate for Payer: EPIC Health Plan Medicare	$18,561.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,561.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,345.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,387.39
Rate for Payer: Molina Healthcare of CA Medicare	$23,387.39
Rate for Payer: Multiplan WC	$28,277.62

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC

Facility

$11,390.48

Service Code	MSDRG 159
Min. Negotiated Rate	$7,667.38
Max. Negotiated Rate	$11,390.48
Rate for Payer: EPIC Health Plan Medicare	$7,667.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,667.38
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,817.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,660.90
Rate for Payer: Molina Healthcare of CA Medicare	$9,660.90
Rate for Payer: Multiplan WC	$11,390.48

MS-DRG 42.00: DEPRESSIVE NEUROSES

Facility

$15,785.39

Service Code	MSDRG 881
Min. Negotiated Rate	$10,502.57
Max. Negotiated Rate	$15,785.39
Rate for Payer: EPIC Health Plan Medicare	$10,502.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,502.57
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,077.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,233.24
Rate for Payer: Molina Healthcare of CA Medicare	$13,233.24
Rate for Payer: Multiplan WC	$15,785.39

MS-DRG 42.00: DIABETES WITH CC

Facility

$15,838.92

Service Code	MSDRG 638
Min. Negotiated Rate	$10,537.10
Max. Negotiated Rate	$15,838.92
Rate for Payer: EPIC Health Plan Medicare	$10,537.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,537.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,117.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,276.75
Rate for Payer: Molina Healthcare of CA Medicare	$13,276.75
Rate for Payer: Multiplan WC	$15,838.92

MS-DRG 42.00: DIABETES WITH MCC

Facility

$25,148.51

Service Code	MSDRG 637
Min. Negotiated Rate	$16,542.82
Max. Negotiated Rate	$25,148.51
Rate for Payer: EPIC Health Plan Medicare	$16,542.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,542.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,024.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,843.95
Rate for Payer: Molina Healthcare of CA Medicare	$20,843.95
Rate for Payer: Multiplan WC	$25,148.51

MS-DRG 42.00: DIABETES WITHOUT CC/MCC

Facility

$10,820.61

Service Code	MSDRG 639
Min. Negotiated Rate	$7,299.75
Max. Negotiated Rate	$10,820.61
Rate for Payer: EPIC Health Plan Medicare	$7,299.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,299.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,394.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,197.68
Rate for Payer: Molina Healthcare of CA Medicare	$9,197.68
Rate for Payer: Multiplan WC	$10,820.61

MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH CC

Facility

$21,218.14

Service Code	MSDRG 375
Min. Negotiated Rate	$14,007.31
Max. Negotiated Rate	$21,218.14
Rate for Payer: EPIC Health Plan Medicare	$14,007.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,007.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,108.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,649.21
Rate for Payer: Molina Healthcare of CA Medicare	$17,649.21
Rate for Payer: Multiplan WC	$21,218.14

MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH MCC

Facility

$36,461.28

Service Code	MSDRG 374
Min. Negotiated Rate	$23,840.80
Max. Negotiated Rate	$36,461.28
Rate for Payer: EPIC Health Plan Medicare	$23,840.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,840.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,416.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,039.41
Rate for Payer: Molina Healthcare of CA Medicare	$30,039.41
Rate for Payer: Multiplan WC	$36,461.28

MS-DRG 42.00: DIGESTIVE MALIGNANCY WITHOUT CC/MCC

Facility

$15,248.33

Service Code	MSDRG 376
Min. Negotiated Rate	$10,156.11
Max. Negotiated Rate	$15,248.33
Rate for Payer: EPIC Health Plan Medicare	$10,156.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,156.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,679.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,796.70
Rate for Payer: Molina Healthcare of CA Medicare	$12,796.70
Rate for Payer: Multiplan WC	$15,248.33

MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC

Facility

$16,685.09

Service Code	MSDRG 442
Min. Negotiated Rate	$11,082.98
Max. Negotiated Rate	$16,685.09
Rate for Payer: EPIC Health Plan Medicare	$11,082.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,082.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,745.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,964.55
Rate for Payer: Molina Healthcare of CA Medicare	$13,964.55
Rate for Payer: Multiplan WC	$16,685.09

MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC

Facility

$32,644.89

Service Code	MSDRG 441
Min. Negotiated Rate	$21,378.80
Max. Negotiated Rate	$32,644.89
Rate for Payer: EPIC Health Plan Medicare	$21,378.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,378.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,585.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,937.29
Rate for Payer: Molina Healthcare of CA Medicare	$26,937.29
Rate for Payer: Multiplan WC	$32,644.89

Know your out-of-pocket cost for care.

All Charges