Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 011: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility

$84,298.79

Service Code	MS-DRG 011
Min. Negotiated Rate	$58,266.66
Max. Negotiated Rate	$84,298.79
Rate for Payer: EPIC Health Plan Medicare	$58,266.66
Rate for Payer: Humana Medicare	$58,266.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$58,266.66
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$68,754.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$73,415.99
Rate for Payer: Molina Healthcare of CA Medicare	$73,415.99
Rate for Payer: Multiplan WC	$84,298.79

INPATIENT MS-DRG 012: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC

Facility

$63,805.10

Service Code	MS-DRG 012
Min. Negotiated Rate	$45,301.37
Max. Negotiated Rate	$63,805.10
Rate for Payer: EPIC Health Plan Medicare	$45,301.37
Rate for Payer: Humana Medicare	$45,301.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$45,301.37
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$53,455.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$57,079.73
Rate for Payer: Molina Healthcare of CA Medicare	$57,079.73
Rate for Payer: Multiplan WC	$63,805.10

INPATIENT MS-DRG 013: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility

$46,159.35

Service Code	MS-DRG 013
Min. Negotiated Rate	$30,446.58
Max. Negotiated Rate	$46,159.35
Rate for Payer: EPIC Health Plan Medicare	$30,446.58
Rate for Payer: Humana Medicare	$30,446.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$30,446.58
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$35,926.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,362.69
Rate for Payer: Molina Healthcare of CA Medicare	$38,362.69
Rate for Payer: Multiplan WC	$46,159.35

INPATIENT MS-DRG 014: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$182,675.67

Service Code	MS-DRG 014
Min. Negotiated Rate	$129,259.27
Max. Negotiated Rate	$182,675.67
Rate for Payer: EPIC Health Plan Medicare	$129,259.27
Rate for Payer: Humana Medicare	$129,259.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$129,259.27
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$152,525.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$162,866.68
Rate for Payer: Molina Healthcare of CA Medicare	$162,866.68
Rate for Payer: Multiplan WC	$182,675.67

INPATIENT MS-DRG 016: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC

Facility

$99,300.62

Service Code	MS-DRG 016
Min. Negotiated Rate	$69,760.18
Max. Negotiated Rate	$99,300.62
Rate for Payer: EPIC Health Plan Medicare	$69,760.18
Rate for Payer: Humana Medicare	$69,760.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,760.18
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$82,317.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$87,897.83
Rate for Payer: Molina Healthcare of CA Medicare	$87,897.83
Rate for Payer: Multiplan WC	$99,300.62

INPATIENT MS-DRG 017: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC

Facility

$87,897.83

Service Code	MS-DRG 017
Min. Negotiated Rate	$69,760.18
Max. Negotiated Rate	$87,897.83
Rate for Payer: EPIC Health Plan Medicare	$69,760.18
Rate for Payer: Humana Medicare	$69,760.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,760.18
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$82,317.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$87,897.83
Rate for Payer: Molina Healthcare of CA Medicare	$87,897.83
Rate for Payer: Multiplan WC	$71,322.34

INPATIENT MS-DRG 018: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$589,908.75

Service Code	MS-DRG 018
Min. Negotiated Rate	$415,069.80
Max. Negotiated Rate	$589,908.75
Rate for Payer: EPIC Health Plan Medicare	$415,069.80
Rate for Payer: Humana Medicare	$415,069.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$415,069.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$489,782.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$522,987.95
Rate for Payer: Molina Healthcare of CA Medicare	$522,987.95
Rate for Payer: Multiplan WC	$589,908.75

INPATIENT MS-DRG 019: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS

Facility

$116,440.43

Service Code	MS-DRG 019
Min. Negotiated Rate	$90,214.79
Max. Negotiated Rate	$116,440.43
Rate for Payer: EPIC Health Plan Medicare	$90,214.79
Rate for Payer: Humana Medicare	$90,214.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$90,214.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$106,453.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$113,670.64
Rate for Payer: Molina Healthcare of CA Medicare	$113,670.64
Rate for Payer: Multiplan WC	$116,440.43

INPATIENT MS-DRG 020: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$151,834.77

Service Code	MS-DRG 020
Min. Negotiated Rate	$95,382.21
Max. Negotiated Rate	$151,834.77
Rate for Payer: EPIC Health Plan Medicare	$95,382.21
Rate for Payer: Humana Medicare	$95,382.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$95,382.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$112,551.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$120,181.58
Rate for Payer: Molina Healthcare of CA Medicare	$120,181.58
Rate for Payer: Multiplan WC	$151,834.77

