Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 666: PROSTATECTOMY WITH CC

Facility

$28,102.31

Service Code	MS-DRG 666
Min. Negotiated Rate	$19,543.08
Max. Negotiated Rate	$28,102.31
Rate for Payer: EPIC Health Plan Medicare	$19,543.08
Rate for Payer: Humana Medicare	$19,543.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,543.08
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$23,060.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,624.28
Rate for Payer: Molina Healthcare of CA Medicare	$24,624.28
Rate for Payer: Multiplan WC	$28,102.31

INPATIENT MS-DRG 667: PROSTATECTOMY WITHOUT CC/MCC

Facility

$16,057.77

Service Code	MS-DRG 667
Min. Negotiated Rate	$12,023.34
Max. Negotiated Rate	$16,057.77
Rate for Payer: EPIC Health Plan Medicare	$12,023.34
Rate for Payer: Humana Medicare	$12,023.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,023.34
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,187.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,149.41
Rate for Payer: Molina Healthcare of CA Medicare	$15,149.41
Rate for Payer: Multiplan WC	$16,057.77

INPATIENT MS-DRG 668: TRANSURETHRAL PROCEDURES WITH MCC

Facility

$46,071.22

Service Code	MS-DRG 668
Min. Negotiated Rate	$31,936.33
Max. Negotiated Rate	$46,071.22
Rate for Payer: EPIC Health Plan Medicare	$31,936.33
Rate for Payer: Humana Medicare	$31,936.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$31,936.33
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$37,684.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,239.78
Rate for Payer: Molina Healthcare of CA Medicare	$40,239.78
Rate for Payer: Multiplan WC	$46,071.22

INPATIENT MS-DRG 669: TRANSURETHRAL PROCEDURES WITH CC

Facility

$25,691.78

Service Code	MS-DRG 669
Min. Negotiated Rate	$17,484.67
Max. Negotiated Rate	$25,691.78
Rate for Payer: EPIC Health Plan Medicare	$17,484.67
Rate for Payer: Humana Medicare	$17,484.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,484.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,631.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,030.68
Rate for Payer: Molina Healthcare of CA Medicare	$22,030.68
Rate for Payer: Multiplan WC	$25,691.78

INPATIENT MS-DRG 670: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$16,116.52

Service Code	MS-DRG 670
Min. Negotiated Rate	$11,043.68
Max. Negotiated Rate	$16,116.52
Rate for Payer: EPIC Health Plan Medicare	$11,043.68
Rate for Payer: Humana Medicare	$11,043.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,043.68
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,031.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,915.04
Rate for Payer: Molina Healthcare of CA Medicare	$13,915.04
Rate for Payer: Multiplan WC	$16,116.52

INPATIENT MS-DRG 671: URETHRAL PROCEDURES WITH CC/MCC

Facility

$29,891.05

Service Code	MS-DRG 671
Min. Negotiated Rate	$19,481.13
Max. Negotiated Rate	$29,891.05
Rate for Payer: EPIC Health Plan Medicare	$19,481.13
Rate for Payer: Humana Medicare	$19,481.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$19,481.13
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,987.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,546.22
Rate for Payer: Molina Healthcare of CA Medicare	$24,546.22
Rate for Payer: Multiplan WC	$29,891.05

INPATIENT MS-DRG 672: URETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$17,001.10

Service Code	MS-DRG 672
Min. Negotiated Rate	$10,761.05
Max. Negotiated Rate	$17,001.10
Rate for Payer: EPIC Health Plan Medicare	$10,761.05
Rate for Payer: Humana Medicare	$10,761.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,761.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,698.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,558.92
Rate for Payer: Molina Healthcare of CA Medicare	$13,558.92
Rate for Payer: Multiplan WC	$17,001.10

INPATIENT MS-DRG 673: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$57,023.93

Service Code	MS-DRG 673
Min. Negotiated Rate	$41,845.53
Max. Negotiated Rate	$57,023.93
Rate for Payer: EPIC Health Plan Medicare	$41,845.53
Rate for Payer: Humana Medicare	$41,845.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$41,845.53
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$49,377.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$52,725.37
Rate for Payer: Molina Healthcare of CA Medicare	$52,725.37
Rate for Payer: Multiplan WC	$57,023.93

