Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC

Facility

$127,270.65

Service Code	MSDRG 288
Min. Negotiated Rate	$34,413.00
Max. Negotiated Rate	$127,270.65
Rate for Payer: Aetna of CA HMO/PPO	$82,041.16
Rate for Payer: EPIC Health Plan Commercial	$127,270.65
Rate for Payer: EPIC Health Plan Senior	$84,847.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$77,133.73
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$107,987.22
Rate for Payer: Molina Healthcare of CA Medicare	$103,359.20
Rate for Payer: United Healthcare All Other Commercial	$37,549.00
Rate for Payer: United Healthcare All Other HMO	$37,549.00
Rate for Payer: United Healthcare HMO Rider	$37,563.00
Rate for Payer: United Healthcare Select/Navigate/Core	$34,413.00

ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC

Facility

$95,746.99

Service Code	MSDRG 290
Min. Negotiated Rate	$23,302.00
Max. Negotiated Rate	$95,746.99
Rate for Payer: Aetna of CA HMO/PPO	$28,184.79
Rate for Payer: EPIC Health Plan Commercial	$95,746.99
Rate for Payer: EPIC Health Plan Senior	$63,831.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$58,028.48
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$81,239.87
Rate for Payer: Molina Healthcare of CA Medicare	$77,758.16
Rate for Payer: United Healthcare All Other Commercial	$33,040.00
Rate for Payer: United Healthcare All Other HMO	$33,040.00
Rate for Payer: United Healthcare HMO Rider	$25,436.00
Rate for Payer: United Healthcare Select/Navigate/Core	$23,302.00

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$6,330.59

Service Code	APR-DRG 7561
Min. Negotiated Rate	$5,056.14
Max. Negotiated Rate	$6,330.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,056.14
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$6,330.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$5,664.21

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$20,852.92

Service Code	APR-DRG 7564
Min. Negotiated Rate	$16,654.90
Max. Negotiated Rate	$20,852.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,654.90
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$20,852.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,657.87

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$13,356.09

Service Code	APR-DRG 7563
Min. Negotiated Rate	$10,667.30
Max. Negotiated Rate	$13,356.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,667.30
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$13,356.09
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,950.18

ACUTE ANXIETY AND STRESS SYNDROMES

Facility

$9,442.52

Service Code	APR-DRG 7562
Min. Negotiated Rate	$7,541.60
Max. Negotiated Rate	$9,442.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,541.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,442.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,448.58

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$12,499.97

Service Code	APR-DRG 1452
Min. Negotiated Rate	$9,983.53
Max. Negotiated Rate	$12,499.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,983.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,499.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,184.18

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$9,889.58

Service Code	APR-DRG 1451
Min. Negotiated Rate	$7,898.65
Max. Negotiated Rate	$9,889.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,898.65
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,889.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,848.57

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$17,397.16

Service Code	APR-DRG 1453
Min. Negotiated Rate	$13,894.84
Max. Negotiated Rate	$17,397.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,894.84
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,397.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,565.88

ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility

$36,309.30

Service Code	APR-DRG 1454
Min. Negotiated Rate	$28,999.67
Max. Negotiated Rate	$36,309.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,999.67
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$36,309.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,487.27

ACUTE KIDNEY INJURY

Facility

$22,794.68

Service Code	APR-DRG 4693
Min. Negotiated Rate	$18,205.75
Max. Negotiated Rate	$22,794.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,205.75
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,794.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,395.24

ACUTE KIDNEY INJURY

Facility

$10,294.73

Service Code	APR-DRG 4691
Min. Negotiated Rate	$8,222.24
Max. Negotiated Rate	$10,294.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,222.24
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$10,294.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,211.08

ACUTE KIDNEY INJURY

Facility

$14,014.53

Service Code	APR-DRG 4692
Min. Negotiated Rate	$11,193.19
Max. Negotiated Rate	$14,014.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,193.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,014.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,539.32

ACUTE KIDNEY INJURY

Facility

$56,760.37

Service Code	APR-DRG 4694
Min. Negotiated Rate	$45,333.61
Max. Negotiated Rate	$56,760.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$45,333.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$56,760.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,785.60

