Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$25,135.88

Service Code	APR-DRG 4613
Min. Negotiated Rate	$20,075.63
Max. Negotiated Rate	$25,135.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,075.63
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,135.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,490.00

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$13,133.52

Service Code	APR-DRG 4611
Min. Negotiated Rate	$10,489.54
Max. Negotiated Rate	$13,133.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,489.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,133.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,751.05

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$52,735.01

Service Code	APR-DRG 4614
Min. Negotiated Rate	$42,118.62
Max. Negotiated Rate	$52,735.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,118.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$52,735.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$47,183.96

KIDNEY AND URINARY TRACT MALIGNANCY

Facility

$16,595.02

Service Code	APR-DRG 4612
Min. Negotiated Rate	$13,254.18
Max. Negotiated Rate	$16,595.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,254.18
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,595.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,848.17

KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$97,842.64

Service Code	MSDRG 687
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$97,842.64
Rate for Payer: Aetna of CA HMO/PPO	$31,765.10
Rate for Payer: EPIC Health Plan Commercial	$97,842.64
Rate for Payer: EPIC Health Plan Senior	$65,228.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,298.57
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$83,018.00
Rate for Payer: Molina Healthcare of CA Medicare	$79,460.08
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$111,255.95

Service Code	MSDRG 686
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$111,255.95
Rate for Payer: Aetna of CA HMO/PPO	$54,680.97
Rate for Payer: EPIC Health Plan Commercial	$111,255.95
Rate for Payer: EPIC Health Plan Senior	$74,170.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$67,427.85
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$94,398.99
Rate for Payer: Molina Healthcare of CA Medicare	$90,353.32
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$93,273.35

Service Code	MSDRG 688
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$93,273.35
Rate for Payer: Aetna of CA HMO/PPO	$23,958.73
Rate for Payer: EPIC Health Plan Commercial	$93,273.35
Rate for Payer: EPIC Health Plan Senior	$62,182.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$56,529.30
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$79,141.02
Rate for Payer: Molina Healthcare of CA Medicare	$75,749.26
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$51,598.72

Service Code	APR-DRG 4423
Min. Negotiated Rate	$41,211.08
Max. Negotiated Rate	$51,598.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,211.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$51,598.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,167.27

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$30,413.76

Service Code	APR-DRG 4421
Min. Negotiated Rate	$24,290.99
Max. Negotiated Rate	$30,413.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,290.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,413.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,212.31

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$35,381.67

Service Code	APR-DRG 4422
Min. Negotiated Rate	$28,258.78
Max. Negotiated Rate	$35,381.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,258.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$35,381.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,657.28

KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$115,494.65

Service Code	APR-DRG 4424
Min. Negotiated Rate	$92,243.76
Max. Negotiated Rate	$115,494.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$92,243.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$115,494.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$103,337.32

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$26,019.61

Service Code	APR-DRG 4431
Min. Negotiated Rate	$20,781.45
Max. Negotiated Rate	$26,019.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,781.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$26,019.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,280.70

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$32,330.78

Service Code	APR-DRG 4432
Min. Negotiated Rate	$25,822.08
Max. Negotiated Rate	$32,330.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,822.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$32,330.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,927.54

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$43,734.92

Service Code	APR-DRG 4433
Min. Negotiated Rate	$34,930.39
Max. Negotiated Rate	$43,734.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$34,930.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$43,734.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,131.25

KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY

Facility

$94,116.56

Service Code	APR-DRG 4434
Min. Negotiated Rate	$75,169.41
Max. Negotiated Rate	$94,116.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,169.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$94,116.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,209.55

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$99,546.13

Service Code	MSDRG 695
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$99,546.13
Rate for Payer: Aetna of CA HMO/PPO	$34,675.44
Rate for Payer: EPIC Health Plan Commercial	$99,546.13
Rate for Payer: EPIC Health Plan Senior	$66,364.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,330.99
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$84,463.39
Rate for Payer: Molina Healthcare of CA Medicare	$80,843.53
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$91,475.80

Service Code	MSDRG 696
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$91,475.80
Rate for Payer: Aetna of CA HMO/PPO	$20,887.72
Rate for Payer: EPIC Health Plan Commercial	$91,475.80
Rate for Payer: EPIC Health Plan Senior	$60,983.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$55,439.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$77,615.83
Rate for Payer: Molina Healthcare of CA Medicare	$74,289.44
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 652
Min. Negotiated Rate	$285,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 651
Min. Negotiated Rate	$285,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 001
Min. Negotiated Rate	$285,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 002
Min. Negotiated Rate	$285,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00

Kidney-Heart Transplant

Facility

$285,000.00

Service Code	MSDRG 650
Min. Negotiated Rate	$285,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 652
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 005
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00

Kidney-Liver Transplant

Facility

$285,000.00

Service Code	MSDRG 651
Min. Negotiated Rate	$203,000.00
Max. Negotiated Rate	$285,000.00
Rate for Payer: EPIC Health Plan Transplant	$285,000.00
Rate for Payer: Health Plan of Nevada (Sierra) Transplant	$203,000.00

Know your out-of-pocket cost for care.

All Charges