Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$25,383.37

Service Code	MSDRG 388
Min. Negotiated Rate	$16,694.29
Max. Negotiated Rate	$25,383.37
Rate for Payer: EPIC Health Plan Medicare	$16,694.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,694.29
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,198.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,034.81
Rate for Payer: Molina Healthcare of CA Medicare	$21,034.81
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	$6,415.16
Max. Negotiated Rate	$9,449.47
Rate for Payer: EPIC Health Plan Medicare	$6,415.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,415.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,377.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,083.10
Rate for Payer: Molina Healthcare of CA Medicare	$8,083.10
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	$17,092.00
Max. Negotiated Rate	$25,999.86
Rate for Payer: EPIC Health Plan Medicare	$17,092.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,092.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,655.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,535.92
Rate for Payer: Molina Healthcare of CA Medicare	$21,535.92
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	$11,677.82
Max. Negotiated Rate	$17,607.24
Rate for Payer: EPIC Health Plan Medicare	$11,677.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,677.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,429.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,714.05
Rate for Payer: Molina Healthcare of CA Medicare	$14,714.05
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	$24,632.84
Max. Negotiated Rate	$37,689.09
Rate for Payer: EPIC Health Plan Medicare	$24,632.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,632.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,327.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,037.38
Rate for Payer: Molina Healthcare of CA Medicare	$31,037.38
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	$13,236.35
Max. Negotiated Rate	$20,023.14
Rate for Payer: EPIC Health Plan Medicare	$13,236.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,236.35
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,221.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,677.80
Rate for Payer: Molina Healthcare of CA Medicare	$16,677.80
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	$9,790.66
Max. Negotiated Rate	$14,681.91
Rate for Payer: EPIC Health Plan Medicare	$9,790.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,790.66
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,259.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,336.23
Rate for Payer: Molina Healthcare of CA Medicare	$12,336.23
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	$9,913.20
Max. Negotiated Rate	$14,871.86
Rate for Payer: EPIC Health Plan Medicare	$9,913.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,913.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,400.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,490.63
Rate for Payer: Molina Healthcare of CA Medicare	$12,490.63
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	$14,855.03
Max. Negotiated Rate	$22,532.30
Rate for Payer: EPIC Health Plan Medicare	$14,855.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,855.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,083.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,717.34
Rate for Payer: Molina Healthcare of CA Medicare	$18,717.34
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	$6,431.89
Max. Negotiated Rate	$9,475.38
Rate for Payer: EPIC Health Plan Medicare	$6,431.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,431.89
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,396.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,104.18
Rate for Payer: Molina Healthcare of CA Medicare	$8,104.18
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	$314,121.37
Max. Negotiated Rate	$486,431.96
Rate for Payer: EPIC Health Plan Medicare	$314,121.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$314,121.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$361,239.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$395,792.93
Rate for Payer: Molina Healthcare of CA Medicare	$395,792.93
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	$123,081.53
Max. Negotiated Rate	$190,296.68
Rate for Payer: EPIC Health Plan Medicare	$123,081.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$123,081.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$141,543.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$155,082.73
Rate for Payer: Molina Healthcare of CA Medicare	$155,082.73
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	$18,562.52
Max. Negotiated Rate	$28,279.34
Rate for Payer: EPIC Health Plan Medicare	$18,562.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,562.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,346.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,388.78
Rate for Payer: Molina Healthcare of CA Medicare	$23,388.78
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	$39,638.76
Max. Negotiated Rate	$60,950.13
Rate for Payer: EPIC Health Plan Medicare	$39,638.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,638.76
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,584.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,944.84
Rate for Payer: Molina Healthcare of CA Medicare	$49,944.84
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	$16,688.73
Max. Negotiated Rate	$25,374.74
Rate for Payer: EPIC Health Plan Medicare	$16,688.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,688.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,192.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,027.80
Rate for Payer: Molina Healthcare of CA Medicare	$21,027.80
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	$19,269.92
Max. Negotiated Rate	$29,375.91
Rate for Payer: EPIC Health Plan Medicare	$19,269.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,269.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,160.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,280.10
Rate for Payer: Molina Healthcare of CA Medicare	$24,280.10
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	$32,993.60
Max. Negotiated Rate	$50,649.31
Rate for Payer: EPIC Health Plan Medicare	$32,993.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,993.60
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,942.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,571.94
Rate for Payer: Molina Healthcare of CA Medicare	$41,571.94
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	$15,171.41
Max. Negotiated Rate	$23,022.73
Rate for Payer: EPIC Health Plan Medicare	$15,171.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,171.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,447.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,115.98
Rate for Payer: Molina Healthcare of CA Medicare	$19,115.98
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	$23,434.12
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	$23,434.12
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,949.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,526.99
Rate for Payer: Molina Healthcare of CA Medicare	$29,526.99
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	$33,082.73
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	$33,082.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,045.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,684.24
Rate for Payer: Molina Healthcare of CA Medicare	$41,684.24
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	$17,992.13
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	$17,992.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,690.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,670.08
Rate for Payer: Molina Healthcare of CA Medicare	$22,670.08
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	$32,789.74
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	$32,789.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,708.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,315.07
Rate for Payer: Molina Healthcare of CA Medicare	$41,315.07
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	$23,803.99
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	$23,803.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,374.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,993.03
Rate for Payer: Molina Healthcare of CA Medicare	$29,993.03
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	$70,773.55
Max. Negotiated Rate	$109,212.90
Rate for Payer: EPIC Health Plan Medicare	$70,773.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,773.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$81,389.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$89,174.67
Rate for Payer: Molina Healthcare of CA Medicare	$89,174.67
Rate for Payer: Multiplan WC	$109,212.90

MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC

Facility

$45,819.23

Service Code	MSDRG 970
Min. Negotiated Rate	$29,877.67
Max. Negotiated Rate	$45,819.23
Rate for Payer: EPIC Health Plan Medicare	$29,877.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,877.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$34,359.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,645.86
Rate for Payer: Molina Healthcare of CA Medicare	$37,645.86
Rate for Payer: Multiplan WC	$45,819.23

Know your out-of-pocket cost for care.

All Charges