Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$0.78

Service Code	APR-DRG 1143
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.78

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$1.51

Service Code	APR-DRG 1144
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.51

APR-DRG 41.00: DENTAL DISEASES AND DISORDERS

Facility

$0.38

Service Code	APR-DRG 1141
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.38

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$1.58

Service Code	APR-DRG 7544
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.58

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$0.67

Service Code	APR-DRG 7543
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.67

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$0.31

Service Code	APR-DRG 7541
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.31

APR-DRG 41.00: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$0.41

Service Code	APR-DRG 7542
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.41

APR-DRG 41.00: DIABETES

Facility

$0.44

Service Code	APR-DRG 4201
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.44

APR-DRG 41.00: DIABETES

Facility

$0.55

Service Code	APR-DRG 4202
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$0.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.55

APR-DRG 41.00: DIABETES

Facility

$0.81

Service Code	APR-DRG 4203
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.81

APR-DRG 41.00: DIABETES

Facility

$1.66

Service Code	APR-DRG 4204
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$1.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.66

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$0.82

Service Code	APR-DRG 2402
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.82

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$0.68

Service Code	APR-DRG 2401
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.68

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$1.10

Service Code	APR-DRG 2403
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.10

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$1.80

Service Code	APR-DRG 2404
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.80

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$0.68

Service Code	APR-DRG 5171
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.68

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$0.85

Service Code	APR-DRG 5172
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.85

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$1.37

Service Code	APR-DRG 5173
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$1.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.37

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$2.41

Service Code	APR-DRG 5174
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$2.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.41

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$1.14

Service Code	APR-DRG 2843
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.14

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$0.82

Service Code	APR-DRG 2842
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.82

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$0.63

Service Code	APR-DRG 2841
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.63

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$1.95

Service Code	APR-DRG 2844
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.95

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$0.52

Service Code	APR-DRG 2821
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$0.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.52

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$0.66

Service Code	APR-DRG 2822
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.66

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All Charges