Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH MCC

Facility

$32,536.10

Service Code	MSDRG 196
Min. Negotiated Rate	$21,308.59
Max. Negotiated Rate	$32,536.10
Rate for Payer: EPIC Health Plan Medicare	$21,308.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,308.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,504.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,848.82
Rate for Payer: Molina Healthcare of CA Medicare	$26,848.82
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	$8,121.85
Max. Negotiated Rate	$12,095.05
Rate for Payer: EPIC Health Plan Medicare	$8,121.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,121.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,340.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,233.53
Rate for Payer: Molina Healthcare of CA Medicare	$10,233.53
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	$11,647.74
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$11,647.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,647.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,394.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,676.15
Rate for Payer: Molina Healthcare of CA Medicare	$14,676.15
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	$22,479.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,479.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,851.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,324.07
Rate for Payer: Molina Healthcare of CA Medicare	$28,324.07
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	$7,987.06
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$7,987.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,987.06
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,185.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,063.70
Rate for Payer: Molina Healthcare of CA Medicare	$10,063.70
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	$61,894.78
Max. Negotiated Rate	$95,449.69
Rate for Payer: EPIC Health Plan Medicare	$61,894.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$61,894.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$71,179.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$77,987.42
Rate for Payer: Molina Healthcare of CA Medicare	$77,987.42
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	$90,121.95
Max. Negotiated Rate	$139,205.30
Rate for Payer: EPIC Health Plan Medicare	$90,121.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$90,121.95
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$103,640.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$113,553.66
Rate for Payer: Molina Healthcare of CA Medicare	$113,553.66
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	$39,648.80
Max. Negotiated Rate	$60,965.67
Rate for Payer: EPIC Health Plan Medicare	$39,648.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,648.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,596.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,957.49
Rate for Payer: Molina Healthcare of CA Medicare	$49,957.49
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	$18,907.85
Max. Negotiated Rate	$28,814.68
Rate for Payer: EPIC Health Plan Medicare	$18,907.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,907.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,744.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,823.89
Rate for Payer: Molina Healthcare of CA Medicare	$23,823.89
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	$12,335.11
Max. Negotiated Rate	$18,626.10
Rate for Payer: EPIC Health Plan Medicare	$12,335.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,335.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,185.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,542.24
Rate for Payer: Molina Healthcare of CA Medicare	$15,542.24
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	$20,158.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,158.90
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,182.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,400.21
Rate for Payer: Molina Healthcare of CA Medicare	$25,400.21
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	$30,435.80
Max. Negotiated Rate	$46,684.40
Rate for Payer: EPIC Health Plan Medicare	$30,435.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,435.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$35,001.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,349.11
Rate for Payer: Molina Healthcare of CA Medicare	$38,349.11
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	$15,969.06
Max. Negotiated Rate	$24,259.17
Rate for Payer: EPIC Health Plan Medicare	$15,969.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,969.06
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,364.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,121.02
Rate for Payer: Molina Healthcare of CA Medicare	$20,121.02
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	$20,684.73
Max. Negotiated Rate	$31,569.04
Rate for Payer: EPIC Health Plan Medicare	$20,684.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,684.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,787.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,062.76
Rate for Payer: Molina Healthcare of CA Medicare	$26,062.76
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	$36,614.18
Max. Negotiated Rate	$56,261.66
Rate for Payer: EPIC Health Plan Medicare	$36,614.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$36,614.18
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$42,106.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,133.87
Rate for Payer: Molina Healthcare of CA Medicare	$46,133.87
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	$17,074.17
Max. Negotiated Rate	$25,972.23
Rate for Payer: EPIC Health Plan Medicare	$17,074.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,074.17
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,635.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,513.45
Rate for Payer: Molina Healthcare of CA Medicare	$21,513.45
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	$15,247.16
Max. Negotiated Rate	$23,140.15
Rate for Payer: EPIC Health Plan Medicare	$15,247.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,247.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,534.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,211.42
Rate for Payer: Molina Healthcare of CA Medicare	$19,211.42
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	$29,109.00
Max. Negotiated Rate	$44,627.69
Rate for Payer: EPIC Health Plan Medicare	$29,109.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,109.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,475.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,677.34
Rate for Payer: Molina Healthcare of CA Medicare	$36,677.34
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	$11,755.81
Max. Negotiated Rate	$17,728.12
Rate for Payer: EPIC Health Plan Medicare	$11,755.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,755.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,519.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,812.32
Rate for Payer: Molina Healthcare of CA Medicare	$14,812.32
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	$13,356.67
Max. Negotiated Rate	$20,209.65
Rate for Payer: EPIC Health Plan Medicare	$13,356.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,356.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,360.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,829.40
Rate for Payer: Molina Healthcare of CA Medicare	$16,829.40
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	$9,260.38
Max. Negotiated Rate	$13,859.91
Rate for Payer: EPIC Health Plan Medicare	$9,260.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,260.38
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,649.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,668.08
Rate for Payer: Molina Healthcare of CA Medicare	$11,668.08
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	$12,046.58
Max. Negotiated Rate	$18,178.83
Rate for Payer: EPIC Health Plan Medicare	$12,046.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,046.58
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,853.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,178.69
Rate for Payer: Molina Healthcare of CA Medicare	$15,178.69
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	$21,326.40
Max. Negotiated Rate	$32,563.72
Rate for Payer: EPIC Health Plan Medicare	$21,326.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,326.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,525.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,871.26
Rate for Payer: Molina Healthcare of CA Medicare	$26,871.26
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	$8,386.99
Max. Negotiated Rate	$12,506.04
Rate for Payer: EPIC Health Plan Medicare	$8,386.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,386.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,645.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,567.61
Rate for Payer: Molina Healthcare of CA Medicare	$10,567.61
Rate for Payer: Multiplan WC	$12,506.04

MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$19,475.72

Service Code	MSDRG 695
Min. Negotiated Rate	$12,883.20
Max. Negotiated Rate	$19,475.72
Rate for Payer: EPIC Health Plan Medicare	$12,883.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,883.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,815.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,232.83
Rate for Payer: Molina Healthcare of CA Medicare	$16,232.83
Rate for Payer: Multiplan WC	$19,475.72

Know your out-of-pocket cost for care.

All Charges