Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 541: OSTEOMYELITIS WITHOUT CC/MCC

Facility

$13,350.19

Service Code	MS-DRG 541
Min. Negotiated Rate	$9,864.72
Max. Negotiated Rate	$13,350.19
Rate for Payer: EPIC Health Plan Medicare	$9,864.72
Rate for Payer: Humana Medicare	$9,864.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,864.72
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,640.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,429.55
Rate for Payer: Molina Healthcare of CA Medicare	$12,429.55
Rate for Payer: Multiplan WC	$13,350.19

INPATIENT MS-DRG 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC

Facility

$29,833.92

Service Code	MS-DRG 542
Min. Negotiated Rate	$20,740.07
Max. Negotiated Rate	$29,833.92
Rate for Payer: EPIC Health Plan Medicare	$20,740.07
Rate for Payer: Humana Medicare	$20,740.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,740.07
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,473.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,132.49
Rate for Payer: Molina Healthcare of CA Medicare	$26,132.49
Rate for Payer: Multiplan WC	$29,833.92

INPATIENT MS-DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC

Facility

$17,773.05

Service Code	MS-DRG 543
Min. Negotiated Rate	$12,486.15
Max. Negotiated Rate	$17,773.05
Rate for Payer: EPIC Health Plan Medicare	$12,486.15
Rate for Payer: Humana Medicare	$12,486.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,486.15
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,733.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,732.55
Rate for Payer: Molina Healthcare of CA Medicare	$15,732.55
Rate for Payer: Multiplan WC	$17,773.05

INPATIENT MS-DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC

Facility

$12,699.01

Service Code	MS-DRG 544
Min. Negotiated Rate	$8,846.77
Max. Negotiated Rate	$12,699.01
Rate for Payer: EPIC Health Plan Medicare	$8,846.77
Rate for Payer: Humana Medicare	$8,846.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,846.77
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,439.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,146.93
Rate for Payer: Molina Healthcare of CA Medicare	$11,146.93
Rate for Payer: Multiplan WC	$12,699.01

INPATIENT MS-DRG 545: CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$40,941.68

Service Code	MS-DRG 545
Min. Negotiated Rate	$28,278.94
Max. Negotiated Rate	$40,941.68
Rate for Payer: EPIC Health Plan Medicare	$28,278.94
Rate for Payer: Humana Medicare	$28,278.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$28,278.94
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$33,369.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$35,631.46
Rate for Payer: Molina Healthcare of CA Medicare	$35,631.46
Rate for Payer: Multiplan WC	$40,941.68

INPATIENT MS-DRG 546: CONNECTIVE TISSUE DISORDERS WITH CC

Facility

$19,676.03

Service Code	MS-DRG 546
Min. Negotiated Rate	$13,709.04
Max. Negotiated Rate	$19,676.03
Rate for Payer: EPIC Health Plan Medicare	$13,709.04
Rate for Payer: Humana Medicare	$13,709.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,709.04
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,176.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,273.39
Rate for Payer: Molina Healthcare of CA Medicare	$17,273.39
Rate for Payer: Multiplan WC	$19,676.03

INPATIENT MS-DRG 547: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC

Facility

$14,930.02

Service Code	MS-DRG 547
Min. Negotiated Rate	$9,475.12
Max. Negotiated Rate	$14,930.02
Rate for Payer: EPIC Health Plan Medicare	$9,475.12
Rate for Payer: Humana Medicare	$9,475.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,475.12
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,180.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,938.65
Rate for Payer: Molina Healthcare of CA Medicare	$11,938.65
Rate for Payer: Multiplan WC	$14,930.02

INPATIENT MS-DRG 548: SEPTIC ARTHRITIS WITH MCC

Facility

$31,660.19

Service Code	MS-DRG 548
Min. Negotiated Rate	$22,160.02
Max. Negotiated Rate	$31,660.19
Rate for Payer: EPIC Health Plan Medicare	$22,160.02
Rate for Payer: Humana Medicare	$22,160.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,160.02
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,148.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,921.63
Rate for Payer: Molina Healthcare of CA Medicare	$27,921.63
Rate for Payer: Multiplan WC	$31,660.19

