Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: OTHER ESOPHAGEAL DISORDERS

Facility

$13,882.48

Service Code	APR-DRG 2432
Min. Negotiated Rate	$11,087.72
Max. Negotiated Rate	$13,882.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,087.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,882.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,421.17

APR-DRG 41.00: OTHER ESOPHAGEAL DISORDERS

Facility

$10,925.32

Service Code	APR-DRG 2431
Min. Negotiated Rate	$8,725.88
Max. Negotiated Rate	$10,925.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,725.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,925.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,775.29

APR-DRG 41.00: OTHER ESOPHAGEAL DISORDERS

Facility

$20,369.69

Service Code	APR-DRG 2433
Min. Negotiated Rate	$16,268.95
Max. Negotiated Rate	$20,369.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,268.95
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,369.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$18,225.51

APR-DRG 41.00: OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$17,122.51

Service Code	APR-DRG 5181
Min. Negotiated Rate	$13,675.48
Max. Negotiated Rate	$17,122.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,675.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,122.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,320.15

APR-DRG 41.00: OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$41,012.75

Service Code	APR-DRG 5183
Min. Negotiated Rate	$32,756.24
Max. Negotiated Rate	$41,012.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,756.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,012.75
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,695.62

APR-DRG 41.00: OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$24,527.31

Service Code	APR-DRG 5182
Min. Negotiated Rate	$19,589.57
Max. Negotiated Rate	$24,527.31
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,589.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,527.31
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,945.49

APR-DRG 41.00: OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES

Facility

$108,868.61

Service Code	APR-DRG 5184
Min. Negotiated Rate	$86,951.64
Max. Negotiated Rate	$108,868.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$86,951.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$108,868.61
Rate for Payer: Molina Healthcare of CA Medi-Cal	$97,408.76

APR-DRG 41.00: OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$43,320.47

Service Code	APR-DRG 2494
Min. Negotiated Rate	$34,599.38
Max. Negotiated Rate	$43,320.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$34,599.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,320.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,760.43

APR-DRG 41.00: OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$9,363.54

Service Code	APR-DRG 2491
Min. Negotiated Rate	$7,478.51
Max. Negotiated Rate	$9,363.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,478.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,363.54
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,377.91

APR-DRG 41.00: OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$11,695.53

Service Code	APR-DRG 2492
Min. Negotiated Rate	$9,341.03
Max. Negotiated Rate	$11,695.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,341.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,695.53
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,464.42

APR-DRG 41.00: OTHER GASTROENTERITIS, NAUSEA AND VOMITING

Facility

$16,811.12

Service Code	APR-DRG 2493
Min. Negotiated Rate	$13,426.78
Max. Negotiated Rate	$16,811.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,426.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,811.12
Rate for Payer: Molina Healthcare of CA Medi-Cal	$15,041.53

APR-DRG 41.00: OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$27,303.80

Service Code	APR-DRG 2641
Min. Negotiated Rate	$21,807.11
Max. Negotiated Rate	$27,303.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,807.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,303.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,429.71

APR-DRG 41.00: OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$28,993.94

Service Code	APR-DRG 2642
Min. Negotiated Rate	$23,157.00
Max. Negotiated Rate	$28,993.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,157.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,993.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,941.95

APR-DRG 41.00: OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$43,948.52

Service Code	APR-DRG 2643
Min. Negotiated Rate	$35,100.99
Max. Negotiated Rate	$43,948.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,100.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,948.52
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,322.36

APR-DRG 41.00: OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES

Facility

$126,180.84

Service Code	APR-DRG 2644
Min. Negotiated Rate	$100,778.65
Max. Negotiated Rate	$126,180.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$100,778.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$126,180.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$112,898.65

APR-DRG 41.00: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$23,169.97

Service Code	APR-DRG 7243
Min. Negotiated Rate	$18,505.49
Max. Negotiated Rate	$23,169.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$18,505.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,169.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$20,731.02

APR-DRG 41.00: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$14,108.32

Service Code	APR-DRG 7242
Min. Negotiated Rate	$11,268.09
Max. Negotiated Rate	$14,108.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,268.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,108.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,623.23

APR-DRG 41.00: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$65,198.71

Service Code	APR-DRG 7244
Min. Negotiated Rate	$52,073.18
Max. Negotiated Rate	$65,198.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,073.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$65,198.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$58,335.69

APR-DRG 41.00: OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$11,833.39

Service Code	APR-DRG 7241
Min. Negotiated Rate	$9,451.14
Max. Negotiated Rate	$11,833.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,451.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,833.39
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,587.77

APR-DRG 41.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$56,875.40

Service Code	APR-DRG 8154
Min. Negotiated Rate	$45,425.48
Max. Negotiated Rate	$56,875.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$45,425.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$56,875.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$50,888.51

APR-DRG 41.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$7,968.16

Service Code	APR-DRG 8151
Min. Negotiated Rate	$6,364.05
Max. Negotiated Rate	$7,968.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,364.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,968.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,129.41

APR-DRG 41.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$18,995.71

Service Code	APR-DRG 8153
Min. Negotiated Rate	$15,171.57
Max. Negotiated Rate	$18,995.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,171.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,995.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,996.16

APR-DRG 41.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$11,077.46

Service Code	APR-DRG 8152
Min. Negotiated Rate	$8,847.39
Max. Negotiated Rate	$11,077.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,847.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,077.46
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,911.41

APR-DRG 41.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$12,903.11

Service Code	APR-DRG 4682
Min. Negotiated Rate	$10,305.51
Max. Negotiated Rate	$12,903.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,305.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,903.11
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,544.89

APR-DRG 41.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS

Facility

$9,560.84

Service Code	APR-DRG 4681
Min. Negotiated Rate	$7,636.09
Max. Negotiated Rate	$9,560.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,636.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,560.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,554.43

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All Charges