Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH CC

Facility

$13,842.65

Service Code	MSDRG 389
Min. Negotiated Rate	$9,249.30
Max. Negotiated Rate	$13,842.65
Rate for Payer: EPIC Health Plan Medicare	$9,249.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,249.30
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,636.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,654.12
Rate for Payer: Molina Healthcare of CA Medicare	$11,654.12
Rate for Payer: Multiplan WC	$13,842.65

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$25,383.37

Service Code	MSDRG 388
Min. Negotiated Rate	$16,694.33
Max. Negotiated Rate	$25,383.37
Rate for Payer: EPIC Health Plan Medicare	$16,694.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,694.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,198.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,034.86
Rate for Payer: Molina Healthcare of CA Medicare	$21,034.86
Rate for Payer: Multiplan WC	$25,383.37

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility

$9,449.47

Service Code	MSDRG 390
Min. Negotiated Rate	$6,415.20
Max. Negotiated Rate	$9,449.47
Rate for Payer: EPIC Health Plan Medicare	$6,415.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,415.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,377.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,083.15
Rate for Payer: Molina Healthcare of CA Medicare	$8,083.15
Rate for Payer: Multiplan WC	$9,449.47

MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC

Facility

$25,999.86

Service Code	MSDRG 513
Min. Negotiated Rate	$17,092.04
Max. Negotiated Rate	$25,999.86
Rate for Payer: EPIC Health Plan Medicare	$17,092.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,092.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,655.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,535.97
Rate for Payer: Molina Healthcare of CA Medicare	$21,535.97
Rate for Payer: Multiplan WC	$25,999.86

MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$17,607.24

Service Code	MSDRG 514
Min. Negotiated Rate	$11,677.86
Max. Negotiated Rate	$17,607.24
Rate for Payer: EPIC Health Plan Medicare	$11,677.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,677.86
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,429.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,714.10
Rate for Payer: Molina Healthcare of CA Medicare	$14,714.10
Rate for Payer: Multiplan WC	$17,607.24

MS-DRG 42.00: HAND PROCEDURES FOR INJURIES

Facility

$37,689.09

Service Code	MSDRG 906
Min. Negotiated Rate	$24,632.88
Max. Negotiated Rate	$37,689.09
Rate for Payer: EPIC Health Plan Medicare	$24,632.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,632.88
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,327.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,037.43
Rate for Payer: Molina Healthcare of CA Medicare	$31,037.43
Rate for Payer: Multiplan WC	$37,689.09

MS-DRG 42.00: HEADACHES WITH MCC

Facility

$20,023.14

Service Code	MSDRG 102
Min. Negotiated Rate	$13,236.39
Max. Negotiated Rate	$20,023.14
Rate for Payer: EPIC Health Plan Medicare	$13,236.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,236.39
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,221.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,677.85
Rate for Payer: Molina Healthcare of CA Medicare	$16,677.85
Rate for Payer: Multiplan WC	$20,023.14

MS-DRG 42.00: HEADACHES WITHOUT MCC

Facility

$14,681.91

Service Code	MSDRG 103
Min. Negotiated Rate	$9,790.70
Max. Negotiated Rate	$14,681.91
Rate for Payer: EPIC Health Plan Medicare	$9,790.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,790.70
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,259.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,336.28
Rate for Payer: Molina Healthcare of CA Medicare	$12,336.28
Rate for Payer: Multiplan WC	$14,681.91

MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC

Facility

$14,871.86

Service Code	MSDRG 292
Min. Negotiated Rate	$9,913.24
Max. Negotiated Rate	$14,871.86
Rate for Payer: EPIC Health Plan Medicare	$9,913.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,913.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,400.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,490.68
Rate for Payer: Molina Healthcare of CA Medicare	$12,490.68
Rate for Payer: Multiplan WC	$14,871.86

MS-DRG 42.00: HEART FAILURE AND SHOCK WITH MCC

Facility

$22,532.30

Service Code	MSDRG 291
Min. Negotiated Rate	$14,855.07
Max. Negotiated Rate	$22,532.30
Rate for Payer: EPIC Health Plan Medicare	$14,855.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,855.07
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,083.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,717.39
Rate for Payer: Molina Healthcare of CA Medicare	$18,717.39
Rate for Payer: Multiplan WC	$22,532.30

MS-DRG 42.00: HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$9,475.38

Service Code	MSDRG 293
Min. Negotiated Rate	$6,431.93
Max. Negotiated Rate	$9,475.38
Rate for Payer: EPIC Health Plan Medicare	$6,431.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,431.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,396.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,104.23
Rate for Payer: Molina Healthcare of CA Medicare	$8,104.23
Rate for Payer: Multiplan WC	$9,475.38

MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$486,431.96

Service Code	MSDRG 001
Min. Negotiated Rate	$314,121.41
Max. Negotiated Rate	$486,431.96
Rate for Payer: EPIC Health Plan Medicare	$314,121.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$314,121.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$361,239.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$395,792.98
Rate for Payer: Molina Healthcare of CA Medicare	$395,792.98
Rate for Payer: Multiplan WC	$486,431.96

MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$190,296.68

Service Code	MSDRG 002
Min. Negotiated Rate	$123,081.57
Max. Negotiated Rate	$190,296.68
Rate for Payer: EPIC Health Plan Medicare	$123,081.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$123,081.57
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$141,543.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$155,082.78
Rate for Payer: Molina Healthcare of CA Medicare	$155,082.78
Rate for Payer: Multiplan WC	$190,296.68

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC

Facility

$28,279.34

Service Code	MSDRG 421
Min. Negotiated Rate	$18,562.56
Max. Negotiated Rate	$28,279.34
Rate for Payer: EPIC Health Plan Medicare	$18,562.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,562.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,346.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,388.83
Rate for Payer: Molina Healthcare of CA Medicare	$23,388.83
Rate for Payer: Multiplan WC	$28,279.34

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC

Facility

$60,950.13

Service Code	MSDRG 420
Min. Negotiated Rate	$39,638.80
Max. Negotiated Rate	$60,950.13
Rate for Payer: EPIC Health Plan Medicare	$39,638.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,638.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,584.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,944.89
Rate for Payer: Molina Healthcare of CA Medicare	$49,944.89
Rate for Payer: Multiplan WC	$60,950.13

MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$25,374.74

Service Code	MSDRG 422
Min. Negotiated Rate	$16,688.77
Max. Negotiated Rate	$25,374.74
Rate for Payer: EPIC Health Plan Medicare	$16,688.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,688.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,192.09
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,027.85
Rate for Payer: Molina Healthcare of CA Medicare	$21,027.85
Rate for Payer: Multiplan WC	$25,374.74

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility

$29,375.91

Service Code	MSDRG 354
Min. Negotiated Rate	$19,269.96
Max. Negotiated Rate	$29,375.91
Rate for Payer: EPIC Health Plan Medicare	$19,269.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,269.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,160.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,280.15
Rate for Payer: Molina Healthcare of CA Medicare	$24,280.15
Rate for Payer: Multiplan WC	$29,375.91

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility

$50,649.31

Service Code	MSDRG 353
Min. Negotiated Rate	$32,993.64
Max. Negotiated Rate	$50,649.31
Rate for Payer: EPIC Health Plan Medicare	$32,993.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,993.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,942.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,571.99
Rate for Payer: Molina Healthcare of CA Medicare	$41,571.99
Rate for Payer: Multiplan WC	$50,649.31

MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility

$23,022.73

Service Code	MSDRG 355
Min. Negotiated Rate	$15,171.45
Max. Negotiated Rate	$23,022.73
Rate for Payer: EPIC Health Plan Medicare	$15,171.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,171.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,447.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,116.03
Rate for Payer: Molina Healthcare of CA Medicare	$19,116.03
Rate for Payer: Multiplan WC	$23,022.73

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$35,830.98

Service Code	MSDRG 481
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$35,830.98
Rate for Payer: EPIC Health Plan Medicare	$23,434.16
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	$23,434.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,949.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,527.04
Rate for Payer: Molina Healthcare of CA Medicare	$29,527.04
Rate for Payer: Multiplan WC	$35,830.98

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$50,787.46

Service Code	MSDRG 480
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$50,787.46
Rate for Payer: EPIC Health Plan Medicare	$33,082.77
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	$33,082.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,045.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,684.29
Rate for Payer: Molina Healthcare of CA Medicare	$41,684.29
Rate for Payer: Multiplan WC	$50,787.46

MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$27,395.18

Service Code	MSDRG 482
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$27,395.18
Rate for Payer: EPIC Health Plan Medicare	$17,992.17
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	$17,992.17
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,691.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,670.13
Rate for Payer: Molina Healthcare of CA Medicare	$22,670.13
Rate for Payer: Multiplan WC	$27,395.18

MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

Facility

$50,333.29

Service Code	MSDRG 521
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$50,333.29
Rate for Payer: EPIC Health Plan Medicare	$32,789.78
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	$32,789.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,708.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,315.12
Rate for Payer: Molina Healthcare of CA Medicare	$41,315.12
Rate for Payer: Multiplan WC	$50,333.29

MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC

Facility

$36,404.30

Service Code	MSDRG 522
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$36,404.30
Rate for Payer: EPIC Health Plan Medicare	$23,804.03
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	$23,804.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,374.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,993.08
Rate for Payer: Molina Healthcare of CA Medicare	$29,993.08
Rate for Payer: Multiplan WC	$36,404.30

MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC

Facility

$109,212.90

Service Code	MSDRG 969
Min. Negotiated Rate	$70,773.59
Max. Negotiated Rate	$109,212.90
Rate for Payer: EPIC Health Plan Medicare	$70,773.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,773.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$81,389.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$89,174.72
Rate for Payer: Molina Healthcare of CA Medicare	$89,174.72
Rate for Payer: Multiplan WC	$109,212.90

Know your out-of-pocket cost for care.

All Charges