Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 071: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC

Facility

$17,446.65

Service Code	MS-DRG 071
Min. Negotiated Rate	$12,160.73
Max. Negotiated Rate	$17,446.65
Rate for Payer: EPIC Health Plan Medicare	$12,160.73
Rate for Payer: Humana Medicare	$12,160.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,160.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,349.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,322.52
Rate for Payer: Molina Healthcare of CA Medicare	$15,322.52
Rate for Payer: Multiplan WC	$17,446.65

INPATIENT MS-DRG 072: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$12,599.45

Service Code	MS-DRG 072
Min. Negotiated Rate	$9,021.31
Max. Negotiated Rate	$12,599.45
Rate for Payer: EPIC Health Plan Medicare	$9,021.31
Rate for Payer: Humana Medicare	$9,021.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,021.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,645.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,366.85
Rate for Payer: Molina Healthcare of CA Medicare	$11,366.85
Rate for Payer: Multiplan WC	$12,599.45

INPATIENT MS-DRG 073: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC

Facility

$24,469.37

Service Code	MS-DRG 073
Min. Negotiated Rate	$17,241.44
Max. Negotiated Rate	$24,469.37
Rate for Payer: EPIC Health Plan Medicare	$17,241.44
Rate for Payer: Humana Medicare	$17,241.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,241.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,344.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,724.21
Rate for Payer: Molina Healthcare of CA Medicare	$21,724.21
Rate for Payer: Multiplan WC	$24,469.37

INPATIENT MS-DRG 074: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC

Facility

$16,705.69

Service Code	MS-DRG 074
Min. Negotiated Rate	$11,759.84
Max. Negotiated Rate	$16,705.69
Rate for Payer: EPIC Health Plan Medicare	$11,759.84
Rate for Payer: Humana Medicare	$11,759.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,759.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,876.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,817.40
Rate for Payer: Molina Healthcare of CA Medicare	$14,817.40
Rate for Payer: Multiplan WC	$16,705.69

INPATIENT MS-DRG 075: VIRAL MENINGITIS WITH CC/MCC

Facility

$29,784.96

Service Code	MS-DRG 075
Min. Negotiated Rate	$21,754.65
Max. Negotiated Rate	$29,784.96
Rate for Payer: EPIC Health Plan Medicare	$21,754.65
Rate for Payer: Humana Medicare	$21,754.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,754.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,670.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,410.86
Rate for Payer: Molina Healthcare of CA Medicare	$27,410.86
Rate for Payer: Multiplan WC	$29,784.96

INPATIENT MS-DRG 076: VIRAL MENINGITIS WITHOUT CC/MCC

Facility

$16,113.26

Service Code	MS-DRG 076
Min. Negotiated Rate	$10,592.14
Max. Negotiated Rate	$16,113.26
Rate for Payer: EPIC Health Plan Medicare	$10,592.14
Rate for Payer: Humana Medicare	$10,592.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,592.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,498.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,346.10
Rate for Payer: Molina Healthcare of CA Medicare	$13,346.10
Rate for Payer: Multiplan WC	$16,113.26

INPATIENT MS-DRG 077: HYPERTENSIVE ENCEPHALOPATHY WITH MCC

Facility

$25,528.57

Service Code	MS-DRG 077
Min. Negotiated Rate	$17,217.79
Max. Negotiated Rate	$25,528.57
Rate for Payer: EPIC Health Plan Medicare	$17,217.79
Rate for Payer: Humana Medicare	$17,217.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,217.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,316.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,694.42
Rate for Payer: Molina Healthcare of CA Medicare	$21,694.42
Rate for Payer: Multiplan WC	$25,528.57

INPATIENT MS-DRG 078: HYPERTENSIVE ENCEPHALOPATHY WITH CC

Facility

$16,203.02

Service Code	MS-DRG 078
Min. Negotiated Rate	$11,655.14
Max. Negotiated Rate	$16,203.02
Rate for Payer: EPIC Health Plan Medicare	$11,655.14
Rate for Payer: Humana Medicare	$11,655.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,655.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,753.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,685.48
Rate for Payer: Molina Healthcare of CA Medicare	$14,685.48
Rate for Payer: Multiplan WC	$16,203.02