INPATIENT MS-DRG 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$38,687.81

Service Code	MS-DRG 674
Min. Negotiated Rate	$27,029.02
Max. Negotiated Rate	$38,687.81
Rate for Payer: EPIC Health Plan Medicare	$27,029.02
Rate for Payer: Humana Medicare	$27,029.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$27,029.02
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$31,894.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,056.57
Rate for Payer: Molina Healthcare of CA Medicare	$34,056.57
Rate for Payer: Multiplan WC	$38,687.81

INPATIENT MS-DRG 675: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility

$27,522.94

Service Code	MS-DRG 675
Min. Negotiated Rate	$18,069.09
Max. Negotiated Rate	$27,522.94
Rate for Payer: EPIC Health Plan Medicare	$18,069.09
Rate for Payer: Humana Medicare	$18,069.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,069.09
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,321.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,767.05
Rate for Payer: Molina Healthcare of CA Medicare	$22,767.05
Rate for Payer: Multiplan WC	$27,522.94

INPATIENT MS-DRG 682: RENAL FAILURE WITH MCC

Facility

$24,262.10

Service Code	MS-DRG 682
Min. Negotiated Rate	$17,104.06
Max. Negotiated Rate	$24,262.10
Rate for Payer: EPIC Health Plan Medicare	$17,104.06
Rate for Payer: Humana Medicare	$17,104.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$17,104.06
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$20,182.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,551.12
Rate for Payer: Molina Healthcare of CA Medicare	$21,551.12
Rate for Payer: Multiplan WC	$24,262.10

INPATIENT MS-DRG 683: RENAL FAILURE WITH CC

Facility

$14,605.24

Service Code	MS-DRG 683
Min. Negotiated Rate	$10,347.80
Max. Negotiated Rate	$14,605.24
Rate for Payer: EPIC Health Plan Medicare	$10,347.80
Rate for Payer: Humana Medicare	$10,347.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,347.80
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,210.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,038.23
Rate for Payer: Molina Healthcare of CA Medicare	$13,038.23
Rate for Payer: Multiplan WC	$14,605.24

INPATIENT MS-DRG 684: RENAL FAILURE WITHOUT CC/MCC

Facility

$9,870.66

Service Code	MS-DRG 684
Min. Negotiated Rate	$7,056.36
Max. Negotiated Rate	$9,870.66
Rate for Payer: EPIC Health Plan Medicare	$7,056.36
Rate for Payer: Humana Medicare	$7,056.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,056.36
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,326.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,891.01
Rate for Payer: Molina Healthcare of CA Medicare	$8,891.01
Rate for Payer: Multiplan WC	$9,870.66

INPATIENT MS-DRG 686: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$27,708.99

Service Code	MS-DRG 686
Min. Negotiated Rate	$20,916.85
Max. Negotiated Rate	$27,708.99
Rate for Payer: EPIC Health Plan Medicare	$20,916.85
Rate for Payer: Humana Medicare	$20,916.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,916.85
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,681.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,355.23
Rate for Payer: Molina Healthcare of CA Medicare	$26,355.23
Rate for Payer: Multiplan WC	$27,708.99

INPATIENT MS-DRG 687: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$16,970.08

Service Code	MS-DRG 687
Min. Negotiated Rate	$11,974.93
Max. Negotiated Rate	$16,970.08
Rate for Payer: EPIC Health Plan Medicare	$11,974.93
Rate for Payer: Humana Medicare	$11,974.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,974.93
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$14,130.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,088.41
Rate for Payer: Molina Healthcare of CA Medicare	$15,088.41
Rate for Payer: Multiplan WC	$16,970.08

INPATIENT MS-DRG 688: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$14,140.11

Service Code	MS-DRG 688
Min. Negotiated Rate	$8,997.67
Max. Negotiated Rate	$14,140.11
Rate for Payer: EPIC Health Plan Medicare	$8,997.67
Rate for Payer: Humana Medicare	$8,997.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,997.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,617.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,337.06
Rate for Payer: Molina Healthcare of CA Medicare	$11,337.06
Rate for Payer: Multiplan WC	$14,140.11

