Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: NEONATAL AFTERCARE

Facility

$120,137.21

Service Code	APR-DRG 8633
Min. Negotiated Rate	$95,951.69
Max. Negotiated Rate	$120,137.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$95,951.69
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$120,137.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$107,491.19

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$720,420.14

Service Code	APR-DRG 6034
Min. Negotiated Rate	$397,540.93
Max. Negotiated Rate	$720,420.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$397,540.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$497,744.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$720,420.14

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$132,747.07

Service Code	APR-DRG 6032
Min. Negotiated Rate	$73,252.24
Max. Negotiated Rate	$132,747.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$73,252.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$91,716.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$132,747.07

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$6,363.03

Service Code	APR-DRG 6031
Min. Negotiated Rate	$3,511.24
Max. Negotiated Rate	$6,363.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,511.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,396.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,363.03

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$264,684.89

Service Code	APR-DRG 6033
Min. Negotiated Rate	$146,057.93
Max. Negotiated Rate	$264,684.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$146,057.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$182,873.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$264,684.89

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$692,989.25

Service Code	APR-DRG 6024
Min. Negotiated Rate	$382,404.07
Max. Negotiated Rate	$692,989.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$382,404.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$478,792.57
Rate for Payer: Molina Healthcare of CA Medi-Cal	$692,989.25

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$49,141.32

Service Code	APR-DRG 6021
Min. Negotiated Rate	$27,117.07
Max. Negotiated Rate	$49,141.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,117.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,952.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,141.32

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$309,009.36

Service Code	APR-DRG 6022
Min. Negotiated Rate	$170,516.98
Max. Negotiated Rate	$309,009.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$170,516.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$213,497.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$309,009.36

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$398,318.22

Service Code	APR-DRG 6023
Min. Negotiated Rate	$219,799.24
Max. Negotiated Rate	$398,318.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$219,799.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$275,201.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$398,318.22

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$157,380.33

Service Code	APR-DRG 6082
Min. Negotiated Rate	$86,845.33
Max. Negotiated Rate	$157,380.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$86,845.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$108,735.50
Rate for Payer: Molina Healthcare of CA Medi-Cal	$157,380.33

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$294,199.95

Service Code	APR-DRG 6084
Min. Negotiated Rate	$162,344.88
Max. Negotiated Rate	$294,199.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$162,344.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$203,265.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$294,199.95

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$31,328.66

Service Code	APR-DRG 6081
Min. Negotiated Rate	$17,287.72
Max. Negotiated Rate	$31,328.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,287.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,645.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,328.66

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$218,857.54

Service Code	APR-DRG 6083
Min. Negotiated Rate	$120,769.57
Max. Negotiated Rate	$218,857.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$120,769.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$151,210.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$218,857.54

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$91,042.93

Service Code	APR-DRG 6071
Min. Negotiated Rate	$50,239.14
Max. Negotiated Rate	$91,042.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$50,239.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,902.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$91,042.93

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$224,396.89

Service Code	APR-DRG 6072
Min. Negotiated Rate	$123,826.29
Max. Negotiated Rate	$224,396.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$123,826.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$155,037.85
Rate for Payer: Molina Healthcare of CA Medi-Cal	$224,396.89

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$308,440.96

Service Code	APR-DRG 6073
Min. Negotiated Rate	$170,203.33
Max. Negotiated Rate	$308,440.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$170,203.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$213,104.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$308,440.96

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$538,697.61

Service Code	APR-DRG 6074
Min. Negotiated Rate	$297,263.14
Max. Negotiated Rate	$538,697.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$297,263.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$372,191.08
Rate for Payer: Molina Healthcare of CA Medi-Cal	$538,697.61

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$181,714.97

Service Code	APR-DRG 6133
Min. Negotiated Rate	$100,273.62
Max. Negotiated Rate	$181,714.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$100,273.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$125,548.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$181,714.97

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$66,067.65

Service Code	APR-DRG 6131
Min. Negotiated Rate	$36,457.33
Max. Negotiated Rate	$66,067.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,457.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,646.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$66,067.65

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$102,608.14

Service Code	APR-DRG 6132
Min. Negotiated Rate	$56,621.04
Max. Negotiated Rate	$102,608.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$56,621.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,892.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$102,608.14

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$332,867.81

Service Code	APR-DRG 6134
Min. Negotiated Rate	$183,682.51
Max. Negotiated Rate	$332,867.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$183,682.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$229,981.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$332,867.81

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$105,267.03

Service Code	APR-DRG 6112
Min. Negotiated Rate	$58,088.26
Max. Negotiated Rate	$105,267.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$58,088.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$72,729.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$105,267.03

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$186,512.54

Service Code	APR-DRG 6113
Min. Negotiated Rate	$102,921.01
Max. Negotiated Rate	$186,512.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$102,921.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$128,863.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$186,512.54

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$46,511.33

Service Code	APR-DRG 6111
Min. Negotiated Rate	$25,665.80
Max. Negotiated Rate	$46,511.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,665.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,135.10
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,511.33

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$408,570.22

Service Code	APR-DRG 6114
Min. Negotiated Rate	$225,456.48
Max. Negotiated Rate	$408,570.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$225,456.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$282,284.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$408,570.22

Know your out-of-pocket cost for care.

All Charges