Loma Linda University Medical Center

All Charges

Charge

Type

Price

ACUTE AND SUBACUTE ENDOCARDITIS

Facility IP

$9,824.60

Service Code	APR-DRG 1932
Min. Negotiated Rate	$9,824.60
Max. Negotiated Rate	$9,824.60
Rate for Payer: IEHP Medi-Cal	$9,824.60

ACUTE AND SUBACUTE ENDOCARDITIS

Facility IP

$6,669.78

Service Code	APR-DRG 1931
Min. Negotiated Rate	$6,669.78
Max. Negotiated Rate	$6,669.78
Rate for Payer: IEHP Medi-Cal	$6,669.78

ACUTE AND SUBACUTE ENDOCARDITIS

Facility IP

$20,223.25

Service Code	APR-DRG 1934
Min. Negotiated Rate	$20,223.25
Max. Negotiated Rate	$20,223.25
Rate for Payer: IEHP Medi-Cal	$20,223.25

ACUTE AND SUBACUTE ENDOCARDITIS

Facility IP

$13,013.24

Service Code	APR-DRG 1933
Min. Negotiated Rate	$13,013.24
Max. Negotiated Rate	$13,013.24
Rate for Payer: IEHP Medi-Cal	$13,013.24

ACUTE ANXIETY AND DELIRIUM STATES

Facility IP

$5,227.18

Service Code	APR-DRG 7563
Min. Negotiated Rate	$5,227.18
Max. Negotiated Rate	$5,227.18
Rate for Payer: IEHP Medi-Cal	$5,227.18

ACUTE ANXIETY AND DELIRIUM STATES

Facility IP

$10,800.59

Service Code	APR-DRG 7564
Min. Negotiated Rate	$10,800.59
Max. Negotiated Rate	$10,800.59
Rate for Payer: IEHP Medi-Cal	$10,800.59

ACUTE ANXIETY AND DELIRIUM STATES

Facility IP

$5,042.13

Service Code	APR-DRG 7562
Min. Negotiated Rate	$5,042.13
Max. Negotiated Rate	$5,042.13
Rate for Payer: IEHP Medi-Cal	$5,042.13

ACUTE ANXIETY AND DELIRIUM STATES

Facility IP

$3,856.22

Service Code	APR-DRG 7561
Min. Negotiated Rate	$3,856.22
Max. Negotiated Rate	$3,856.22
Rate for Payer: IEHP Medi-Cal	$3,856.22

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$6,786.19

Service Code	APR-DRG 1453
Min. Negotiated Rate	$6,786.19
Max. Negotiated Rate	$6,786.19
Rate for Payer: IEHP Medi-Cal	$6,786.19

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$5,260.01

Service Code	APR-DRG 1452
Min. Negotiated Rate	$5,260.01
Max. Negotiated Rate	$5,260.01
Rate for Payer: IEHP Medi-Cal	$5,260.01

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$10,337.97

Service Code	APR-DRG 1454
Min. Negotiated Rate	$10,337.97
Max. Negotiated Rate	$10,337.97
Rate for Payer: IEHP Medi-Cal	$10,337.97

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$4,114.89

Service Code	APR-DRG 1451
Min. Negotiated Rate	$4,114.89
Max. Negotiated Rate	$4,114.89
Rate for Payer: IEHP Medi-Cal	$4,114.89

ACUTE KIDNEY INJURY

Facility IP

$8,282.51

Service Code	APR-DRG 4693
Min. Negotiated Rate	$8,282.51
Max. Negotiated Rate	$8,282.51
Rate for Payer: IEHP Medi-Cal	$8,282.51

ACUTE KIDNEY INJURY

Facility IP

$15,496.50

Service Code	APR-DRG 4694
Min. Negotiated Rate	$15,496.50
Max. Negotiated Rate	$15,496.50
Rate for Payer: IEHP Medi-Cal	$15,496.50

