Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

OTHER DISORDERS OF THE LIVER

Facility

$11,412.29

Service Code	APR-DRG 2831
Min. Negotiated Rate	$9,114.82
Max. Negotiated Rate	$11,412.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,114.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,412.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,211.00

OTHER DISORDERS OF THE LIVER

Facility

$56,178.78

Service Code	APR-DRG 2834
Min. Negotiated Rate	$44,869.11
Max. Negotiated Rate	$56,178.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$44,869.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$56,178.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,265.23

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$23,777.51

Service Code	APR-DRG 7764
Min. Negotiated Rate	$18,990.72
Max. Negotiated Rate	$23,777.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,990.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,777.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,274.62

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$7,033.55

Service Code	APR-DRG 7762
Min. Negotiated Rate	$5,617.59
Max. Negotiated Rate	$7,033.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,617.59
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,033.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,293.18

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$12,665.23

Service Code	APR-DRG 7763
Min. Negotiated Rate	$10,115.52
Max. Negotiated Rate	$12,665.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,115.52
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,665.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,332.05

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$5,383.94

Service Code	APR-DRG 7761
Min. Negotiated Rate	$4,300.06
Max. Negotiated Rate	$5,383.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$4,300.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$5,383.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$4,817.20

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$95,512.74

Service Code	MSDRG 155
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$95,512.74
Rate for Payer: Aetna of CA HMO/PPO	$27,784.61
Rate for Payer: EPIC Health Plan Commercial	$95,512.74
Rate for Payer: EPIC Health Plan Senior	$63,675.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$57,886.51
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$81,041.11
Rate for Payer: Molina Healthcare of CA Medicare	$77,567.92
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 EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$106,993.64

Service Code	MSDRG 154
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$106,993.64
Rate for Payer: Aetna of CA HMO/PPO	$47,399.07
Rate for Payer: EPIC Health Plan Commercial	$106,993.64
Rate for Payer: EPIC Health Plan Senior	$71,329.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,844.63
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$90,782.48
Rate for Payer: Molina Healthcare of CA Medicare	$86,891.80
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 EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$91,513.08

Service Code	MSDRG 156
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$91,513.08
Rate for Payer: Aetna of CA HMO/PPO	$20,951.39
Rate for Payer: EPIC Health Plan Commercial	$91,513.08
Rate for Payer: EPIC Health Plan Senior	$61,008.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$55,462.47
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$77,647.46
Rate for Payer: Molina Healthcare of CA Medicare	$74,319.71
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 EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$109,999.63

Service Code	MSDRG 144
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$109,999.63
Rate for Payer: Aetna of CA HMO/PPO	$52,534.60
Rate for Payer: EPIC Health Plan Commercial	$109,999.63
Rate for Payer: EPIC Health Plan Senior	$73,333.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$66,666.44
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$93,333.02
Rate for Payer: Molina Healthcare of CA Medicare	$89,333.03
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 EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$145,732.37

Service Code	MSDRG 143
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$145,732.37
Rate for Payer: Aetna of CA HMO/PPO	$113,581.93
Rate for Payer: EPIC Health Plan Commercial	$145,732.37
Rate for Payer: EPIC Health Plan Senior	$97,154.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$88,322.65
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$123,651.71
Rate for Payer: Molina Healthcare of CA Medicare	$118,352.35
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 EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$100,584.23

Service Code	MSDRG 145
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$100,584.23
Rate for Payer: Aetna of CA HMO/PPO	$36,448.93
Rate for Payer: EPIC Health Plan Commercial	$100,584.23
Rate for Payer: EPIC Health Plan Senior	$67,056.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,960.14
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$85,344.20
Rate for Payer: Molina Healthcare of CA Medicare	$81,686.59
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 EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$13,971.02

Service Code	APR-DRG 1152
Min. Negotiated Rate	$11,158.44
Max. Negotiated Rate	$13,971.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,158.44
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,971.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,500.39

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$21,119.70

Service Code	APR-DRG 1153
Min. Negotiated Rate	$16,867.97
Max. Negotiated Rate	$21,119.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,867.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,119.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,896.57

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$50,433.30

Service Code	APR-DRG 1154
Min. Negotiated Rate	$40,280.28
Max. Negotiated Rate	$50,433.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,280.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$50,433.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,124.53

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES

Facility

$9,734.57

Service Code	APR-DRG 1151
Min. Negotiated Rate	$7,774.85
Max. Negotiated Rate	$9,734.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,774.85
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,734.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,709.88

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$45,937.42

Service Code	APR-DRG 0983
Min. Negotiated Rate	$36,689.49
Max. Negotiated Rate	$45,937.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,689.49
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$45,937.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,101.90

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$29,358.72

Service Code	APR-DRG 0982
Min. Negotiated Rate	$23,448.35
Max. Negotiated Rate	$29,358.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,448.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$29,358.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,268.33

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$101,772.49

Service Code	APR-DRG 0984
Min. Negotiated Rate	$81,284.08
Max. Negotiated Rate	$101,772.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,284.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$101,772.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$91,059.60

OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES

Facility

$17,989.94

Service Code	APR-DRG 0981
Min. Negotiated Rate	$14,368.28
Max. Negotiated Rate	$17,989.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,368.28
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,989.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,096.26

OTHER ENDOCRINE DISORDERS

Facility

$51,177.05

Service Code	APR-DRG 4244
Min. Negotiated Rate	$40,874.30
Max. Negotiated Rate	$51,177.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,874.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$51,177.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,789.99

OTHER ENDOCRINE DISORDERS

Facility

$10,667.25

Service Code	APR-DRG 4241
Min. Negotiated Rate	$8,519.76
Max. Negotiated Rate	$10,667.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,519.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,667.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,544.38

OTHER ENDOCRINE DISORDERS

Facility

$23,248.78

Service Code	APR-DRG 4243
Min. Negotiated Rate	$18,568.43
Max. Negotiated Rate	$23,248.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,568.43
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,248.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,801.54

OTHER ENDOCRINE DISORDERS

Facility

$15,341.47

Service Code	APR-DRG 4242
Min. Negotiated Rate	$12,252.99
Max. Negotiated Rate	$15,341.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,252.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,341.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,726.58

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$117,912.04

Service Code	MSDRG 629
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$117,912.04
Rate for Payer: Aetna of CA HMO/PPO	$66,052.50
Rate for Payer: EPIC Health Plan Commercial	$117,912.04
Rate for Payer: EPIC Health Plan Senior	$78,608.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$71,461.84
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$100,046.58
Rate for Payer: Molina Healthcare of CA Medicare	$95,758.87
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

Know your out-of-pocket cost for care.

All Charges