Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$31,871.24

Service Code	APR-DRG 6111
Min. Negotiated Rate	$17,587.13
Max. Negotiated Rate	$31,871.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,587.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,020.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,871.24

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$72,772.56

Service Code	APR-DRG 6112
Min. Negotiated Rate	$40,157.22
Max. Negotiated Rate	$72,772.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,157.22
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$50,279.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$72,772.56

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$124,285.45

Service Code	APR-DRG 6113
Min. Negotiated Rate	$68,582.97
Max. Negotiated Rate	$124,285.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$68,582.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$85,869.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$124,285.45

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$176,805.58

Service Code	APR-DRG 6144
Min. Negotiated Rate	$97,564.54
Max. Negotiated Rate	$176,805.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$97,564.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$122,156.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$176,805.58

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$59,391.45

Service Code	APR-DRG 6142
Min. Negotiated Rate	$32,773.28
Max. Negotiated Rate	$59,391.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,773.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$41,034.09
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,391.45

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$114,490.15

Service Code	APR-DRG 6143
Min. Negotiated Rate	$63,177.74
Max. Negotiated Rate	$114,490.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$63,177.74
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$79,102.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$114,490.15

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$23,967.21

Service Code	APR-DRG 6141
Min. Negotiated Rate	$13,225.54
Max. Negotiated Rate	$23,967.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,225.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,559.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,967.21

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$64,161.57

Service Code	APR-DRG 6121
Min. Negotiated Rate	$35,405.52
Max. Negotiated Rate	$64,161.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,405.52
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$44,329.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$64,161.57

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$95,442.46

Service Code	APR-DRG 6122
Min. Negotiated Rate	$52,666.89
Max. Negotiated Rate	$95,442.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,666.89
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$65,942.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$95,442.46

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$144,969.33

Service Code	APR-DRG 6123
Min. Negotiated Rate	$79,996.71
Max. Negotiated Rate	$144,969.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$79,996.71
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$100,160.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$144,969.33

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$268,181.98

Service Code	APR-DRG 6124
Min. Negotiated Rate	$147,987.69
Max. Negotiated Rate	$268,181.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$147,987.69
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$185,289.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$268,181.98

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$221,874.29

Service Code	APR-DRG 6093
Min. Negotiated Rate	$122,434.27
Max. Negotiated Rate	$221,874.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$122,434.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$153,294.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$221,874.29

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$924,813.86

Service Code	APR-DRG 6094
Min. Negotiated Rate	$510,329.10
Max. Negotiated Rate	$924,813.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$510,329.10
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$638,962.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$924,813.86

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$142,075.92

Service Code	APR-DRG 6092
Min. Negotiated Rate	$78,400.07
Max. Negotiated Rate	$142,075.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$78,400.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$98,161.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$142,075.92

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$114,358.94

Service Code	APR-DRG 6091
Min. Negotiated Rate	$63,105.34
Max. Negotiated Rate	$114,358.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$63,105.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$79,011.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$114,358.94

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$1,315,138.85

Service Code	APR-DRG 5884
Min. Negotiated Rate	$725,717.53
Max. Negotiated Rate	$1,315,138.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$725,717.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$908,641.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$1,315,138.85

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$426,639.57

Service Code	APR-DRG 5881
Min. Negotiated Rate	$235,427.47
Max. Negotiated Rate	$426,639.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$235,427.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$294,769.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$426,639.57

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$665,105.40

Service Code	APR-DRG 5883
Min. Negotiated Rate	$367,017.25
Max. Negotiated Rate	$665,105.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$367,017.25
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$459,527.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$665,105.40

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$641,455.24

Service Code	APR-DRG 5882
Min. Negotiated Rate	$353,966.66
Max. Negotiated Rate	$641,455.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$353,966.66
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$443,187.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$641,455.24

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$19,109.64

Service Code	APR-DRG 6263
Min. Negotiated Rate	$10,545.05
Max. Negotiated Rate	$19,109.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,545.05
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,203.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,109.64

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$77,499.68

Service Code	APR-DRG 6264
Min. Negotiated Rate	$42,765.73
Max. Negotiated Rate	$77,499.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,765.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$53,545.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$77,499.68

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$5,942.20

Service Code	APR-DRG 6262
Min. Negotiated Rate	$3,279.01
Max. Negotiated Rate	$5,942.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,279.01
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$4,105.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$5,942.20

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$3,591.61

Service Code	APR-DRG 6261
Min. Negotiated Rate	$1,981.92
Max. Negotiated Rate	$3,591.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1,981.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$2,481.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$3,591.61

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$150,554.14

Service Code	APR-DRG 6234
Min. Negotiated Rate	$83,078.51
Max. Negotiated Rate	$150,554.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$83,078.51
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$104,019.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$150,554.14

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$89,050.72

Service Code	APR-DRG 6233
Min. Negotiated Rate	$49,139.81
Max. Negotiated Rate	$89,050.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,139.81
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$61,525.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$89,050.72

Know your out-of-pocket cost for care.

All Charges