Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 320: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$40,334.56

Service Code	MS-DRG 320
Min. Negotiated Rate	$25,270.14
Max. Negotiated Rate	$40,334.56
Rate for Payer: EPIC Health Plan Medicare	$25,270.14
Rate for Payer: Humana Medicare	$25,270.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,270.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,818.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,840.38
Rate for Payer: Molina Healthcare of CA Medicare	$31,840.38
Rate for Payer: Multiplan WC	$40,334.56

INPATIENT MS-DRG 321: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES

Facility

$41,044.25

Service Code	MS-DRG 321
Min. Negotiated Rate	$32,574.80
Max. Negotiated Rate	$41,044.25
Rate for Payer: EPIC Health Plan Medicare	$32,574.80
Rate for Payer: Humana Medicare	$32,574.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,574.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,438.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,044.25
Rate for Payer: Molina Healthcare of CA Medicare	$41,044.25

INPATIENT MS-DRG 322: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$26,128.23

Service Code	MS-DRG 322
Min. Negotiated Rate	$20,736.69
Max. Negotiated Rate	$26,128.23
Rate for Payer: EPIC Health Plan Medicare	$20,736.69
Rate for Payer: Humana Medicare	$20,736.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,736.69
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,469.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,128.23
Rate for Payer: Molina Healthcare of CA Medicare	$26,128.23

INPATIENT MS-DRG 323: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$58,996.54

Service Code	MS-DRG 323
Min. Negotiated Rate	$46,822.65
Max. Negotiated Rate	$58,996.54
Rate for Payer: EPIC Health Plan Medicare	$46,822.65
Rate for Payer: Humana Medicare	$46,822.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$46,822.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$55,250.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$58,996.54
Rate for Payer: Molina Healthcare of CA Medicare	$58,996.54

INPATIENT MS-DRG 324: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$42,376.52

Service Code	MS-DRG 324
Min. Negotiated Rate	$33,632.16
Max. Negotiated Rate	$42,376.52
Rate for Payer: EPIC Health Plan Medicare	$33,632.16
Rate for Payer: Humana Medicare	$33,632.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$33,632.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$39,685.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,376.52
Rate for Payer: Molina Healthcare of CA Medicare	$42,376.52

INPATIENT MS-DRG 325: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE

Facility

$37,775.30

Service Code	MS-DRG 325
Min. Negotiated Rate	$29,980.40
Max. Negotiated Rate	$37,775.30
Rate for Payer: EPIC Health Plan Medicare	$29,980.40
Rate for Payer: Humana Medicare	$29,980.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$29,980.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$35,376.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,775.30
Rate for Payer: Molina Healthcare of CA Medicare	$37,775.30

INPATIENT MS-DRG 326: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC

Facility

$83,541.52

Service Code	MS-DRG 326
Min. Negotiated Rate	$57,396.20
Max. Negotiated Rate	$83,541.52
Rate for Payer: EPIC Health Plan Medicare	$57,396.20
Rate for Payer: Humana Medicare	$57,396.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$57,396.20
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$67,727.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$72,319.21
Rate for Payer: Molina Healthcare of CA Medicare	$72,319.21
Rate for Payer: Multiplan WC	$83,541.52

INPATIENT MS-DRG 327: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC

Facility

$41,801.77

Service Code	MS-DRG 327
Min. Negotiated Rate	$28,326.23
Max. Negotiated Rate	$41,801.77
Rate for Payer: EPIC Health Plan Medicare	$28,326.23
Rate for Payer: Humana Medicare	$28,326.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$28,326.23
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,424.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$35,691.05
Rate for Payer: Molina Healthcare of CA Medicare	$35,691.05
Rate for Payer: Multiplan WC	$41,801.77

INPATIENT MS-DRG 328: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC

Facility

$27,054.54

Service Code	MS-DRG 328
Min. Negotiated Rate	$18,190.69
Max. Negotiated Rate	$27,054.54
Rate for Payer: EPIC Health Plan Medicare	$18,190.69
Rate for Payer: Humana Medicare	$18,190.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,190.69
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,465.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,920.27
Rate for Payer: Molina Healthcare of CA Medicare	$22,920.27
Rate for Payer: Multiplan WC	$27,054.54

