Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES

Facility

$216,063.25

Service Code	APR-DRG 1674
Min. Negotiated Rate	$172,566.31
Max. Negotiated Rate	$216,063.25
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$172,566.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$216,063.25
Rate for Payer: Molina Healthcare of CA Medi-Cal	$193,319.75

APR-DRG 41.00: OTHER CHEMOTHERAPY

Facility

$24,272.96

Service Code	APR-DRG 6963
Min. Negotiated Rate	$19,386.43
Max. Negotiated Rate	$24,272.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,386.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,272.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,717.91

APR-DRG 41.00: OTHER CHEMOTHERAPY

Facility

$69,435.23

Service Code	APR-DRG 6964
Min. Negotiated Rate	$55,456.83
Max. Negotiated Rate	$69,435.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,456.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,435.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$62,126.26

APR-DRG 41.00: OTHER CHEMOTHERAPY

Facility

$16,559.15

Service Code	APR-DRG 6962
Min. Negotiated Rate	$13,225.53
Max. Negotiated Rate	$16,559.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,225.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,559.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,816.08

APR-DRG 41.00: OTHER CHEMOTHERAPY

Facility

$12,893.59

Service Code	APR-DRG 6961
Min. Negotiated Rate	$10,297.91
Max. Negotiated Rate	$12,893.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,297.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,893.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,536.37

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$48,342.42

Service Code	APR-DRG 2074
Min. Negotiated Rate	$38,610.33
Max. Negotiated Rate	$48,342.42
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,610.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,342.42
Rate for Payer: Molina Healthcare of CA Medi-Cal	$43,253.75

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$19,357.03

Service Code	APR-DRG 2073
Min. Negotiated Rate	$15,460.15
Max. Negotiated Rate	$19,357.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,460.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,357.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,319.45

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$10,953.84

Service Code	APR-DRG 2071
Min. Negotiated Rate	$8,748.66
Max. Negotiated Rate	$10,953.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,748.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,953.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,800.81

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$13,675.67

Service Code	APR-DRG 2072
Min. Negotiated Rate	$10,922.54
Max. Negotiated Rate	$13,675.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,922.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,675.67
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,236.12

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$24,475.00

Service Code	APR-DRG 1801
Min. Negotiated Rate	$19,547.80
Max. Negotiated Rate	$24,475.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,547.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,475.00
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,898.69

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$41,823.35

Service Code	APR-DRG 1803
Min. Negotiated Rate	$33,403.65
Max. Negotiated Rate	$41,823.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,403.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,823.35
Rate for Payer: Molina Healthcare of CA Medi-Cal	$37,420.89

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$102,169.37

Service Code	APR-DRG 1804
Min. Negotiated Rate	$81,601.06
Max. Negotiated Rate	$102,169.37
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,601.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$102,169.37
Rate for Payer: Molina Healthcare of CA Medi-Cal	$91,414.70

APR-DRG 41.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$30,063.66

Service Code	APR-DRG 1802
Min. Negotiated Rate	$24,011.37
Max. Negotiated Rate	$30,063.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,011.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,063.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,899.07

APR-DRG 41.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$11,472.07

Service Code	APR-DRG 8131
Min. Negotiated Rate	$9,162.56
Max. Negotiated Rate	$11,472.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,162.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,472.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,264.48

APR-DRG 41.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$20,208.04

Service Code	APR-DRG 8133
Min. Negotiated Rate	$16,139.84
Max. Negotiated Rate	$20,208.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,139.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,208.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,080.88

APR-DRG 41.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$50,222.74

Service Code	APR-DRG 8134
Min. Negotiated Rate	$40,112.11
Max. Negotiated Rate	$50,222.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,112.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,222.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,936.13

APR-DRG 41.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$13,896.75

Service Code	APR-DRG 8132
Min. Negotiated Rate	$11,099.12
Max. Negotiated Rate	$13,896.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,099.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,896.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,433.94

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$23,348.24

Service Code	APR-DRG 2291
Min. Negotiated Rate	$18,647.87
Max. Negotiated Rate	$23,348.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,647.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,348.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,890.53

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$31,936.83

Service Code	APR-DRG 2292
Min. Negotiated Rate	$25,507.45
Max. Negotiated Rate	$31,936.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,507.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,936.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,575.06

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$47,982.52

Service Code	APR-DRG 2293
Min. Negotiated Rate	$38,322.88
Max. Negotiated Rate	$47,982.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,322.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$47,982.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$42,931.73

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES

Facility

$114,952.18

Service Code	APR-DRG 2294
Min. Negotiated Rate	$91,810.50
Max. Negotiated Rate	$114,952.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$91,810.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$114,952.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$102,851.96

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$10,247.84

Service Code	APR-DRG 2541
Min. Negotiated Rate	$8,184.79
Max. Negotiated Rate	$10,247.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,184.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,247.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,169.12

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$14,067.90

Service Code	APR-DRG 2542
Min. Negotiated Rate	$11,235.81
Max. Negotiated Rate	$14,067.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,235.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,067.90
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,587.07

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$20,353.05

Service Code	APR-DRG 2543
Min. Negotiated Rate	$16,255.66
Max. Negotiated Rate	$20,353.05
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,255.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,353.05
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,210.62

APR-DRG 41.00: OTHER DIGESTIVE SYSTEM DIAGNOSES

Facility

$49,780.11

Service Code	APR-DRG 2544
Min. Negotiated Rate	$39,758.59
Max. Negotiated Rate	$49,780.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,758.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,780.11
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,540.10

Know your out-of-pocket cost for care.

All Charges