Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$30,794.44

Service Code	APR-DRG 2201
Min. Negotiated Rate	$24,595.03
Max. Negotiated Rate	$30,794.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,595.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,794.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,552.92

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

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$151,779.30

Service Code	APR-DRG 2204
Min. Negotiated Rate	$121,223.73
Max. Negotiated Rate	$151,779.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$121,223.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$151,779.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$135,802.53

MAJOR THUMB OR JOINT PROCEDURES

Facility

$103,190.93

Service Code	MSDRG 506
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$103,190.93
Rate for Payer: Aetna of CA HMO/PPO	$36,367.07
Rate for Payer: EPIC Health Plan Commercial	$103,190.93
Rate for Payer: EPIC Health Plan Senior	$68,793.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$62,539.96
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$87,555.94
Rate for Payer: Molina Healthcare of CA Medicare	$83,803.55
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

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$47,306.77

Service Code	APR-DRG 5014
Min. Negotiated Rate	$37,783.17
Max. Negotiated Rate	$47,306.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,783.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$47,306.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,327.11

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$10,060.88

Service Code	APR-DRG 5011
Min. Negotiated Rate	$8,035.47
Max. Negotiated Rate	$10,060.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,035.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,060.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,001.84

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$19,874.32

Service Code	APR-DRG 5013
Min. Negotiated Rate	$15,873.31
Max. Negotiated Rate	$19,874.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,873.31
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,874.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,782.29

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$13,315.71

Service Code	APR-DRG 5012
Min. Negotiated Rate	$10,635.05
Max. Negotiated Rate	$13,315.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,635.05
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,315.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,914.06

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$22,490.15

Service Code	APR-DRG 2523
Min. Negotiated Rate	$17,962.53
Max. Negotiated Rate	$22,490.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,962.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,490.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,122.76

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$15,624.27

Service Code	APR-DRG 2522
Min. Negotiated Rate	$12,478.86
Max. Negotiated Rate	$15,624.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,478.86
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,624.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,979.61

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$12,287.87

Service Code	APR-DRG 2521
Min. Negotiated Rate	$9,814.13
Max. Negotiated Rate	$12,287.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,814.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,287.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,994.41

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$52,382.54

Service Code	APR-DRG 2524
Min. Negotiated Rate	$41,837.11
Max. Negotiated Rate	$52,382.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,837.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$52,382.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,868.59

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$57,010.64

Service Code	APR-DRG 2064
Min. Negotiated Rate	$45,533.50
Max. Negotiated Rate	$57,010.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$45,533.50
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$57,010.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$51,009.52

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$23,583.24

Service Code	APR-DRG 2063
Min. Negotiated Rate	$18,835.56
Max. Negotiated Rate	$23,583.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,835.56
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,583.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,100.79

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$15,529.10

Service Code	APR-DRG 2062
Min. Negotiated Rate	$12,402.85
Max. Negotiated Rate	$15,529.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,402.85
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,529.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,894.46

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$12,255.25

Service Code	APR-DRG 2061
Min. Negotiated Rate	$9,788.07
Max. Negotiated Rate	$12,255.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,788.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,255.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,965.22

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$14,813.96

Service Code	APR-DRG 4662
Min. Negotiated Rate	$11,831.67
Max. Negotiated Rate	$14,813.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,831.67
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,813.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,254.59

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$11,357.92

Service Code	APR-DRG 4661
Min. Negotiated Rate	$9,071.39
Max. Negotiated Rate	$11,357.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,071.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,357.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,162.34

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$22,049.63

Service Code	APR-DRG 4663
Min. Negotiated Rate	$17,610.69
Max. Negotiated Rate	$22,049.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,610.69
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,049.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,728.62

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$49,259.53

Service Code	APR-DRG 4664
Min. Negotiated Rate	$39,342.81
Max. Negotiated Rate	$49,259.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,342.81
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,259.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,074.32

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$23,871.47

Service Code	APR-DRG 3493
Min. Negotiated Rate	$19,065.76
Max. Negotiated Rate	$23,871.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,065.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,871.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,358.68

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$16,510.72

Service Code	APR-DRG 3492
Min. Negotiated Rate	$13,186.85
Max. Negotiated Rate	$16,510.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,186.85
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,510.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,772.75

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$52,082.93

Service Code	APR-DRG 3494
Min. Negotiated Rate	$41,597.82
Max. Negotiated Rate	$52,082.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,597.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$52,082.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,600.52

MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$11,801.15

Service Code	APR-DRG 3491
Min. Negotiated Rate	$9,425.39
Max. Negotiated Rate	$11,801.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,425.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,801.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,558.92

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$98,552.44

Service Code	MSDRG 755
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$98,552.44
Rate for Payer: Aetna of CA HMO/PPO	$32,977.74
Rate for Payer: EPIC Health Plan Commercial	$98,552.44
Rate for Payer: EPIC Health Plan Senior	$65,701.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,728.75
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$83,620.25
Rate for Payer: Molina Healthcare of CA Medicare	$80,036.52
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

Know your out-of-pocket cost for care.

All Charges