INPATIENT MS-DRG 021: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$110,803.33

Service Code	MS-DRG 021
Min. Negotiated Rate	$69,359.32
Max. Negotiated Rate	$110,803.33
Rate for Payer: EPIC Health Plan Medicare	$69,359.32
Rate for Payer: Humana Medicare	$69,359.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$69,359.32
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$81,844.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$87,392.74
Rate for Payer: Molina Healthcare of CA Medicare	$87,392.74
Rate for Payer: Multiplan WC	$110,803.33

INPATIENT MS-DRG 022: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$71,133.03

Service Code	MS-DRG 022
Min. Negotiated Rate	$44,375.75
Max. Negotiated Rate	$71,133.03
Rate for Payer: EPIC Health Plan Medicare	$44,375.75
Rate for Payer: Humana Medicare	$44,375.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$44,375.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$52,363.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,913.44
Rate for Payer: Molina Healthcare of CA Medicare	$55,913.44
Rate for Payer: Multiplan WC	$71,133.03

INPATIENT MS-DRG 023: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR

Facility

$93,539.47

Service Code	MS-DRG 023
Min. Negotiated Rate	$64,037.62
Max. Negotiated Rate	$93,539.47
Rate for Payer: EPIC Health Plan Medicare	$64,037.62
Rate for Payer: Humana Medicare	$64,037.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,037.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$75,564.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$80,687.40
Rate for Payer: Molina Healthcare of CA Medicare	$80,687.40
Rate for Payer: Multiplan WC	$93,539.47

INPATIENT MS-DRG 024: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC

Facility

$64,446.51

Service Code	MS-DRG 024
Min. Negotiated Rate	$42,867.97
Max. Negotiated Rate	$64,446.51
Rate for Payer: EPIC Health Plan Medicare	$42,867.97
Rate for Payer: Humana Medicare	$42,867.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$42,867.97
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$50,584.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$54,013.64
Rate for Payer: Molina Healthcare of CA Medicare	$54,013.64
Rate for Payer: Multiplan WC	$64,446.51

INPATIENT MS-DRG 025: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC

Facility

$74,103.36

Service Code	MS-DRG 025
Min. Negotiated Rate	$49,930.53
Max. Negotiated Rate	$74,103.36
Rate for Payer: EPIC Health Plan Medicare	$49,930.53
Rate for Payer: Humana Medicare	$49,930.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$49,930.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$58,918.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,912.47
Rate for Payer: Molina Healthcare of CA Medicare	$62,912.47
Rate for Payer: Multiplan WC	$74,103.36

INPATIENT MS-DRG 026: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC

Facility

$49,345.12

Service Code	MS-DRG 026
Min. Negotiated Rate	$33,457.64
Max. Negotiated Rate	$49,345.12
Rate for Payer: EPIC Health Plan Medicare	$33,457.64
Rate for Payer: Humana Medicare	$33,457.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$33,457.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$39,480.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,156.63
Rate for Payer: Molina Healthcare of CA Medicare	$42,156.63
Rate for Payer: Multiplan WC	$49,345.12

INPATIENT MS-DRG 027: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$40,726.24

Service Code	MS-DRG 027
Min. Negotiated Rate	$27,599.93
Max. Negotiated Rate	$40,726.24
Rate for Payer: EPIC Health Plan Medicare	$27,599.93
Rate for Payer: Humana Medicare	$27,599.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,599.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$32,567.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,775.91
Rate for Payer: Molina Healthcare of CA Medicare	$34,775.91
Rate for Payer: Multiplan WC	$40,726.24

INPATIENT MS-DRG 028: SPINAL PROCEDURES WITH MCC

Facility

$95,923.90

Service Code	MS-DRG 028
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$95,923.90
Rate for Payer: EPIC Health Plan Medicare	$68,060.98
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Humana Medicare	$68,060.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$68,060.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$80,311.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$85,756.83
Rate for Payer: Molina Healthcare of CA Medicare	$85,756.83
Rate for Payer: Multiplan WC	$95,923.90

INPATIENT MS-DRG 029: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS

Facility

$55,777.03

Service Code	MS-DRG 029
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$55,777.03
Rate for Payer: EPIC Health Plan Medicare	$38,807.44
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Humana Medicare	$38,807.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$38,807.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,792.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,897.37
Rate for Payer: Molina Healthcare of CA Medicare	$48,897.37
Rate for Payer: Multiplan WC	$55,777.03