INPATIENT MS-DRG 549: SEPTIC ARTHRITIS WITH CC

Facility

$19,775.59

Service Code	MS-DRG 549
Min. Negotiated Rate	$13,786.74
Max. Negotiated Rate	$19,775.59
Rate for Payer: EPIC Health Plan Medicare	$13,786.74
Rate for Payer: Humana Medicare	$13,786.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,786.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,268.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,371.29
Rate for Payer: Molina Healthcare of CA Medicare	$17,371.29
Rate for Payer: Multiplan WC	$19,775.59

INPATIENT MS-DRG 550: SEPTIC ARTHRITIS WITHOUT CC/MCC

Facility

$17,108.81

Service Code	MS-DRG 550
Min. Negotiated Rate	$10,828.62
Max. Negotiated Rate	$17,108.81
Rate for Payer: EPIC Health Plan Medicare	$10,828.62
Rate for Payer: Humana Medicare	$10,828.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,828.62
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,777.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,644.06
Rate for Payer: Molina Healthcare of CA Medicare	$13,644.06
Rate for Payer: Multiplan WC	$17,108.81

INPATIENT MS-DRG 551: MEDICAL BACK PROBLEMS WITH MCC

Facility

$27,310.77

Service Code	MS-DRG 551
Min. Negotiated Rate	$19,368.54
Max. Negotiated Rate	$27,310.77
Rate for Payer: EPIC Health Plan Medicare	$19,368.54
Rate for Payer: Humana Medicare	$19,368.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,368.54
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,854.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,404.36
Rate for Payer: Molina Healthcare of CA Medicare	$24,404.36
Rate for Payer: Multiplan WC	$27,310.77

INPATIENT MS-DRG 552: MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$15,675.86

Service Code	MS-DRG 552
Min. Negotiated Rate	$11,085.36
Max. Negotiated Rate	$15,675.86
Rate for Payer: EPIC Health Plan Medicare	$11,085.36
Rate for Payer: Humana Medicare	$11,085.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,085.36
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,080.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,967.55
Rate for Payer: Molina Healthcare of CA Medicare	$13,967.55
Rate for Payer: Multiplan WC	$15,675.86

INPATIENT MS-DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$21,639.39

Service Code	MS-DRG 553
Min. Negotiated Rate	$15,422.89
Max. Negotiated Rate	$21,639.39
Rate for Payer: EPIC Health Plan Medicare	$15,422.89
Rate for Payer: Humana Medicare	$15,422.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,422.89
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,199.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,432.84
Rate for Payer: Molina Healthcare of CA Medicare	$19,432.84
Rate for Payer: Multiplan WC	$21,639.39

INPATIENT MS-DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Facility

$13,386.09

Service Code	MS-DRG 554
Min. Negotiated Rate	$9,458.22
Max. Negotiated Rate	$13,386.09
Rate for Payer: EPIC Health Plan Medicare	$9,458.22
Rate for Payer: Humana Medicare	$9,458.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,458.22
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,160.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,917.36
Rate for Payer: Molina Healthcare of CA Medicare	$11,917.36
Rate for Payer: Multiplan WC	$13,386.09

INPATIENT MS-DRG 555: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$21,725.88

Service Code	MS-DRG 555
Min. Negotiated Rate	$15,957.74
Max. Negotiated Rate	$21,725.88
Rate for Payer: EPIC Health Plan Medicare	$15,957.74
Rate for Payer: Humana Medicare	$15,957.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$15,957.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$18,830.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,106.75
Rate for Payer: Molina Healthcare of CA Medicare	$20,106.75
Rate for Payer: Multiplan WC	$21,725.88

INPATIENT MS-DRG 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC

Facility

$13,186.99

Service Code	MS-DRG 556
Min. Negotiated Rate	$9,487.50
Max. Negotiated Rate	$13,186.99
Rate for Payer: EPIC Health Plan Medicare	$9,487.50
Rate for Payer: Humana Medicare	$9,487.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,487.50
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,195.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,954.25
Rate for Payer: Molina Healthcare of CA Medicare	$11,954.25
Rate for Payer: Multiplan WC	$13,186.99

