Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC

Facility

$27,153.42

Service Code	MSDRG 142
Min. Negotiated Rate	$17,836.16
Max. Negotiated Rate	$27,153.42
Rate for Payer: EPIC Health Plan Medicare	$17,836.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,836.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,511.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,473.56
Rate for Payer: Molina Healthcare of CA Medicare	$22,473.56
Rate for Payer: Multiplan WC	$27,153.42

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC

Facility

$21,387.37

Service Code	MSDRG 809
Min. Negotiated Rate	$14,116.42
Max. Negotiated Rate	$21,387.37
Rate for Payer: EPIC Health Plan Medicare	$14,116.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,116.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,233.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,786.69
Rate for Payer: Molina Healthcare of CA Medicare	$17,786.69
Rate for Payer: Multiplan WC	$21,387.37

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC

Facility

$39,550.67

Service Code	MSDRG 808
Min. Negotiated Rate	$25,833.75
Max. Negotiated Rate	$39,550.67
Rate for Payer: EPIC Health Plan Medicare	$25,833.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,833.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,708.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,550.53
Rate for Payer: Molina Healthcare of CA Medicare	$32,550.53
Rate for Payer: Multiplan WC	$39,550.67

MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC

Facility

$16,436.41

Service Code	MSDRG 810
Min. Negotiated Rate	$10,922.53
Max. Negotiated Rate	$16,436.41
Rate for Payer: EPIC Health Plan Medicare	$10,922.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,922.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,560.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,762.39
Rate for Payer: Molina Healthcare of CA Medicare	$13,762.39
Rate for Payer: Multiplan WC	$16,436.41

MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT

Facility

$56,446.43

Service Code	MSDRG 469
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$56,446.43
Rate for Payer: EPIC Health Plan Medicare	$36,733.40
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	$36,733.40
Rate for Payer: Kaiser Permanente of CA Commercial	$9,944.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$42,243.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,284.08
Rate for Payer: Molina Healthcare of CA Medicare	$46,284.08
Rate for Payer: Multiplan WC	$56,446.43

MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC

Facility

$32,560.27

Service Code	MSDRG 470
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$32,560.27
Rate for Payer: EPIC Health Plan Medicare	$21,324.19
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	$21,324.19
Rate for Payer: Kaiser Permanente of CA Commercial	$9,944.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,522.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,868.48
Rate for Payer: Molina Healthcare of CA Medicare	$26,868.48
Rate for Payer: Multiplan WC	$32,560.27

MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES

Facility

$44,004.28

Service Code	MSDRG 483
Min. Negotiated Rate	$28,706.82
Max. Negotiated Rate	$44,004.28
Rate for Payer: EPIC Health Plan Medicare	$28,706.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$28,706.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,012.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,170.59
Rate for Payer: Molina Healthcare of CA Medicare	$36,170.59
Rate for Payer: Multiplan WC	$44,004.28

MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$33,511.78

Service Code	MSDRG 707
Min. Negotiated Rate	$16,674.00
Max. Negotiated Rate	$33,511.78
Rate for Payer: EPIC Health Plan Medicare	$21,938.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,938.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,228.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,641.88
Rate for Payer: Molina Healthcare of CA Medicare	$27,641.88
Rate for Payer: Multiplan WC	$33,511.78
Rate for Payer: United Healthcare All Other HMO/non HMO	$19,873.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$16,674.00

MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$25,600.95

Service Code	MSDRG 708
Min. Negotiated Rate	$16,674.00
Max. Negotiated Rate	$25,600.95
Rate for Payer: EPIC Health Plan Medicare	$16,834.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,834.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,359.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,211.65
Rate for Payer: Molina Healthcare of CA Medicare	$21,211.65
Rate for Payer: Multiplan WC	$25,600.95
Rate for Payer: United Healthcare All Other HMO/non HMO	$19,873.00
Rate for Payer: United Healthcare Navigate/Select/Select+	$16,674.00

MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$33,470.33

Service Code	MSDRG 507
Min. Negotiated Rate	$21,911.27
Max. Negotiated Rate	$33,470.33
Rate for Payer: EPIC Health Plan Medicare	$21,911.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,911.27
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,197.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,608.20
Rate for Payer: Molina Healthcare of CA Medicare	$27,608.20
Rate for Payer: Multiplan WC	$33,470.33

MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$22,287.08

Service Code	MSDRG 508
Min. Negotiated Rate	$14,696.85
Max. Negotiated Rate	$22,287.08
Rate for Payer: EPIC Health Plan Medicare	$14,696.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,696.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,901.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,518.03
Rate for Payer: Molina Healthcare of CA Medicare	$18,518.03
Rate for Payer: Multiplan WC	$22,287.08

MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC

Facility

$36,525.18

Service Code	MSDRG 595
Min. Negotiated Rate	$23,881.97
Max. Negotiated Rate	$36,525.18
Rate for Payer: EPIC Health Plan Medicare	$23,881.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,881.97
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,464.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,091.28
Rate for Payer: Molina Healthcare of CA Medicare	$30,091.28
Rate for Payer: Multiplan WC	$36,525.18

MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$18,669.26

Service Code	MSDRG 596
Min. Negotiated Rate	$12,362.95
Max. Negotiated Rate	$18,669.26
Rate for Payer: EPIC Health Plan Medicare	$12,362.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,362.95
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,217.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,577.32
Rate for Payer: Molina Healthcare of CA Medicare	$15,577.32
Rate for Payer: Multiplan WC	$18,669.26

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$40,818.20

Service Code	MSDRG 330
Min. Negotiated Rate	$26,651.45
Max. Negotiated Rate	$40,818.20
Rate for Payer: EPIC Health Plan Medicare	$26,651.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,651.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,649.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,580.83
Rate for Payer: Molina Healthcare of CA Medicare	$33,580.83
Rate for Payer: Multiplan WC	$40,818.20

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$79,296.47

Service Code	MSDRG 329
Min. Negotiated Rate	$51,474.16
Max. Negotiated Rate	$79,296.47
Rate for Payer: EPIC Health Plan Medicare	$51,474.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$51,474.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$59,195.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$64,857.44
Rate for Payer: Molina Healthcare of CA Medicare	$64,857.44
Rate for Payer: Multiplan WC	$79,296.47

MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$28,510.74

Service Code	MSDRG 331
Min. Negotiated Rate	$18,711.81
Max. Negotiated Rate	$28,510.74
Rate for Payer: EPIC Health Plan Medicare	$18,711.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,711.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,518.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,576.88
Rate for Payer: Molina Healthcare of CA Medicare	$23,576.88
Rate for Payer: Multiplan WC	$28,510.74

MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES

Facility

$25,887.61

Service Code	MSDRG 506
Min. Negotiated Rate	$17,019.58
Max. Negotiated Rate	$25,887.61
Rate for Payer: EPIC Health Plan Medicare	$17,019.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,019.58
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,572.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,444.67
Rate for Payer: Molina Healthcare of CA Medicare	$21,444.67
Rate for Payer: Multiplan WC	$25,887.61

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

Facility

$19,170.06

Service Code	MSDRG 755
Min. Negotiated Rate	$12,686.01
Max. Negotiated Rate	$19,170.06
Rate for Payer: EPIC Health Plan Medicare	$12,686.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,686.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,588.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,984.37
Rate for Payer: Molina Healthcare of CA Medicare	$15,984.37
Rate for Payer: Multiplan WC	$19,170.06

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

Facility

$31,244.39

Service Code	MSDRG 754
Min. Negotiated Rate	$20,475.28
Max. Negotiated Rate	$31,244.39
Rate for Payer: EPIC Health Plan Medicare	$20,475.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,475.28
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,546.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,798.85
Rate for Payer: Molina Healthcare of CA Medicare	$25,798.85
Rate for Payer: Multiplan WC	$31,244.39

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

Facility

$16,491.68

Service Code	MSDRG 756
Min. Negotiated Rate	$10,958.16
Max. Negotiated Rate	$16,491.68
Rate for Payer: EPIC Health Plan Medicare	$10,958.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,958.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,601.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,807.28
Rate for Payer: Molina Healthcare of CA Medicare	$13,807.28
Rate for Payer: Multiplan WC	$16,491.68

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$19,391.10

Service Code	MSDRG 723
Min. Negotiated Rate	$12,828.62
Max. Negotiated Rate	$19,391.10
Rate for Payer: EPIC Health Plan Medicare	$12,828.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,828.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,752.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,164.06
Rate for Payer: Molina Healthcare of CA Medicare	$16,164.06
Rate for Payer: Multiplan WC	$19,391.10

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$29,855.98

Service Code	MSDRG 722
Min. Negotiated Rate	$19,579.63
Max. Negotiated Rate	$29,855.98
Rate for Payer: EPIC Health Plan Medicare	$19,579.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,579.63
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,516.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,670.33
Rate for Payer: Molina Healthcare of CA Medicare	$24,670.33
Rate for Payer: Multiplan WC	$29,855.98

MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$12,582.02

Service Code	MSDRG 724
Min. Negotiated Rate	$8,436.02
Max. Negotiated Rate	$12,582.02
Rate for Payer: EPIC Health Plan Medicare	$8,436.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,436.02
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,701.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,629.39
Rate for Payer: Molina Healthcare of CA Medicare	$10,629.39
Rate for Payer: Multiplan WC	$12,582.02

MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$19,473.99

Service Code	MSDRG 436
Min. Negotiated Rate	$12,882.10
Max. Negotiated Rate	$19,473.99
Rate for Payer: EPIC Health Plan Medicare	$12,882.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,882.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,814.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,231.45
Rate for Payer: Molina Healthcare of CA Medicare	$16,231.45
Rate for Payer: Multiplan WC	$19,473.99

MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$31,508.60

Service Code	MSDRG 435
Min. Negotiated Rate	$20,645.73
Max. Negotiated Rate	$31,508.60
Rate for Payer: EPIC Health Plan Medicare	$20,645.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,645.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,742.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,013.62
Rate for Payer: Molina Healthcare of CA Medicare	$26,013.62
Rate for Payer: Multiplan WC	$31,508.60

Know your out-of-pocket cost for care.

All Charges