Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$23,363.21

Service Code	MSDRG 750
Min. Negotiated Rate	$17,435.23
Max. Negotiated Rate	$23,363.21
Rate for Payer: EPIC Health Plan Medicare	$17,435.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,435.23
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$20,050.51
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$23,363.21

OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$153,595.96

Service Code	MSDRG 215
Min. Negotiated Rate	$114,623.85
Max. Negotiated Rate	$153,595.96
Rate for Payer: EPIC Health Plan Medicare	$114,623.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$114,623.85
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$131,817.43
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$153,595.96

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$34,297.82

Service Code	MSDRG 424
Min. Negotiated Rate	$25,595.39
Max. Negotiated Rate	$34,297.82
Rate for Payer: EPIC Health Plan Medicare	$25,595.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,595.39
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$29,434.70
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$34,297.82

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$64,472.85

Service Code	MSDRG 423
Min. Negotiated Rate	$48,114.07
Max. Negotiated Rate	$64,472.85
Rate for Payer: EPIC Health Plan Medicare	$48,114.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$48,114.07
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$55,331.18
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$64,472.85

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$23,739.41

Service Code	MSDRG 425
Min. Negotiated Rate	$17,715.98
Max. Negotiated Rate	$23,739.41
Rate for Payer: EPIC Health Plan Medicare	$17,715.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,715.98
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$20,373.38
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$23,739.41

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$16,534.62

Service Code	MSDRG 868
Min. Negotiated Rate	$12,339.27
Max. Negotiated Rate	$16,534.62
Rate for Payer: EPIC Health Plan Medicare	$12,339.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,339.27
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,190.16
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,534.62

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$32,843.67

Service Code	MSDRG 867
Min. Negotiated Rate	$24,510.20
Max. Negotiated Rate	$32,843.67
Rate for Payer: EPIC Health Plan Medicare	$24,510.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,510.20
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$28,186.73
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$32,843.67

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$11,906.49

Service Code	MSDRG 869
Min. Negotiated Rate	$8,885.44
Max. Negotiated Rate	$11,906.49
Rate for Payer: EPIC Health Plan Medicare	$8,885.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,885.44
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$10,218.26
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,906.49

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$27,564.44

Service Code	MSDRG 922
Min. Negotiated Rate	$20,570.48
Max. Negotiated Rate	$27,564.44
Rate for Payer: EPIC Health Plan Medicare	$20,570.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,570.48
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$23,656.05
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$27,564.44

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$16,328.82

Service Code	MSDRG 923
Min. Negotiated Rate	$12,185.69
Max. Negotiated Rate	$16,328.82
Rate for Payer: EPIC Health Plan Medicare	$12,185.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,185.69
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,013.54
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,328.82

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$16,287.38

Service Code	MSDRG 699
Min. Negotiated Rate	$12,154.76
Max. Negotiated Rate	$16,287.38
Rate for Payer: EPIC Health Plan Medicare	$12,154.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,154.76
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$13,977.97
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,287.38

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$26,105.67

Service Code	MSDRG 698
Min. Negotiated Rate	$19,481.84
Max. Negotiated Rate	$26,105.67
Rate for Payer: EPIC Health Plan Medicare	$19,481.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,481.84
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$22,404.12
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$26,105.67

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

Facility

$11,295.33

Service Code	MSDRG 700
Min. Negotiated Rate	$8,429.35
Max. Negotiated Rate	$11,295.33
Rate for Payer: EPIC Health Plan Medicare	$8,429.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,429.35
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$9,693.75
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,295.33

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$36,611.90

Service Code	MSDRG 674
Min. Negotiated Rate	$27,322.31
Max. Negotiated Rate	$36,611.90
Rate for Payer: EPIC Health Plan Medicare	$27,322.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,322.31
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$31,420.66
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$36,611.90

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$65,219.11

Service Code	MSDRG 673
Min. Negotiated Rate	$48,670.98
Max. Negotiated Rate	$65,219.11
Rate for Payer: EPIC Health Plan Medicare	$48,670.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$48,670.98
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$55,971.63
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$65,219.11

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility

$25,906.07

Service Code	MSDRG 675
Min. Negotiated Rate	$19,332.89
Max. Negotiated Rate	$25,906.07
Rate for Payer: EPIC Health Plan Medicare	$19,332.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,332.89
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$22,232.82
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$25,906.07

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$55,310.23

Service Code	MSDRG 271
Min. Negotiated Rate	$41,276.29
Max. Negotiated Rate	$55,310.23
Rate for Payer: EPIC Health Plan Medicare	$41,276.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$41,276.29
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$47,467.73
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$55,310.23

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$81,721.64

Service Code	MSDRG 270
Min. Negotiated Rate	$60,986.30
Max. Negotiated Rate	$81,721.64
Rate for Payer: EPIC Health Plan Medicare	$60,986.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,986.30
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$70,134.24
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$81,721.64

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$39,904.07

Service Code	MSDRG 272
Min. Negotiated Rate	$29,779.16
Max. Negotiated Rate	$39,904.07
Rate for Payer: EPIC Health Plan Medicare	$29,779.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,779.16
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$34,246.03
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$39,904.07

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$16,958.44

Service Code	MSDRG 729
Min. Negotiated Rate	$12,655.55
Max. Negotiated Rate	$16,958.44
Rate for Payer: EPIC Health Plan Medicare	$12,655.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,655.55
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$14,553.88
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$16,958.44

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$11,020.47

Service Code	MSDRG 730
Min. Negotiated Rate	$8,224.23
Max. Negotiated Rate	$11,020.47
Rate for Payer: EPIC Health Plan Medicare	$8,224.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,224.23
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$9,457.86
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$11,020.47

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$29,731.09

Service Code	MSDRG 717
Min. Negotiated Rate	$22,187.38
Max. Negotiated Rate	$29,731.09
Rate for Payer: EPIC Health Plan Medicare	$22,187.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,187.38
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$25,515.49
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$29,731.09

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$21,325.50

Service Code	MSDRG 718
Min. Negotiated Rate	$15,914.55
Max. Negotiated Rate	$21,325.50
Rate for Payer: EPIC Health Plan Medicare	$15,914.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,914.55
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$18,301.73
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$21,325.50

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$35,056.38

Service Code	MSDRG 715
Min. Negotiated Rate	$26,161.48
Max. Negotiated Rate	$35,056.38
Rate for Payer: EPIC Health Plan Medicare	$26,161.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,161.48
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$30,085.70
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$35,056.38

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$23,289.48

Service Code	MSDRG 716
Min. Negotiated Rate	$17,380.21
Max. Negotiated Rate	$23,289.48
Rate for Payer: EPIC Health Plan Medicare	$17,380.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,380.21
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$19,987.24
Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare	$23,289.48

Know your out-of-pocket cost for care.

All Charges