Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 037: EXTRACRANIAL PROCEDURES WITH MCC

Facility

$55,049.14

Service Code	MS-DRG 037
Min. Negotiated Rate	$38,215.15
Max. Negotiated Rate	$55,049.14
Rate for Payer: EPIC Health Plan Medicare	$38,215.15
Rate for Payer: Humana Medicare	$38,215.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$38,215.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$45,093.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,151.09
Rate for Payer: Molina Healthcare of CA Medicare	$48,151.09
Rate for Payer: Multiplan WC	$55,049.14

INPATIENT MS-DRG 038: EXTRACRANIAL PROCEDURES WITH CC

Facility

$26,692.22

Service Code	MS-DRG 038
Min. Negotiated Rate	$18,219.98
Max. Negotiated Rate	$26,692.22
Rate for Payer: EPIC Health Plan Medicare	$18,219.98
Rate for Payer: Humana Medicare	$18,219.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,219.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,499.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,957.17
Rate for Payer: Molina Healthcare of CA Medicare	$22,957.17
Rate for Payer: Multiplan WC	$26,692.22

INPATIENT MS-DRG 039: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$18,812.67

Service Code	MS-DRG 039
Min. Negotiated Rate	$13,052.55
Max. Negotiated Rate	$18,812.67
Rate for Payer: EPIC Health Plan Medicare	$13,052.55
Rate for Payer: Humana Medicare	$13,052.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,052.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,402.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,446.21
Rate for Payer: Molina Healthcare of CA Medicare	$16,446.21
Rate for Payer: Multiplan WC	$18,812.67

INPATIENT MS-DRG 040: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC

Facility

$61,828.69

Service Code	MS-DRG 040
Min. Negotiated Rate	$43,562.75
Max. Negotiated Rate	$61,828.69
Rate for Payer: EPIC Health Plan Medicare	$43,562.75
Rate for Payer: Humana Medicare	$43,562.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$43,562.75
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$51,404.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$54,889.06
Rate for Payer: Molina Healthcare of CA Medicare	$54,889.06
Rate for Payer: Multiplan WC	$61,828.69

INPATIENT MS-DRG 041: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR

Facility

$38,159.02

Service Code	MS-DRG 041
Min. Negotiated Rate	$25,323.07
Max. Negotiated Rate	$38,159.02
Rate for Payer: EPIC Health Plan Medicare	$25,323.07
Rate for Payer: Humana Medicare	$25,323.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,323.07
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,881.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,907.07
Rate for Payer: Molina Healthcare of CA Medicare	$31,907.07
Rate for Payer: Multiplan WC	$38,159.02

INPATIENT MS-DRG 042: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC

Facility

$30,188.08

Service Code	MS-DRG 042
Min. Negotiated Rate	$19,795.32
Max. Negotiated Rate	$30,188.08
Rate for Payer: EPIC Health Plan Medicare	$19,795.32
Rate for Payer: Humana Medicare	$19,795.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,795.32
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,358.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,942.10
Rate for Payer: Molina Healthcare of CA Medicare	$24,942.10
Rate for Payer: Multiplan WC	$30,188.08

INPATIENT MS-DRG 052: SPINAL DISORDERS AND INJURIES WITH CC/MCC

Facility

$29,055.43

Service Code	MS-DRG 052
Min. Negotiated Rate	$22,100.33
Max. Negotiated Rate	$29,055.43
Rate for Payer: EPIC Health Plan Medicare	$22,100.33
Rate for Payer: Humana Medicare	$22,100.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,100.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,078.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,846.42
Rate for Payer: Molina Healthcare of CA Medicare	$27,846.42
Rate for Payer: Multiplan WC	$29,055.43

INPATIENT MS-DRG 053: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC

Facility

$16,692.63

Service Code	MS-DRG 053
Min. Negotiated Rate	$11,282.41
Max. Negotiated Rate	$16,692.63
Rate for Payer: EPIC Health Plan Medicare	$11,282.41
Rate for Payer: Humana Medicare	$11,282.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,282.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,313.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,215.84
Rate for Payer: Molina Healthcare of CA Medicare	$14,215.84
Rate for Payer: Multiplan WC	$16,692.63

