Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT MS-DRG 700: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

Facility

$12,090.25

Service Code	MS-DRG 700
Min. Negotiated Rate	$8,180.16
Max. Negotiated Rate	$12,090.25
Rate for Payer: EPIC Health Plan Medicare	$8,180.16
Rate for Payer: Humana Medicare	$8,180.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,180.16
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,652.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,307.00
Rate for Payer: Molina Healthcare of CA Medicare	$10,307.00
Rate for Payer: Multiplan WC	$12,090.25

INPATIENT MS-DRG 707: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC

Facility

$32,564.35

Service Code	MS-DRG 707
Min. Negotiated Rate	$22,296.25
Max. Negotiated Rate	$32,564.35
Rate for Payer: EPIC Health Plan Medicare	$22,296.25
Rate for Payer: Humana Medicare	$22,296.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$22,296.25
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$26,309.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,093.28
Rate for Payer: Molina Healthcare of CA Medicare	$28,093.28
Rate for Payer: Multiplan WC	$32,564.35

INPATIENT MS-DRG 708: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC

Facility

$24,231.09

Service Code	MS-DRG 708
Min. Negotiated Rate	$16,627.74
Max. Negotiated Rate	$24,231.09
Rate for Payer: EPIC Health Plan Medicare	$16,627.74
Rate for Payer: Humana Medicare	$16,627.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,627.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,620.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,950.95
Rate for Payer: Molina Healthcare of CA Medicare	$20,950.95
Rate for Payer: Multiplan WC	$24,231.09

INPATIENT MS-DRG 709: PENIS PROCEDURES WITH CC/MCC

Facility

$39,365.11

Service Code	MS-DRG 709
Min. Negotiated Rate	$24,648.55
Max. Negotiated Rate	$39,365.11
Rate for Payer: EPIC Health Plan Medicare	$24,648.55
Rate for Payer: Humana Medicare	$24,648.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,648.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,085.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,057.17
Rate for Payer: Molina Healthcare of CA Medicare	$31,057.17
Rate for Payer: Multiplan WC	$39,365.11

INPATIENT MS-DRG 710: PENIS PROCEDURES WITHOUT CC/MCC

Facility

$23,524.41

Service Code	MS-DRG 710
Min. Negotiated Rate	$14,812.55
Max. Negotiated Rate	$23,524.41
Rate for Payer: EPIC Health Plan Medicare	$14,812.55
Rate for Payer: Humana Medicare	$14,812.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,812.55
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$17,478.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,663.81
Rate for Payer: Molina Healthcare of CA Medicare	$18,663.81
Rate for Payer: Multiplan WC	$23,524.41

INPATIENT MS-DRG 711: TESTES PROCEDURES WITH CC/MCC

Facility

$33,349.37

Service Code	MS-DRG 711
Min. Negotiated Rate	$24,109.18
Max. Negotiated Rate	$33,349.37
Rate for Payer: EPIC Health Plan Medicare	$24,109.18
Rate for Payer: Humana Medicare	$24,109.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,109.18
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$28,448.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,377.57
Rate for Payer: Molina Healthcare of CA Medicare	$30,377.57
Rate for Payer: Multiplan WC	$33,349.37

INPATIENT MS-DRG 712: TESTES PROCEDURES WITHOUT CC/MCC

Facility

$20,263.57

Service Code	MS-DRG 712
Min. Negotiated Rate	$13,586.30
Max. Negotiated Rate	$20,263.57
Rate for Payer: EPIC Health Plan Medicare	$13,586.30
Rate for Payer: Humana Medicare	$13,586.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,586.30
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,031.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,118.74
Rate for Payer: Molina Healthcare of CA Medicare	$17,118.74
Rate for Payer: Multiplan WC	$20,263.57

INPATIENT MS-DRG 713: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC

Facility

$24,185.39

Service Code	MS-DRG 713
Min. Negotiated Rate	$16,539.92
Max. Negotiated Rate	$24,185.39
Rate for Payer: EPIC Health Plan Medicare	$16,539.92
Rate for Payer: Humana Medicare	$16,539.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,539.92
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,517.11
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,840.30
Rate for Payer: Molina Healthcare of CA Medicare	$20,840.30
Rate for Payer: Multiplan WC	$24,185.39

