Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS

Facility

$18,576.00

Service Code	MSDRG 065
Min. Negotiated Rate	$12,100.89
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC

Facility

$31,581.44

Service Code	MSDRG 064
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$31,581.44
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC

Facility

$18,576.00

Service Code	MSDRG 066
Min. Negotiated Rate	$8,366.33
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC

Facility

$32,611.81

Service Code	MSDRG 516
Min. Negotiated Rate	$24,337.17
Max. Negotiated Rate	$32,611.81
Rate for Payer: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC

Facility

$27,318.00

Service Code	MSDRG 517
Min. Negotiated Rate	$18,133.08
Max. Negotiated Rate	$27,318.00
Rate for Payer: EPIC Health Plan Commercial	$27,318.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,633.00

MS-DRG 33.00: PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC

Facility

$23,650.33

Service Code	MSDRG 251
Min. Negotiated Rate	$9,725.00
Max. Negotiated Rate	$23,650.33
Rate for Payer: EPIC Health Plan Commercial	$9,725.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$8,850.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: 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: EPIC Health Plan Commercial	$24,040.00

MS-DRG 33.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT 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: EPIC Health Plan Commercial	$28,410.00

MS-DRG 33.00: SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC

Facility

$129,739.72

Service Code	MSDRG 456
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$129,739.72
Rate for Payer: EPIC Health Plan Commercial	$28,410.00

Know your out-of-pocket cost for care.

All Charges