Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$45,819.23

Service Code	MSDRG 970
Min. Negotiated Rate	$29,877.71
Max. Negotiated Rate	$45,819.23
Rate for Payer: EPIC Health Plan Medicare	$29,877.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,877.71
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$34,359.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,645.91
Rate for Payer: Molina Healthcare of CA Medicare	$37,645.91
Rate for Payer: Multiplan WC	$45,819.23

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

Facility

$24,545.83

Service Code	MSDRG 975
Min. Negotiated Rate	$16,154.02
Max. Negotiated Rate	$24,545.83
Rate for Payer: EPIC Health Plan Medicare	$16,154.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,154.02
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,577.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,354.07
Rate for Payer: Molina Healthcare of CA Medicare	$20,354.07
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	$33,586.31
Max. Negotiated Rate	$51,568.01
Rate for Payer: EPIC Health Plan Medicare	$33,586.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$33,586.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,624.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,318.75
Rate for Payer: Molina Healthcare of CA Medicare	$42,318.75
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	$11,492.93
Max. Negotiated Rate	$17,320.58
Rate for Payer: EPIC Health Plan Medicare	$11,492.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,492.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,216.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,481.09
Rate for Payer: Molina Healthcare of CA Medicare	$14,481.09
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	$16,382.41
Max. Negotiated Rate	$24,899.84
Rate for Payer: EPIC Health Plan Medicare	$16,382.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,382.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,839.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,641.84
Rate for Payer: Molina Healthcare of CA Medicare	$20,641.84
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	$13,406.83
Max. Negotiated Rate	$20,287.35
Rate for Payer: EPIC Health Plan Medicare	$13,406.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,406.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,417.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,892.61
Rate for Payer: Molina Healthcare of CA Medicare	$16,892.61
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	$8,682.25
Max. Negotiated Rate	$12,963.67
Rate for Payer: EPIC Health Plan Medicare	$8,682.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,682.25
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,984.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,939.64
Rate for Payer: Molina Healthcare of CA Medicare	$10,939.64
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	$11,436.13
Max. Negotiated Rate	$17,232.51
Rate for Payer: EPIC Health Plan Medicare	$11,436.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,436.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,151.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,409.52
Rate for Payer: Molina Healthcare of CA Medicare	$14,409.52
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	$17,545.43
Max. Negotiated Rate	$26,702.71
Rate for Payer: EPIC Health Plan Medicare	$17,545.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,545.43
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,177.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,107.24
Rate for Payer: Molina Healthcare of CA Medicare	$22,107.24
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	$7,746.46
Max. Negotiated Rate	$11,513.09
Rate for Payer: EPIC Health Plan Medicare	$7,746.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,746.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,908.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,760.54
Rate for Payer: Molina Healthcare of CA Medicare	$9,760.54
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	$14,145.45
Max. Negotiated Rate	$21,432.28
Rate for Payer: EPIC Health Plan Medicare	$14,145.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,145.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,267.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,823.27
Rate for Payer: Molina Healthcare of CA Medicare	$17,823.27
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	$11,674.53
Max. Negotiated Rate	$17,602.06
Rate for Payer: EPIC Health Plan Medicare	$11,674.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,674.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,425.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,709.91
Rate for Payer: Molina Healthcare of CA Medicare	$14,709.91
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	$16,086.08
Max. Negotiated Rate	$24,440.49
Rate for Payer: EPIC Health Plan Medicare	$16,086.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,086.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,498.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,268.46
Rate for Payer: Molina Healthcare of CA Medicare	$20,268.46
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	$7,449.03
Max. Negotiated Rate	$11,052.02
Rate for Payer: EPIC Health Plan Medicare	$7,449.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,449.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,566.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,385.78
Rate for Payer: Molina Healthcare of CA Medicare	$9,385.78
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	$22,578.60
Max. Negotiated Rate	$34,504.73
Rate for Payer: EPIC Health Plan Medicare	$22,578.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,578.60
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,965.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,449.04
Rate for Payer: Molina Healthcare of CA Medicare	$28,449.04
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	$56,035.03
Max. Negotiated Rate	$86,366.31
Rate for Payer: EPIC Health Plan Medicare	$56,035.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$56,035.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$64,440.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$70,604.14
Rate for Payer: Molina Healthcare of CA Medicare	$70,604.14
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	$18,428.85
Max. Negotiated Rate	$28,072.12
Rate for Payer: EPIC Health Plan Medicare	$18,428.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,428.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,193.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,220.35
Rate for Payer: Molina Healthcare of CA Medicare	$23,220.35
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	$16,688.77
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: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

Facility

$14,110.31

Service Code	MSDRG 728
Min. Negotiated Rate	$9,421.96
Max. Negotiated Rate	$14,110.31
Rate for Payer: EPIC Health Plan Medicare	$9,421.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,421.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,835.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,871.67
Rate for Payer: Molina Healthcare of CA Medicare	$11,871.67
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	$11,375.96
Max. Negotiated Rate	$17,139.26
Rate for Payer: EPIC Health Plan Medicare	$11,375.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,375.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,082.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,333.71
Rate for Payer: Molina Healthcare of CA Medicare	$14,333.71
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	$18,419.96
Max. Negotiated Rate	$28,058.30
Rate for Payer: EPIC Health Plan Medicare	$18,419.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,419.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,182.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,209.15
Rate for Payer: Molina Healthcare of CA Medicare	$23,209.15
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	$7,786.57
Max. Negotiated Rate	$11,575.26
Rate for Payer: EPIC Health Plan Medicare	$7,786.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,786.57
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,954.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,811.08
Rate for Payer: Molina Healthcare of CA Medicare	$9,811.08
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	$17,079.79
Max. Negotiated Rate	$25,980.87
Rate for Payer: EPIC Health Plan Medicare	$17,079.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,079.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,641.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,520.54
Rate for Payer: Molina Healthcare of CA Medicare	$21,520.54
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	$27,264.20
Max. Negotiated Rate	$41,767.98
Rate for Payer: EPIC Health Plan Medicare	$27,264.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,264.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,353.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,352.89
Rate for Payer: Molina Healthcare of CA Medicare	$34,352.89
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	$12,602.51
Max. Negotiated Rate	$19,040.55
Rate for Payer: EPIC Health Plan Medicare	$12,602.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,602.51
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,492.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,879.16
Rate for Payer: Molina Healthcare of CA Medicare	$15,879.16
Rate for Payer: Multiplan WC	$19,040.55

Know your out-of-pocket cost for care.

All Charges