INPATIENT MS-DRG 714: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC

Facility

$15,638.33

Service Code	MS-DRG 714
Min. Negotiated Rate	$10,997.52
Max. Negotiated Rate	$15,638.33
Rate for Payer: EPIC Health Plan Medicare	$10,997.52
Rate for Payer: Humana Medicare	$10,997.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$10,997.52
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$12,977.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,856.88
Rate for Payer: Molina Healthcare of CA Medicare	$13,856.88
Rate for Payer: Multiplan WC	$15,638.33

INPATIENT MS-DRG 715: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$36,447.00

Service Code	MS-DRG 715
Min. Negotiated Rate	$25,061.83
Max. Negotiated Rate	$36,447.00
Rate for Payer: EPIC Health Plan Medicare	$25,061.83
Rate for Payer: Humana Medicare	$25,061.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$25,061.83
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,572.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,577.91
Rate for Payer: Molina Healthcare of CA Medicare	$31,577.91
Rate for Payer: Multiplan WC	$36,447.00

INPATIENT MS-DRG 716: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$21,450.07

Service Code	MS-DRG 716
Min. Negotiated Rate	$16,218.99
Max. Negotiated Rate	$21,450.07
Rate for Payer: EPIC Health Plan Medicare	$16,218.99
Rate for Payer: Humana Medicare	$16,218.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$16,218.99
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$19,138.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,435.93
Rate for Payer: Molina Healthcare of CA Medicare	$20,435.93
Rate for Payer: Multiplan WC	$21,450.07

INPATIENT MS-DRG 717: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$28,892.23

Service Code	MS-DRG 717
Min. Negotiated Rate	$20,627.45
Max. Negotiated Rate	$28,892.23
Rate for Payer: EPIC Health Plan Medicare	$20,627.45
Rate for Payer: Humana Medicare	$20,627.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$20,627.45
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$24,340.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,990.59
Rate for Payer: Molina Healthcare of CA Medicare	$25,990.59
Rate for Payer: Multiplan WC	$28,892.23

INPATIENT MS-DRG 718: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$20,710.75

Service Code	MS-DRG 718
Min. Negotiated Rate	$13,444.41
Max. Negotiated Rate	$20,710.75
Rate for Payer: EPIC Health Plan Medicare	$13,444.41
Rate for Payer: Humana Medicare	$13,444.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$13,444.41
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,864.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,939.96
Rate for Payer: Molina Healthcare of CA Medicare	$16,939.96
Rate for Payer: Multiplan WC	$20,710.75

INPATIENT MS-DRG 722: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$27,707.36

Service Code	MS-DRG 722
Min. Negotiated Rate	$21,315.47
Max. Negotiated Rate	$27,707.36
Rate for Payer: EPIC Health Plan Medicare	$21,315.47
Rate for Payer: Humana Medicare	$21,315.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$21,315.47
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$25,152.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,857.49
Rate for Payer: Molina Healthcare of CA Medicare	$26,857.49
Rate for Payer: Multiplan WC	$27,707.36

INPATIENT MS-DRG 723: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$18,807.78

Service Code	MS-DRG 723
Min. Negotiated Rate	$12,751.90
Max. Negotiated Rate	$18,807.78
Rate for Payer: EPIC Health Plan Medicare	$12,751.90
Rate for Payer: Humana Medicare	$12,751.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$12,751.90
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$15,047.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,067.39
Rate for Payer: Molina Healthcare of CA Medicare	$16,067.39
Rate for Payer: Multiplan WC	$18,807.78

INPATIENT MS-DRG 724: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$12,486.84

Service Code	MS-DRG 724
Min. Negotiated Rate	$9,319.72
Max. Negotiated Rate	$12,486.84
Rate for Payer: EPIC Health Plan Medicare	$9,319.72
Rate for Payer: Humana Medicare	$9,319.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,319.72
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,997.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,742.85
Rate for Payer: Molina Healthcare of CA Medicare	$11,742.85
Rate for Payer: Multiplan WC	$12,486.84

INPATIENT MS-DRG 725: BENIGN PROSTATIC HYPERTROPHY WITH MCC

Facility

$20,389.23

Service Code	MS-DRG 725
Min. Negotiated Rate	$14,177.48
Max. Negotiated Rate	$20,389.23
Rate for Payer: EPIC Health Plan Medicare	$14,177.48
Rate for Payer: Humana Medicare	$14,177.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,177.48
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,729.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,863.62
Rate for Payer: Molina Healthcare of CA Medicare	$17,863.62
Rate for Payer: Multiplan WC	$20,389.23