INPATIENT MS-DRG 054: NERVOUS SYSTEM NEOPLASMS WITH MCC

Facility

$22,636.57

Service Code	MS-DRG 054
Min. Negotiated Rate	$16,796.65
Max. Negotiated Rate	$22,636.57
Rate for Payer: EPIC Health Plan Medicare	$16,796.65
Rate for Payer: Humana Medicare	$16,796.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,796.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,820.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,163.78
Rate for Payer: Molina Healthcare of CA Medicare	$21,163.78
Rate for Payer: Multiplan WC	$22,636.57

INPATIENT MS-DRG 055: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC

Facility

$16,455.98

Service Code	MS-DRG 055
Min. Negotiated Rate	$12,289.09
Max. Negotiated Rate	$16,455.98
Rate for Payer: EPIC Health Plan Medicare	$12,289.09
Rate for Payer: Humana Medicare	$12,289.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,289.09
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,501.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,484.25
Rate for Payer: Molina Healthcare of CA Medicare	$15,484.25
Rate for Payer: Multiplan WC	$16,455.98

INPATIENT MS-DRG 056: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC

Facility

$36,407.83

Service Code	MS-DRG 056
Min. Negotiated Rate	$27,161.91
Max. Negotiated Rate	$36,407.83
Rate for Payer: EPIC Health Plan Medicare	$27,161.91
Rate for Payer: Humana Medicare	$27,161.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,161.91
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$32,051.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,224.01
Rate for Payer: Molina Healthcare of CA Medicare	$34,224.01
Rate for Payer: Multiplan WC	$36,407.83

INPATIENT MS-DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC

Facility

$21,241.17

Service Code	MS-DRG 057
Min. Negotiated Rate	$15,554.61
Max. Negotiated Rate	$21,241.17
Rate for Payer: EPIC Health Plan Medicare	$15,554.61
Rate for Payer: Humana Medicare	$15,554.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,554.61
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,354.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,598.81
Rate for Payer: Molina Healthcare of CA Medicare	$19,598.81
Rate for Payer: Multiplan WC	$21,241.17

INPATIENT MS-DRG 058: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC

Facility

$28,157.81

Service Code	MS-DRG 058
Min. Negotiated Rate	$19,661.32
Max. Negotiated Rate	$28,157.81
Rate for Payer: EPIC Health Plan Medicare	$19,661.32
Rate for Payer: Humana Medicare	$19,661.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,661.32
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,200.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,773.26
Rate for Payer: Molina Healthcare of CA Medicare	$24,773.26
Rate for Payer: Multiplan WC	$28,157.81

INPATIENT MS-DRG 059: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC

Facility

$18,662.52

Service Code	MS-DRG 059
Min. Negotiated Rate	$13,572.78
Max. Negotiated Rate	$18,662.52
Rate for Payer: EPIC Health Plan Medicare	$13,572.78
Rate for Payer: Humana Medicare	$13,572.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,572.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,015.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,101.70
Rate for Payer: Molina Healthcare of CA Medicare	$17,101.70
Rate for Payer: Multiplan WC	$18,662.52

INPATIENT MS-DRG 060: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC

Facility

$14,791.30

Service Code	MS-DRG 060
Min. Negotiated Rate	$10,309.52
Max. Negotiated Rate	$14,791.30
Rate for Payer: EPIC Health Plan Medicare	$10,309.52
Rate for Payer: Humana Medicare	$10,309.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,309.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,165.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,990.00
Rate for Payer: Molina Healthcare of CA Medicare	$12,990.00
Rate for Payer: Multiplan WC	$14,791.30

INPATIENT MS-DRG 061: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC

Facility

$47,861.58

Service Code	MS-DRG 061
Min. Negotiated Rate	$31,765.17
Max. Negotiated Rate	$47,861.58
Rate for Payer: EPIC Health Plan Medicare	$31,765.17
Rate for Payer: Humana Medicare	$31,765.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$31,765.17
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,482.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,024.11
Rate for Payer: Molina Healthcare of CA Medicare	$40,024.11
Rate for Payer: Multiplan WC	$47,861.58

