Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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: CHRONIC KIDNEY DISEASE

Facility

$17,849.93

Service Code	APR-DRG 4703
Min. Negotiated Rate	$14,256.46
Max. Negotiated Rate	$17,849.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,256.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,849.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,970.99

APR-DRG 41.00: CHRONIC KIDNEY DISEASE

Facility

$8,079.88

Service Code	APR-DRG 4701
Min. Negotiated Rate	$6,453.27
Max. Negotiated Rate	$8,079.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,453.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,079.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,229.37

APR-DRG 41.00: CHRONIC KIDNEY DISEASE

Facility

$10,388.10

Service Code	APR-DRG 4702
Min. Negotiated Rate	$8,296.81
Max. Negotiated Rate	$10,388.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,296.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,388.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,294.61

APR-DRG 41.00: CHRONIC KIDNEY DISEASE

Facility

$47,716.75

Service Code	APR-DRG 4704
Min. Negotiated Rate	$38,110.62
Max. Negotiated Rate	$47,716.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,110.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$47,716.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,693.94

APR-DRG 41.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$10,963.36

Service Code	APR-DRG 1401
Min. Negotiated Rate	$8,756.26
Max. Negotiated Rate	$10,963.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,756.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,963.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,809.32

APR-DRG 41.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$16,763.57

Service Code	APR-DRG 1403
Min. Negotiated Rate	$13,388.80
Max. Negotiated Rate	$16,763.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,388.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,763.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,998.98

APR-DRG 41.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$44,280.94

Service Code	APR-DRG 1404
Min. Negotiated Rate	$35,366.49
Max. Negotiated Rate	$44,280.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,366.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,280.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,619.79

APR-DRG 41.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$13,511.64

Service Code	APR-DRG 1402
Min. Negotiated Rate	$10,791.53
Max. Negotiated Rate	$13,511.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,791.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,511.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,089.36

APR-DRG 41.00: CLEFT LIP AND PALATE REPAIR

Facility

$64,226.93

Service Code	APR-DRG 0954
Min. Negotiated Rate	$51,297.04
Max. Negotiated Rate	$64,226.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$51,297.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$64,226.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$57,466.21

APR-DRG 41.00: CLEFT LIP AND PALATE REPAIR

Facility

$19,323.76

Service Code	APR-DRG 0952
Min. Negotiated Rate	$15,433.58
Max. Negotiated Rate	$19,323.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,433.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,323.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,289.68

APR-DRG 41.00: CLEFT LIP AND PALATE REPAIR

Facility

$27,567.67

Service Code	APR-DRG 0953
Min. Negotiated Rate	$22,017.86
Max. Negotiated Rate	$27,567.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,017.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,567.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,665.81

APR-DRG 41.00: CLEFT LIP AND PALATE REPAIR

Facility

$17,215.24

Service Code	APR-DRG 0951
Min. Negotiated Rate	$13,749.54
Max. Negotiated Rate	$17,215.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,749.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,215.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,403.10

APR-DRG 41.00: COAGULATION AND PLATELET DISORDERS

Facility

$14,638.42

Service Code	APR-DRG 6611
Min. Negotiated Rate	$11,691.47
Max. Negotiated Rate	$14,638.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,691.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,638.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,097.53

APR-DRG 41.00: COAGULATION AND PLATELET DISORDERS

Facility

$19,276.20

Service Code	APR-DRG 6612
Min. Negotiated Rate	$15,395.60
Max. Negotiated Rate	$19,276.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,395.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,276.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,247.13

APR-DRG 41.00: COAGULATION AND PLATELET DISORDERS

Facility

$67,531.62

Service Code	APR-DRG 6614
Min. Negotiated Rate	$53,936.44
Max. Negotiated Rate	$67,531.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,936.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$67,531.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,423.03

APR-DRG 41.00: COAGULATION AND PLATELET DISORDERS

Facility

$24,527.31

Service Code	APR-DRG 6613
Min. Negotiated Rate	$19,589.57
Max. Negotiated Rate	$24,527.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,589.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,527.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,945.49

APR-DRG 41.00: COCAINE ABUSE AND DEPENDENCE

Facility

$6,547.59

Service Code	APR-DRG 7742
Min. Negotiated Rate	$5,229.46
Max. Negotiated Rate	$6,547.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,229.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,547.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$5,858.37

APR-DRG 41.00: COCAINE ABUSE AND DEPENDENCE

Facility

$5,360.93

Service Code	APR-DRG 7741
Min. Negotiated Rate	$4,281.69
Max. Negotiated Rate	$5,360.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$4,281.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,360.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$4,796.62

APR-DRG 41.00: COCAINE ABUSE AND DEPENDENCE

Facility

$11,851.46

Service Code	APR-DRG 7743
Min. Negotiated Rate	$9,465.57
Max. Negotiated Rate	$11,851.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,465.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,851.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,603.94

APR-DRG 41.00: COCAINE ABUSE AND DEPENDENCE

Facility

$28,748.16

Service Code	APR-DRG 7744
Min. Negotiated Rate	$22,960.70
Max. Negotiated Rate	$28,748.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,960.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,748.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,722.04

APR-DRG 41.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$16,825.37

Service Code	APR-DRG 0572
Min. Negotiated Rate	$13,438.16
Max. Negotiated Rate	$16,825.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,438.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,825.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,054.28

APR-DRG 41.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$24,593.87

Service Code	APR-DRG 0573
Min. Negotiated Rate	$19,642.73
Max. Negotiated Rate	$24,593.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,642.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,593.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,005.04

APR-DRG 41.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$54,083.21

Service Code	APR-DRG 0574
Min. Negotiated Rate	$43,195.41
Max. Negotiated Rate	$54,083.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$43,195.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$54,083.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,390.25

APR-DRG 41.00: CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$11,136.89

Service Code	APR-DRG 0571
Min. Negotiated Rate	$8,894.86
Max. Negotiated Rate	$11,136.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,894.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,136.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,964.58

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All Charges