INPATIENT MS-DRG 726: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Facility

$12,592.92

Service Code	MS-DRG 726
Min. Negotiated Rate	$8,434.64
Max. Negotiated Rate	$12,592.92
Rate for Payer: EPIC Health Plan Medicare	$8,434.64
Rate for Payer: Humana Medicare	$8,434.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$8,434.64
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$9,952.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,627.65
Rate for Payer: Molina Healthcare of CA Medicare	$10,627.65
Rate for Payer: Multiplan WC	$12,592.92

INPATIENT MS-DRG 727: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$23,449.33

Service Code	MS-DRG 727
Min. Negotiated Rate	$18,457.57
Max. Negotiated Rate	$23,449.33
Rate for Payer: EPIC Health Plan Medicare	$18,457.57
Rate for Payer: Humana Medicare	$18,457.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$18,457.57
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$21,779.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,256.54
Rate for Payer: Molina Healthcare of CA Medicare	$23,256.54
Rate for Payer: Multiplan WC	$23,449.33

INPATIENT MS-DRG 728: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

Facility

$13,410.57

Service Code	MS-DRG 728
Min. Negotiated Rate	$9,213.87
Max. Negotiated Rate	$13,410.57
Rate for Payer: EPIC Health Plan Medicare	$9,213.87
Rate for Payer: Humana Medicare	$9,213.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$9,213.87
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$10,872.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,609.48
Rate for Payer: Molina Healthcare of CA Medicare	$11,609.48
Rate for Payer: Multiplan WC	$13,410.57

INPATIENT MS-DRG 729: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$17,590.26

Service Code	MS-DRG 729
Min. Negotiated Rate	$11,508.74
Max. Negotiated Rate	$17,590.26
Rate for Payer: EPIC Health Plan Medicare	$11,508.74
Rate for Payer: Humana Medicare	$11,508.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$11,508.74
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$13,580.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,501.01
Rate for Payer: Molina Healthcare of CA Medicare	$14,501.01
Rate for Payer: Multiplan WC	$17,590.26

INPATIENT MS-DRG 730: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$10,703.00

Service Code	MS-DRG 730
Min. Negotiated Rate	$7,203.87
Max. Negotiated Rate	$10,703.00
Rate for Payer: EPIC Health Plan Medicare	$7,203.87
Rate for Payer: Humana Medicare	$7,203.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$7,203.87
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$8,500.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,076.88
Rate for Payer: Molina Healthcare of CA Medicare	$9,076.88
Rate for Payer: Multiplan WC	$10,703.00

INPATIENT MS-DRG 734: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC

Facility

$35,663.62

Service Code	MS-DRG 734
Min. Negotiated Rate	$24,680.10
Max. Negotiated Rate	$35,663.62
Rate for Payer: EPIC Health Plan Medicare	$24,680.10
Rate for Payer: Humana Medicare	$24,680.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$24,680.10
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$29,122.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,096.93
Rate for Payer: Molina Healthcare of CA Medicare	$31,096.93
Rate for Payer: Multiplan WC	$35,663.62

INPATIENT MS-DRG 735: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC

Facility

$20,762.98

Service Code	MS-DRG 735
Min. Negotiated Rate	$14,394.81
Max. Negotiated Rate	$20,762.98
Rate for Payer: EPIC Health Plan Medicare	$14,394.81
Rate for Payer: Humana Medicare	$14,394.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$14,394.81
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$16,985.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,137.46
Rate for Payer: Molina Healthcare of CA Medicare	$18,137.46
Rate for Payer: Multiplan WC	$20,762.98

INPATIENT MS-DRG 736: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC

Facility

$69,610.31

Service Code	MS-DRG 736
Min. Negotiated Rate	$43,976.01
Max. Negotiated Rate	$69,610.31
Rate for Payer: EPIC Health Plan Medicare	$43,976.01
Rate for Payer: Humana Medicare	$43,976.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$43,976.01
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$51,891.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,409.77
Rate for Payer: Molina Healthcare of CA Medicare	$55,409.77
Rate for Payer: Multiplan WC	$69,610.31

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