INPATIENT MS-DRG 030: SPINAL PROCEDURES WITHOUT CC/MCC

Facility

$38,209.62

Service Code	MS-DRG 030
Min. Negotiated Rate	$3,928.00
Max. Negotiated Rate	$38,209.62
Rate for Payer: EPIC Health Plan Medicare	$26,317.38
Rate for Payer: Heritage Provider Network Commercial	$4,319.00
Rate for Payer: Heritage Provider Network Senior	$3,928.00
Rate for Payer: Humana Medicare	$26,317.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,317.38
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,054.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,159.90
Rate for Payer: Molina Healthcare of CA Medicare	$33,159.90
Rate for Payer: Multiplan WC	$38,209.62

INPATIENT MS-DRG 031: VENTRICULAR SHUNT PROCEDURES WITH MCC

Facility

$67,256.90

Service Code	MS-DRG 031
Min. Negotiated Rate	$46,559.15
Max. Negotiated Rate	$67,256.90
Rate for Payer: EPIC Health Plan Medicare	$46,559.15
Rate for Payer: Humana Medicare	$46,559.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$46,559.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$54,939.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$58,664.53
Rate for Payer: Molina Healthcare of CA Medicare	$58,664.53
Rate for Payer: Multiplan WC	$67,256.90

INPATIENT MS-DRG 032: VENTRICULAR SHUNT PROCEDURES WITH CC

Facility

$33,530.52

Service Code	MS-DRG 032
Min. Negotiated Rate	$24,457.13
Max. Negotiated Rate	$33,530.52
Rate for Payer: EPIC Health Plan Medicare	$24,457.13
Rate for Payer: Humana Medicare	$24,457.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,457.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,859.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,815.98
Rate for Payer: Molina Healthcare of CA Medicare	$30,815.98
Rate for Payer: Multiplan WC	$33,530.52

INPATIENT MS-DRG 033: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$27,720.42

Service Code	MS-DRG 033
Min. Negotiated Rate	$18,478.96
Max. Negotiated Rate	$27,720.42
Rate for Payer: EPIC Health Plan Medicare	$18,478.96
Rate for Payer: Humana Medicare	$18,478.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,478.96
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,805.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,283.49
Rate for Payer: Molina Healthcare of CA Medicare	$23,283.49
Rate for Payer: Multiplan WC	$27,720.42

INPATIENT MS-DRG 034: CAROTID ARTERY STENT PROCEDURES WITH MCC

Facility

$65,272.32

Service Code	MS-DRG 034
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$65,272.32
Rate for Payer: Cigna of CA HMO/PPO	$24,300.00
Rate for Payer: EPIC Health Plan Commercial	$14,752.00
Rate for Payer: EPIC Health Plan Medicare	$44,135.92
Rate for Payer: Humana Medicare	$44,135.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$44,135.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$52,080.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,611.26
Rate for Payer: Molina Healthcare of CA Medicare	$55,611.26
Rate for Payer: Multiplan WC	$65,272.32

INPATIENT MS-DRG 035: CAROTID ARTERY STENT PROCEDURES WITH CC

Facility

$37,272.82

Service Code	MS-DRG 035
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$37,272.82
Rate for Payer: Cigna of CA HMO/PPO	$24,300.00
Rate for Payer: EPIC Health Plan Commercial	$14,752.00
Rate for Payer: EPIC Health Plan Medicare	$26,097.79
Rate for Payer: Humana Medicare	$26,097.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,097.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,795.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,883.22
Rate for Payer: Molina Healthcare of CA Medicare	$32,883.22
Rate for Payer: Multiplan WC	$37,272.82

INPATIENT MS-DRG 036: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC

Facility

$30,694.02

Service Code	MS-DRG 036
Min. Negotiated Rate	$14,752.00
Max. Negotiated Rate	$30,694.02
Rate for Payer: Cigna of CA HMO/PPO	$24,300.00
Rate for Payer: EPIC Health Plan Commercial	$14,752.00
Rate for Payer: EPIC Health Plan Medicare	$20,565.53
Rate for Payer: Humana Medicare	$20,565.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,565.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,267.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,912.57
Rate for Payer: Molina Healthcare of CA Medicare	$25,912.57
Rate for Payer: Multiplan WC	$30,694.02

Know your out-of-pocket cost for care.

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