Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$51,486.43

Service Code	APR-DRG 3133
Min. Negotiated Rate	$41,121.40
Max. Negotiated Rate	$51,486.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,121.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$51,486.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,066.80

APR-DRG 41.00: KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$115,361.54

Service Code	APR-DRG 3134
Min. Negotiated Rate	$92,137.44
Max. Negotiated Rate	$115,361.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$92,137.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$115,361.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$103,218.22

APR-DRG 41.00: KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$35,837.72

Service Code	APR-DRG 3132
Min. Negotiated Rate	$28,623.02
Max. Negotiated Rate	$35,837.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,623.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,837.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,065.33

APR-DRG 41.00: KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$27,793.49

Service Code	APR-DRG 3131
Min. Negotiated Rate	$22,198.22
Max. Negotiated Rate	$27,793.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,198.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,793.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,867.85

APR-DRG 41.00: LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT

Facility

$130,172.06

Service Code	APR-DRG 0011
Min. Negotiated Rate	$68,511.61
Max. Negotiated Rate	$130,172.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$103,966.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$68,511.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$130,172.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$116,469.74

APR-DRG 41.00: LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT

Facility

$146,046.58

Service Code	APR-DRG 0012
Min. Negotiated Rate	$76,866.62
Max. Negotiated Rate	$146,046.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$116,645.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$76,866.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$146,046.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$130,673.25

APR-DRG 41.00: LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT

Facility

$175,047.65

Service Code	APR-DRG 0013
Min. Negotiated Rate	$92,130.34
Max. Negotiated Rate	$175,047.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$139,807.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$92,130.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$175,047.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$156,621.58

APR-DRG 41.00: LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT

Facility

$430,705.45

Service Code	APR-DRG 0014
Min. Negotiated Rate	$226,687.08
Max. Negotiated Rate	$430,705.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$343,997.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant	$226,687.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$430,705.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$385,368.04

APR-DRG 41.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$44,100.65

Service Code	APR-DRG 1812
Min. Negotiated Rate	$35,222.50
Max. Negotiated Rate	$44,100.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,222.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,100.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,458.48

APR-DRG 41.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$144,115.38

Service Code	APR-DRG 1814
Min. Negotiated Rate	$115,102.68
Max. Negotiated Rate	$144,115.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$115,102.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$144,115.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$128,945.34

APR-DRG 41.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$66,840.35

Service Code	APR-DRG 1813
Min. Negotiated Rate	$53,384.33
Max. Negotiated Rate	$66,840.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,384.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$66,840.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,804.52

APR-DRG 41.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$31,974.87

Service Code	APR-DRG 1811
Min. Negotiated Rate	$25,537.83
Max. Negotiated Rate	$31,974.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,537.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,974.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,609.10

APR-DRG 41.00: LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$12,522.77

Service Code	APR-DRG 6941
Min. Negotiated Rate	$10,001.74
Max. Negotiated Rate	$12,522.77
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,001.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,522.77
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,204.58

APR-DRG 41.00: LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$23,692.92

Service Code	APR-DRG 6943
Min. Negotiated Rate	$18,923.16
Max. Negotiated Rate	$23,692.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,923.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,692.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,198.93

APR-DRG 41.00: LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$15,819.86

Service Code	APR-DRG 6942
Min. Negotiated Rate	$12,635.07
Max. Negotiated Rate	$15,819.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,635.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,819.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,154.61

APR-DRG 41.00: LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$59,284.86

Service Code	APR-DRG 6944
Min. Negotiated Rate	$47,349.88
Max. Negotiated Rate	$59,284.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,349.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$59,284.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$53,044.35

APR-DRG 41.00: LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$92,365.10

Service Code	APR-DRG 6914
Min. Negotiated Rate	$73,770.55
Max. Negotiated Rate	$92,365.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$73,770.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$92,365.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$82,642.46

APR-DRG 41.00: LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$17,578.93

Service Code	APR-DRG 6911
Min. Negotiated Rate	$14,040.02
Max. Negotiated Rate	$17,578.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,040.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,578.93
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,728.52

APR-DRG 41.00: LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$23,255.54

Service Code	APR-DRG 6912
Min. Negotiated Rate	$18,573.84
Max. Negotiated Rate	$23,255.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,573.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,255.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,807.59

APR-DRG 41.00: LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$34,390.06

Service Code	APR-DRG 6913
Min. Negotiated Rate	$27,466.80
Max. Negotiated Rate	$34,390.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,466.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$34,390.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,770.05

APR-DRG 41.00: MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$170,795.90

Service Code	APR-DRG 1694
Min. Negotiated Rate	$136,411.99
Max. Negotiated Rate	$170,795.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$136,411.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$170,795.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$152,817.39

APR-DRG 41.00: MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$77,706.26

Service Code	APR-DRG 1693
Min. Negotiated Rate	$62,062.76
Max. Negotiated Rate	$77,706.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$62,062.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$77,706.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$69,526.65

APR-DRG 41.00: MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$59,224.01

Service Code	APR-DRG 1691
Min. Negotiated Rate	$47,301.28
Max. Negotiated Rate	$59,224.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,301.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$59,224.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$52,989.90

APR-DRG 41.00: MAJOR ABDOMINAL VASCULAR PROCEDURES

Facility

$60,331.75

Service Code	APR-DRG 1692
Min. Negotiated Rate	$48,186.01
Max. Negotiated Rate	$60,331.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,186.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$60,331.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$53,981.04

APR-DRG 41.00: MAJOR BILIARY TRACT PROCEDURES

Facility

$38,721.20

Service Code	APR-DRG 2612
Min. Negotiated Rate	$30,926.01
Max. Negotiated Rate	$38,721.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$30,926.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,721.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,645.29

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