Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 293: HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$9,144.39

Service Code	MS-DRG 293
Min. Negotiated Rate	$6,527.10
Max. Negotiated Rate	$9,144.39
Rate for Payer: EPIC Health Plan Medicare	$6,527.10
Rate for Payer: Humana Medicare	$6,527.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,527.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,701.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,224.15
Rate for Payer: Molina Healthcare of CA Medicare	$8,224.15
Rate for Payer: Multiplan WC	$9,144.39

INPATIENT MS-DRG 294: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC

Facility

$18,842.05

Service Code	MS-DRG 294
Min. Negotiated Rate	$12,519.93
Max. Negotiated Rate	$18,842.05
Rate for Payer: EPIC Health Plan Medicare	$12,519.93
Rate for Payer: Humana Medicare	$12,519.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,519.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,773.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,775.11
Rate for Payer: Molina Healthcare of CA Medicare	$15,775.11
Rate for Payer: Multiplan WC	$18,842.05

INPATIENT MS-DRG 295: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC

Facility

$14,455.09

Service Code	MS-DRG 295
Min. Negotiated Rate	$9,180.08
Max. Negotiated Rate	$14,455.09
Rate for Payer: EPIC Health Plan Medicare	$9,180.08
Rate for Payer: Humana Medicare	$9,180.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,180.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,832.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,566.90
Rate for Payer: Molina Healthcare of CA Medicare	$11,566.90
Rate for Payer: Multiplan WC	$14,455.09

INPATIENT MS-DRG 296: CARDIAC ARREST, UNEXPLAINED WITH MCC

Facility

$26,737.92

Service Code	MS-DRG 296
Min. Negotiated Rate	$18,257.15
Max. Negotiated Rate	$26,737.92
Rate for Payer: EPIC Health Plan Medicare	$18,257.15
Rate for Payer: Humana Medicare	$18,257.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,257.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,543.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,004.01
Rate for Payer: Molina Healthcare of CA Medicare	$23,004.01
Rate for Payer: Multiplan WC	$26,737.92

INPATIENT MS-DRG 297: CARDIAC ARREST, UNEXPLAINED WITH CC

Facility

$10,595.00

Service Code	MS-DRG 297
Min. Negotiated Rate	$8,408.73
Max. Negotiated Rate	$10,595.00
Rate for Payer: EPIC Health Plan Medicare	$8,408.73
Rate for Payer: Humana Medicare	$8,408.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,408.73
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,922.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,595.00
Rate for Payer: Molina Healthcare of CA Medicare	$10,595.00
Rate for Payer: Multiplan WC	$10,384.76

INPATIENT MS-DRG 298: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC

Facility

$7,972.57

Service Code	MS-DRG 298
Min. Negotiated Rate	$5,155.60
Max. Negotiated Rate	$7,972.57
Rate for Payer: EPIC Health Plan Medicare	$5,155.60
Rate for Payer: Humana Medicare	$5,155.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$5,155.60
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$6,083.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,496.06
Rate for Payer: Molina Healthcare of CA Medicare	$6,496.06
Rate for Payer: Multiplan WC	$7,972.57

INPATIENT MS-DRG 299: PERIPHERAL VASCULAR DISORDERS WITH MCC

Facility

$25,100.98

Service Code	MS-DRG 299
Min. Negotiated Rate	$17,953.10
Max. Negotiated Rate	$25,100.98
Rate for Payer: EPIC Health Plan Medicare	$17,953.10
Rate for Payer: Humana Medicare	$17,953.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,953.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,184.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,620.91
Rate for Payer: Molina Healthcare of CA Medicare	$22,620.91
Rate for Payer: Multiplan WC	$25,100.98

INPATIENT MS-DRG 300: PERIPHERAL VASCULAR DISORDERS WITH CC

Facility

$16,828.10

Service Code	MS-DRG 300
Min. Negotiated Rate	$12,219.27
Max. Negotiated Rate	$16,828.10
Rate for Payer: EPIC Health Plan Medicare	$12,219.27
Rate for Payer: Humana Medicare	$12,219.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,219.27
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,418.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,396.28
Rate for Payer: Molina Healthcare of CA Medicare	$15,396.28
Rate for Payer: Multiplan WC	$16,828.10