INPATIENT MS-DRG 329: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$75,454.70

Service Code	MS-DRG 329
Min. Negotiated Rate	$51,065.59
Max. Negotiated Rate	$75,454.70
Rate for Payer: EPIC Health Plan Medicare	$51,065.59
Rate for Payer: Humana Medicare	$51,065.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$51,065.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$60,257.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$64,342.64
Rate for Payer: Molina Healthcare of CA Medicare	$64,342.64
Rate for Payer: Multiplan WC	$75,454.70

INPATIENT MS-DRG 330: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$40,073.42

Service Code	MS-DRG 330
Min. Negotiated Rate	$26,915.30
Max. Negotiated Rate	$40,073.42
Rate for Payer: EPIC Health Plan Medicare	$26,915.30
Rate for Payer: Humana Medicare	$26,915.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$26,915.30
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,760.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,913.28
Rate for Payer: Molina Healthcare of CA Medicare	$33,913.28
Rate for Payer: Multiplan WC	$40,073.42

INPATIENT MS-DRG 331: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$27,888.52

Service Code	MS-DRG 331
Min. Negotiated Rate	$19,031.86
Max. Negotiated Rate	$27,888.52
Rate for Payer: EPIC Health Plan Medicare	$19,031.86
Rate for Payer: Humana Medicare	$19,031.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,031.86
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,457.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,980.14
Rate for Payer: Molina Healthcare of CA Medicare	$23,980.14
Rate for Payer: Multiplan WC	$27,888.52

INPATIENT MS-DRG 332: RECTAL RESECTION WITH MCC

Facility

$66,266.24

Service Code	MS-DRG 332
Min. Negotiated Rate	$41,353.44
Max. Negotiated Rate	$66,266.24
Rate for Payer: EPIC Health Plan Medicare	$41,353.44
Rate for Payer: Humana Medicare	$41,353.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$41,353.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$48,797.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$52,105.33
Rate for Payer: Molina Healthcare of CA Medicare	$52,105.33
Rate for Payer: Multiplan WC	$66,266.24

INPATIENT MS-DRG 333: RECTAL RESECTION WITH CC

Facility

$36,445.37

Service Code	MS-DRG 333
Min. Negotiated Rate	$23,620.49
Max. Negotiated Rate	$36,445.37
Rate for Payer: EPIC Health Plan Medicare	$23,620.49
Rate for Payer: Humana Medicare	$23,620.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,620.49
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,872.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,761.82
Rate for Payer: Molina Healthcare of CA Medicare	$29,761.82
Rate for Payer: Multiplan WC	$36,445.37

INPATIENT MS-DRG 334: RECTAL RESECTION WITHOUT CC/MCC

Facility

$27,981.55

Service Code	MS-DRG 334
Min. Negotiated Rate	$18,278.53
Max. Negotiated Rate	$27,981.55
Rate for Payer: EPIC Health Plan Medicare	$18,278.53
Rate for Payer: Humana Medicare	$18,278.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,278.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,568.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,030.95
Rate for Payer: Molina Healthcare of CA Medicare	$23,030.95
Rate for Payer: Multiplan WC	$27,981.55

INPATIENT MS-DRG 335: PERITONEAL ADHESIOLYSIS WITH MCC

Facility

$60,121.56

Service Code	MS-DRG 335
Min. Negotiated Rate	$40,460.48
Max. Negotiated Rate	$60,121.56
Rate for Payer: EPIC Health Plan Medicare	$40,460.48
Rate for Payer: Humana Medicare	$40,460.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$40,460.48
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$47,743.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,980.20
Rate for Payer: Molina Healthcare of CA Medicare	$50,980.20
Rate for Payer: Multiplan WC	$60,121.56

INPATIENT MS-DRG 336: PERITONEAL ADHESIOLYSIS WITH CC

Facility

$34,713.77

Service Code	MS-DRG 336
Min. Negotiated Rate	$23,911.01
Max. Negotiated Rate	$34,713.77
Rate for Payer: EPIC Health Plan Medicare	$23,911.01
Rate for Payer: Humana Medicare	$23,911.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,911.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,214.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,127.87
Rate for Payer: Molina Healthcare of CA Medicare	$30,127.87
Rate for Payer: Multiplan WC	$34,713.77

