Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES

Facility

$69,186.22

Service Code	APR-DRG 2603
Min. Negotiated Rate	$55,257.94
Max. Negotiated Rate	$69,186.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,257.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$69,186.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$61,903.46

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$149,597.41

Service Code	APR-DRG 1204
Min. Negotiated Rate	$119,481.09
Max. Negotiated Rate	$149,597.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$119,481.09
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$149,597.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$133,850.32

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$41,061.98

Service Code	APR-DRG 1201
Min. Negotiated Rate	$32,795.56
Max. Negotiated Rate	$41,061.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,795.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$41,061.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,739.67

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$71,013.49

Service Code	APR-DRG 1203
Min. Negotiated Rate	$56,717.35
Max. Negotiated Rate	$71,013.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$56,717.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$71,013.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$63,538.38

MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$49,820.39

Service Code	APR-DRG 1202
Min. Negotiated Rate	$39,790.76
Max. Negotiated Rate	$49,820.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,790.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,820.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,576.14

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$20,505.16

Service Code	APR-DRG 1373
Min. Negotiated Rate	$16,377.15
Max. Negotiated Rate	$20,505.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,377.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,505.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,346.72

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$49,428.73

Service Code	APR-DRG 1374
Min. Negotiated Rate	$39,477.94
Max. Negotiated Rate	$49,428.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,477.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,428.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,225.70

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$13,032.92

Service Code	APR-DRG 1371
Min. Negotiated Rate	$10,409.19
Max. Negotiated Rate	$13,032.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,409.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,032.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,661.03

MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$14,427.84

Service Code	APR-DRG 1372
Min. Negotiated Rate	$11,523.29
Max. Negotiated Rate	$14,427.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,523.29
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,427.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,909.12

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC

Facility

$111,303.85

Service Code	MSDRG 507
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$111,303.85
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: Aetna of CA HMO/PPO	$54,762.82
Rate for Payer: EPIC Health Plan Commercial	$111,303.85
Rate for Payer: EPIC Health Plan Senior	$74,202.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$67,456.88
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$94,439.63
Rate for Payer: Molina Healthcare of CA Medicare	$90,392.22
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

Facility

$106,122.36

Service Code	MSDRG 508
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$106,122.36
Rate for Payer: Aetna of CA HMO/PPO	$45,910.55
Rate for Payer: EPIC Health Plan Commercial	$106,122.36
Rate for Payer: EPIC Health Plan Senior	$70,748.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,316.58
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$90,043.21
Rate for Payer: Molina Healthcare of CA Medicare	$86,184.22
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

MAJOR SKIN DISORDERS

Facility

$61,751.54

Service Code	APR-DRG 3814
Min. Negotiated Rate	$49,319.98
Max. Negotiated Rate	$61,751.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,319.98
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$61,751.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,251.38

MAJOR SKIN DISORDERS

Facility

$23,719.20

Service Code	APR-DRG 3813
Min. Negotiated Rate	$18,944.15
Max. Negotiated Rate	$23,719.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,944.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,719.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,222.44

MAJOR SKIN DISORDERS

Facility

$8,358.69

Service Code	APR-DRG 3811
Min. Negotiated Rate	$6,675.95
Max. Negotiated Rate	$8,358.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,675.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,358.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,478.83

MAJOR SKIN DISORDERS

Facility

$14,283.73

Service Code	APR-DRG 3812
Min. Negotiated Rate	$11,408.19
Max. Negotiated Rate	$14,283.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,408.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,283.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,780.17

MAJOR SKIN DISORDERS WITH MCC

Facility

$116,881.05

Service Code	MSDRG 595
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$116,881.05
Rate for Payer: Aetna of CA HMO/PPO	$64,291.14
Rate for Payer: EPIC Health Plan Commercial	$116,881.05
Rate for Payer: EPIC Health Plan Senior	$77,920.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,837.00
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$99,171.80
Rate for Payer: Molina Healthcare of CA Medicare	$94,921.58
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

MAJOR SKIN DISORDERS WITHOUT MCC

Facility

$98,458.39

Service Code	MSDRG 596
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$98,458.39
Rate for Payer: Aetna of CA HMO/PPO	$32,817.07
Rate for Payer: EPIC Health Plan Commercial	$98,458.39
Rate for Payer: EPIC Health Plan Senior	$65,638.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,671.75
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$83,540.45
Rate for Payer: Molina Healthcare of CA Medicare	$79,960.15
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

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$121,787.51

Service Code	MSDRG 330
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$121,787.51
Rate for Payer: Aetna of CA HMO/PPO	$72,673.52
Rate for Payer: EPIC Health Plan Commercial	$121,787.51
Rate for Payer: EPIC Health Plan Senior	$81,191.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$73,810.61
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$103,334.85
Rate for Payer: Molina Healthcare of CA Medicare	$98,906.22
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$160,813.72

Service Code	MSDRG 329
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$160,813.72
Rate for Payer: Aetna of CA HMO/PPO	$139,347.49
Rate for Payer: EPIC Health Plan Commercial	$160,813.72
Rate for Payer: EPIC Health Plan Senior	$107,209.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$97,462.86
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$136,448.00
Rate for Payer: Molina Healthcare of CA Medicare	$130,600.23
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$109,112.37

Service Code	MSDRG 331
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$109,112.37
Rate for Payer: Aetna of CA HMO/PPO	$51,018.80
Rate for Payer: EPIC Health Plan Commercial	$109,112.37
Rate for Payer: EPIC Health Plan Senior	$72,741.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$66,128.71
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$92,580.19
Rate for Payer: Molina Healthcare of CA Medicare	$88,612.47
Rate for Payer: United Healthcare All Other Commercial	$12,844.00
Rate for Payer: United Healthcare All Other HMO	$10,823.00
Rate for Payer: United Healthcare HMO Rider	$8,307.00
Rate for Payer: United Healthcare Select/Navigate/Core	$7,611.00

MAJOR SMALL BOWEL PROCEDURES

Facility

$129,812.52

Service Code	APR-DRG 2304
Min. Negotiated Rate	$103,679.21
Max. Negotiated Rate	$129,812.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$103,679.21
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$129,812.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$116,148.05

MAJOR SMALL BOWEL PROCEDURES

Facility

$41,831.50

Service Code	APR-DRG 2302
Min. Negotiated Rate	$33,410.16
Max. Negotiated Rate	$41,831.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,410.16
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$41,831.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,428.19

MAJOR SMALL BOWEL PROCEDURES

Facility

$61,504.60

Service Code	APR-DRG 2303
Min. Negotiated Rate	$49,122.75
Max. Negotiated Rate	$61,504.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,122.75
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$61,504.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,030.43

MAJOR SMALL BOWEL PROCEDURES

Facility

$25,791.21

Service Code	APR-DRG 2301
Min. Negotiated Rate	$20,599.03
Max. Negotiated Rate	$25,791.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,599.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,791.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,076.34

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$66,225.05

Service Code	APR-DRG 2203
Min. Negotiated Rate	$52,892.90
Max. Negotiated Rate	$66,225.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,892.90
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$66,225.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,253.99

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All Charges