Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$23,795.94

Service Code	APR-DRG 6231
Min. Negotiated Rate	$13,131.03
Max. Negotiated Rate	$23,795.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,131.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,440.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,795.94

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

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$250,555.06

Service Code	APR-DRG 6214
Min. Negotiated Rate	$138,260.84
Max. Negotiated Rate	$250,555.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$138,260.84
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$173,110.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$250,555.06

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$36,156.70

Service Code	APR-DRG 6212
Min. Negotiated Rate	$19,951.92
Max. Negotiated Rate	$36,156.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,951.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,980.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,156.70

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$84,834.50

Service Code	APR-DRG 6213
Min. Negotiated Rate	$46,813.22
Max. Negotiated Rate	$84,834.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$46,813.22
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$58,612.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,834.50

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$9,580.31

Service Code	APR-DRG 6211
Min. Negotiated Rate	$5,286.59
Max. Negotiated Rate	$9,580.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,286.59
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$6,619.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,580.31

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$38,066.21

Service Code	APR-DRG 6252
Min. Negotiated Rate	$21,005.63
Max. Negotiated Rate	$38,066.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,005.63
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$26,300.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,066.21

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$25,206.20

Service Code	APR-DRG 6251
Min. Negotiated Rate	$13,909.24
Max. Negotiated Rate	$25,206.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,909.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,415.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,206.20

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$76,926.82

Service Code	APR-DRG 6253
Min. Negotiated Rate	$42,449.62
Max. Negotiated Rate	$76,926.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,449.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$53,149.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$76,926.82

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$143,011.74

Service Code	APR-DRG 6254
Min. Negotiated Rate	$78,916.48
Max. Negotiated Rate	$143,011.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$78,916.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$98,808.11
Rate for Payer: Molina Healthcare of CA Medi-Cal	$143,011.74

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$156,627.24

Service Code	APR-DRG 6224
Min. Negotiated Rate	$86,429.76
Max. Negotiated Rate	$156,627.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$86,429.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$108,215.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$156,627.24

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$56,909.82

Service Code	APR-DRG 6222
Min. Negotiated Rate	$31,403.87
Max. Negotiated Rate	$56,909.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$31,403.87
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$39,319.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$56,909.82

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$86,576.38

Service Code	APR-DRG 6223
Min. Negotiated Rate	$47,774.42
Max. Negotiated Rate	$86,576.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,774.42
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$59,816.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$86,576.38

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$37,326.46

Service Code	APR-DRG 6221
Min. Negotiated Rate	$20,597.42
Max. Negotiated Rate	$37,326.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,597.42
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,789.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,326.46

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

Facility

$3,700.65

Service Code	APR-DRG 6402
Min. Negotiated Rate	$2,042.08
Max. Negotiated Rate	$3,700.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,042.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$2,556.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$3,700.65

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

Facility

$6,917.07

Service Code	APR-DRG 6403
Min. Negotiated Rate	$3,816.97
Max. Negotiated Rate	$6,917.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,816.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$4,779.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,917.07

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

Facility

$2,696.93

Service Code	APR-DRG 6401
Min. Negotiated Rate	$1,488.21
Max. Negotiated Rate	$2,696.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1,488.21
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$1,863.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$2,696.93

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

Facility

$72,186.87

Service Code	APR-DRG 6404
Min. Negotiated Rate	$39,834.03
Max. Negotiated Rate	$72,186.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,834.03
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,874.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$72,186.87

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$61,224.43

Service Code	APR-DRG 6363
Min. Negotiated Rate	$33,784.76
Max. Negotiated Rate	$61,224.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,784.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$42,300.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$61,224.43

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$96,488.62

Service Code	APR-DRG 6364
Min. Negotiated Rate	$53,244.17
Max. Negotiated Rate	$96,488.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,244.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$66,664.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$96,488.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$14,984.50

Service Code	APR-DRG 6361
Min. Negotiated Rate	$8,268.72
Max. Negotiated Rate	$14,984.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,268.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,352.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,984.50

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$23,653.82

Service Code	APR-DRG 6362
Min. Negotiated Rate	$13,052.61
Max. Negotiated Rate	$23,653.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,052.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,342.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,653.82

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$60,517.46

Service Code	APR-DRG 6333
Min. Negotiated Rate	$33,394.64
Max. Negotiated Rate	$60,517.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,394.64
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$41,812.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,517.46

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$5,203.77

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,871.53
Max. Negotiated Rate	$5,203.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,871.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$3,595.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$5,203.77

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$262,528.67

Service Code	APR-DRG 6334
Min. Negotiated Rate	$144,868.09
Max. Negotiated Rate	$262,528.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$144,868.09
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$181,383.44
Rate for Payer: Molina Healthcare of CA Medi-Cal	$262,528.67

Know your out-of-pocket cost for care.

All Charges