Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$76,099.29

Service Code	APR-DRG 0213
Min. Negotiated Rate	$60,779.30
Max. Negotiated Rate	$76,099.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$60,779.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$76,099.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$68,088.84

APR-DRG 41.00: OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$40,356.67

Service Code	APR-DRG 0211
Min. Negotiated Rate	$32,232.23
Max. Negotiated Rate	$40,356.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,232.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,356.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,108.60

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

APR-DRG 41.00: OPEN CRANIOTOMY FOR TRAUMA

Facility

$42,957.25

Service Code	APR-DRG 0201
Min. Negotiated Rate	$34,309.28
Max. Negotiated Rate	$42,957.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$34,309.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,957.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,435.44

APR-DRG 41.00: OPEN CRANIOTOMY FOR TRAUMA

Facility

$70,453.60

Service Code	APR-DRG 0203
Min. Negotiated Rate	$56,270.17
Max. Negotiated Rate	$70,453.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$56,270.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,453.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$63,037.43

APR-DRG 41.00: OPEN CRANIOTOMY FOR TRAUMA

Facility

$50,309.74

Service Code	APR-DRG 0202
Min. Negotiated Rate	$40,181.59
Max. Negotiated Rate	$50,309.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,181.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,309.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,013.98

APR-DRG 41.00: OPEN CRANIOTOMY FOR TRAUMA

Facility

$157,051.30

Service Code	APR-DRG 0204
Min. Negotiated Rate	$125,434.40
Max. Negotiated Rate	$157,051.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$125,434.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$157,051.30
Rate for Payer: Molina Healthcare of CA Medi-Cal	$140,519.59

APR-DRG 41.00: OPEN EXTRACRANIAL VASCULAR PROCEDURES

Facility

$116,326.65

Service Code	APR-DRG 0244
Min. Negotiated Rate	$92,908.25
Max. Negotiated Rate	$116,326.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$92,908.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$116,326.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$104,081.74

APR-DRG 41.00: OPEN EXTRACRANIAL VASCULAR PROCEDURES

Facility

$21,712.78

Service Code	APR-DRG 0241
Min. Negotiated Rate	$17,341.66
Max. Negotiated Rate	$21,712.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,341.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,712.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,427.23

APR-DRG 41.00: OPEN EXTRACRANIAL VASCULAR PROCEDURES

Facility

$46,972.24

Service Code	APR-DRG 0243
Min. Negotiated Rate	$37,515.98
Max. Negotiated Rate	$46,972.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,515.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,972.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,027.79

APR-DRG 41.00: OPEN EXTRACRANIAL VASCULAR PROCEDURES

Facility

$26,975.76

Service Code	APR-DRG 0242
Min. Negotiated Rate	$21,545.12
Max. Negotiated Rate	$26,975.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,545.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,975.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,136.21

APR-DRG 41.00: OPIOID ABUSE AND DEPENDENCE

Facility

$29,834.03

Service Code	APR-DRG 7734
Min. Negotiated Rate	$23,827.97
Max. Negotiated Rate	$29,834.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,827.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$29,834.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,693.60

APR-DRG 41.00: OPIOID ABUSE AND DEPENDENCE

Facility

$6,855.66

Service Code	APR-DRG 7732
Min. Negotiated Rate	$5,475.50
Max. Negotiated Rate	$6,855.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,475.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,855.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,134.01

APR-DRG 41.00: OPIOID ABUSE AND DEPENDENCE

Facility

$4,758.07

Service Code	APR-DRG 7731
Min. Negotiated Rate	$3,800.20
Max. Negotiated Rate	$4,758.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,800.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,758.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$4,257.23

APR-DRG 41.00: OPIOID ABUSE AND DEPENDENCE

Facility

$12,929.73

Service Code	APR-DRG 7733
Min. Negotiated Rate	$10,326.77
Max. Negotiated Rate	$12,929.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,326.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,929.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,568.70

APR-DRG 41.00: ORBIT AND EYE PROCEDURES

Facility

$36,828.99

Service Code	APR-DRG 0733
Min. Negotiated Rate	$29,414.73
Max. Negotiated Rate	$36,828.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$29,414.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,828.99
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,952.26

APR-DRG 41.00: ORBIT AND EYE PROCEDURES

Facility

$19,019.47

Service Code	APR-DRG 0731
Min. Negotiated Rate	$15,190.55
Max. Negotiated Rate	$19,019.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,190.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,019.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,017.42

APR-DRG 41.00: ORBIT AND EYE PROCEDURES

Facility

$94,002.48

Service Code	APR-DRG 0734
Min. Negotiated Rate	$75,078.30
Max. Negotiated Rate	$94,002.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$75,078.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$94,002.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$84,107.48

APR-DRG 41.00: ORBIT AND EYE PROCEDURES

Facility

$23,388.66

Service Code	APR-DRG 0732
Min. Negotiated Rate	$18,680.15
Max. Negotiated Rate	$23,388.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,680.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,388.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,926.69

APR-DRG 41.00: ORGANIC MENTAL HEALTH DISTURBANCES

Facility

$32,593.42

Service Code	APR-DRG 7574
Min. Negotiated Rate	$26,031.85
Max. Negotiated Rate	$32,593.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$26,031.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,593.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$29,162.53

APR-DRG 41.00: ORGANIC MENTAL HEALTH DISTURBANCES

Facility

$10,212.18

Service Code	APR-DRG 7572
Min. Negotiated Rate	$8,156.30
Max. Negotiated Rate	$10,212.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,156.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,212.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,137.21

APR-DRG 41.00: ORGANIC MENTAL HEALTH DISTURBANCES

Facility

$16,364.21

Service Code	APR-DRG 7573
Min. Negotiated Rate	$13,069.83
Max. Negotiated Rate	$16,364.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,069.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,364.21
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,641.66

APR-DRG 41.00: ORGANIC MENTAL HEALTH DISTURBANCES

Facility

$7,736.15

Service Code	APR-DRG 7571
Min. Negotiated Rate	$6,178.74
Max. Negotiated Rate	$7,736.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,178.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,736.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,921.82

APR-DRG 41.00: OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$17,324.58

Service Code	APR-DRG 3442
Min. Negotiated Rate	$13,836.87
Max. Negotiated Rate	$17,324.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,836.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,324.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,500.94

APR-DRG 41.00: OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS

Facility

$13,670.92

Service Code	APR-DRG 3441
Min. Negotiated Rate	$10,918.75
Max. Negotiated Rate	$13,670.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,918.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,670.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,231.87

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All Charges