Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 385: INFLAMMATORY BOWEL DISEASE WITH MCC

Facility

$26,581.25

Service Code	MS-DRG 385
Min. Negotiated Rate	$17,848.39
Max. Negotiated Rate	$26,581.25
Rate for Payer: EPIC Health Plan Medicare	$17,848.39
Rate for Payer: Humana Medicare	$17,848.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,848.39
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,061.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,488.97
Rate for Payer: Molina Healthcare of CA Medicare	$22,488.97
Rate for Payer: Multiplan WC	$26,581.25

INPATIENT MS-DRG 386: INFLAMMATORY BOWEL DISEASE WITH CC

Facility

$16,154.06

Service Code	MS-DRG 386
Min. Negotiated Rate	$11,145.05
Max. Negotiated Rate	$16,154.06
Rate for Payer: EPIC Health Plan Medicare	$11,145.05
Rate for Payer: Humana Medicare	$11,145.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,145.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,151.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,042.76
Rate for Payer: Molina Healthcare of CA Medicare	$14,042.76
Rate for Payer: Multiplan WC	$16,154.06

INPATIENT MS-DRG 387: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility

$11,287.28

Service Code	MS-DRG 387
Min. Negotiated Rate	$7,907.65
Max. Negotiated Rate	$11,287.28
Rate for Payer: EPIC Health Plan Medicare	$7,907.65
Rate for Payer: Humana Medicare	$7,907.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,907.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,331.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,963.64
Rate for Payer: Molina Healthcare of CA Medicare	$9,963.64
Rate for Payer: Multiplan WC	$11,287.28

INPATIENT MS-DRG 388: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$23,948.74

Service Code	MS-DRG 388
Min. Negotiated Rate	$16,571.45
Max. Negotiated Rate	$23,948.74
Rate for Payer: EPIC Health Plan Medicare	$16,571.45
Rate for Payer: Humana Medicare	$16,571.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,571.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,554.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,880.03
Rate for Payer: Molina Healthcare of CA Medicare	$20,880.03
Rate for Payer: Multiplan WC	$23,948.74

INPATIENT MS-DRG 389: GASTROINTESTINAL OBSTRUCTION WITH CC

Facility

$13,172.30

Service Code	MS-DRG 389
Min. Negotiated Rate	$9,172.21
Max. Negotiated Rate	$13,172.30
Rate for Payer: EPIC Health Plan Medicare	$9,172.21
Rate for Payer: Humana Medicare	$9,172.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,172.21
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,823.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,556.98
Rate for Payer: Molina Healthcare of CA Medicare	$11,556.98
Rate for Payer: Multiplan WC	$13,172.30

INPATIENT MS-DRG 390: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility

$9,229.26

Service Code	MS-DRG 390
Min. Negotiated Rate	$6,498.98
Max. Negotiated Rate	$9,229.26
Rate for Payer: EPIC Health Plan Medicare	$6,498.98
Rate for Payer: Humana Medicare	$6,498.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$6,498.98
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,668.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,188.71
Rate for Payer: Molina Healthcare of CA Medicare	$8,188.71
Rate for Payer: Multiplan WC	$9,229.26

INPATIENT MS-DRG 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC

Facility

$20,955.56

Service Code	MS-DRG 391
Min. Negotiated Rate	$14,569.34
Max. Negotiated Rate	$20,955.56
Rate for Payer: EPIC Health Plan Medicare	$14,569.34
Rate for Payer: Humana Medicare	$14,569.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,569.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,191.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,357.37
Rate for Payer: Molina Healthcare of CA Medicare	$18,357.37
Rate for Payer: Multiplan WC	$20,955.56

INPATIENT MS-DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC

Facility

$12,854.05

Service Code	MS-DRG 392
Min. Negotiated Rate	$9,050.59
Max. Negotiated Rate	$12,854.05
Rate for Payer: EPIC Health Plan Medicare	$9,050.59
Rate for Payer: Humana Medicare	$9,050.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,050.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,679.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,403.74
Rate for Payer: Molina Healthcare of CA Medicare	$11,403.74
Rate for Payer: Multiplan WC	$12,854.05