INPATIENT MS-DRG 079: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC

Facility

$11,977.64

Service Code	MS-DRG 079
Min. Negotiated Rate	$8,546.13
Max. Negotiated Rate	$11,977.64
Rate for Payer: EPIC Health Plan Medicare	$8,546.13
Rate for Payer: Humana Medicare	$8,546.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,546.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,084.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,768.12
Rate for Payer: Molina Healthcare of CA Medicare	$10,768.12
Rate for Payer: Multiplan WC	$11,977.64

INPATIENT MS-DRG 080: NONTRAUMATIC STUPOR AND COMA WITH MCC

Facility

$33,290.61

Service Code	MS-DRG 080
Min. Negotiated Rate	$25,075.34
Max. Negotiated Rate	$33,290.61
Rate for Payer: EPIC Health Plan Medicare	$25,075.34
Rate for Payer: Humana Medicare	$25,075.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,075.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,588.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,594.93
Rate for Payer: Molina Healthcare of CA Medicare	$31,594.93
Rate for Payer: Multiplan WC	$33,290.61

INPATIENT MS-DRG 081: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC

Facility

$14,663.99

Service Code	MS-DRG 081
Min. Negotiated Rate	$10,445.76
Max. Negotiated Rate	$14,663.99
Rate for Payer: EPIC Health Plan Medicare	$10,445.76
Rate for Payer: Humana Medicare	$10,445.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,445.76
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,326.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,161.66
Rate for Payer: Molina Healthcare of CA Medicare	$13,161.66
Rate for Payer: Multiplan WC	$14,663.99

INPATIENT MS-DRG 082: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC

Facility

$36,970.89

Service Code	MS-DRG 082
Min. Negotiated Rate	$25,859.05
Max. Negotiated Rate	$36,970.89
Rate for Payer: EPIC Health Plan Medicare	$25,859.05
Rate for Payer: Humana Medicare	$25,859.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,859.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,513.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,582.40
Rate for Payer: Molina Healthcare of CA Medicare	$32,582.40
Rate for Payer: Multiplan WC	$36,970.89

INPATIENT MS-DRG 083: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC

Facility

$22,003.33

Service Code	MS-DRG 083
Min. Negotiated Rate	$15,478.05
Max. Negotiated Rate	$22,003.33
Rate for Payer: EPIC Health Plan Medicare	$15,478.05
Rate for Payer: Humana Medicare	$15,478.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,478.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,264.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,502.34
Rate for Payer: Molina Healthcare of CA Medicare	$19,502.34
Rate for Payer: Multiplan WC	$22,003.33

INPATIENT MS-DRG 084: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC

Facility

$14,957.76

Service Code	MS-DRG 084
Min. Negotiated Rate	$10,560.62
Max. Negotiated Rate	$14,957.76
Rate for Payer: EPIC Health Plan Medicare	$10,560.62
Rate for Payer: Humana Medicare	$10,560.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,560.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,461.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,306.38
Rate for Payer: Molina Healthcare of CA Medicare	$13,306.38
Rate for Payer: Multiplan WC	$14,957.76

INPATIENT MS-DRG 085: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC

Facility

$38,119.85

Service Code	MS-DRG 085
Min. Negotiated Rate	$25,797.13
Max. Negotiated Rate	$38,119.85
Rate for Payer: EPIC Health Plan Medicare	$25,797.13
Rate for Payer: Humana Medicare	$25,797.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,797.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,440.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,504.38
Rate for Payer: Molina Healthcare of CA Medicare	$32,504.38
Rate for Payer: Multiplan WC	$38,119.85

INPATIENT MS-DRG 086: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC

Facility

$21,211.79

Service Code	MS-DRG 086
Min. Negotiated Rate	$15,035.52
Max. Negotiated Rate	$21,211.79
Rate for Payer: EPIC Health Plan Medicare	$15,035.52
Rate for Payer: Humana Medicare	$15,035.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,035.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,741.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,944.76
Rate for Payer: Molina Healthcare of CA Medicare	$18,944.76
Rate for Payer: Multiplan WC	$21,211.79

INPATIENT MS-DRG 087: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC

Facility

$14,238.03

Service Code	MS-DRG 087
Min. Negotiated Rate	$10,183.39
Max. Negotiated Rate	$14,238.03
Rate for Payer: EPIC Health Plan Medicare	$10,183.39
Rate for Payer: Humana Medicare	$10,183.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,183.39
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,016.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,831.07
Rate for Payer: Molina Healthcare of CA Medicare	$12,831.07
Rate for Payer: Multiplan WC	$14,238.03

