Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$17,455.32

Service Code	APR-DRG 2402
Min. Negotiated Rate	$13,941.29
Max. Negotiated Rate	$17,455.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,941.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,455.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,617.92

APR-DRG 41.00: DIGESTIVE MALIGNANCY

Facility

$23,324.48

Service Code	APR-DRG 2403
Min. Negotiated Rate	$18,628.89
Max. Negotiated Rate	$23,324.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,628.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,324.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,869.27

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$14,531.45

Service Code	APR-DRG 5171
Min. Negotiated Rate	$11,606.04
Max. Negotiated Rate	$14,531.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,606.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,531.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,001.82

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$71,655.00

Service Code	APR-DRG 5174
Min. Negotiated Rate	$57,229.72
Max. Negotiated Rate	$71,655.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$57,229.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$71,655.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$64,112.37

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$17,964.03

Service Code	APR-DRG 5172
Min. Negotiated Rate	$14,347.58
Max. Negotiated Rate	$17,964.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,347.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,964.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,073.08

APR-DRG 41.00: DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$28,970.17

Service Code	APR-DRG 5173
Min. Negotiated Rate	$23,138.02
Max. Negotiated Rate	$28,970.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,138.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,970.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,920.68

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$13,342.86

Service Code	APR-DRG 2841
Min. Negotiated Rate	$10,656.73
Max. Negotiated Rate	$13,342.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,656.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,342.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,938.35

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$17,384.01

Service Code	APR-DRG 2842
Min. Negotiated Rate	$13,884.34
Max. Negotiated Rate	$17,384.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,884.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,384.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,554.12

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$58,030.20

Service Code	APR-DRG 2844
Min. Negotiated Rate	$46,347.80
Max. Negotiated Rate	$58,030.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$46,347.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$58,030.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$51,921.76

APR-DRG 41.00: DISORDERS OF GALLBLADDER AND BILIARY TRACT

Facility

$24,349.01

Service Code	APR-DRG 2843
Min. Negotiated Rate	$19,447.17
Max. Negotiated Rate	$24,349.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,447.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,349.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,785.96

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$21,800.73

Service Code	APR-DRG 2823
Min. Negotiated Rate	$17,411.90
Max. Negotiated Rate	$21,800.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,411.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,800.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,505.92

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$10,908.68

Service Code	APR-DRG 2821
Min. Negotiated Rate	$8,712.59
Max. Negotiated Rate	$10,908.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,712.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,908.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,760.40

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$66,719.60

Service Code	APR-DRG 2824
Min. Negotiated Rate	$53,287.89
Max. Negotiated Rate	$66,719.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,287.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$66,719.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,696.49

APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$14,110.69

Service Code	APR-DRG 2822
Min. Negotiated Rate	$11,269.99
Max. Negotiated Rate	$14,110.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,269.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,110.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,625.36

APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL

Facility

$4,661.10

Service Code	APR-DRG 7521
Min. Negotiated Rate	$3,722.75
Max. Negotiated Rate	$4,661.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,722.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,661.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$4,170.46

APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL

Facility

$16,430.78

Service Code	APR-DRG 7523
Min. Negotiated Rate	$13,123.01
Max. Negotiated Rate	$16,430.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,123.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,430.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,701.23

APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL

Facility

$59,966.62

Service Code	APR-DRG 7524
Min. Negotiated Rate	$47,894.39
Max. Negotiated Rate	$59,966.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,894.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$59,966.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$53,654.35

APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL

Facility

$6,608.45

Service Code	APR-DRG 7522
Min. Negotiated Rate	$5,278.06
Max. Negotiated Rate	$6,608.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,278.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,608.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$5,912.82

APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS

Facility

$21,275.38

Service Code	APR-DRG 2443
Min. Negotiated Rate	$16,992.31
Max. Negotiated Rate	$21,275.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,992.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,275.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,035.87

APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS

Facility

$52,226.19

Service Code	APR-DRG 2444
Min. Negotiated Rate	$41,712.24
Max. Negotiated Rate	$52,226.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,712.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,226.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,728.70

APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS

Facility

$14,063.15

Service Code	APR-DRG 2442
Min. Negotiated Rate	$11,232.02
Max. Negotiated Rate	$14,063.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,232.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,063.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,582.82

APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS

Facility

$10,742.28

Service Code	APR-DRG 2441
Min. Negotiated Rate	$8,579.69
Max. Negotiated Rate	$10,742.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,579.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,742.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,611.51

APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK

Facility

$94,705.16

Service Code	APR-DRG 3043
Min. Negotiated Rate	$75,639.51
Max. Negotiated Rate	$94,705.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,639.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$94,705.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,736.19

APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK

Facility

$68,104.99

Service Code	APR-DRG 3042
Min. Negotiated Rate	$54,394.38
Max. Negotiated Rate	$68,104.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$54,394.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$68,104.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,936.04

APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK

Facility

$57,560.01

Service Code	APR-DRG 3041
Min. Negotiated Rate	$45,972.27
Max. Negotiated Rate	$57,560.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$45,972.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$57,560.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$51,501.06

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All Charges