Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$101,515.18

Service Code	APR-DRG 3234
Min. Negotiated Rate	$81,078.57
Max. Negotiated Rate	$101,515.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,078.57
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$101,515.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$90,829.37

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$55,897.70

Service Code	APR-DRG 3233
Min. Negotiated Rate	$44,644.61
Max. Negotiated Rate	$55,897.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$44,644.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$55,897.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,013.73

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$66,505.13

Service Code	APR-DRG 3253
Min. Negotiated Rate	$53,116.60
Max. Negotiated Rate	$66,505.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,116.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$66,505.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,504.59

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$54,695.83

Service Code	APR-DRG 3252
Min. Negotiated Rate	$43,684.70
Max. Negotiated Rate	$54,695.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$43,684.70
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$54,695.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,938.38

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$45,336.49

Service Code	APR-DRG 3251
Min. Negotiated Rate	$36,209.54
Max. Negotiated Rate	$45,336.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,209.54
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$45,336.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,564.23

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$111,240.19

Service Code	APR-DRG 3254
Min. Negotiated Rate	$88,845.79
Max. Negotiated Rate	$111,240.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$88,845.79
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$111,240.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$99,530.70

NON-EXTENSIVE BURNS

Facility

$115,803.95

Service Code	MSDRG 935
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$115,803.95
Rate for Payer: Aetna of CA HMO/PPO	$62,450.96
Rate for Payer: EPIC Health Plan Commercial	$115,803.95
Rate for Payer: EPIC Health Plan Senior	$77,202.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,184.21
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$98,257.89
Rate for Payer: Molina Healthcare of CA Medicare	$94,046.84
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

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$91,092.25

Service Code	APR-DRG 7944
Min. Negotiated Rate	$72,753.94
Max. Negotiated Rate	$91,092.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$72,753.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$91,092.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$81,503.59

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$18,123.17

Service Code	APR-DRG 7941
Min. Negotiated Rate	$14,474.69
Max. Negotiated Rate	$18,123.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,474.69
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$18,123.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,215.47

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$35,028.17

Service Code	APR-DRG 7943
Min. Negotiated Rate	$27,976.45
Max. Negotiated Rate	$35,028.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,976.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$35,028.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,341.00

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$23,931.30

Service Code	APR-DRG 7942
Min. Negotiated Rate	$19,113.55
Max. Negotiated Rate	$23,931.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,113.55
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,931.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,412.21

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$108,415.02

Service Code	MSDRG 988
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$108,415.02
Rate for Payer: Aetna of CA HMO/PPO	$49,827.38
Rate for Payer: EPIC Health Plan Commercial	$108,415.02
Rate for Payer: EPIC Health Plan Senior	$72,276.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$65,706.07
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$91,988.50
Rate for Payer: Molina Healthcare of CA Medicare	$88,046.13
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

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$140,085.97

Service Code	MSDRG 987
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$140,085.97
Rate for Payer: Aetna of CA HMO/PPO	$103,935.37
Rate for Payer: EPIC Health Plan Commercial	$140,085.97
Rate for Payer: EPIC Health Plan Senior	$93,390.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$84,900.59
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$118,860.83
Rate for Payer: Molina Healthcare of CA Medicare	$113,766.79
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

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$100,529.20

Service Code	MSDRG 989
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$100,529.20
Rate for Payer: EPIC Health Plan Senior	$67,019.47
Rate for Payer: Aetna of CA HMO/PPO	$36,354.95
Rate for Payer: EPIC Health Plan Commercial	$100,529.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,926.79
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$85,297.51
Rate for Payer: Molina Healthcare of CA Medicare	$81,641.90
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

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$28,428.79

Service Code	APR-DRG 9522
Min. Negotiated Rate	$22,705.62
Max. Negotiated Rate	$28,428.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,705.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$28,428.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,436.28

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$19,406.62

Service Code	APR-DRG 9521
Min. Negotiated Rate	$15,499.76
Max. Negotiated Rate	$19,406.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,499.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$19,406.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,363.82

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$43,900.77

Service Code	APR-DRG 9523
Min. Negotiated Rate	$35,062.85
Max. Negotiated Rate	$43,900.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,062.85
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$43,900.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,279.64

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$100,679.78

Service Code	APR-DRG 9524
Min. Negotiated Rate	$80,411.35
Max. Negotiated Rate	$100,679.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$80,411.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$100,679.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$90,081.91

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$10,267.54

Service Code	APR-DRG 4261
Min. Negotiated Rate	$8,200.52
Max. Negotiated Rate	$10,267.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,200.52
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,267.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,186.75

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$20,227.80

Service Code	APR-DRG 4263
Min. Negotiated Rate	$16,155.62
Max. Negotiated Rate	$20,227.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,155.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,227.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,098.56

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$13,584.91

Service Code	APR-DRG 4262
Min. Negotiated Rate	$10,850.05
Max. Negotiated Rate	$13,584.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,850.05
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,584.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,154.92

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$46,133.01

Service Code	APR-DRG 4264
Min. Negotiated Rate	$36,845.70
Max. Negotiated Rate	$46,133.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,845.70
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$46,133.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,276.90

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility

$97,732.65

Service Code	MSDRG 600
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$97,732.65
Rate for Payer: Aetna of CA HMO/PPO	$31,577.15
Rate for Payer: EPIC Health Plan Commercial	$97,732.65
Rate for Payer: EPIC Health Plan Senior	$65,155.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,231.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$82,924.67
Rate for Payer: Molina Healthcare of CA Medicare	$79,370.76
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

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$89,985.23

Service Code	MSDRG 601
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$89,985.23
Rate for Payer: Aetna of CA HMO/PPO	$18,341.18
Rate for Payer: EPIC Health Plan Commercial	$89,985.23
Rate for Payer: EPIC Health Plan Senior	$59,990.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$54,536.50
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$76,351.10
Rate for Payer: Molina Healthcare of CA Medicare	$73,078.91
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

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$14,142.33

Service Code	APR-DRG 0461
Min. Negotiated Rate	$11,295.25
Max. Negotiated Rate	$14,142.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,295.25
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,142.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,653.66

Know your out-of-pocket cost for care.

All Charges