INPATIENT MS-DRG 557: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC

Facility

$23,369.36

Service Code	MS-DRG 557
Min. Negotiated Rate	$17,734.66
Max. Negotiated Rate	$23,369.36
Rate for Payer: EPIC Health Plan Medicare	$17,734.66
Rate for Payer: Humana Medicare	$17,734.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,734.66
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,926.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,345.67
Rate for Payer: Molina Healthcare of CA Medicare	$22,345.67
Rate for Payer: Multiplan WC	$23,369.36

INPATIENT MS-DRG 558: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC

Facility

$14,182.54

Service Code	MS-DRG 558
Min. Negotiated Rate	$10,095.56
Max. Negotiated Rate	$14,182.54
Rate for Payer: EPIC Health Plan Medicare	$10,095.56
Rate for Payer: Humana Medicare	$10,095.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,095.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$11,912.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,720.41
Rate for Payer: Molina Healthcare of CA Medicare	$12,720.41
Rate for Payer: Multiplan WC	$14,182.54

INPATIENT MS-DRG 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$29,132.15

Service Code	MS-DRG 559
Min. Negotiated Rate	$21,041.84
Max. Negotiated Rate	$29,132.15
Rate for Payer: EPIC Health Plan Medicare	$21,041.84
Rate for Payer: Humana Medicare	$21,041.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,041.84
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,829.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,512.72
Rate for Payer: Molina Healthcare of CA Medicare	$26,512.72
Rate for Payer: Multiplan WC	$29,132.15

INPATIENT MS-DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$17,880.77

Service Code	MS-DRG 560
Min. Negotiated Rate	$12,952.34
Max. Negotiated Rate	$17,880.77
Rate for Payer: EPIC Health Plan Medicare	$12,952.34
Rate for Payer: Humana Medicare	$12,952.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,952.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,283.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,319.95
Rate for Payer: Molina Healthcare of CA Medicare	$16,319.95
Rate for Payer: Multiplan WC	$17,880.77

INPATIENT MS-DRG 561: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$12,896.48

Service Code	MS-DRG 561
Min. Negotiated Rate	$8,989.78
Max. Negotiated Rate	$12,896.48
Rate for Payer: EPIC Health Plan Medicare	$8,989.78
Rate for Payer: Humana Medicare	$8,989.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,989.78
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,607.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,327.12
Rate for Payer: Molina Healthcare of CA Medicare	$11,327.12
Rate for Payer: Multiplan WC	$12,896.48

INPATIENT MS-DRG 562: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$23,873.67

Service Code	MS-DRG 562
Min. Negotiated Rate	$17,328.14
Max. Negotiated Rate	$23,873.67
Rate for Payer: EPIC Health Plan Medicare	$17,328.14
Rate for Payer: Humana Medicare	$17,328.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,328.14
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,447.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,833.46
Rate for Payer: Molina Healthcare of CA Medicare	$21,833.46
Rate for Payer: Multiplan WC	$23,873.67

INPATIENT MS-DRG 563: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

Facility

$14,055.24

Service Code	MS-DRG 563
Min. Negotiated Rate	$10,289.24
Max. Negotiated Rate	$14,055.24
Rate for Payer: EPIC Health Plan Medicare	$10,289.24
Rate for Payer: Humana Medicare	$10,289.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,289.24
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,141.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,964.44
Rate for Payer: Molina Healthcare of CA Medicare	$12,964.44
Rate for Payer: Multiplan WC	$14,055.24

INPATIENT MS-DRG 564: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$25,350.68

Service Code	MS-DRG 564
Min. Negotiated Rate	$17,792.08
Max. Negotiated Rate	$25,350.68
Rate for Payer: EPIC Health Plan Medicare	$17,792.08
Rate for Payer: Humana Medicare	$17,792.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,792.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,994.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,418.02
Rate for Payer: Molina Healthcare of CA Medicare	$22,418.02
Rate for Payer: Multiplan WC	$25,350.68

INPATIENT MS-DRG 565: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$16,114.88

Service Code	MS-DRG 565
Min. Negotiated Rate	$11,458.08
Max. Negotiated Rate	$16,114.88
Rate for Payer: EPIC Health Plan Medicare	$11,458.08
Rate for Payer: Humana Medicare	$11,458.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,458.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,520.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,437.18
Rate for Payer: Molina Healthcare of CA Medicare	$14,437.18
Rate for Payer: Multiplan WC	$16,114.88

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