Loma Linda University Children's Hospital

All Charges

Charge

Type

Price

UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility IP

$56,078.58

Service Code	APR-DRG 5194
Min. Negotiated Rate	$43,018.17
Max. Negotiated Rate	$56,078.58
Rate for Payer: IEHP Medi-Cal	$43,018.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$56,078.58

UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA

Facility IP

$14,272.80

Service Code	APR-DRG 5191
Min. Negotiated Rate	$10,948.74
Max. Negotiated Rate	$14,272.80
Rate for Payer: IEHP Medi-Cal	$10,948.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,272.80

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility IP

$18,167.32

Service Code	APR-DRG 5132
Min. Negotiated Rate	$13,936.25
Max. Negotiated Rate	$18,167.32
Rate for Payer: IEHP Medi-Cal	$13,936.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,167.32

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility IP

$46,842.39

Service Code	APR-DRG 5134
Min. Negotiated Rate	$35,933.04
Max. Negotiated Rate	$46,842.39
Rate for Payer: IEHP Medi-Cal	$35,933.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,842.39

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility IP

$28,863.07

Service Code	APR-DRG 5133
Min. Negotiated Rate	$22,141.01
Max. Negotiated Rate	$28,863.07
Rate for Payer: IEHP Medi-Cal	$22,141.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,863.07

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility IP

$15,092.14

Service Code	APR-DRG 5131
Min. Negotiated Rate	$11,577.26
Max. Negotiated Rate	$15,092.14
Rate for Payer: IEHP Medi-Cal	$11,577.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,092.14

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility IP

$19,531.11

Service Code	APR-DRG 5121
Min. Negotiated Rate	$14,982.41
Max. Negotiated Rate	$19,531.11
Rate for Payer: IEHP Medi-Cal	$14,982.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,531.11

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility IP

$62,306.97

Service Code	APR-DRG 5124
Min. Negotiated Rate	$47,796.00
Max. Negotiated Rate	$62,306.97
Rate for Payer: IEHP Medi-Cal	$47,796.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,306.97

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility IP

$36,366.57

Service Code	APR-DRG 5123
Min. Negotiated Rate	$27,896.99
Max. Negotiated Rate	$36,366.57
Rate for Payer: IEHP Medi-Cal	$27,896.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,366.57

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility IP

$23,108.18

Service Code	APR-DRG 5122
Min. Negotiated Rate	$17,726.41
Max. Negotiated Rate	$23,108.18
Rate for Payer: IEHP Medi-Cal	$17,726.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,108.18

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility IP

$21,301.03

Service Code	APR-DRG 5111
Min. Negotiated Rate	$16,340.13
Max. Negotiated Rate	$21,301.03
Rate for Payer: IEHP Medi-Cal	$16,340.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,301.03

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility IP

$70,166.94

Service Code	APR-DRG 5114
Min. Negotiated Rate	$53,825.43
Max. Negotiated Rate	$70,166.94
Rate for Payer: IEHP Medi-Cal	$53,825.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,166.94

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility IP

$38,097.47

Service Code	APR-DRG 5113
Min. Negotiated Rate	$29,224.77
Max. Negotiated Rate	$38,097.47
Rate for Payer: IEHP Medi-Cal	$29,224.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,097.47

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility IP

$25,867.68

Service Code	APR-DRG 5112
Min. Negotiated Rate	$19,843.24
Max. Negotiated Rate	$25,867.68
Rate for Payer: IEHP Medi-Cal	$19,843.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,867.68

VAGINAL DELIVERY

Facility IP

$8,223.54

Service Code	APR-DRG 5603
Min. Negotiated Rate	$6,308.32
Max. Negotiated Rate	$8,223.54
Rate for Payer: IEHP Medi-Cal	$6,308.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,223.54

VAGINAL DELIVERY

Facility IP

$12,736.82

Service Code	APR-DRG 5604
Min. Negotiated Rate	$9,770.48
Max. Negotiated Rate	$12,736.82
Rate for Payer: IEHP Medi-Cal	$9,770.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,736.82

VAGINAL DELIVERY

Facility IP

$5,529.65

Service Code	APR-DRG 5601
Min. Negotiated Rate	$4,241.82
Max. Negotiated Rate	$5,529.65
Rate for Payer: IEHP Medi-Cal	$4,241.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,529.65

VAGINAL DELIVERY

Facility IP

$6,313.51

Service Code	APR-DRG 5602
Min. Negotiated Rate	$4,843.13
Max. Negotiated Rate	$6,313.51
Rate for Payer: IEHP Medi-Cal	$4,843.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,313.51

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$27,020.62

Service Code	APR-DRG 5424
Min. Negotiated Rate	$20,727.66
Max. Negotiated Rate	$27,020.62
Rate for Payer: IEHP Medi-Cal	$20,727.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,020.62

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$7,251.67

Service Code	APR-DRG 5422
Min. Negotiated Rate	$5,562.80
Max. Negotiated Rate	$7,251.67
Rate for Payer: IEHP Medi-Cal	$5,562.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,251.67

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$10,697.51

Service Code	APR-DRG 5423
Min. Negotiated Rate	$8,206.12
Max. Negotiated Rate	$10,697.51
Rate for Payer: IEHP Medi-Cal	$8,206.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,697.51

VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C

Facility IP

$6,375.58

Service Code	APR-DRG 5421
Min. Negotiated Rate	$4,890.74
Max. Negotiated Rate	$6,375.58
Rate for Payer: IEHP Medi-Cal	$4,890.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,375.58

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$12,465.65

Service Code	APR-DRG 5413
Min. Negotiated Rate	$9,562.47
Max. Negotiated Rate	$12,465.65
Rate for Payer: IEHP Medi-Cal	$9,562.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,465.65

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$10,126.45

Service Code	APR-DRG 5412
Min. Negotiated Rate	$7,768.05
Max. Negotiated Rate	$10,126.45
Rate for Payer: IEHP Medi-Cal	$7,768.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,126.45

VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C

Facility IP

$18,437.07

Service Code	APR-DRG 5414
Min. Negotiated Rate	$14,143.17
Max. Negotiated Rate	$18,437.07
Rate for Payer: IEHP Medi-Cal	$14,143.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,437.07

Price Transparency.

All Charges