Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$25,245.21

Service Code	APR-DRG 1922
Min. Negotiated Rate	$20,162.95
Max. Negotiated Rate	$25,245.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,162.95
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,245.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,587.81

APR-DRG 41.00: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$20,379.19

Service Code	APR-DRG 1921
Min. Negotiated Rate	$16,276.54
Max. Negotiated Rate	$20,379.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,276.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,379.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,234.01

APR-DRG 41.00: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$35,735.50

Service Code	APR-DRG 1923
Min. Negotiated Rate	$28,541.38
Max. Negotiated Rate	$35,735.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,541.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,735.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,973.87

APR-DRG 41.00: CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$94,212.15

Service Code	APR-DRG 1774
Min. Negotiated Rate	$75,245.75
Max. Negotiated Rate	$94,212.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,245.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$94,212.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,295.08

APR-DRG 41.00: CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$24,432.21

Service Code	APR-DRG 1771
Min. Negotiated Rate	$19,513.62
Max. Negotiated Rate	$24,432.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,513.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,432.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,860.40

APR-DRG 41.00: CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$35,069.92

Service Code	APR-DRG 1772
Min. Negotiated Rate	$28,009.79
Max. Negotiated Rate	$35,069.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,009.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,069.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,378.35

APR-DRG 41.00: CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$48,303.43

Service Code	APR-DRG 1773
Min. Negotiated Rate	$38,579.19
Max. Negotiated Rate	$48,303.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,579.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,303.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,218.86

APR-DRG 41.00: CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$19,333.26

Service Code	APR-DRG 2003
Min. Negotiated Rate	$15,441.17
Max. Negotiated Rate	$19,333.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,441.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,333.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,298.18

APR-DRG 41.00: CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$13,195.48

Service Code	APR-DRG 2002
Min. Negotiated Rate	$10,539.02
Max. Negotiated Rate	$13,195.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,539.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,195.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,806.48

APR-DRG 41.00: CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$48,029.59

Service Code	APR-DRG 2004
Min. Negotiated Rate	$38,360.47
Max. Negotiated Rate	$48,029.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,360.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,029.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,973.84

APR-DRG 41.00: CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$9,351.67

Service Code	APR-DRG 2001
Min. Negotiated Rate	$7,469.03
Max. Negotiated Rate	$9,351.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,469.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,351.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,367.28

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$104,406.25

Service Code	APR-DRG 1622
Min. Negotiated Rate	$83,387.63
Max. Negotiated Rate	$104,406.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$83,387.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$104,406.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$93,416.12

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$133,628.41

Service Code	APR-DRG 1623
Min. Negotiated Rate	$106,726.90
Max. Negotiated Rate	$133,628.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$106,726.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$133,628.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$119,562.26

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$90,661.65

Service Code	APR-DRG 1621
Min. Negotiated Rate	$72,410.03
Max. Negotiated Rate	$90,661.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$72,410.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$90,661.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$81,118.32

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$276,213.39

Service Code	APR-DRG 1624
Min. Negotiated Rate	$220,607.28
Max. Negotiated Rate	$276,213.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$220,607.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$276,213.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$247,138.30

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$87,687.85

Service Code	APR-DRG 1632
Min. Negotiated Rate	$70,034.90
Max. Negotiated Rate	$87,687.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$70,034.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,687.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$78,457.55

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$78,488.34

Service Code	APR-DRG 1631
Min. Negotiated Rate	$62,687.39
Max. Negotiated Rate	$78,488.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$62,687.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$78,488.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$70,226.40

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$109,961.63

Service Code	APR-DRG 1633
Min. Negotiated Rate	$87,824.61
Max. Negotiated Rate	$109,961.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$87,824.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,961.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$98,386.72

APR-DRG 41.00: CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS

Facility

$233,698.29

Service Code	APR-DRG 1634
Min. Negotiated Rate	$186,651.13
Max. Negotiated Rate	$233,698.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$186,651.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$233,698.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$209,098.47

APR-DRG 41.00: CARDIOMYOPATHY

Facility

$9,967.34

Service Code	APR-DRG 2051
Min. Negotiated Rate	$7,960.76
Max. Negotiated Rate	$9,967.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,960.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,967.34
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,918.15

APR-DRG 41.00: CARDIOMYOPATHY

Facility

$12,479.98

Service Code	APR-DRG 2052
Min. Negotiated Rate	$9,967.56
Max. Negotiated Rate	$12,479.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,967.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,479.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,166.30

APR-DRG 41.00: CARDIOMYOPATHY

Facility

$55,081.61

Service Code	APR-DRG 2054
Min. Negotiated Rate	$43,992.81
Max. Negotiated Rate	$55,081.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$43,992.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$55,081.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,283.54

APR-DRG 41.00: CARDIOMYOPATHY

Facility

$18,548.81

Service Code	APR-DRG 2053
Min. Negotiated Rate	$14,814.64
Max. Negotiated Rate	$18,548.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,814.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,548.81
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,596.30

APR-DRG 41.00: CELLULITIS AND OTHER SKIN INFECTIONS

Facility

$12,299.31

Service Code	APR-DRG 3832
Min. Negotiated Rate	$9,823.26
Max. Negotiated Rate	$12,299.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,823.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,299.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,004.64

APR-DRG 41.00: CELLULITIS AND OTHER SKIN INFECTIONS

Facility

$49,750.15

Service Code	APR-DRG 3834
Min. Negotiated Rate	$39,734.66
Max. Negotiated Rate	$49,750.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,734.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,750.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,513.29

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