Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

NEONATAL AFTERCARE

Facility

$87,242.13

Service Code	APR-DRG 8633
Min. Negotiated Rate	$69,678.91
Max. Negotiated Rate	$87,242.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$69,678.91
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$87,242.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$78,058.75

NEONATAL AFTERCARE

Facility

$43,539.24

Service Code	APR-DRG 8632
Min. Negotiated Rate	$34,774.10
Max. Negotiated Rate	$43,539.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$34,774.10
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$43,539.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,956.16

NEONATAL AFTERCARE

Facility

$241,232.28

Service Code	APR-DRG 8634
Min. Negotiated Rate	$192,668.42
Max. Negotiated Rate	$241,232.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$192,668.42
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$241,232.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$215,839.41

NEONATAL AFTERCARE

Facility

$18,804.98

Service Code	APR-DRG 8631
Min. Negotiated Rate	$15,019.24
Max. Negotiated Rate	$18,804.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,019.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$18,804.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,825.51

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$116,075.33

Service Code	APR-DRG 6032
Min. Negotiated Rate	$64,052.48
Max. Negotiated Rate	$116,075.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$64,052.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$80,197.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$116,075.33

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$134,915.27

Service Code	APR-DRG 6033
Min. Negotiated Rate	$74,448.70
Max. Negotiated Rate	$134,915.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$74,448.70
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$93,214.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$134,915.27

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$7,787.42

Service Code	APR-DRG 6031
Min. Negotiated Rate	$4,297.24
Max. Negotiated Rate	$7,787.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$4,297.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$5,380.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,787.42

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$421,954.58

Service Code	APR-DRG 6034
Min. Negotiated Rate	$232,842.21
Max. Negotiated Rate	$421,954.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$232,842.21
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$291,532.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$421,954.58

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$136,194.36

Service Code	APR-DRG 6021
Min. Negotiated Rate	$75,154.52
Max. Negotiated Rate	$136,194.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,154.52
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$94,097.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$136,194.36

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$317,710.30

Service Code	APR-DRG 6023
Min. Negotiated Rate	$175,318.32
Max. Negotiated Rate	$317,710.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$175,318.32
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$219,508.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$317,710.30

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$232,263.60

Service Code	APR-DRG 6022
Min. Negotiated Rate	$128,167.28
Max. Negotiated Rate	$232,263.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$128,167.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$160,473.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$232,263.60

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$583,404.83

Service Code	APR-DRG 6024
Min. Negotiated Rate	$321,933.39
Max. Negotiated Rate	$583,404.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$321,933.39
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$403,079.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$583,404.83

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$43,244.46

Service Code	APR-DRG 6081
Min. Negotiated Rate	$23,863.08
Max. Negotiated Rate	$43,244.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,863.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,877.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,244.46

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$212,656.48

Service Code	APR-DRG 6084
Min. Negotiated Rate	$117,347.71
Max. Negotiated Rate	$212,656.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$117,347.71
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$146,926.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$212,656.48

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$166,137.87

Service Code	APR-DRG 6083
Min. Negotiated Rate	$91,677.90
Max. Negotiated Rate	$166,137.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$91,677.90
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$114,786.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$166,137.87

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$100,216.21

Service Code	APR-DRG 6082
Min. Negotiated Rate	$55,301.13
Max. Negotiated Rate	$100,216.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,301.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$69,240.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$100,216.21

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$101,436.99

Service Code	APR-DRG 6071
Min. Negotiated Rate	$55,974.78
Max. Negotiated Rate	$101,436.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,974.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$70,083.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$101,436.99

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$238,258.13

Service Code	APR-DRG 6073
Min. Negotiated Rate	$131,475.17
Max. Negotiated Rate	$238,258.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$131,475.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$164,614.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$238,258.13

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$162,286.08

Service Code	APR-DRG 6072
Min. Negotiated Rate	$89,552.41
Max. Negotiated Rate	$162,286.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$89,552.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$112,124.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$162,286.08

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$434,264.02

Service Code	APR-DRG 6074
Min. Negotiated Rate	$239,634.78
Max. Negotiated Rate	$434,264.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$239,634.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$300,036.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$434,264.02

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$73,924.10

Service Code	APR-DRG 6132
Min. Negotiated Rate	$40,792.66
Max. Negotiated Rate	$73,924.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,792.66
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$51,074.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$73,924.10

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$45,795.34

Service Code	APR-DRG 6131
Min. Negotiated Rate	$25,270.70
Max. Negotiated Rate	$45,795.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,270.70
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$31,640.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,795.34

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$134,561.82

Service Code	APR-DRG 6133
Min. Negotiated Rate	$74,253.66
Max. Negotiated Rate	$134,561.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$74,253.66
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$92,969.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$134,561.82

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$233,571.83

Service Code	APR-DRG 6134
Min. Negotiated Rate	$128,889.18
Max. Negotiated Rate	$233,571.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$128,889.18
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$161,376.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$233,571.83

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$365,948.63

Service Code	APR-DRG 6114
Min. Negotiated Rate	$201,937.11
Max. Negotiated Rate	$365,948.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$201,937.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$252,837.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$365,948.63

Know your out-of-pocket cost for care.

All Charges