ACUTE KIDNEY INJURY

Facility IP

$5,306.77

Service Code	APR-DRG 4692
Min. Negotiated Rate	$5,306.77
Max. Negotiated Rate	$5,306.77
Rate for Payer: IEHP Medi-Cal	$5,306.77

ACUTE KIDNEY INJURY

Facility IP

$4,092.01

Service Code	APR-DRG 4691
Min. Negotiated Rate	$4,092.01
Max. Negotiated Rate	$4,092.01
Rate for Payer: IEHP Medi-Cal	$4,092.01

ACUTE LEUKEMIA

Facility IP

$7,475.65

Service Code	APR-DRG 6901
Min. Negotiated Rate	$7,475.65
Max. Negotiated Rate	$7,475.65
Rate for Payer: IEHP Medi-Cal	$7,475.65

ACUTE LEUKEMIA

Facility IP

$26,961.68

Service Code	APR-DRG 6903
Min. Negotiated Rate	$26,961.68
Max. Negotiated Rate	$26,961.68
Rate for Payer: IEHP Medi-Cal	$26,961.68

ACUTE LEUKEMIA

Facility IP

$46,944.17

Service Code	APR-DRG 6904
Min. Negotiated Rate	$46,944.17
Max. Negotiated Rate	$46,944.17
Rate for Payer: IEHP Medi-Cal	$46,944.17

ACUTE LEUKEMIA

Facility IP

$14,474.74

Service Code	APR-DRG 6902
Min. Negotiated Rate	$14,474.74
Max. Negotiated Rate	$14,474.74
Rate for Payer: IEHP Medi-Cal	$14,474.74

ACUTE MYOCARDIAL INFARCTION

Facility IP

$6,862.80

Service Code	APR-DRG 1901
Min. Negotiated Rate	$6,862.80
Max. Negotiated Rate	$6,862.80
Rate for Payer: IEHP Medi-Cal	$6,862.80

ACUTE MYOCARDIAL INFARCTION

Facility IP

$9,580.85

Service Code	APR-DRG 1903
Min. Negotiated Rate	$9,580.85
Max. Negotiated Rate	$9,580.85
Rate for Payer: IEHP Medi-Cal	$9,580.85

ACUTE MYOCARDIAL INFARCTION

Facility IP

$7,481.61

Service Code	APR-DRG 1902
Min. Negotiated Rate	$7,481.61
Max. Negotiated Rate	$7,481.61
Rate for Payer: IEHP Medi-Cal	$7,481.61

ACUTE MYOCARDIAL INFARCTION

Facility IP

$13,902.68

Service Code	APR-DRG 1904
Min. Negotiated Rate	$13,902.68
Max. Negotiated Rate	$13,902.68
Rate for Payer: IEHP Medi-Cal	$13,902.68

ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION [8970]

Facility IP

$0.90

Service Code	CPT J8499
Hospital Charge Code	1715057
Hospital Revenue Code	259
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.68
Rate for Payer: Adventist Health Commercial	$0.18
Rate for Payer: Adventist Health Commercial	$0.04
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.14
Rate for Payer: Aetna of CA Non-Gatekeeper	$0.62
Rate for Payer: Cash Price	$0.09
Rate for Payer: Cash Price	$0.41
Rate for Payer: EPIC Health Plan Commercial	$0.49
Rate for Payer: EPIC Health Plan Commercial	$0.11
Rate for Payer: Heritage Provider Network Commercial	$0.14
Rate for Payer: Heritage Provider Network Commercial	$0.61
Rate for Payer: Heritage Provider Network Senior	$0.61
Rate for Payer: Heritage Provider Network Senior	$0.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$0.04
Rate for Payer: LLUH Dept of Risk Management WC	$0.05
Rate for Payer: LLUH Dept of Risk Management WC	$0.23
Rate for Payer: Multiplan Commercial	$0.15
Rate for Payer: Multiplan Commercial	$0.68

Price Transparency.

All Charges