Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$51,826.36

Service Code	APR-DRG 3233
Min. Negotiated Rate	$41,392.89
Max. Negotiated Rate	$51,826.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$41,392.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$51,826.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$46,370.95

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$102,099.48

Service Code	APR-DRG 3234
Min. Negotiated Rate	$81,545.24
Max. Negotiated Rate	$102,099.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,545.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$102,099.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$91,352.17

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$34,523.17

Service Code	APR-DRG 3231
Min. Negotiated Rate	$27,573.11
Max. Negotiated Rate	$34,523.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,573.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$34,523.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$30,889.15

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$38,778.24

Service Code	APR-DRG 3232
Min. Negotiated Rate	$30,971.57
Max. Negotiated Rate	$38,778.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$30,971.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$38,778.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$34,696.32

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$48,900.09

Service Code	APR-DRG 3252
Min. Negotiated Rate	$39,055.73
Max. Negotiated Rate	$48,900.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,055.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,900.09
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,752.71

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$127,009.51

Service Code	APR-DRG 3254
Min. Negotiated Rate	$101,440.49
Max. Negotiated Rate	$127,009.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$101,440.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$127,009.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$113,640.09

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$42,484.21

Service Code	APR-DRG 3251
Min. Negotiated Rate	$33,931.47
Max. Negotiated Rate	$42,484.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,931.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,484.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,012.19

APR-DRG 41.00: NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$64,743.72

Service Code	APR-DRG 3253
Min. Negotiated Rate	$51,709.78
Max. Negotiated Rate	$64,743.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$51,709.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$64,743.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$57,928.59

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$22,456.82

Service Code	APR-DRG 7942
Min. Negotiated Rate	$17,935.91
Max. Negotiated Rate	$22,456.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,935.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,456.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,092.95

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$88,957.24

Service Code	APR-DRG 7944
Min. Negotiated Rate	$71,048.74
Max. Negotiated Rate	$88,957.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$71,048.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$88,957.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$79,593.32

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$17,419.66

Service Code	APR-DRG 7941
Min. Negotiated Rate	$13,912.80
Max. Negotiated Rate	$17,419.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,912.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,419.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,586.01

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$33,068.36

Service Code	APR-DRG 7943
Min. Negotiated Rate	$26,411.18
Max. Negotiated Rate	$33,068.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$26,411.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$33,068.36
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,587.48

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$18,919.63

Service Code	APR-DRG 9521
Min. Negotiated Rate	$15,110.81
Max. Negotiated Rate	$18,919.63
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,110.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,919.63
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,928.09

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$25,378.32

Service Code	APR-DRG 9522
Min. Negotiated Rate	$20,269.26
Max. Negotiated Rate	$25,378.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,269.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,378.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$22,706.92

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$40,870.12

Service Code	APR-DRG 9523
Min. Negotiated Rate	$32,642.32
Max. Negotiated Rate	$40,870.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,642.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,870.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,568.00

APR-DRG 41.00: NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$107,038.23

Service Code	APR-DRG 9524
Min. Negotiated Rate	$85,489.74
Max. Negotiated Rate	$107,038.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$85,489.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$107,038.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$95,771.05

APR-DRG 41.00: NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$9,615.52

Service Code	APR-DRG 4261
Min. Negotiated Rate	$7,679.76
Max. Negotiated Rate	$9,615.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,679.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,615.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,603.36

APR-DRG 41.00: NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$47,610.26

Service Code	APR-DRG 4264
Min. Negotiated Rate	$38,025.56
Max. Negotiated Rate	$47,610.26
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,025.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$47,610.26
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,598.65

APR-DRG 41.00: NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$18,936.27

Service Code	APR-DRG 4263
Min. Negotiated Rate	$15,124.10
Max. Negotiated Rate	$18,936.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,124.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,936.27
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,942.98

APR-DRG 41.00: NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$12,655.88

Service Code	APR-DRG 4262
Min. Negotiated Rate	$10,108.05
Max. Negotiated Rate	$12,655.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,108.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,655.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,323.68

APR-DRG 41.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$56,020.09

Service Code	APR-DRG 0464
Min. Negotiated Rate	$44,742.36
Max. Negotiated Rate	$56,020.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$44,742.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$56,020.09
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,123.24

APR-DRG 41.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$20,495.68

Service Code	APR-DRG 0463
Min. Negotiated Rate	$16,369.58
Max. Negotiated Rate	$20,495.68
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,369.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,495.68
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,338.24

APR-DRG 41.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$13,606.74

Service Code	APR-DRG 0461
Min. Negotiated Rate	$10,867.49
Max. Negotiated Rate	$13,606.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,867.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,606.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,174.45

APR-DRG 41.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$16,297.65

Service Code	APR-DRG 0462
Min. Negotiated Rate	$13,016.67
Max. Negotiated Rate	$16,297.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,016.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,297.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,582.11

APR-DRG 41.00: OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$167,198.35

Service Code	APR-DRG 0214
Min. Negotiated Rate	$133,538.68
Max. Negotiated Rate	$167,198.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$133,538.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$167,198.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$149,598.52

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All Charges