INPATIENT MS-DRG 301: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC

Facility

$11,688.76

Service Code	MS-DRG 301
Min. Negotiated Rate	$8,197.04
Max. Negotiated Rate	$11,688.76
Rate for Payer: EPIC Health Plan Medicare	$8,197.04
Rate for Payer: Humana Medicare	$8,197.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,197.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,672.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,328.27
Rate for Payer: Molina Healthcare of CA Medicare	$10,328.27
Rate for Payer: Multiplan WC	$11,688.76

INPATIENT MS-DRG 302: ATHEROSCLEROSIS WITH MCC

Facility

$19,679.29

Service Code	MS-DRG 302
Min. Negotiated Rate	$12,828.47
Max. Negotiated Rate	$19,679.29
Rate for Payer: EPIC Health Plan Medicare	$12,828.47
Rate for Payer: Humana Medicare	$12,828.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,828.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,137.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,163.87
Rate for Payer: Molina Healthcare of CA Medicare	$16,163.87
Rate for Payer: Multiplan WC	$19,679.29

INPATIENT MS-DRG 303: ATHEROSCLEROSIS WITHOUT MCC

Facility

$11,034.31

Service Code	MS-DRG 303
Min. Negotiated Rate	$7,614.87
Max. Negotiated Rate	$11,034.31
Rate for Payer: EPIC Health Plan Medicare	$7,614.87
Rate for Payer: Humana Medicare	$7,614.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,614.87
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,985.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,594.74
Rate for Payer: Molina Healthcare of CA Medicare	$9,594.74
Rate for Payer: Multiplan WC	$11,034.31

INPATIENT MS-DRG 304: HYPERTENSION WITH MCC

Facility

$17,929.73

Service Code	MS-DRG 304
Min. Negotiated Rate	$13,142.63
Max. Negotiated Rate	$17,929.73
Rate for Payer: EPIC Health Plan Medicare	$13,142.63
Rate for Payer: Humana Medicare	$13,142.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,142.63
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,508.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,559.71
Rate for Payer: Molina Healthcare of CA Medicare	$16,559.71
Rate for Payer: Multiplan WC	$17,929.73

INPATIENT MS-DRG 305: HYPERTENSION WITHOUT MCC

Facility

$12,168.58

Service Code	MS-DRG 305
Min. Negotiated Rate	$8,689.13
Max. Negotiated Rate	$12,168.58
Rate for Payer: EPIC Health Plan Medicare	$8,689.13
Rate for Payer: Humana Medicare	$8,689.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,689.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,253.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,948.30
Rate for Payer: Molina Healthcare of CA Medicare	$10,948.30
Rate for Payer: Multiplan WC	$12,168.58

INPATIENT MS-DRG 306: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC

Facility

$24,085.83

Service Code	MS-DRG 306
Min. Negotiated Rate	$17,509.44
Max. Negotiated Rate	$24,085.83
Rate for Payer: EPIC Health Plan Medicare	$17,509.44
Rate for Payer: Humana Medicare	$17,509.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,509.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,661.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,061.89
Rate for Payer: Molina Healthcare of CA Medicare	$22,061.89
Rate for Payer: Multiplan WC	$24,085.83

INPATIENT MS-DRG 307: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC

Facility

$14,874.53

Service Code	MS-DRG 307
Min. Negotiated Rate	$10,818.47
Max. Negotiated Rate	$14,874.53
Rate for Payer: EPIC Health Plan Medicare	$10,818.47
Rate for Payer: Humana Medicare	$10,818.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,818.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,765.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,631.27
Rate for Payer: Molina Healthcare of CA Medicare	$13,631.27
Rate for Payer: Multiplan WC	$14,874.53

INPATIENT MS-DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC

Facility

$19,137.45

Service Code	MS-DRG 308
Min. Negotiated Rate	$13,741.70
Max. Negotiated Rate	$19,137.45
Rate for Payer: EPIC Health Plan Medicare	$13,741.70
Rate for Payer: Humana Medicare	$13,741.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,741.70
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,215.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,314.54
Rate for Payer: Molina Healthcare of CA Medicare	$17,314.54
Rate for Payer: Multiplan WC	$19,137.45

INPATIENT MS-DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$12,038.03

Service Code	MS-DRG 309
Min. Negotiated Rate	$8,590.03
Max. Negotiated Rate	$12,038.03
Rate for Payer: EPIC Health Plan Medicare	$8,590.03
Rate for Payer: Humana Medicare	$8,590.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,590.03
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,136.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,823.44
Rate for Payer: Molina Healthcare of CA Medicare	$10,823.44
Rate for Payer: Multiplan WC	$12,038.03

