Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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

APR-DRG 41.00: CELLULITIS AND OTHER SKIN INFECTIONS

Facility

$18,527.41

Service Code	APR-DRG 3833
Min. Negotiated Rate	$14,797.55
Max. Negotiated Rate	$18,527.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,797.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,527.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,577.16

APR-DRG 41.00: CESAREAN SECTION WITHOUT STERILIZATION

Facility

$14,932.39

Service Code	APR-DRG 5401
Min. Negotiated Rate	$8,239.96
Max. Negotiated Rate	$14,932.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,239.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,316.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,932.39

APR-DRG 41.00: CESAREAN SECTION WITHOUT STERILIZATION

Facility

$18,305.18

Service Code	APR-DRG 5402
Min. Negotiated Rate	$10,101.13
Max. Negotiated Rate	$18,305.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,101.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,647.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,305.18

APR-DRG 41.00: CESAREAN SECTION WITHOUT STERILIZATION

Facility

$45,467.32

Service Code	APR-DRG 5404
Min. Negotiated Rate	$25,089.69
Max. Negotiated Rate	$45,467.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,089.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,413.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,467.32

APR-DRG 41.00: CESAREAN SECTION WITHOUT STERILIZATION

Facility

$23,259.31

Service Code	APR-DRG 5403
Min. Negotiated Rate	$12,834.91
Max. Negotiated Rate	$23,259.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,834.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,070.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,259.31

APR-DRG 41.00: CESAREAN SECTION WITH STERILIZATION

Facility

$17,701.23

Service Code	APR-DRG 5392
Min. Negotiated Rate	$9,767.86
Max. Negotiated Rate	$17,701.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,767.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,229.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,701.23

APR-DRG 41.00: CESAREAN SECTION WITH STERILIZATION

Facility

$60,024.61

Service Code	APR-DRG 5394
Min. Negotiated Rate	$33,122.67
Max. Negotiated Rate	$60,024.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,122.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,471.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,024.61

APR-DRG 41.00: CESAREAN SECTION WITH STERILIZATION

Facility

$25,036.14

Service Code	APR-DRG 5393
Min. Negotiated Rate	$13,815.40
Max. Negotiated Rate	$25,036.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,815.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,297.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,036.14

APR-DRG 41.00: CESAREAN SECTION WITH STERILIZATION

Facility

$15,300.01

Service Code	APR-DRG 5391
Min. Negotiated Rate	$8,442.82
Max. Negotiated Rate	$15,300.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,442.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,570.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,300.01

APR-DRG 41.00: CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$15,993.38

Service Code	APR-DRG 6952
Min. Negotiated Rate	$12,773.66
Max. Negotiated Rate	$15,993.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,773.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,993.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,309.87

APR-DRG 41.00: CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$12,368.24

Service Code	APR-DRG 6951
Min. Negotiated Rate	$9,878.32
Max. Negotiated Rate	$12,368.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,878.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,368.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,066.32

APR-DRG 41.00: CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$31,005.00

Service Code	APR-DRG 6953
Min. Negotiated Rate	$24,763.20
Max. Negotiated Rate	$31,005.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,763.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,005.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,741.31

APR-DRG 41.00: CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$137,509.33

Service Code	APR-DRG 6954
Min. Negotiated Rate	$109,826.53
Max. Negotiated Rate	$137,509.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$109,826.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,509.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$123,034.66

APR-DRG 41.00: CHEST PAIN

Facility

$33,106.87

Service Code	APR-DRG 2034
Min. Negotiated Rate	$26,441.94
Max. Negotiated Rate	$33,106.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$26,441.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,106.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,621.94

APR-DRG 41.00: CHEST PAIN

Facility

$14,676.45

Service Code	APR-DRG 2033
Min. Negotiated Rate	$11,721.85
Max. Negotiated Rate	$14,676.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,721.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,676.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,131.57

APR-DRG 41.00: CHEST PAIN

Facility

$9,831.83

Service Code	APR-DRG 2031
Min. Negotiated Rate	$7,852.53
Max. Negotiated Rate	$9,831.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,852.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,831.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,796.91

APR-DRG 41.00: CHEST PAIN

Facility

$11,664.61

Service Code	APR-DRG 2032
Min. Negotiated Rate	$9,316.34
Max. Negotiated Rate	$11,664.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,316.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,664.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,436.76

APR-DRG 41.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$533,061.21

Service Code	APR-DRG 0114
Min. Negotiated Rate	$425,747.57
Max. Negotiated Rate	$533,061.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$425,747.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$533,061.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$476,949.50

APR-DRG 41.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$73,037.56

Service Code	APR-DRG 0111
Min. Negotiated Rate	$58,333.94
Max. Negotiated Rate	$73,037.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$58,333.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$73,037.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$65,349.39

APR-DRG 41.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$146,139.28

Service Code	APR-DRG 0112
Min. Negotiated Rate	$116,719.13
Max. Negotiated Rate	$146,139.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$116,719.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$146,139.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$130,756.20

APR-DRG 41.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$204,593.10

Service Code	APR-DRG 0113
Min. Negotiated Rate	$163,405.28
Max. Negotiated Rate	$204,593.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$163,405.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$204,593.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$183,056.99

APR-DRG 41.00: CHOLECYSTECTOMY

Facility

$22,328.46

Service Code	APR-DRG 2631
Min. Negotiated Rate	$17,833.39
Max. Negotiated Rate	$22,328.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,833.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,328.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,978.09

APR-DRG 41.00: CHOLECYSTECTOMY

Facility

$93,460.01

Service Code	APR-DRG 2634
Min. Negotiated Rate	$74,645.04
Max. Negotiated Rate	$93,460.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$74,645.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$93,460.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$83,622.12

APR-DRG 41.00: CHOLECYSTECTOMY

Facility

$35,678.47

Service Code	APR-DRG 2633
Min. Negotiated Rate	$28,495.83
Max. Negotiated Rate	$35,678.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,495.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,678.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,922.84

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