INPATIENT MS-DRG 088: CONCUSSION WITH MCC

Facility

$25,726.05

Service Code	MS-DRG 088
Min. Negotiated Rate	$17,475.65
Max. Negotiated Rate	$25,726.05
Rate for Payer: EPIC Health Plan Medicare	$17,475.65
Rate for Payer: Humana Medicare	$17,475.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,475.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,621.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,019.32
Rate for Payer: Molina Healthcare of CA Medicare	$22,019.32
Rate for Payer: Multiplan WC	$25,726.05

INPATIENT MS-DRG 089: CONCUSSION WITH CC

Facility

$19,057.48

Service Code	MS-DRG 089
Min. Negotiated Rate	$13,152.77
Max. Negotiated Rate	$19,057.48
Rate for Payer: EPIC Health Plan Medicare	$13,152.77
Rate for Payer: Humana Medicare	$13,152.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,152.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,520.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,572.49
Rate for Payer: Molina Healthcare of CA Medicare	$16,572.49
Rate for Payer: Multiplan WC	$19,057.48

INPATIENT MS-DRG 090: CONCUSSION WITHOUT CC/MCC

Facility

$13,520.63

Service Code	MS-DRG 090
Min. Negotiated Rate	$10,730.66
Max. Negotiated Rate	$13,520.63
Rate for Payer: EPIC Health Plan Medicare	$10,730.66
Rate for Payer: Humana Medicare	$10,730.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,730.66
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,662.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,520.63
Rate for Payer: Molina Healthcare of CA Medicare	$13,520.63
Rate for Payer: Multiplan WC	$13,433.43

INPATIENT MS-DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility

$28,192.08

Service Code	MS-DRG 091
Min. Negotiated Rate	$20,351.59
Max. Negotiated Rate	$28,192.08
Rate for Payer: EPIC Health Plan Medicare	$20,351.59
Rate for Payer: Humana Medicare	$20,351.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,351.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,014.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,643.00
Rate for Payer: Molina Healthcare of CA Medicare	$25,643.00
Rate for Payer: Multiplan WC	$28,192.08

INPATIENT MS-DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$16,227.50

Service Code	MS-DRG 092
Min. Negotiated Rate	$11,758.73
Max. Negotiated Rate	$16,227.50
Rate for Payer: EPIC Health Plan Medicare	$11,758.73
Rate for Payer: Humana Medicare	$11,758.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,758.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,875.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,816.00
Rate for Payer: Molina Healthcare of CA Medicare	$14,816.00
Rate for Payer: Multiplan WC	$16,227.50

INPATIENT MS-DRG 093: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$12,481.94

Service Code	MS-DRG 093
Min. Negotiated Rate	$8,924.47
Max. Negotiated Rate	$12,481.94
Rate for Payer: EPIC Health Plan Medicare	$8,924.47
Rate for Payer: Humana Medicare	$8,924.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,924.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,530.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,244.83
Rate for Payer: Molina Healthcare of CA Medicare	$11,244.83
Rate for Payer: Multiplan WC	$12,481.94

INPATIENT MS-DRG 094: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC

Facility

$58,321.41

Service Code	MS-DRG 094
Min. Negotiated Rate	$40,997.61
Max. Negotiated Rate	$58,321.41
Rate for Payer: EPIC Health Plan Medicare	$40,997.61
Rate for Payer: Humana Medicare	$40,997.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$40,997.61
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$48,377.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$51,656.99
Rate for Payer: Molina Healthcare of CA Medicare	$51,656.99
Rate for Payer: Multiplan WC	$58,321.41

INPATIENT MS-DRG 095: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC

Facility

$41,728.32

Service Code	MS-DRG 095
Min. Negotiated Rate	$27,051.55
Max. Negotiated Rate	$41,728.32
Rate for Payer: EPIC Health Plan Medicare	$27,051.55
Rate for Payer: Humana Medicare	$27,051.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,051.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,920.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,084.95
Rate for Payer: Molina Healthcare of CA Medicare	$34,084.95
Rate for Payer: Multiplan WC	$41,728.32

Know your out-of-pocket cost for care.

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