Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$21,548.76

Service Code	APR-DRG 2463
Min. Negotiated Rate	$17,210.65
Max. Negotiated Rate	$21,548.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,210.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,548.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,280.47

APR-DRG 41.00: GENDER RELATED PROCEDURES

Facility

$139,697.71

Service Code	APR-DRG 8514
Min. Negotiated Rate	$111,574.35
Max. Negotiated Rate	$139,697.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$111,574.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$139,697.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$124,992.69

APR-DRG 41.00: GENDER RELATED PROCEDURES

Facility

$45,374.79

Service Code	APR-DRG 8513
Min. Negotiated Rate	$36,240.13
Max. Negotiated Rate	$45,374.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,240.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,374.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,598.50

APR-DRG 41.00: GENDER RELATED PROCEDURES

Facility

$30,832.42

Service Code	APR-DRG 8512
Min. Negotiated Rate	$24,625.37
Max. Negotiated Rate	$30,832.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,625.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,832.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,586.90

APR-DRG 41.00: GENDER RELATED PROCEDURES

Facility

$26,774.17

Service Code	APR-DRG 8511
Min. Negotiated Rate	$21,384.11
Max. Negotiated Rate	$26,774.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,384.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,774.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,955.84

APR-DRG 41.00: HAND AND WRIST PROCEDURES

Facility

$35,050.90

Service Code	APR-DRG 3163
Min. Negotiated Rate	$27,994.60
Max. Negotiated Rate	$35,050.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,994.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,050.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,361.33

APR-DRG 41.00: HAND AND WRIST PROCEDURES

Facility

$22,794.38

Service Code	APR-DRG 3162
Min. Negotiated Rate	$18,205.51
Max. Negotiated Rate	$22,794.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,205.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,794.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,394.97

APR-DRG 41.00: HAND AND WRIST PROCEDURES

Facility

$17,082.10

Service Code	APR-DRG 3161
Min. Negotiated Rate	$13,643.21
Max. Negotiated Rate	$17,082.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,643.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,082.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,283.99

APR-DRG 41.00: HAND AND WRIST PROCEDURES

Facility

$90,697.77

Service Code	APR-DRG 3164
Min. Negotiated Rate	$72,438.88
Max. Negotiated Rate	$90,697.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$72,438.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$90,697.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$81,150.64

APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$69,624.93

Service Code	APR-DRG 0554
Min. Negotiated Rate	$55,608.33
Max. Negotiated Rate	$69,624.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,608.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,624.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,295.99

APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$27,669.89

Service Code	APR-DRG 0553
Min. Negotiated Rate	$22,099.50
Max. Negotiated Rate	$27,669.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,099.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,669.89
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,757.27

APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$12,815.14

Service Code	APR-DRG 0551
Min. Negotiated Rate	$10,235.25
Max. Negotiated Rate	$12,815.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,235.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,815.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,466.18

APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$18,330.10

Service Code	APR-DRG 0552
Min. Negotiated Rate	$14,639.96
Max. Negotiated Rate	$18,330.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,639.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,330.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,400.61

APR-DRG 41.00: HEART AND/OR LUNG TRANSPLANT

Facility

$223,282.15

Service Code	APR-DRG 0022
Min. Negotiated Rate	$117,516.92
Max. Negotiated Rate	$223,282.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$178,331.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$117,516.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$223,282.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$199,778.76

APR-DRG 41.00: HEART AND/OR LUNG TRANSPLANT

Facility

$183,560.18

Service Code	APR-DRG 0021
Min. Negotiated Rate	$96,610.62
Max. Negotiated Rate	$183,560.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$146,606.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$96,610.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$183,560.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$164,238.05

APR-DRG 41.00: HEART AND/OR LUNG TRANSPLANT

Facility

$310,230.71

Service Code	APR-DRG 0023
Min. Negotiated Rate	$163,279.32
Max. Negotiated Rate	$310,230.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$247,776.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$163,279.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$310,230.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$277,574.84

APR-DRG 41.00: HEART AND/OR LUNG TRANSPLANT

Facility

$686,235.39

Service Code	APR-DRG 0024
Min. Negotiated Rate	$361,176.52
Max. Negotiated Rate	$686,235.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$548,085.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$361,176.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$686,235.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$614,000.08

APR-DRG 41.00: HEART FAILURE

Facility

$10,583.02

Service Code	APR-DRG 1941
Min. Negotiated Rate	$8,452.49
Max. Negotiated Rate	$10,583.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,452.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,583.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,469.02

APR-DRG 41.00: HEART FAILURE

Facility

$13,834.94

Service Code	APR-DRG 1942
Min. Negotiated Rate	$11,049.75
Max. Negotiated Rate	$13,834.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,049.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,834.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,378.64

APR-DRG 41.00: HEART FAILURE

Facility

$19,677.94

Service Code	APR-DRG 1943
Min. Negotiated Rate	$15,716.46
Max. Negotiated Rate	$19,677.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,716.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,677.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,606.58

APR-DRG 41.00: HEART FAILURE

Facility

$48,695.19

Service Code	APR-DRG 1944
Min. Negotiated Rate	$38,892.08
Max. Negotiated Rate	$48,695.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,892.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,695.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,569.39

APR-DRG 41.00: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$12,983.92

Service Code	APR-DRG 8102
Min. Negotiated Rate	$10,370.05
Max. Negotiated Rate	$12,983.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,370.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,983.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,617.19

APR-DRG 41.00: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$57,560.96

Service Code	APR-DRG 8104
Min. Negotiated Rate	$45,973.03
Max. Negotiated Rate	$57,560.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$45,973.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$57,560.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$51,501.91

APR-DRG 41.00: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$20,414.85

Service Code	APR-DRG 8103
Min. Negotiated Rate	$16,305.02
Max. Negotiated Rate	$20,414.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,305.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,414.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,265.92

APR-DRG 41.00: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$9,441.99

Service Code	APR-DRG 8101
Min. Negotiated Rate	$7,541.17
Max. Negotiated Rate	$9,441.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,541.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,441.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,448.10

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All Charges