INPATIENT MS-DRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility

$26,297.27

Service Code	MS-DRG 393
Min. Negotiated Rate	$18,441.79
Max. Negotiated Rate	$26,297.27
Rate for Payer: EPIC Health Plan Medicare	$18,441.79
Rate for Payer: Humana Medicare	$18,441.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,441.79
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,761.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,236.66
Rate for Payer: Molina Healthcare of CA Medicare	$23,236.66
Rate for Payer: Multiplan WC	$26,297.27

INPATIENT MS-DRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility

$15,390.25

Service Code	MS-DRG 394
Min. Negotiated Rate	$10,754.28
Max. Negotiated Rate	$15,390.25
Rate for Payer: EPIC Health Plan Medicare	$10,754.28
Rate for Payer: Humana Medicare	$10,754.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,754.28
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,690.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,550.39
Rate for Payer: Molina Healthcare of CA Medicare	$13,550.39
Rate for Payer: Multiplan WC	$15,390.25

INPATIENT MS-DRG 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$10,525.11

Service Code	MS-DRG 395
Min. Negotiated Rate	$7,495.52
Max. Negotiated Rate	$10,525.11
Rate for Payer: EPIC Health Plan Medicare	$7,495.52
Rate for Payer: Humana Medicare	$7,495.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,495.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,844.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,444.36
Rate for Payer: Molina Healthcare of CA Medicare	$9,444.36
Rate for Payer: Multiplan WC	$10,525.11

INPATIENT MS-DRG 397: APPENDIX PROCEDURES WITH MCC

Facility

$32,132.66

Service Code	MS-DRG 397
Min. Negotiated Rate	$25,502.11
Max. Negotiated Rate	$32,132.66
Rate for Payer: EPIC Health Plan Medicare	$25,502.11
Rate for Payer: Humana Medicare	$25,502.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,502.11
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$30,092.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,132.66
Rate for Payer: Molina Healthcare of CA Medicare	$32,132.66

INPATIENT MS-DRG 398: APPENDIX PROCEDURES WITH CC

Facility

$21,728.47

Service Code	MS-DRG 398
Min. Negotiated Rate	$17,244.82
Max. Negotiated Rate	$21,728.47
Rate for Payer: EPIC Health Plan Medicare	$17,244.82
Rate for Payer: Humana Medicare	$17,244.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,244.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,348.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,728.47
Rate for Payer: Molina Healthcare of CA Medicare	$21,728.47

INPATIENT MS-DRG 399: APPENDIX PROCEDURES WITHOUT CC/MCC

Facility

$16,050.38

Service Code	MS-DRG 399
Min. Negotiated Rate	$12,738.40
Max. Negotiated Rate	$16,050.38
Rate for Payer: EPIC Health Plan Medicare	$12,738.40
Rate for Payer: Humana Medicare	$12,738.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,738.40
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,031.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,050.38
Rate for Payer: Molina Healthcare of CA Medicare	$16,050.38

INPATIENT MS-DRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility

$90,446.74

Service Code	MS-DRG 405
Min. Negotiated Rate	$62,195.42
Max. Negotiated Rate	$90,446.74
Rate for Payer: EPIC Health Plan Medicare	$62,195.42
Rate for Payer: Humana Medicare	$62,195.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$62,195.42
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$73,390.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$78,366.23
Rate for Payer: Molina Healthcare of CA Medicare	$78,366.23
Rate for Payer: Multiplan WC	$90,446.74

INPATIENT MS-DRG 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility

$47,814.25

Service Code	MS-DRG 406
Min. Negotiated Rate	$32,717.82
Max. Negotiated Rate	$47,814.25
Rate for Payer: EPIC Health Plan Medicare	$32,717.82
Rate for Payer: Humana Medicare	$32,717.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$32,717.82
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$38,607.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,224.45
Rate for Payer: Molina Healthcare of CA Medicare	$41,224.45
Rate for Payer: Multiplan WC	$47,814.25

INPATIENT MS-DRG 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$36,324.60

Service Code	MS-DRG 407
Min. Negotiated Rate	$24,425.62
Max. Negotiated Rate	$36,324.60
Rate for Payer: EPIC Health Plan Medicare	$24,425.62
Rate for Payer: Humana Medicare	$24,425.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,425.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,822.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,776.28
Rate for Payer: Molina Healthcare of CA Medicare	$30,776.28
Rate for Payer: Multiplan WC	$36,324.60

