Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$20,460.04

Service Code	MSDRG 145
Min. Negotiated Rate	$13,518.24
Max. Negotiated Rate	$20,460.04
Rate for Payer: EPIC Health Plan Medicare	$13,518.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,518.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,545.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,032.98
Rate for Payer: Molina Healthcare of CA Medicare	$17,032.98
Rate for Payer: Multiplan WC	$20,460.04

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$38,839.19

Service Code	MSDRG 629
Min. Negotiated Rate	$25,374.82
Max. Negotiated Rate	$38,839.19
Rate for Payer: EPIC Health Plan Medicare	$25,374.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,374.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,181.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,972.27
Rate for Payer: Molina Healthcare of CA Medicare	$31,972.27
Rate for Payer: Multiplan WC	$38,839.19

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$68,137.39

Service Code	MSDRG 628
Min. Negotiated Rate	$44,275.37
Max. Negotiated Rate	$68,137.39
Rate for Payer: EPIC Health Plan Medicare	$44,275.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$44,275.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$50,916.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,786.97
Rate for Payer: Molina Healthcare of CA Medicare	$55,786.97
Rate for Payer: Multiplan WC	$68,137.39

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$24,198.73

Service Code	MSDRG 630
Min. Negotiated Rate	$15,930.11
Max. Negotiated Rate	$24,198.73
Rate for Payer: EPIC Health Plan Medicare	$15,930.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,930.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,319.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,071.94
Rate for Payer: Molina Healthcare of CA Medicare	$20,071.94
Rate for Payer: Multiplan WC	$24,198.73

MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$75,858.26

Service Code	MSDRG 319
Min. Negotiated Rate	$49,256.19
Max. Negotiated Rate	$75,858.26
Rate for Payer: EPIC Health Plan Medicare	$49,256.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$49,256.19
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$56,644.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,062.80
Rate for Payer: Molina Healthcare of CA Medicare	$62,062.80
Rate for Payer: Multiplan WC	$75,858.26

MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$39,973.75

Service Code	MSDRG 320
Min. Negotiated Rate	$26,106.73
Max. Negotiated Rate	$39,973.75
Rate for Payer: EPIC Health Plan Medicare	$26,106.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,106.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,022.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,894.48
Rate for Payer: Molina Healthcare of CA Medicare	$32,894.48
Rate for Payer: Multiplan WC	$39,973.75

MS-DRG 42.00: OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$9,791.40

Service Code	MSDRG 951
Min. Negotiated Rate	$6,635.79
Max. Negotiated Rate	$9,791.40
Rate for Payer: EPIC Health Plan Medicare	$6,635.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,635.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,631.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,361.10
Rate for Payer: Molina Healthcare of CA Medicare	$8,361.10
Rate for Payer: Multiplan WC	$9,791.40

MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$44,701.95

Service Code	MSDRG 749
Min. Negotiated Rate	$29,156.93
Max. Negotiated Rate	$44,701.95
Rate for Payer: EPIC Health Plan Medicare	$29,156.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,156.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,530.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,737.73
Rate for Payer: Molina Healthcare of CA Medicare	$36,737.73
Rate for Payer: Multiplan WC	$44,701.95

MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$22,268.08

Service Code	MSDRG 750
Min. Negotiated Rate	$14,684.63
Max. Negotiated Rate	$22,268.08
Rate for Payer: EPIC Health Plan Medicare	$14,684.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,684.63
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,887.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,502.63
Rate for Payer: Molina Healthcare of CA Medicare	$18,502.63
Rate for Payer: Multiplan WC	$22,268.08

MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$182,959.19

Service Code	MSDRG 215
Min. Negotiated Rate	$118,348.08
Max. Negotiated Rate	$182,959.19
Rate for Payer: EPIC Health Plan Medicare	$118,348.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$118,348.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$136,100.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$149,118.58
Rate for Payer: Molina Healthcare of CA Medicare	$149,118.58
Rate for Payer: Multiplan WC	$182,959.19

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$39,429.79

Service Code	MSDRG 424
Min. Negotiated Rate	$25,755.81
Max. Negotiated Rate	$39,429.79
Rate for Payer: EPIC Health Plan Medicare	$25,755.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,755.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,619.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,452.32
Rate for Payer: Molina Healthcare of CA Medicare	$32,452.32
Rate for Payer: Multiplan WC	$39,429.79

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$70,239.00

Service Code	MSDRG 423
Min. Negotiated Rate	$45,631.14
Max. Negotiated Rate	$70,239.00
Rate for Payer: EPIC Health Plan Medicare	$45,631.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$45,631.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$52,475.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$57,495.24
Rate for Payer: Molina Healthcare of CA Medicare	$57,495.24
Rate for Payer: Multiplan WC	$70,239.00

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$26,694.06

Service Code	MSDRG 425
Min. Negotiated Rate	$17,539.88
Max. Negotiated Rate	$26,694.06
Rate for Payer: EPIC Health Plan Medicare	$17,539.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,539.88
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,170.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,100.25
Rate for Payer: Molina Healthcare of CA Medicare	$22,100.25
Rate for Payer: Multiplan WC	$26,694.06