INPATIENT MS-DRG 337: PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC

Facility

$25,713.00

Service Code	MS-DRG 337
Min. Negotiated Rate	$17,054.52
Max. Negotiated Rate	$25,713.00
Rate for Payer: EPIC Health Plan Medicare	$17,054.52
Rate for Payer: Humana Medicare	$17,054.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,054.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,124.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,488.70
Rate for Payer: Molina Healthcare of CA Medicare	$21,488.70
Rate for Payer: Multiplan WC	$25,713.00

INPATIENT MS-DRG 344: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$42,963.79

Service Code	MS-DRG 344
Min. Negotiated Rate	$31,062.52
Max. Negotiated Rate	$42,963.79
Rate for Payer: EPIC Health Plan Medicare	$31,062.52
Rate for Payer: Humana Medicare	$31,062.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$31,062.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$36,653.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,138.78
Rate for Payer: Molina Healthcare of CA Medicare	$39,138.78
Rate for Payer: Multiplan WC	$42,963.79

INPATIENT MS-DRG 345: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$25,321.30

Service Code	MS-DRG 345
Min. Negotiated Rate	$17,552.24
Max. Negotiated Rate	$25,321.30
Rate for Payer: EPIC Health Plan Medicare	$17,552.24
Rate for Payer: Humana Medicare	$17,552.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,552.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,711.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,115.82
Rate for Payer: Molina Healthcare of CA Medicare	$22,115.82
Rate for Payer: Multiplan WC	$25,321.30

INPATIENT MS-DRG 346: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$20,412.09

Service Code	MS-DRG 346
Min. Negotiated Rate	$14,705.59
Max. Negotiated Rate	$20,412.09
Rate for Payer: EPIC Health Plan Medicare	$14,705.59
Rate for Payer: Humana Medicare	$14,705.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,705.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,352.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,529.04
Rate for Payer: Molina Healthcare of CA Medicare	$18,529.04
Rate for Payer: Multiplan WC	$20,412.09

INPATIENT MS-DRG 347: ANAL AND STOMAL PROCEDURES WITH MCC

Facility

$41,424.77

Service Code	MS-DRG 347
Min. Negotiated Rate	$28,908.38
Max. Negotiated Rate	$41,424.77
Rate for Payer: EPIC Health Plan Medicare	$28,908.38
Rate for Payer: Humana Medicare	$28,908.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$28,908.38
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$34,111.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,424.56
Rate for Payer: Molina Healthcare of CA Medicare	$36,424.56
Rate for Payer: Multiplan WC	$41,424.77

INPATIENT MS-DRG 348: ANAL AND STOMAL PROCEDURES WITH CC

Facility

$22,538.65

Service Code	MS-DRG 348
Min. Negotiated Rate	$14,858.74
Max. Negotiated Rate	$22,538.65
Rate for Payer: EPIC Health Plan Medicare	$14,858.74
Rate for Payer: Humana Medicare	$14,858.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,858.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,533.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,722.01
Rate for Payer: Molina Healthcare of CA Medicare	$18,722.01
Rate for Payer: Multiplan WC	$22,538.65

INPATIENT MS-DRG 349: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC

Facility

$16,274.83

Service Code	MS-DRG 349
Min. Negotiated Rate	$11,192.33
Max. Negotiated Rate	$16,274.83
Rate for Payer: EPIC Health Plan Medicare	$11,192.33
Rate for Payer: Humana Medicare	$11,192.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,192.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,206.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,102.34
Rate for Payer: Molina Healthcare of CA Medicare	$14,102.34
Rate for Payer: Multiplan WC	$16,274.83

INPATIENT MS-DRG 350: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC

Facility

$38,467.49

Service Code	MS-DRG 350
Min. Negotiated Rate	$27,229.45
Max. Negotiated Rate	$38,467.49
Rate for Payer: EPIC Health Plan Medicare	$27,229.45
Rate for Payer: Humana Medicare	$27,229.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,229.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$32,130.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,309.11
Rate for Payer: Molina Healthcare of CA Medicare	$34,309.11
Rate for Payer: Multiplan WC	$38,467.49

Know your out-of-pocket cost for care.

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