Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$147,895.98

Service Code	APR-DRG 0093
Min. Negotiated Rate	$118,122.18
Max. Negotiated Rate	$147,895.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$118,122.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$147,895.98
Rate for Payer: Molina Healthcare of CA Medi-Cal	$132,327.98

APR-DRG 41.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$82,030.26

Service Code	APR-DRG 0091
Min. Negotiated Rate	$65,516.27
Max. Negotiated Rate	$82,030.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$65,516.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$82,030.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$73,395.49

APR-DRG 41.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$86,349.53

Service Code	APR-DRG 0092
Min. Negotiated Rate	$68,966.00
Max. Negotiated Rate	$86,349.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$68,966.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$86,349.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$77,260.10

APR-DRG 41.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$13,770.76

Service Code	APR-DRG 0822
Min. Negotiated Rate	$10,998.49
Max. Negotiated Rate	$13,770.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,998.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,770.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,321.21

APR-DRG 41.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$20,065.42

Service Code	APR-DRG 0823
Min. Negotiated Rate	$16,025.94
Max. Negotiated Rate	$20,065.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,025.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,065.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,953.28

APR-DRG 41.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$11,255.75

Service Code	APR-DRG 0821
Min. Negotiated Rate	$8,989.79
Max. Negotiated Rate	$11,255.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,989.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,255.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,070.94

APR-DRG 41.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$51,593.87

Service Code	APR-DRG 0824
Min. Negotiated Rate	$41,207.21
Max. Negotiated Rate	$51,593.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,207.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$51,593.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,162.94

APR-DRG 41.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$34,097.67

Service Code	APR-DRG 0922
Min. Negotiated Rate	$27,233.27
Max. Negotiated Rate	$34,097.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,233.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$34,097.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,508.44

APR-DRG 41.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$26,657.23

Service Code	APR-DRG 0921
Min. Negotiated Rate	$21,290.71
Max. Negotiated Rate	$26,657.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,290.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,657.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,851.20

APR-DRG 41.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$133,708.76

Service Code	APR-DRG 0924
Min. Negotiated Rate	$106,791.07
Max. Negotiated Rate	$133,708.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$106,791.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$133,708.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$119,634.15

APR-DRG 41.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES

Facility

$53,219.36

Service Code	APR-DRG 0923
Min. Negotiated Rate	$42,505.46
Max. Negotiated Rate	$53,219.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,505.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$53,219.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$47,617.32

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$10,145.62

Service Code	APR-DRG 5311
Min. Negotiated Rate	$8,103.15
Max. Negotiated Rate	$10,145.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,103.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,145.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,077.66

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$49,061.27

Service Code	APR-DRG 5314
Min. Negotiated Rate	$39,184.46
Max. Negotiated Rate	$49,061.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,184.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,061.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,896.92

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$20,538.47

Service Code	APR-DRG 5313
Min. Negotiated Rate	$16,403.75
Max. Negotiated Rate	$20,538.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,403.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,538.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,376.52

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$13,285.83

Service Code	APR-DRG 5312
Min. Negotiated Rate	$10,611.18
Max. Negotiated Rate	$13,285.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,611.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,285.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,887.32

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$22,171.56

Service Code	APR-DRG 5303
Min. Negotiated Rate	$17,708.07
Max. Negotiated Rate	$22,171.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,708.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,171.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,837.71

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$14,830.96

Service Code	APR-DRG 5302
Min. Negotiated Rate	$11,845.26
Max. Negotiated Rate	$14,830.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,845.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,830.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,269.81

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$11,255.75

Service Code	APR-DRG 5301
Min. Negotiated Rate	$8,989.79
Max. Negotiated Rate	$11,255.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,989.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,255.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,070.94

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$49,400.72

Service Code	APR-DRG 5304
Min. Negotiated Rate	$39,455.58
Max. Negotiated Rate	$49,400.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,455.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,400.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,200.65

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$16,547.25

Service Code	APR-DRG 5141
Min. Negotiated Rate	$13,216.03
Max. Negotiated Rate	$16,547.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,216.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,547.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,805.44

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$24,693.71

Service Code	APR-DRG 5142
Min. Negotiated Rate	$19,722.48
Max. Negotiated Rate	$24,693.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,722.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,693.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,094.37

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$118,929.13

Service Code	APR-DRG 5144
Min. Negotiated Rate	$94,986.82
Max. Negotiated Rate	$118,929.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$94,986.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$118,929.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$106,410.28

APR-DRG 41.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$41,656.95

Service Code	APR-DRG 5143
Min. Negotiated Rate	$33,270.75
Max. Negotiated Rate	$41,656.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,270.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,656.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,272.01

APR-DRG 41.00: FEVER AND INFLAMMATORY CONDITIONS

Facility

$11,507.73

Service Code	APR-DRG 7222
Min. Negotiated Rate	$9,191.04
Max. Negotiated Rate	$11,507.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,191.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,507.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,296.39

APR-DRG 41.00: FEVER AND INFLAMMATORY CONDITIONS

Facility

$34,311.61

Service Code	APR-DRG 7224
Min. Negotiated Rate	$27,404.14
Max. Negotiated Rate	$34,311.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,404.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$34,311.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,699.86

Know your out-of-pocket cost for care.

All Charges