Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH CC

Facility

$17,096.08

Service Code	MSDRG 197
Min. Negotiated Rate	$11,348.12
Max. Negotiated Rate	$17,096.08
Rate for Payer: EPIC Health Plan Medicare	$11,348.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,348.12
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,050.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,298.63
Rate for Payer: Molina Healthcare of CA Medicare	$14,298.63
Rate for Payer: Multiplan WC	$17,096.08

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH MCC

Facility

$32,536.10

Service Code	MSDRG 196
Min. Negotiated Rate	$21,308.63
Max. Negotiated Rate	$32,536.10
Rate for Payer: EPIC Health Plan Medicare	$21,308.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,308.63
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,504.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,848.87
Rate for Payer: Molina Healthcare of CA Medicare	$26,848.87
Rate for Payer: Multiplan WC	$32,536.10

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC

Facility

$12,095.05

Service Code	MSDRG 198
Min. Negotiated Rate	$8,121.89
Max. Negotiated Rate	$12,095.05
Rate for Payer: EPIC Health Plan Medicare	$8,121.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,121.89
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,340.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,233.58
Rate for Payer: Molina Healthcare of CA Medicare	$10,233.58
Rate for Payer: Multiplan WC	$12,095.05

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$18,576.00

Service Code	MSDRG 065
Min. Negotiated Rate	$11,647.78
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$11,647.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,647.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,394.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,676.20
Rate for Payer: Molina Healthcare of CA Medicare	$14,676.20
Rate for Payer: Multiplan WC	$17,560.61

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$34,351.04

Service Code	MSDRG 064
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$34,351.04
Rate for Payer: EPIC Health Plan Medicare	$22,479.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,479.46
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,851.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,324.12
Rate for Payer: Molina Healthcare of CA Medicare	$28,324.12
Rate for Payer: Multiplan WC	$34,351.04

MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$18,576.00

Service Code	MSDRG 066
Min. Negotiated Rate	$7,987.10
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$7,987.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,987.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,185.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,063.75
Rate for Payer: Molina Healthcare of CA Medicare	$10,063.75
Rate for Payer: Multiplan WC	$11,886.10

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$95,449.69

Service Code	MSDRG 021
Min. Negotiated Rate	$61,894.82
Max. Negotiated Rate	$95,449.69
Rate for Payer: EPIC Health Plan Medicare	$61,894.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$61,894.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$71,179.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$77,987.47
Rate for Payer: Molina Healthcare of CA Medicare	$77,987.47
Rate for Payer: Multiplan WC	$95,449.69

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$139,205.30

Service Code	MSDRG 020
Min. Negotiated Rate	$90,121.99
Max. Negotiated Rate	$139,205.30
Rate for Payer: EPIC Health Plan Medicare	$90,121.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$90,121.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$103,640.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$113,553.71
Rate for Payer: Molina Healthcare of CA Medicare	$113,553.71
Rate for Payer: Multiplan WC	$139,205.30

MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$60,965.67

Service Code	MSDRG 022
Min. Negotiated Rate	$39,648.84
Max. Negotiated Rate	$60,965.67
Rate for Payer: EPIC Health Plan Medicare	$39,648.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,648.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,596.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,957.54
Rate for Payer: Molina Healthcare of CA Medicare	$49,957.54
Rate for Payer: Multiplan WC	$60,965.67

MS-DRG 42.00: INTRAOCULAR PROCEDURES WITH CC/MCC

Facility

$28,814.68

Service Code	MSDRG 116
Min. Negotiated Rate	$18,907.89
Max. Negotiated Rate	$28,814.68
Rate for Payer: EPIC Health Plan Medicare	$18,907.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,907.89
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,744.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,823.94
Rate for Payer: Molina Healthcare of CA Medicare	$23,823.94
Rate for Payer: Multiplan WC	$28,814.68

MS-DRG 42.00: INTRAOCULAR PROCEDURES WITHOUT CC/MCC

Facility

$18,626.10

Service Code	MSDRG 117
Min. Negotiated Rate	$12,335.15
Max. Negotiated Rate	$18,626.10
Rate for Payer: EPIC Health Plan Medicare	$12,335.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,335.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,185.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,542.29
Rate for Payer: Molina Healthcare of CA Medicare	$15,542.29
Rate for Payer: Multiplan WC	$18,626.10

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC

Facility

$30,753.96

Service Code	MSDRG 062
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$30,753.96
Rate for Payer: EPIC Health Plan Medicare	$20,158.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,158.94
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,182.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,400.26
Rate for Payer: Molina Healthcare of CA Medicare	$25,400.26
Rate for Payer: Multiplan WC	$30,753.96

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC

Facility

$46,684.40

Service Code	MSDRG 061
Min. Negotiated Rate	$30,435.84
Max. Negotiated Rate	$46,684.40
Rate for Payer: EPIC Health Plan Medicare	$30,435.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,435.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$35,001.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,349.16
Rate for Payer: Molina Healthcare of CA Medicare	$38,349.16
Rate for Payer: Multiplan WC	$46,684.40

MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC

Facility

$24,259.17

Service Code	MSDRG 063
Min. Negotiated Rate	$15,969.10
Max. Negotiated Rate	$24,259.17
Rate for Payer: EPIC Health Plan Medicare	$15,969.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,969.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,364.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,121.07
Rate for Payer: Molina Healthcare of CA Medicare	$20,121.07
Rate for Payer: Multiplan WC	$24,259.17

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC

Facility

$31,569.04

Service Code	MSDRG 657
Min. Negotiated Rate	$20,684.77
Max. Negotiated Rate	$31,569.04
Rate for Payer: EPIC Health Plan Medicare	$20,684.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,684.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,787.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,062.81
Rate for Payer: Molina Healthcare of CA Medicare	$26,062.81
Rate for Payer: Multiplan WC	$31,569.04

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC

Facility

$56,261.66

Service Code	MSDRG 656
Min. Negotiated Rate	$36,614.22
Max. Negotiated Rate	$56,261.66
Rate for Payer: EPIC Health Plan Medicare	$36,614.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$36,614.22
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$42,106.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,133.92
Rate for Payer: Molina Healthcare of CA Medicare	$46,133.92
Rate for Payer: Multiplan WC	$56,261.66

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

Facility

$25,972.23

Service Code	MSDRG 658
Min. Negotiated Rate	$17,074.21
Max. Negotiated Rate	$25,972.23
Rate for Payer: EPIC Health Plan Medicare	$17,074.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,074.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,635.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,513.50
Rate for Payer: Molina Healthcare of CA Medicare	$21,513.50
Rate for Payer: Multiplan WC	$25,972.23

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$23,140.15

Service Code	MSDRG 660
Min. Negotiated Rate	$15,247.20
Max. Negotiated Rate	$23,140.15
Rate for Payer: EPIC Health Plan Medicare	$15,247.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,247.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,534.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,211.47
Rate for Payer: Molina Healthcare of CA Medicare	$19,211.47
Rate for Payer: Multiplan WC	$23,140.15

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$44,627.69

Service Code	MSDRG 659
Min. Negotiated Rate	$29,109.04
Max. Negotiated Rate	$44,627.69
Rate for Payer: EPIC Health Plan Medicare	$29,109.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,109.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,475.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,677.39
Rate for Payer: Molina Healthcare of CA Medicare	$36,677.39
Rate for Payer: Multiplan WC	$44,627.69

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$17,728.12

Service Code	MSDRG 661
Min. Negotiated Rate	$11,755.85
Max. Negotiated Rate	$17,728.12
Rate for Payer: EPIC Health Plan Medicare	$11,755.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,755.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,519.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,812.37
Rate for Payer: Molina Healthcare of CA Medicare	$14,812.37
Rate for Payer: Multiplan WC	$17,728.12

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$20,209.65

Service Code	MSDRG 689
Min. Negotiated Rate	$13,356.71
Max. Negotiated Rate	$20,209.65
Rate for Payer: EPIC Health Plan Medicare	$13,356.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,356.71
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,360.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,829.45
Rate for Payer: Molina Healthcare of CA Medicare	$16,829.45
Rate for Payer: Multiplan WC	$20,209.65

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$13,859.91

Service Code	MSDRG 690
Min. Negotiated Rate	$9,260.42
Max. Negotiated Rate	$13,859.91
Rate for Payer: EPIC Health Plan Medicare	$9,260.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,260.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,649.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,668.13
Rate for Payer: Molina Healthcare of CA Medicare	$11,668.13
Rate for Payer: Multiplan WC	$13,859.91

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$18,178.83

Service Code	MSDRG 687
Min. Negotiated Rate	$12,046.62
Max. Negotiated Rate	$18,178.83
Rate for Payer: EPIC Health Plan Medicare	$12,046.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,046.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,853.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,178.74
Rate for Payer: Molina Healthcare of CA Medicare	$15,178.74
Rate for Payer: Multiplan WC	$18,178.83

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$32,563.72

Service Code	MSDRG 686
Min. Negotiated Rate	$21,326.44
Max. Negotiated Rate	$32,563.72
Rate for Payer: EPIC Health Plan Medicare	$21,326.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,326.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,525.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,871.31
Rate for Payer: Molina Healthcare of CA Medicare	$26,871.31
Rate for Payer: Multiplan WC	$32,563.72

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$12,506.04

Service Code	MSDRG 688
Min. Negotiated Rate	$8,387.03
Max. Negotiated Rate	$12,506.04
Rate for Payer: EPIC Health Plan Medicare	$8,387.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,387.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,645.08
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,567.66
Rate for Payer: Molina Healthcare of CA Medicare	$10,567.66
Rate for Payer: Multiplan WC	$12,506.04

Know your out-of-pocket cost for care.

All Charges