INPATIENT MS-DRG 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$18,721.27

Service Code	MS-DRG 689
Min. Negotiated Rate	$13,428.67
Max. Negotiated Rate	$18,721.27
Rate for Payer: EPIC Health Plan Medicare	$13,428.67
Rate for Payer: Humana Medicare	$13,428.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,428.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,845.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,920.12
Rate for Payer: Molina Healthcare of CA Medicare	$16,920.12
Rate for Payer: Multiplan WC	$18,721.27

INPATIENT MS-DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$12,984.61

Service Code	MS-DRG 690
Min. Negotiated Rate	$9,290.44
Max. Negotiated Rate	$12,984.61
Rate for Payer: EPIC Health Plan Medicare	$9,290.44
Rate for Payer: Humana Medicare	$9,290.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,290.44
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,962.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,705.95
Rate for Payer: Molina Healthcare of CA Medicare	$11,705.95
Rate for Payer: Multiplan WC	$12,984.61

INPATIENT MS-DRG 693: URINARY STONES WITH MCC

Facility

$23,351.41

Service Code	MS-DRG 693
Min. Negotiated Rate	$16,152.56
Max. Negotiated Rate	$23,351.41
Rate for Payer: EPIC Health Plan Medicare	$16,152.56
Rate for Payer: Humana Medicare	$16,152.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,152.56
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,060.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,352.23
Rate for Payer: Molina Healthcare of CA Medicare	$20,352.23
Rate for Payer: Multiplan WC	$23,351.41

INPATIENT MS-DRG 694: URINARY STONES WITHOUT MCC

Facility

$13,009.09

Service Code	MS-DRG 694
Min. Negotiated Rate	$9,017.94
Max. Negotiated Rate	$13,009.09
Rate for Payer: EPIC Health Plan Medicare	$9,017.94
Rate for Payer: Humana Medicare	$9,017.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,017.94
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,641.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,362.60
Rate for Payer: Molina Healthcare of CA Medicare	$11,362.60
Rate for Payer: Multiplan WC	$13,009.09

INPATIENT MS-DRG 695: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$18,740.86

Service Code	MS-DRG 695
Min. Negotiated Rate	$13,671.88
Max. Negotiated Rate	$18,740.86
Rate for Payer: EPIC Health Plan Medicare	$13,671.88
Rate for Payer: Humana Medicare	$13,671.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,671.88
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,132.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,226.57
Rate for Payer: Molina Healthcare of CA Medicare	$17,226.57
Rate for Payer: Multiplan WC	$18,740.86

INPATIENT MS-DRG 696: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$11,310.12

Service Code	MS-DRG 696
Min. Negotiated Rate	$7,997.74
Max. Negotiated Rate	$11,310.12
Rate for Payer: EPIC Health Plan Medicare	$7,997.74
Rate for Payer: Humana Medicare	$7,997.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,997.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,437.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,077.15
Rate for Payer: Molina Healthcare of CA Medicare	$10,077.15
Rate for Payer: Multiplan WC	$11,310.12

INPATIENT MS-DRG 697: URETHRAL STRICTURE

Facility

$16,196.49

Service Code	MS-DRG 697
Min. Negotiated Rate	$12,738.40
Max. Negotiated Rate	$16,196.49
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
Rate for Payer: Multiplan WC	$16,196.49

INPATIENT MS-DRG 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$26,153.64

Service Code	MS-DRG 698
Min. Negotiated Rate	$18,833.67
Max. Negotiated Rate	$26,153.64
Rate for Payer: EPIC Health Plan Medicare	$18,833.67
Rate for Payer: Humana Medicare	$18,833.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,833.67
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$22,223.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,730.42
Rate for Payer: Molina Healthcare of CA Medicare	$23,730.42
Rate for Payer: Multiplan WC	$26,153.64

INPATIENT MS-DRG 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$16,518.01

Service Code	MS-DRG 699
Min. Negotiated Rate	$11,699.05
Max. Negotiated Rate	$16,518.01
Rate for Payer: EPIC Health Plan Medicare	$11,699.05
Rate for Payer: Humana Medicare	$11,699.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,699.05
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,804.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,740.80
Rate for Payer: Molina Healthcare of CA Medicare	$14,740.80
Rate for Payer: Multiplan WC	$16,518.01

Know your out-of-pocket cost for care.

All Charges