Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$23,534.29

Service Code	APR-DRG 2533
Min. Negotiated Rate	$18,796.47
Max. Negotiated Rate	$23,534.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,796.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,534.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,057.00

OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$50,859.81

Service Code	APR-DRG 2534
Min. Negotiated Rate	$40,620.93
Max. Negotiated Rate	$50,859.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,620.93
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$50,859.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,506.14

OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$16,486.24

Service Code	APR-DRG 2532
Min. Negotiated Rate	$13,167.30
Max. Negotiated Rate	$16,486.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,167.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$16,486.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,750.85

OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$10,574.79

Service Code	APR-DRG 6631
Min. Negotiated Rate	$8,445.92
Max. Negotiated Rate	$10,574.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,445.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,574.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,461.66

OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$15,047.81

Service Code	APR-DRG 6632
Min. Negotiated Rate	$12,018.45
Max. Negotiated Rate	$15,047.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,018.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,047.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,463.83

OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$20,959.26

Service Code	APR-DRG 6633
Min. Negotiated Rate	$16,739.83
Max. Negotiated Rate	$20,959.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,739.83
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,959.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,753.02

OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$46,552.47

Service Code	APR-DRG 6634
Min. Negotiated Rate	$37,180.72
Max. Negotiated Rate	$46,552.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,180.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$46,552.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,652.21

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC

Facility

$99,819.42

Service Code	MSDRG 818
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$99,819.42
Rate for Payer: Aetna of CA HMO/PPO	$31,959.13
Rate for Payer: EPIC Health Plan Commercial	$99,819.42
Rate for Payer: EPIC Health Plan Senior	$66,546.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,496.62
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$84,695.27
Rate for Payer: Molina Healthcare of CA Medicare	$81,065.47
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

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC

Facility

$119,736.21

Service Code	MSDRG 817
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$119,736.21
Rate for Payer: Aetna of CA HMO/PPO	$51,173.41
Rate for Payer: EPIC Health Plan Commercial	$119,736.21
Rate for Payer: EPIC Health Plan Senior	$79,824.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$72,567.40
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$101,594.36
Rate for Payer: Molina Healthcare of CA Medicare	$97,240.32
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

OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$94,508.37

Service Code	MSDRG 819
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$94,508.37
Rate for Payer: Aetna of CA HMO/PPO	$26,068.73
Rate for Payer: EPIC Health Plan Commercial	$94,508.37
Rate for Payer: EPIC Health Plan Senior	$63,005.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$57,277.80
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$80,188.92
Rate for Payer: Molina Healthcare of CA Medicare	$76,752.25
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

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC

Facility

$92,054.29

Service Code	MSDRG 832
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$92,054.29
Rate for Payer: Aetna of CA HMO/PPO	$21,876.03
Rate for Payer: EPIC Health Plan Commercial	$92,054.29
Rate for Payer: EPIC Health Plan Senior	$61,369.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$55,790.48
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$78,106.67
Rate for Payer: Molina Healthcare of CA Medicare	$74,759.24
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

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC

Facility

$100,587.76

Service Code	MSDRG 831
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$100,587.76
Rate for Payer: Aetna of CA HMO/PPO	$36,454.99
Rate for Payer: EPIC Health Plan Commercial	$100,587.76
Rate for Payer: EPIC Health Plan Senior	$67,058.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,962.28
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$85,347.19
Rate for Payer: Molina Healthcare of CA Medicare	$81,689.46
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

OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$88,528.37

Service Code	MSDRG 833
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$88,528.37
Rate for Payer: Aetna of CA HMO/PPO	$15,852.24
Rate for Payer: EPIC Health Plan Commercial	$88,528.37
Rate for Payer: EPIC Health Plan Senior	$59,018.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$53,653.56
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$75,114.98
Rate for Payer: Molina Healthcare of CA Medicare	$71,895.77
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

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$24,545.83

Service Code	APR-DRG 3473
Min. Negotiated Rate	$19,604.37
Max. Negotiated Rate	$24,545.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,604.37
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,545.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,962.06

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$12,807.24

Service Code	APR-DRG 3471
Min. Negotiated Rate	$10,228.94
Max. Negotiated Rate	$12,807.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,228.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,807.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,459.10

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$52,957.08

Service Code	APR-DRG 3474
Min. Negotiated Rate	$42,295.99
Max. Negotiated Rate	$52,957.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,295.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$52,957.08
Rate for Payer: Molina Healthcare of CA Medi-Cal	$47,382.65

OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES

Facility

$17,038.23

Service Code	APR-DRG 3472
Min. Negotiated Rate	$13,608.17
Max. Negotiated Rate	$17,038.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,608.17
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,038.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,244.73

OTHER BLADDER PROCEDURES

Facility

$29,187.42

Service Code	APR-DRG 4452
Min. Negotiated Rate	$23,311.53
Max. Negotiated Rate	$29,187.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,311.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,187.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,115.06

OTHER BLADDER PROCEDURES

Facility

$80,077.15

Service Code	APR-DRG 4454
Min. Negotiated Rate	$63,956.36
Max. Negotiated Rate	$80,077.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$63,956.36
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$80,077.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$71,647.98

OTHER BLADDER PROCEDURES

Facility

$21,984.39

Service Code	APR-DRG 4451
Min. Negotiated Rate	$17,558.58
Max. Negotiated Rate	$21,984.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,558.58
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,984.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,670.24

OTHER BLADDER PROCEDURES

Facility

$40,800.94

Service Code	APR-DRG 4453
Min. Negotiated Rate	$32,587.07
Max. Negotiated Rate	$40,800.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,587.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$40,800.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,506.11

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$65,567.02

Service Code	APR-DRG 1672
Min. Negotiated Rate	$52,367.35
Max. Negotiated Rate	$65,567.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,367.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$65,567.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$58,665.23

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$86,015.07

Service Code	APR-DRG 1673
Min. Negotiated Rate	$68,698.88
Max. Negotiated Rate	$86,015.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$68,698.88
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$86,015.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$76,960.85

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$179,646.61

Service Code	APR-DRG 1674
Min. Negotiated Rate	$143,480.91
Max. Negotiated Rate	$179,646.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$143,480.91
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$179,646.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$160,736.45

OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES

Facility

$51,237.07

Service Code	APR-DRG 1671
Min. Negotiated Rate	$40,922.24
Max. Negotiated Rate	$51,237.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,922.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$51,237.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,843.70

Know your out-of-pocket cost for care.

All Charges