Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: MAJOR ESOPHAGEAL DISORDERS

Facility

$21,194.56

Service Code	APR-DRG 2423
Min. Negotiated Rate	$16,927.76
Max. Negotiated Rate	$21,194.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,927.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,194.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,963.55

APR-DRG 41.00: MAJOR ESOPHAGEAL DISORDERS

Facility

$11,241.48

Service Code	APR-DRG 2421
Min. Negotiated Rate	$8,978.39
Max. Negotiated Rate	$11,241.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,978.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,241.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,058.17

APR-DRG 41.00: MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$21,059.07

Service Code	APR-DRG 2483
Min. Negotiated Rate	$16,819.55
Max. Negotiated Rate	$21,059.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,819.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,059.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,842.32

APR-DRG 41.00: MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$10,934.84

Service Code	APR-DRG 2481
Min. Negotiated Rate	$8,733.49
Max. Negotiated Rate	$10,934.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,733.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,934.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,783.81

APR-DRG 41.00: MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$52,845.19

Service Code	APR-DRG 2484
Min. Negotiated Rate	$42,206.62
Max. Negotiated Rate	$52,845.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,206.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,845.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$47,282.54

APR-DRG 41.00: MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS

Facility

$14,262.83

Service Code	APR-DRG 2482
Min. Negotiated Rate	$11,391.49
Max. Negotiated Rate	$14,262.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,391.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,262.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,761.48

APR-DRG 41.00: MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$66,935.92

Service Code	APR-DRG 6604
Min. Negotiated Rate	$53,460.66
Max. Negotiated Rate	$66,935.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,460.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$66,935.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,890.03

APR-DRG 41.00: MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$14,883.25

Service Code	APR-DRG 6602
Min. Negotiated Rate	$11,887.02
Max. Negotiated Rate	$14,883.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,887.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,883.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,316.59

APR-DRG 41.00: MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$22,715.92

Service Code	APR-DRG 6603
Min. Negotiated Rate	$18,142.85
Max. Negotiated Rate	$22,715.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,142.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,715.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,324.78

APR-DRG 41.00: MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION

Facility

$12,672.52

Service Code	APR-DRG 6601
Min. Negotiated Rate	$10,121.35
Max. Negotiated Rate	$12,672.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,121.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,672.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,338.58

APR-DRG 41.00: MAJOR LARGE BOWEL PROCEDURES

Facility

$31,333.05

Service Code	APR-DRG 2311
Min. Negotiated Rate	$25,025.21
Max. Negotiated Rate	$31,333.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,025.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,333.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,034.84

APR-DRG 41.00: MAJOR LARGE BOWEL PROCEDURES

Facility

$120,576.49

Service Code	APR-DRG 2314
Min. Negotiated Rate	$96,302.54
Max. Negotiated Rate	$120,576.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$96,302.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$120,576.49
Rate for Payer: Molina Healthcare of CA Medi-Cal	$107,884.23

APR-DRG 41.00: MAJOR LARGE BOWEL PROCEDURES

Facility

$53,713.80

Service Code	APR-DRG 2313
Min. Negotiated Rate	$42,900.36
Max. Negotiated Rate	$53,713.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,900.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$53,713.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,059.71

APR-DRG 41.00: MAJOR LARGE BOWEL PROCEDURES

Facility

$38,295.68

Service Code	APR-DRG 2312
Min. Negotiated Rate	$30,586.15
Max. Negotiated Rate	$38,295.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$30,586.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,295.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,264.55

APR-DRG 41.00: MAJOR MALE PELVIC PROCEDURES

Facility

$27,047.07

Service Code	APR-DRG 4801
Min. Negotiated Rate	$21,602.07
Max. Negotiated Rate	$27,047.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,602.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,047.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,200.01

APR-DRG 41.00: MAJOR MALE PELVIC PROCEDURES

Facility

$114,256.63

Service Code	APR-DRG 4804
Min. Negotiated Rate	$91,254.97
Max. Negotiated Rate	$114,256.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$91,254.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$114,256.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$102,229.62

APR-DRG 41.00: MAJOR MALE PELVIC PROCEDURES

Facility

$47,654.47

Service Code	APR-DRG 4803
Min. Negotiated Rate	$38,060.87
Max. Negotiated Rate	$47,654.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,060.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$47,654.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,638.21

APR-DRG 41.00: MAJOR MALE PELVIC PROCEDURES

Facility

$31,047.79

Service Code	APR-DRG 4802
Min. Negotiated Rate	$24,797.38
Max. Negotiated Rate	$31,047.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,797.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,047.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,779.60

APR-DRG 41.00: MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$67,139.86

Service Code	APR-DRG 6803
Min. Negotiated Rate	$53,623.55
Max. Negotiated Rate	$67,139.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,623.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$67,139.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,072.51

APR-DRG 41.00: MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$32,146.02

Service Code	APR-DRG 6801
Min. Negotiated Rate	$25,674.52
Max. Negotiated Rate	$32,146.02
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,674.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,146.02
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,762.23

APR-DRG 41.00: MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$42,417.63

Service Code	APR-DRG 6802
Min. Negotiated Rate	$33,878.29
Max. Negotiated Rate	$42,417.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,878.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,417.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,952.62

APR-DRG 41.00: MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$187,994.97

Service Code	APR-DRG 6804
Min. Negotiated Rate	$150,148.61
Max. Negotiated Rate	$187,994.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$150,148.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$187,994.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$168,206.02

APR-DRG 41.00: MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES

Facility

$62,340.43

Service Code	APR-DRG 2603
Min. Negotiated Rate	$49,790.31
Max. Negotiated Rate	$62,340.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,790.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,340.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,778.28

APR-DRG 41.00: MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES

Facility

$159,840.16

Service Code	APR-DRG 2604
Min. Negotiated Rate	$127,661.81
Max. Negotiated Rate	$159,840.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$127,661.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$159,840.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$143,014.88

APR-DRG 41.00: MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES

Facility

$36,767.18

Service Code	APR-DRG 2601
Min. Negotiated Rate	$29,365.37
Max. Negotiated Rate	$36,767.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$29,365.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,767.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,896.96

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