Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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 RESPIRATORY AND CHEST PROCEDURES

Facility

$38,611.84

Service Code	APR-DRG 1201
Min. Negotiated Rate	$30,838.67
Max. Negotiated Rate	$38,611.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$30,838.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,611.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,547.43

APR-DRG 41.00: MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$65,806.29

Service Code	APR-DRG 1203
Min. Negotiated Rate	$52,558.45
Max. Negotiated Rate	$65,806.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,558.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$65,806.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$58,879.31

APR-DRG 41.00: MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$46,865.27

Service Code	APR-DRG 1202
Min. Negotiated Rate	$37,430.55
Max. Negotiated Rate	$46,865.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,430.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,865.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,932.08

APR-DRG 41.00: MAJOR RESPIRATORY AND CHEST PROCEDURES

Facility

$168,685.86

Service Code	APR-DRG 1204
Min. Negotiated Rate	$134,726.73
Max. Negotiated Rate	$168,685.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$134,726.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$168,685.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$150,929.45

APR-DRG 41.00: MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$51,469.40

Service Code	APR-DRG 1374
Min. Negotiated Rate	$41,107.80
Max. Negotiated Rate	$51,469.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,107.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$51,469.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,051.57

APR-DRG 41.00: MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$15,976.74

Service Code	APR-DRG 1372
Min. Negotiated Rate	$12,760.37
Max. Negotiated Rate	$15,976.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,760.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,976.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,294.98

APR-DRG 41.00: MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$12,544.16

Service Code	APR-DRG 1371
Min. Negotiated Rate	$10,018.82
Max. Negotiated Rate	$12,544.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,018.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,544.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,223.72

APR-DRG 41.00: MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS

Facility

$19,181.13

Service Code	APR-DRG 1373
Min. Negotiated Rate	$15,319.66
Max. Negotiated Rate	$19,181.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,319.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,181.13
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,162.06

APR-DRG 41.00: MAJOR SKIN DISORDERS

Facility

$23,985.31

Service Code	APR-DRG 3813
Min. Negotiated Rate	$19,156.69
Max. Negotiated Rate	$23,985.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,156.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,985.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,460.54

APR-DRG 41.00: MAJOR SKIN DISORDERS

Facility

$69,788.01

Service Code	APR-DRG 3814
Min. Negotiated Rate	$55,738.58
Max. Negotiated Rate	$69,788.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,738.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,788.01
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,441.90

APR-DRG 41.00: MAJOR SKIN DISORDERS

Facility

$7,699.54

Service Code	APR-DRG 3811
Min. Negotiated Rate	$6,149.50
Max. Negotiated Rate	$7,699.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,149.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,699.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,889.06

APR-DRG 41.00: MAJOR SKIN DISORDERS

Facility

$12,503.75

Service Code	APR-DRG 3812
Min. Negotiated Rate	$9,986.55
Max. Negotiated Rate	$12,503.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,986.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,503.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,187.56

APR-DRG 41.00: MAJOR SMALL BOWEL PROCEDURES

Facility

$54,277.19

Service Code	APR-DRG 2303
Min. Negotiated Rate	$43,350.33
Max. Negotiated Rate	$54,277.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$43,350.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$54,277.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$48,563.80

APR-DRG 41.00: MAJOR SMALL BOWEL PROCEDURES

Facility

$135,509.20

Service Code	APR-DRG 2304
Min. Negotiated Rate	$108,229.06
Max. Negotiated Rate	$135,509.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$108,229.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$135,509.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$121,245.07

APR-DRG 41.00: MAJOR SMALL BOWEL PROCEDURES

Facility

$27,282.40

Service Code	APR-DRG 2301
Min. Negotiated Rate	$21,790.03
Max. Negotiated Rate	$27,282.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,790.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,282.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,410.57

APR-DRG 41.00: MAJOR SMALL BOWEL PROCEDURES

Facility

$37,342.45

Service Code	APR-DRG 2302
Min. Negotiated Rate	$29,824.82
Max. Negotiated Rate	$37,342.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$29,824.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,342.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,411.66

APR-DRG 41.00: MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$29,497.90

Service Code	APR-DRG 2201
Min. Negotiated Rate	$23,559.51
Max. Negotiated Rate	$29,497.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,559.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$29,497.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,392.86

APR-DRG 41.00: MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$161,048.22

Service Code	APR-DRG 2204
Min. Negotiated Rate	$128,626.67
Max. Negotiated Rate	$161,048.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$128,626.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$161,048.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$144,095.77

APR-DRG 41.00: MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$61,841.24

Service Code	APR-DRG 2203
Min. Negotiated Rate	$49,391.62
Max. Negotiated Rate	$61,841.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$49,391.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,841.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$55,331.63

APR-DRG 41.00: MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$41,214.82

Service Code	APR-DRG 2202
Min. Negotiated Rate	$32,917.63
Max. Negotiated Rate	$41,214.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,917.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,214.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,876.42

APR-DRG 41.00: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$18,593.97

Service Code	APR-DRG 5013
Min. Negotiated Rate	$14,850.71
Max. Negotiated Rate	$18,593.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,850.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,593.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,636.71

APR-DRG 41.00: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$9,453.87

Service Code	APR-DRG 5011
Min. Negotiated Rate	$7,550.66
Max. Negotiated Rate	$9,453.87
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,550.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,453.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,458.72

APR-DRG 41.00: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$12,601.20

Service Code	APR-DRG 5012
Min. Negotiated Rate	$10,064.38
Max. Negotiated Rate	$12,601.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,064.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,601.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,274.76

APR-DRG 41.00: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$52,133.00

Service Code	APR-DRG 5014
Min. Negotiated Rate	$41,637.80
Max. Negotiated Rate	$52,133.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,637.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,133.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,645.31

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All Charges