Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$1.83

Service Code	APR-DRG 5193
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.83

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$1.14

Service Code	APR-DRG 5192
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: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$0.94

Service Code	APR-DRG 5131
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.94

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$1.79

Service Code	APR-DRG 5133
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$1.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.79

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$3.09

Service Code	APR-DRG 5134
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$3.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3.09

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$1.14

Service Code	APR-DRG 5132
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: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$4.18

Service Code	APR-DRG 5124
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$4.18

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$1.42

Service Code	APR-DRG 5122
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$1.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.42

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$1.23

Service Code	APR-DRG 5121
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.23

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$2.22

Service Code	APR-DRG 5123
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.22

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$2.30

Service Code	APR-DRG 5113
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.30

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$1.61

Service Code	APR-DRG 5112
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.61

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$4.51

Service Code	APR-DRG 5114
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$4.51

APR-DRG 41.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$1.33

Service Code	APR-DRG 5111
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.33

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$0.86

Service Code	APR-DRG 5604
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.86

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$0.39

Service Code	APR-DRG 5602
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.39

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$0.50

Service Code	APR-DRG 5603
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.50

APR-DRG 41.00: VAGINAL DELIVERY

Facility

$0.34

Service Code	APR-DRG 5601
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.34

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$0.45

Service Code	APR-DRG 5422
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.45

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$1.92

Service Code	APR-DRG 5424
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.92

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$0.66

Service Code	APR-DRG 5423
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.66

APR-DRG 41.00: VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility

$0.39

Service Code	APR-DRG 5421
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.39

APR-DRG 41.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$0.63

Service Code	APR-DRG 5412
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: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$0.78

Service Code	APR-DRG 5413
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: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility

$1.20

Service Code	APR-DRG 5414
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.20

Know your out-of-pocket cost for care.

All Charges