Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$164,480.33

Service Code	APR-DRG 6143
Min. Negotiated Rate	$90,763.24
Max. Negotiated Rate	$164,480.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$90,763.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$113,640.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$164,480.33

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$36,800.58

Service Code	APR-DRG 6141
Min. Negotiated Rate	$20,307.23
Max. Negotiated Rate	$36,800.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,307.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,425.86
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,800.58

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$278,772.04

Service Code	APR-DRG 6144
Min. Negotiated Rate	$153,831.48
Max. Negotiated Rate	$278,772.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$153,831.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$192,606.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$278,772.04

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$87,844.54

Service Code	APR-DRG 6142
Min. Negotiated Rate	$48,474.22
Max. Negotiated Rate	$87,844.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,474.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$60,692.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$87,844.54

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$147,260.16

Service Code	APR-DRG 6122
Min. Negotiated Rate	$81,260.84
Max. Negotiated Rate	$147,260.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,260.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$101,743.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$147,260.16

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$95,484.04

Service Code	APR-DRG 6121
Min. Negotiated Rate	$52,689.83
Max. Negotiated Rate	$95,484.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,689.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$65,970.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$95,484.04

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$392,718.18

Service Code	APR-DRG 6124
Min. Negotiated Rate	$216,709.03
Max. Negotiated Rate	$392,718.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$216,709.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$271,332.56
Rate for Payer: Molina Healthcare of CA Medi-Cal	$392,718.18

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$187,923.86

Service Code	APR-DRG 6123
Min. Negotiated Rate	$103,699.80
Max. Negotiated Rate	$187,923.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$103,699.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$129,838.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$187,923.86

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$174,118.81

Service Code	APR-DRG 6092
Min. Negotiated Rate	$96,081.92
Max. Negotiated Rate	$174,118.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$96,081.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$120,300.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$174,118.81

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$306,437.17

Service Code	APR-DRG 6093
Min. Negotiated Rate	$169,097.60
Max. Negotiated Rate	$306,437.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$169,097.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$211,720.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$306,437.17

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$923,375.81

Service Code	APR-DRG 6094
Min. Negotiated Rate	$509,535.56
Max. Negotiated Rate	$923,375.81
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$509,535.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$637,968.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$923,375.81

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$157,943.89

Service Code	APR-DRG 6091
Min. Negotiated Rate	$87,156.31
Max. Negotiated Rate	$157,943.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$87,156.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,124.87
Rate for Payer: Molina Healthcare of CA Medi-Cal	$157,943.89

APR-DRG 41.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$461,558.41

Service Code	APR-DRG 5881
Min. Negotiated Rate	$254,696.32
Max. Negotiated Rate	$461,558.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$254,696.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$318,894.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$461,558.41

APR-DRG 41.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$1,460,889.59

Service Code	APR-DRG 5884
Min. Negotiated Rate	$806,145.44
Max. Negotiated Rate	$1,460,889.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$806,145.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$1,009,341.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$1,460,889.59

APR-DRG 41.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$712,915.11

Service Code	APR-DRG 5883
Min. Negotiated Rate	$393,399.52
Max. Negotiated Rate	$712,915.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$393,399.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$492,559.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$712,915.11

APR-DRG 41.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$693,956.06

Service Code	APR-DRG 5882
Min. Negotiated Rate	$382,937.57
Max. Negotiated Rate	$693,956.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$382,937.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$479,460.55
Rate for Payer: Molina Healthcare of CA Medi-Cal	$693,956.06

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$3,655.30

Service Code	APR-DRG 6261
Min. Negotiated Rate	$2,017.06
Max. Negotiated Rate	$3,655.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,017.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,525.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$3,655.30

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$17,070.85

Service Code	APR-DRG 6263
Min. Negotiated Rate	$9,420.00
Max. Negotiated Rate	$17,070.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,420.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,794.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,070.85

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$4,156.24

Service Code	APR-DRG 6262
Min. Negotiated Rate	$2,293.49
Max. Negotiated Rate	$4,156.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,293.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,871.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$4,156.24

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$124,701.97

Service Code	APR-DRG 6264
Min. Negotiated Rate	$68,812.81
Max. Negotiated Rate	$124,701.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$68,812.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$86,157.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$124,701.97

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$60,244.11

Service Code	APR-DRG 6232
Min. Negotiated Rate	$33,243.80
Max. Negotiated Rate	$60,244.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,243.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,623.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$60,244.11

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$135,338.50

Service Code	APR-DRG 6233
Min. Negotiated Rate	$74,682.24
Max. Negotiated Rate	$135,338.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$74,682.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$93,506.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$135,338.50

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$210,495.53

Service Code	APR-DRG 6234
Min. Negotiated Rate	$116,155.26
Max. Negotiated Rate	$210,495.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$116,155.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$145,433.28
Rate for Payer: Molina Healthcare of CA Medi-Cal	$210,495.53

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$37,002.90

Service Code	APR-DRG 6231
Min. Negotiated Rate	$20,418.87
Max. Negotiated Rate	$37,002.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,418.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,565.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,002.90

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$118,209.85

Service Code	APR-DRG 6213
Min. Negotiated Rate	$65,230.34
Max. Negotiated Rate	$118,209.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$65,230.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$81,672.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$118,209.85

Know your out-of-pocket cost for care.

All Charges