Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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

$49,830.03

Service Code	APR-DRG 4684
Min. Negotiated Rate	$39,798.46
Max. Negotiated Rate	$49,830.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$39,798.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,830.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,584.76

APR-DRG 41.00: OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility

$42,569.79

Service Code	APR-DRG 4473
Min. Negotiated Rate	$33,999.82
Max. Negotiated Rate	$42,569.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,999.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,569.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$38,088.75

APR-DRG 41.00: OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility

$26,096.22

Service Code	APR-DRG 4471
Min. Negotiated Rate	$20,842.63
Max. Negotiated Rate	$26,096.22
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,842.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,096.22
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,349.24

APR-DRG 41.00: OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility

$30,983.60

Service Code	APR-DRG 4472
Min. Negotiated Rate	$24,746.12
Max. Negotiated Rate	$30,983.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,746.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,983.60
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,722.17

APR-DRG 41.00: OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES

Facility

$118,989.04

Service Code	APR-DRG 4474
Min. Negotiated Rate	$95,034.67
Max. Negotiated Rate	$118,989.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$95,034.67
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$118,989.04
Rate for Payer: Molina Healthcare of CA Medi-Cal	$106,463.88

APR-DRG 41.00: OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$82,790.94

Service Code	APR-DRG 0913
Min. Negotiated Rate	$66,123.82
Max. Negotiated Rate	$82,790.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$66,123.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$82,790.94
Rate for Payer: Molina Healthcare of CA Medi-Cal	$74,076.11

APR-DRG 41.00: OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$45,916.79

Service Code	APR-DRG 0912
Min. Negotiated Rate	$36,673.01
Max. Negotiated Rate	$45,916.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,673.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,916.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,083.44

APR-DRG 41.00: OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$185,835.11

Service Code	APR-DRG 0914
Min. Negotiated Rate	$148,423.56
Max. Negotiated Rate	$185,835.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$148,423.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$185,835.11
Rate for Payer: Molina Healthcare of CA Medi-Cal	$166,273.52

APR-DRG 41.00: OTHER MAJOR HEAD AND NECK PROCEDURES

Facility

$31,273.62

Service Code	APR-DRG 0911
Min. Negotiated Rate	$24,977.75
Max. Negotiated Rate	$31,273.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,977.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,273.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,981.66

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

Facility

$34,917.78

Service Code	APR-DRG 4843
Min. Negotiated Rate	$27,888.28
Max. Negotiated Rate	$34,917.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$27,888.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$34,917.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$31,242.23

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

Facility

$23,823.66

Service Code	APR-DRG 4841
Min. Negotiated Rate	$19,027.58
Max. Negotiated Rate	$23,823.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,027.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$23,823.66
Rate for Payer: Molina Healthcare of CA Medi-Cal	$21,315.91

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

Facility

$108,911.88

Service Code	APR-DRG 4844
Min. Negotiated Rate	$86,986.20
Max. Negotiated Rate	$108,911.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$86,986.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$108,911.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$97,447.47

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

Facility

$28,946.40

Service Code	APR-DRG 4842
Min. Negotiated Rate	$23,119.04
Max. Negotiated Rate	$28,946.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,119.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,946.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,899.42

APR-DRG 41.00: OTHER MENTAL HEALTH DISORDERS

Facility

$28,421.06

Service Code	APR-DRG 7604
Min. Negotiated Rate	$22,699.45
Max. Negotiated Rate	$28,421.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,699.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,421.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,429.37

APR-DRG 41.00: OTHER MENTAL HEALTH DISORDERS

Facility

$7,336.79

Service Code	APR-DRG 7601
Min. Negotiated Rate	$5,859.78
Max. Negotiated Rate	$7,336.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,859.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,336.79
Rate for Payer: Molina Healthcare of CA Medi-Cal	$6,564.50

APR-DRG 41.00: OTHER MENTAL HEALTH DISORDERS

Facility

$15,209.88

Service Code	APR-DRG 7603
Min. Negotiated Rate	$12,147.89
Max. Negotiated Rate	$15,209.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,147.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,209.88
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,608.84

APR-DRG 41.00: OTHER MENTAL HEALTH DISORDERS

Facility

$10,383.33

Service Code	APR-DRG 7602
Min. Negotiated Rate	$8,293.00
Max. Negotiated Rate	$10,383.33
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,293.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,383.33
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,290.35

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$10,012.51

Service Code	APR-DRG 3511
Min. Negotiated Rate	$7,996.83
Max. Negotiated Rate	$10,012.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,996.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,012.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,958.56

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$12,525.14

Service Code	APR-DRG 3512
Min. Negotiated Rate	$10,003.63
Max. Negotiated Rate	$12,525.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,003.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,525.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,206.71

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$50,798.48

Service Code	APR-DRG 3514
Min. Negotiated Rate	$40,571.94
Max. Negotiated Rate	$50,798.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,571.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,798.48
Rate for Payer: Molina Healthcare of CA Medi-Cal	$45,451.27

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$19,364.15

Service Code	APR-DRG 3513
Min. Negotiated Rate	$15,465.84
Max. Negotiated Rate	$19,364.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,465.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,364.15
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,325.82

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$44,086.38

Service Code	APR-DRG 3203
Min. Negotiated Rate	$35,211.10
Max. Negotiated Rate	$44,086.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,211.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,086.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,445.71

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$107,181.32

Service Code	APR-DRG 3204
Min. Negotiated Rate	$85,604.03
Max. Negotiated Rate	$107,181.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$85,604.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$107,181.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$95,899.07

APR-DRG 41.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES

Facility

$30,375.07

Service Code	APR-DRG 3202
Min. Negotiated Rate	$24,260.09
Max. Negotiated Rate	$30,375.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,260.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,375.07
Rate for Payer: Molina Healthcare of CA Medi-Cal	$27,177.70

Know your out-of-pocket cost for care.

All Charges