INPATIENT MS-DRG 408: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$59,888.18

Service Code	MS-DRG 408
Min. Negotiated Rate	$42,118.02
Max. Negotiated Rate	$59,888.18
Rate for Payer: EPIC Health Plan Medicare	$42,118.02
Rate for Payer: Humana Medicare	$42,118.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$42,118.02
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$49,699.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$53,068.71
Rate for Payer: Molina Healthcare of CA Medicare	$53,068.71
Rate for Payer: Multiplan WC	$59,888.18

INPATIENT MS-DRG 409: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$34,785.57

Service Code	MS-DRG 409
Min. Negotiated Rate	$22,244.47
Max. Negotiated Rate	$34,785.57
Rate for Payer: EPIC Health Plan Medicare	$22,244.47
Rate for Payer: Humana Medicare	$22,244.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,244.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,248.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,028.03
Rate for Payer: Molina Healthcare of CA Medicare	$28,028.03
Rate for Payer: Multiplan WC	$34,785.57

INPATIENT MS-DRG 410: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$27,707.36

Service Code	MS-DRG 410
Min. Negotiated Rate	$17,829.25
Max. Negotiated Rate	$27,707.36
Rate for Payer: EPIC Health Plan Medicare	$17,829.25
Rate for Payer: Humana Medicare	$17,829.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,829.25
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,038.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,464.86
Rate for Payer: Molina Healthcare of CA Medicare	$22,464.86
Rate for Payer: Multiplan WC	$27,707.36

INPATIENT MS-DRG 411: CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility

$55,134.01

Service Code	MS-DRG 411
Min. Negotiated Rate	$34,440.65
Max. Negotiated Rate	$55,134.01
Rate for Payer: EPIC Health Plan Medicare	$34,440.65
Rate for Payer: Humana Medicare	$34,440.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$34,440.65
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$40,639.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,395.22
Rate for Payer: Molina Healthcare of CA Medicare	$43,395.22
Rate for Payer: Multiplan WC	$55,134.01

INPATIENT MS-DRG 412: CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility

$37,467.04

Service Code	MS-DRG 412
Min. Negotiated Rate	$23,469.59
Max. Negotiated Rate	$37,467.04
Rate for Payer: EPIC Health Plan Medicare	$23,469.59
Rate for Payer: Humana Medicare	$23,469.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$23,469.59
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$27,694.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,571.68
Rate for Payer: Molina Healthcare of CA Medicare	$29,571.68
Rate for Payer: Multiplan WC	$37,467.04

INPATIENT MS-DRG 413: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility

$26,445.78

Service Code	MS-DRG 413
Min. Negotiated Rate	$17,203.16
Max. Negotiated Rate	$26,445.78
Rate for Payer: EPIC Health Plan Medicare	$17,203.16
Rate for Payer: Humana Medicare	$17,203.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,203.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,299.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,675.98
Rate for Payer: Molina Healthcare of CA Medicare	$21,675.98
Rate for Payer: Multiplan WC	$26,445.78

INPATIENT MS-DRG 414: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility

$57,688.17

Service Code	MS-DRG 414
Min. Negotiated Rate	$39,899.72
Max. Negotiated Rate	$57,688.17
Rate for Payer: EPIC Health Plan Medicare	$39,899.72
Rate for Payer: Humana Medicare	$39,899.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$39,899.72
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$47,081.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,273.65
Rate for Payer: Molina Healthcare of CA Medicare	$50,273.65
Rate for Payer: Multiplan WC	$57,688.17

INPATIENT MS-DRG 415: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility

$32,641.06

Service Code	MS-DRG 415
Min. Negotiated Rate	$22,452.78
Max. Negotiated Rate	$32,641.06
Rate for Payer: EPIC Health Plan Medicare	$22,452.78
Rate for Payer: Humana Medicare	$22,452.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,452.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,494.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,290.50
Rate for Payer: Molina Healthcare of CA Medicare	$28,290.50
Rate for Payer: Multiplan WC	$32,641.06

Know your out-of-pocket cost for care.

All Charges