ACUTE LEUKEMIA

Facility

$66,040.16

Service Code	APR-DRG 6903
Min. Negotiated Rate	$52,745.23
Max. Negotiated Rate	$66,040.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,745.23
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$66,040.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$59,088.57

ACUTE LEUKEMIA

Facility

$149,886.46

Service Code	APR-DRG 6904
Min. Negotiated Rate	$119,711.95
Max. Negotiated Rate	$149,886.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$119,711.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$149,886.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$134,108.94

ACUTE LEUKEMIA

Facility

$39,017.18

Service Code	APR-DRG 6902
Min. Negotiated Rate	$31,162.41
Max. Negotiated Rate	$39,017.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$31,162.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$39,017.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,910.11

ACUTE LEUKEMIA

Facility

$22,044.20

Service Code	APR-DRG 6901
Min. Negotiated Rate	$17,606.35
Max. Negotiated Rate	$22,044.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,606.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,044.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,723.76

ACUTE LEUKEMIA WITH CC

Facility

$116,261.79

Service Code	MSDRG 835
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$116,261.79
Rate for Payer: Aetna of CA HMO/PPO	$63,233.11
Rate for Payer: EPIC Health Plan Commercial	$116,261.79
Rate for Payer: EPIC Health Plan Senior	$77,507.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$70,461.69
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$98,646.37
Rate for Payer: Molina Healthcare of CA Medicare	$94,418.66
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

ACUTE LEUKEMIA WITH MCC

Facility

$176,666.94

Service Code	MSDRG 834
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$176,666.94
Rate for Payer: Aetna of CA HMO/PPO	$166,431.81
Rate for Payer: EPIC Health Plan Commercial	$176,666.94
Rate for Payer: EPIC Health Plan Senior	$117,777.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$107,070.87
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$149,899.22
Rate for Payer: Molina Healthcare of CA Medicare	$143,474.97
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$262,521.40

Service Code	MSDRG 850
Min. Negotiated Rate	$141,158.14
Max. Negotiated Rate	$262,521.40
Rate for Payer: Aetna of CA HMO/PPO	$262,521.40
Rate for Payer: EPIC Health Plan Commercial	$232,910.93
Rate for Payer: EPIC Health Plan Senior	$155,273.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$141,158.14
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$197,621.40
Rate for Payer: Molina Healthcare of CA Medicare	$189,151.91

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$100,889.41

Service Code	MSDRG 836
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$100,889.41
Rate for Payer: Aetna of CA HMO/PPO	$36,970.36
Rate for Payer: EPIC Health Plan Commercial	$100,889.41
Rate for Payer: EPIC Health Plan Senior	$67,259.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$61,145.10
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$85,603.14
Rate for Payer: Molina Healthcare of CA Medicare	$81,934.43
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$99,892.17

Service Code	MSDRG 121
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$99,892.17
Rate for Payer: Aetna of CA HMO/PPO	$35,266.60
Rate for Payer: EPIC Health Plan Commercial	$99,892.17
Rate for Payer: EPIC Health Plan Senior	$66,594.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$60,540.71
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$84,756.99
Rate for Payer: Molina Healthcare of CA Medicare	$81,124.55
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$93,193.50

Service Code	MSDRG 122
Min. Negotiated Rate	$6,823.00
Max. Negotiated Rate	$93,193.50
Rate for Payer: Aetna of CA HMO/PPO	$23,822.31
Rate for Payer: EPIC Health Plan Commercial	$93,193.50
Rate for Payer: EPIC Health Plan Senior	$62,129.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage	$56,480.91
Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage	$79,073.27
Rate for Payer: Molina Healthcare of CA Medicare	$75,684.42
Rate for Payer: United Healthcare All Other Commercial	$10,506.00
Rate for Payer: United Healthcare All Other HMO	$8,385.00
Rate for Payer: United Healthcare HMO Rider	$7,448.00
Rate for Payer: United Healthcare Select/Navigate/Core	$6,823.00

ACUTE MYOCARDIAL INFARCTION

Facility

$17,030.08

Service Code	APR-DRG 1901
Min. Negotiated Rate	$13,601.66
Max. Negotiated Rate	$17,030.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,601.66
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,030.08
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,237.44

Know your out-of-pocket cost for care.

All Charges