Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC

Facility

$24,545.83

Service Code	MSDRG 975
Min. Negotiated Rate	$16,153.98
Max. Negotiated Rate	$24,545.83
Rate for Payer: EPIC Health Plan Medicare	$16,153.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,153.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,577.08
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,354.01
Rate for Payer: Molina Healthcare of CA Medicare	$20,354.01
Rate for Payer: Multiplan WC	$24,545.83

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC

Facility

$51,568.01

Service Code	MSDRG 974
Min. Negotiated Rate	$33,586.27
Max. Negotiated Rate	$51,568.01
Rate for Payer: EPIC Health Plan Medicare	$33,586.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$33,586.27
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,624.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,318.70
Rate for Payer: Molina Healthcare of CA Medicare	$42,318.70
Rate for Payer: Multiplan WC	$51,568.01

MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC

Facility

$17,320.58

Service Code	MSDRG 976
Min. Negotiated Rate	$11,492.89
Max. Negotiated Rate	$17,320.58
Rate for Payer: EPIC Health Plan Medicare	$11,492.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,492.89
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,216.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,481.04
Rate for Payer: Molina Healthcare of CA Medicare	$14,481.04
Rate for Payer: Multiplan WC	$17,320.58

MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION

Facility

$24,899.84

Service Code	MSDRG 977
Min. Negotiated Rate	$16,382.37
Max. Negotiated Rate	$24,899.84
Rate for Payer: EPIC Health Plan Medicare	$16,382.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,382.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,839.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,641.79
Rate for Payer: Molina Healthcare of CA Medicare	$20,641.79
Rate for Payer: Multiplan WC	$24,899.84

MS-DRG 42.00: HYPERTENSION WITH MCC

Facility

$20,287.35

Service Code	MSDRG 304
Min. Negotiated Rate	$13,406.79
Max. Negotiated Rate	$20,287.35
Rate for Payer: EPIC Health Plan Medicare	$13,406.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,406.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,417.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,892.56
Rate for Payer: Molina Healthcare of CA Medicare	$16,892.56
Rate for Payer: Multiplan WC	$20,287.35

MS-DRG 42.00: HYPERTENSION WITHOUT MCC

Facility

$12,963.67

Service Code	MSDRG 305
Min. Negotiated Rate	$8,682.21
Max. Negotiated Rate	$12,963.67
Rate for Payer: EPIC Health Plan Medicare	$8,682.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,682.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,984.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,939.58
Rate for Payer: Molina Healthcare of CA Medicare	$10,939.58
Rate for Payer: Multiplan WC	$12,963.67

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC

Facility

$17,232.51

Service Code	MSDRG 078
Min. Negotiated Rate	$11,436.09
Max. Negotiated Rate	$17,232.51
Rate for Payer: EPIC Health Plan Medicare	$11,436.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,436.09
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,151.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,409.47
Rate for Payer: Molina Healthcare of CA Medicare	$14,409.47
Rate for Payer: Multiplan WC	$17,232.51

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC

Facility

$26,702.71

Service Code	MSDRG 077
Min. Negotiated Rate	$17,545.39
Max. Negotiated Rate	$26,702.71
Rate for Payer: EPIC Health Plan Medicare	$17,545.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,545.39
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,177.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,107.19
Rate for Payer: Molina Healthcare of CA Medicare	$22,107.19
Rate for Payer: Multiplan WC	$26,702.71

MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC

Facility

$11,513.09

Service Code	MSDRG 079
Min. Negotiated Rate	$7,746.42
Max. Negotiated Rate	$11,513.09
Rate for Payer: EPIC Health Plan Medicare	$7,746.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,746.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,908.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,760.49
Rate for Payer: Molina Healthcare of CA Medicare	$9,760.49
Rate for Payer: Multiplan WC	$11,513.09

MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM

Facility

$21,432.28

Service Code	MSDRG 642
Min. Negotiated Rate	$14,145.41
Max. Negotiated Rate	$21,432.28
Rate for Payer: EPIC Health Plan Medicare	$14,145.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,145.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,267.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,823.22
Rate for Payer: Molina Healthcare of CA Medicare	$17,823.22
Rate for Payer: Multiplan WC	$21,432.28

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$17,602.06

Service Code	MSDRG 758
Min. Negotiated Rate	$11,674.49
Max. Negotiated Rate	$17,602.06
Rate for Payer: EPIC Health Plan Medicare	$11,674.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,674.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,425.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,709.86
Rate for Payer: Molina Healthcare of CA Medicare	$14,709.86
Rate for Payer: Multiplan WC	$17,602.06

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$24,440.49

Service Code	MSDRG 757
Min. Negotiated Rate	$16,086.04
Max. Negotiated Rate	$24,440.49
Rate for Payer: EPIC Health Plan Medicare	$16,086.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,086.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,498.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,268.41
Rate for Payer: Molina Healthcare of CA Medicare	$20,268.41
Rate for Payer: Multiplan WC	$24,440.49

MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$11,052.02

Service Code	MSDRG 759
Min. Negotiated Rate	$7,448.99
Max. Negotiated Rate	$11,052.02
Rate for Payer: EPIC Health Plan Medicare	$7,448.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,448.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,566.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,385.73
Rate for Payer: Molina Healthcare of CA Medicare	$9,385.73
Rate for Payer: Multiplan WC	$11,052.02

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC

Facility

$34,504.73

Service Code	MSDRG 854
Min. Negotiated Rate	$22,578.56
Max. Negotiated Rate	$34,504.73
Rate for Payer: EPIC Health Plan Medicare	$22,578.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,578.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,965.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,448.99
Rate for Payer: Molina Healthcare of CA Medicare	$28,448.99
Rate for Payer: Multiplan WC	$34,504.73

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC

Facility

$86,366.31

Service Code	MSDRG 853
Min. Negotiated Rate	$56,034.99
Max. Negotiated Rate	$86,366.31
Rate for Payer: EPIC Health Plan Medicare	$56,034.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$56,034.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$64,440.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$70,604.09
Rate for Payer: Molina Healthcare of CA Medicare	$70,604.09
Rate for Payer: Multiplan WC	$86,366.31

MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$28,072.12

Service Code	MSDRG 855
Min. Negotiated Rate	$18,428.81
Max. Negotiated Rate	$28,072.12
Rate for Payer: EPIC Health Plan Medicare	$18,428.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,428.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,193.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,220.30
Rate for Payer: Molina Healthcare of CA Medicare	$23,220.30
Rate for Payer: Multiplan WC	$28,072.12

MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$25,374.74

Service Code	MSDRG 727
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: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

Facility

$14,110.31

Service Code	MSDRG 728
Min. Negotiated Rate	$9,421.92
Max. Negotiated Rate	$14,110.31
Rate for Payer: EPIC Health Plan Medicare	$9,421.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,421.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,835.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,871.62
Rate for Payer: Molina Healthcare of CA Medicare	$11,871.62
Rate for Payer: Multiplan WC	$14,110.31

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH CC

Facility

$17,139.26

Service Code	MSDRG 386
Min. Negotiated Rate	$11,375.92
Max. Negotiated Rate	$17,139.26
Rate for Payer: EPIC Health Plan Medicare	$11,375.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,375.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,082.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,333.66
Rate for Payer: Molina Healthcare of CA Medicare	$14,333.66
Rate for Payer: Multiplan WC	$17,139.26

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH MCC

Facility

$28,058.30

Service Code	MSDRG 385
Min. Negotiated Rate	$18,419.92
Max. Negotiated Rate	$28,058.30
Rate for Payer: EPIC Health Plan Medicare	$18,419.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,419.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,182.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,209.10
Rate for Payer: Molina Healthcare of CA Medicare	$23,209.10
Rate for Payer: Multiplan WC	$28,058.30

MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility

$11,575.26

Service Code	MSDRG 387
Min. Negotiated Rate	$7,786.53
Max. Negotiated Rate	$11,575.26
Rate for Payer: EPIC Health Plan Medicare	$7,786.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,786.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,954.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,811.03
Rate for Payer: Molina Healthcare of CA Medicare	$9,811.03
Rate for Payer: Multiplan WC	$11,575.26

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

Facility

$25,980.87

Service Code	MSDRG 351
Min. Negotiated Rate	$17,079.75
Max. Negotiated Rate	$25,980.87
Rate for Payer: EPIC Health Plan Medicare	$17,079.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,079.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,641.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,520.49
Rate for Payer: Molina Healthcare of CA Medicare	$21,520.49
Rate for Payer: Multiplan WC	$25,980.87

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

Facility

$41,767.98

Service Code	MSDRG 350
Min. Negotiated Rate	$27,264.16
Max. Negotiated Rate	$41,767.98
Rate for Payer: EPIC Health Plan Medicare	$27,264.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,264.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,353.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,352.84
Rate for Payer: Molina Healthcare of CA Medicare	$34,352.84
Rate for Payer: Multiplan WC	$41,767.98

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

Facility

$19,040.55

Service Code	MSDRG 352
Min. Negotiated Rate	$12,602.47
Max. Negotiated Rate	$19,040.55
Rate for Payer: EPIC Health Plan Medicare	$12,602.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,602.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,492.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,879.11
Rate for Payer: Molina Healthcare of CA Medicare	$15,879.11
Rate for Payer: Multiplan WC	$19,040.55

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH CC

Facility

$17,096.08

Service Code	MSDRG 197
Min. Negotiated Rate	$11,348.08
Max. Negotiated Rate	$17,096.08
Rate for Payer: EPIC Health Plan Medicare	$11,348.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,348.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,050.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,298.58
Rate for Payer: Molina Healthcare of CA Medicare	$14,298.58
Rate for Payer: Multiplan WC	$17,096.08

Know your out-of-pocket cost for care.

All Charges