Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$152,943.90

Service Code	MSDRG 423
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$152,943.90
Rate for Payer: Aetna of CA HMO/PPO	$125,902.35
Rate for Payer: EPIC Health Plan Commercial	$152,943.90
Rate for Payer: EPIC Health Plan Senior	$101,962.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$92,693.27
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$129,770.58
Rate for Payer: Molina Healthcare of CA Medicare	$124,208.98
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 HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$105,872.20

Service Code	MSDRG 425
Min. Negotiated Rate	$7,611.00
Max. Negotiated Rate	$105,872.20
Rate for Payer: Aetna of CA HMO/PPO	$45,483.09
Rate for Payer: EPIC Health Plan Commercial	$105,872.20
Rate for Payer: EPIC Health Plan Senior	$70,581.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$64,164.97
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$89,830.96
Rate for Payer: Molina Healthcare of CA Medicare	$85,981.06
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 HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$119,477.72

Service Code	APR-DRG 2644
Min. Negotiated Rate	$95,424.97
Max. Negotiated Rate	$119,477.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$95,424.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$119,477.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$106,901.12

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$33,122.05

Service Code	APR-DRG 2642
Min. Negotiated Rate	$26,454.06
Max. Negotiated Rate	$33,122.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$26,454.06
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$33,122.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,635.52

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$49,306.46

Service Code	APR-DRG 2643
Min. Negotiated Rate	$39,380.29
Max. Negotiated Rate	$49,306.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,380.29
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$49,306.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,116.31

OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$25,402.35

Service Code	APR-DRG 2641
Min. Negotiated Rate	$20,288.46
Max. Negotiated Rate	$25,402.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,288.46
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$25,402.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,728.42

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$10,718.91

Service Code	APR-DRG 7241
Min. Negotiated Rate	$8,561.02
Max. Negotiated Rate	$10,718.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,561.02
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,718.91
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,590.60

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$60,436.78

Service Code	APR-DRG 7244
Min. Negotiated Rate	$48,269.90
Max. Negotiated Rate	$60,436.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,269.90
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$60,436.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$54,075.01

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$15,762.95

Service Code	APR-DRG 7242
Min. Negotiated Rate	$12,589.62
Max. Negotiated Rate	$15,762.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,589.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$15,762.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,103.69

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$24,801.42

Service Code	APR-DRG 7243
Min. Negotiated Rate	$19,808.50
Max. Negotiated Rate	$24,801.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,808.50
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,801.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,190.75

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$97,546.30

Service Code	MSDRG 868
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$97,546.30
Rate for Payer: Aetna of CA HMO/PPO	$31,258.83
Rate for Payer: EPIC Health Plan Commercial	$97,546.30
Rate for Payer: EPIC Health Plan Senior	$65,030.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$59,118.97
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$82,766.56
Rate for Payer: Molina Healthcare of CA Medicare	$79,219.42
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 INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$116,393.10

Service Code	MSDRG 867
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$116,393.10
Rate for Payer: Aetna of CA HMO/PPO	$63,457.45
Rate for Payer: EPIC Health Plan Commercial	$116,393.10
Rate for Payer: EPIC Health Plan Senior	$77,595.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,541.27
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$98,757.78
Rate for Payer: Molina Healthcare of CA Medicare	$94,525.30
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 INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$92,198.01

Service Code	MSDRG 869
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$92,198.01
Rate for Payer: Aetna of CA HMO/PPO	$22,121.59
Rate for Payer: EPIC Health Plan Commercial	$92,198.01
Rate for Payer: EPIC Health Plan Senior	$61,465.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$55,877.58
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$78,228.61
Rate for Payer: Molina Healthcare of CA Medicare	$74,875.96
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 INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$12,736.54

Service Code	APR-DRG 8152
Min. Negotiated Rate	$10,172.47
Max. Negotiated Rate	$12,736.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,172.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,736.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,395.85

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$21,220.30

Service Code	APR-DRG 8153
Min. Negotiated Rate	$16,948.32
Max. Negotiated Rate	$21,220.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,948.32
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$21,220.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,986.59

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$8,168.35

Service Code	APR-DRG 8151
Min. Negotiated Rate	$6,523.93
Max. Negotiated Rate	$8,168.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,523.93
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$8,168.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,308.52

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$58,699.04

Service Code	APR-DRG 8154
Min. Negotiated Rate	$46,881.99
Max. Negotiated Rate	$58,699.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$46,881.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$58,699.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$52,520.19

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$110,292.42

Service Code	MSDRG 922
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$110,292.42
Rate for Payer: Aetna of CA HMO/PPO	$53,034.81
Rate for Payer: EPIC Health Plan Commercial	$110,292.42
Rate for Payer: EPIC Health Plan Senior	$73,528.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$66,843.89
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$93,581.45
Rate for Payer: Molina Healthcare of CA Medicare	$89,570.81
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 INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$97,308.54

Service Code	MSDRG 923
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$97,308.54
Rate for Payer: Aetna of CA HMO/PPO	$30,852.59
Rate for Payer: EPIC Health Plan Commercial	$97,308.54
Rate for Payer: EPIC Health Plan Senior	$64,872.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$58,974.87
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$82,564.82
Rate for Payer: Molina Healthcare of CA Medicare	$79,026.33
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 KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$46,753.38

Service Code	APR-DRG 4684
Min. Negotiated Rate	$37,341.18
Max. Negotiated Rate	$46,753.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,341.18
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$46,753.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,831.97

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$20,586.73

Service Code	APR-DRG 4683
Min. Negotiated Rate	$16,442.29
Max. Negotiated Rate	$20,586.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,442.29
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,586.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,419.70

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$10,128.86

Service Code	APR-DRG 4681
Min. Negotiated Rate	$8,089.76
Max. Negotiated Rate	$10,128.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,089.76
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,128.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,062.67

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$13,565.87

Service Code	APR-DRG 4682
Min. Negotiated Rate	$10,834.84
Max. Negotiated Rate	$13,565.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,834.84
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,565.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,137.88

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$97,260.60

Service Code	MSDRG 699
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$97,260.60
Rate for Payer: Aetna of CA HMO/PPO	$30,770.74
Rate for Payer: EPIC Health Plan Commercial	$97,260.60
Rate for Payer: EPIC Health Plan Senior	$64,840.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$58,945.82
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$82,524.15
Rate for Payer: Molina Healthcare of CA Medicare	$78,987.40
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 KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$108,606.66

Service Code	MSDRG 698
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$108,606.66
Rate for Payer: Aetna of CA HMO/PPO	$50,154.79
Rate for Payer: EPIC Health Plan Commercial	$108,606.66
Rate for Payer: EPIC Health Plan Senior	$72,404.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$65,822.22
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$92,151.11
Rate for Payer: Molina Healthcare of CA Medicare	$88,201.77
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

Know your out-of-pocket cost for care.

All Charges