INPATIENT MS-DRG 310: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC

Facility

$8,995.87

Service Code	MS-DRG 310
Min. Negotiated Rate	$6,431.41
Max. Negotiated Rate	$8,995.87
Rate for Payer: EPIC Health Plan Medicare	$6,431.41
Rate for Payer: Humana Medicare	$6,431.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,431.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,589.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,103.58
Rate for Payer: Molina Healthcare of CA Medicare	$8,103.58
Rate for Payer: Multiplan WC	$8,995.87

INPATIENT MS-DRG 311: ANGINA PECTORIS

Facility

$10,903.74

Service Code	MS-DRG 311
Min. Negotiated Rate	$8,065.31
Max. Negotiated Rate	$10,903.74
Rate for Payer: EPIC Health Plan Medicare	$8,065.31
Rate for Payer: Humana Medicare	$8,065.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,065.31
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,517.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,162.29
Rate for Payer: Molina Healthcare of CA Medicare	$10,162.29
Rate for Payer: Multiplan WC	$10,903.74

INPATIENT MS-DRG 312: SYNCOPE AND COLLAPSE

Facility

$13,916.51

Service Code	MS-DRG 312
Min. Negotiated Rate	$9,927.79
Max. Negotiated Rate	$13,916.51
Rate for Payer: EPIC Health Plan Medicare	$9,927.79
Rate for Payer: Humana Medicare	$9,927.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,927.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,714.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,509.02
Rate for Payer: Molina Healthcare of CA Medicare	$12,509.02
Rate for Payer: Multiplan WC	$13,916.51

INPATIENT MS-DRG 313: CHEST PAIN

Facility

$11,806.27

Service Code	MS-DRG 313
Min. Negotiated Rate	$8,352.43
Max. Negotiated Rate	$11,806.27
Rate for Payer: EPIC Health Plan Medicare	$8,352.43
Rate for Payer: Humana Medicare	$8,352.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,352.43
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,855.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,524.06
Rate for Payer: Molina Healthcare of CA Medicare	$10,524.06
Rate for Payer: Multiplan WC	$11,806.27

INPATIENT MS-DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC

Facility

$33,989.13

Service Code	MS-DRG 314
Min. Negotiated Rate	$23,778.13
Max. Negotiated Rate	$33,989.13
Rate for Payer: EPIC Health Plan Medicare	$23,778.13
Rate for Payer: Humana Medicare	$23,778.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,778.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,058.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,960.44
Rate for Payer: Molina Healthcare of CA Medicare	$29,960.44
Rate for Payer: Multiplan WC	$33,989.13

INPATIENT MS-DRG 315: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC

Facility

$15,806.43

Service Code	MS-DRG 315
Min. Negotiated Rate	$11,096.60
Max. Negotiated Rate	$15,806.43
Rate for Payer: EPIC Health Plan Medicare	$11,096.60
Rate for Payer: Humana Medicare	$11,096.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,096.60
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,093.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,981.72
Rate for Payer: Molina Healthcare of CA Medicare	$13,981.72
Rate for Payer: Multiplan WC	$15,806.43

INPATIENT MS-DRG 316: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$11,130.60

Service Code	MS-DRG 316
Min. Negotiated Rate	$8,004.49
Max. Negotiated Rate	$11,130.60
Rate for Payer: EPIC Health Plan Medicare	$8,004.49
Rate for Payer: Humana Medicare	$8,004.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,004.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,445.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,085.66
Rate for Payer: Molina Healthcare of CA Medicare	$10,085.66
Rate for Payer: Multiplan WC	$11,130.60

INPATIENT MS-DRG 319: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$70,285.98

Service Code	MS-DRG 319
Min. Negotiated Rate	$49,321.34
Max. Negotiated Rate	$70,285.98
Rate for Payer: EPIC Health Plan Medicare	$49,321.34
Rate for Payer: Humana Medicare	$49,321.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$49,321.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$58,199.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,144.89
Rate for Payer: Molina Healthcare of CA Medicare	$62,144.89
Rate for Payer: Multiplan WC	$70,285.98

Know your out-of-pocket cost for care.

All Charges