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$18,133.94

Service Code	MSDRG 868
Min. Negotiated Rate	$12,017.64
Max. Negotiated Rate	$18,133.94
Rate for Payer: EPIC Health Plan Medicare	$12,017.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,017.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,820.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,142.23
Rate for Payer: Molina Healthcare of CA Medicare	$15,142.23
Rate for Payer: Multiplan WC	$18,133.94

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$37,029.43

Service Code	MSDRG 867
Min. Negotiated Rate	$24,207.32
Max. Negotiated Rate	$37,029.43
Rate for Payer: EPIC Health Plan Medicare	$24,207.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,207.32
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,838.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,501.22
Rate for Payer: Molina Healthcare of CA Medicare	$30,501.22
Rate for Payer: Multiplan WC	$37,029.43

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$12,426.61

Service Code	MSDRG 869
Min. Negotiated Rate	$8,335.79
Max. Negotiated Rate	$12,426.61
Rate for Payer: EPIC Health Plan Medicare	$8,335.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,335.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,586.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,503.10
Rate for Payer: Molina Healthcare of CA Medicare	$10,503.10
Rate for Payer: Multiplan WC	$12,426.61

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$29,173.87

Service Code	MSDRG 922
Min. Negotiated Rate	$19,139.61
Max. Negotiated Rate	$29,173.87
Rate for Payer: EPIC Health Plan Medicare	$19,139.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,139.61
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,010.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,115.91
Rate for Payer: Molina Healthcare of CA Medicare	$24,115.91
Rate for Payer: Multiplan WC	$29,173.87

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$17,612.42

Service Code	MSDRG 923
Min. Negotiated Rate	$11,681.21
Max. Negotiated Rate	$17,612.42
Rate for Payer: EPIC Health Plan Medicare	$11,681.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,681.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,433.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,718.32
Rate for Payer: Molina Healthcare of CA Medicare	$14,718.32
Rate for Payer: Multiplan WC	$17,612.42

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$17,612.42

Service Code	MSDRG 699
Min. Negotiated Rate	$11,681.21
Max. Negotiated Rate	$17,612.42
Rate for Payer: EPIC Health Plan Medicare	$11,681.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,681.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,433.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,718.32
Rate for Payer: Molina Healthcare of CA Medicare	$14,718.32
Rate for Payer: Multiplan WC	$17,612.42

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$29,027.08

Service Code	MSDRG 698
Min. Negotiated Rate	$19,044.92
Max. Negotiated Rate	$29,027.08
Rate for Payer: EPIC Health Plan Medicare	$19,044.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,044.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,901.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,996.60
Rate for Payer: Molina Healthcare of CA Medicare	$23,996.60
Rate for Payer: Multiplan WC	$29,027.08

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

Facility

$11,987.98

Service Code	MSDRG 700
Min. Negotiated Rate	$8,052.83
Max. Negotiated Rate	$11,987.98
Rate for Payer: EPIC Health Plan Medicare	$8,052.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,052.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,260.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,146.57
Rate for Payer: Molina Healthcare of CA Medicare	$10,146.57
Rate for Payer: Multiplan WC	$11,987.98

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$39,863.23

Service Code	MSDRG 674
Min. Negotiated Rate	$26,035.41
Max. Negotiated Rate	$39,863.23
Rate for Payer: EPIC Health Plan Medicare	$26,035.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,035.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,940.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,804.62
Rate for Payer: Molina Healthcare of CA Medicare	$32,804.62
Rate for Payer: Multiplan WC	$39,863.23

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$72,349.24

Service Code	MSDRG 673
Min. Negotiated Rate	$46,992.49
Max. Negotiated Rate	$72,349.24
Rate for Payer: EPIC Health Plan Medicare	$46,992.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$46,992.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$54,041.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,210.54
Rate for Payer: Molina Healthcare of CA Medicare	$59,210.54
Rate for Payer: Multiplan WC	$72,349.24

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

Facility

$27,030.81

Service Code	MSDRG 675
Min. Negotiated Rate	$17,757.12
Max. Negotiated Rate	$27,030.81
Rate for Payer: EPIC Health Plan Medicare	$17,757.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,757.12
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,420.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,373.97
Rate for Payer: Molina Healthcare of CA Medicare	$22,373.97
Rate for Payer: Multiplan WC	$27,030.81

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$86,939.00

Service Code	MSDRG 271
Min. Negotiated Rate	$38,690.76
Max. Negotiated Rate	$86,939.00
Rate for Payer: Aetna of CA Gatekeeper	$86,939.00
Rate for Payer: EPIC Health Plan Medicare	$38,690.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$38,690.76
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$44,494.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,750.36
Rate for Payer: Molina Healthcare of CA Medicare	$48,750.36
Rate for Payer: Multiplan WC	$59,480.56

Know your out-of-pocket cost for care.

All Charges