Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 29.00: LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC

Facility

$37,345.88

Service Code	MSDRG 417
Min. Negotiated Rate	$14,580.00
Max. Negotiated Rate	$37,345.88
Rate for Payer: Cigna of CA HMO/PPO	$14,580.00

MS-DRG 29.00: LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC

Facility

$21,674.08

Service Code	MSDRG 419
Min. Negotiated Rate	$14,580.00
Max. Negotiated Rate	$21,674.08
Rate for Payer: Cigna of CA HMO/PPO	$14,580.00

MS-DRG 29.00: MAJOR CARDIOVASC PROCEDURES W MCC

Facility

$32,400.00

Service Code	MSDRG 237
Min. Negotiated Rate	$32,400.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: MAJOR CARDIOVASC PROCEDURES W/O MCC

Facility

$32,400.00

Service Code	MSDRG 238
Min. Negotiated Rate	$32,400.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC

Facility

$47,277.80

Service Code	MSDRG 469
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$47,277.80
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC

Facility

$30,320.76

Service Code	MSDRG 470
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$30,320.76
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W CC

Facility

$25,274.95

Service Code	MSDRG 620
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$25,274.95
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W MCC

Facility

$45,038.97

Service Code	MSDRG 619
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$45,038.97
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: O.R. PROCEDURES FOR OBESITY W/O CC/MCC

Facility

$23,863.78

Service Code	MSDRG 621
Min. Negotiated Rate	$12,050.00
Max. Negotiated Rate	$23,863.78
Rate for Payer: Cigna of CA HMO/PPO	$16,000.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W CC

Facility

$49,063.63

Service Code	MSDRG 229
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$49,063.63
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W MCC

Facility

$76,671.22

Service Code	MSDRG 228
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$76,671.22
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC

Facility

$32,400.00

Service Code	MSDRG 230
Min. Negotiated Rate	$28,410.00
Max. Negotiated Rate	$32,400.00
Rate for Payer: Cigna of CA HMO/PPO	$32,400.00

MS-DRG 29.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC

Facility

$49,637.91

Service Code	MSDRG 515
Min. Negotiated Rate	$13,500.00
Max. Negotiated Rate	$49,637.91
Rate for Payer: Cigna of CA HMO/PPO	$13,500.00

MS-DRG 29.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS

Facility

$11,000.00

Service Code	MSDRG 246
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC

Facility

$11,000.00

Service Code	MSDRG 247
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W MCC OR 4+ VES/STENTS

Facility

$11,000.00

Service Code	MSDRG 248
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC

Facility

$11,000.00

Service Code	MSDRG 249
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC

Facility

$34,214.90

Service Code	MSDRG 250
Min. Negotiated Rate	$8,633.00
Max. Negotiated Rate	$34,214.90
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W CC

Facility

$33,422.57

Service Code	MSDRG 243
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$33,422.57
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W MCC

Facility

$49,728.54

Service Code	MSDRG 242
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$49,728.54
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC

Facility

$28,456.60

Service Code	MSDRG 244
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$28,456.60
Rate for Payer: Cigna of CA HMO/PPO	$11,000.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W CC

Facility

$54,854.19

Service Code	MSDRG 467
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$54,854.19
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W MCC

Facility

$80,632.95

Service Code	MSDRG 466
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$80,632.95
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC

Facility

$42,898.41

Service Code	MSDRG 468
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$42,898.41
Rate for Payer: Cigna of CA HMO/PPO	$17,300.00

MS-DRG 29.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC

Facility

$92,267.79

Service Code	MSDRG 457
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$92,267.79
Rate for Payer: Cigna of CA HMO/PPO	$21,600.00

Know your out-of-pocket cost for care.

All Charges