INPATIENT MS-DRG 062: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC

Facility

$31,289.71

Service Code	MS-DRG 062
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$31,289.71
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$21,280.57
Rate for Payer: Humana Medicare	$21,280.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,280.57
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,111.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,813.52
Rate for Payer: Molina Healthcare of CA Medicare	$26,813.52
Rate for Payer: Multiplan WC	$31,289.71

INPATIENT MS-DRG 063: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC

Facility

$25,802.75

Service Code	MS-DRG 063
Min. Negotiated Rate	$16,946.42
Max. Negotiated Rate	$25,802.75
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$16,946.42
Rate for Payer: Humana Medicare	$16,946.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,946.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,996.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,352.49
Rate for Payer: Molina Healthcare of CA Medicare	$21,352.49
Rate for Payer: Multiplan WC	$25,802.75

INPATIENT MS-DRG 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$32,184.08

Service Code	MS-DRG 064
Min. Negotiated Rate	$18,576.00
Max. Negotiated Rate	$32,184.08
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$22,759.06
Rate for Payer: Humana Medicare	$22,759.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,759.06
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,855.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,676.42
Rate for Payer: Molina Healthcare of CA Medicare	$28,676.42
Rate for Payer: Multiplan WC	$32,184.08

INPATIENT MS-DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$18,576.00

Service Code	MS-DRG 065
Min. Negotiated Rate	$11,649.51
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$11,649.51
Rate for Payer: Humana Medicare	$11,649.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,649.51
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,746.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,678.38
Rate for Payer: Molina Healthcare of CA Medicare	$14,678.38
Rate for Payer: Multiplan WC	$16,588.19

INPATIENT MS-DRG 066: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$18,576.00

Service Code	MS-DRG 066
Min. Negotiated Rate	$7,945.94
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$7,945.94
Rate for Payer: Humana Medicare	$7,945.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,945.94
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,376.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,011.88
Rate for Payer: Molina Healthcare of CA Medicare	$10,011.88
Rate for Payer: Multiplan WC	$11,399.89

INPATIENT MS-DRG 067: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC

Facility

$23,078.86

Service Code	MS-DRG 067
Min. Negotiated Rate	$16,159.33
Max. Negotiated Rate	$23,078.86
Rate for Payer: EPIC Health Plan Medicare	$16,159.33
Rate for Payer: Humana Medicare	$16,159.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,159.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,068.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,360.76
Rate for Payer: Molina Healthcare of CA Medicare	$20,360.76
Rate for Payer: Multiplan WC	$23,078.86

INPATIENT MS-DRG 068: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC

Facility

$14,748.86

Service Code	MS-DRG 068
Min. Negotiated Rate	$10,012.24
Max. Negotiated Rate	$14,748.86
Rate for Payer: EPIC Health Plan Medicare	$10,012.24
Rate for Payer: Humana Medicare	$10,012.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,012.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,814.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,615.42
Rate for Payer: Molina Healthcare of CA Medicare	$12,615.42
Rate for Payer: Multiplan WC	$14,748.86

INPATIENT MS-DRG 069: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$18,576.00

Service Code	MS-DRG 069
Min. Negotiated Rate	$9,198.10
Max. Negotiated Rate	$18,576.00
Rate for Payer: EPIC Health Plan Commercial	$18,576.00
Rate for Payer: EPIC Health Plan Medicare	$9,198.10
Rate for Payer: Humana Medicare	$9,198.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,198.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,853.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,589.61
Rate for Payer: Molina Healthcare of CA Medicare	$11,589.61
Rate for Payer: Multiplan WC	$13,022.15

INPATIENT MS-DRG 070: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC

Facility

$28,139.86

Service Code	MS-DRG 070
Min. Negotiated Rate	$20,354.97
Max. Negotiated Rate	$28,139.86
Rate for Payer: EPIC Health Plan Medicare	$20,354.97
Rate for Payer: Humana Medicare	$20,354.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,354.97
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,018.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,647.26
Rate for Payer: Molina Healthcare of CA Medicare	$25,647.26
Rate for Payer: Multiplan WC	$28,139.86

Know your out-of-pocket cost for care.

All Charges