Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: OTHER PNEUMONIA

Facility

$18,346.74

Service Code	APR-DRG 1393
Min. Negotiated Rate	$14,653.25
Max. Negotiated Rate	$18,346.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,653.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,346.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$16,415.51

APR-DRG 41.00: OTHER PNEUMONIA

Facility

$12,862.70

Service Code	APR-DRG 1392
Min. Negotiated Rate	$10,273.23
Max. Negotiated Rate	$12,862.70
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,273.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,862.70
Rate for Payer: Molina Healthcare of CA Medi-Cal	$11,508.73

APR-DRG 41.00: OTHER PNEUMONIA

Facility

$9,427.72

Service Code	APR-DRG 1391
Min. Negotiated Rate	$7,529.77
Max. Negotiated Rate	$9,427.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,529.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,427.72
Rate for Payer: Molina Healthcare of CA Medi-Cal	$8,435.33

APR-DRG 41.00: OTHER PNEUMONIA

Facility

$45,595.40

Service Code	APR-DRG 1394
Min. Negotiated Rate	$36,416.33
Max. Negotiated Rate	$45,595.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,416.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,595.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,795.89

APR-DRG 41.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$45,405.71

Service Code	APR-DRG 4053
Min. Negotiated Rate	$36,264.82
Max. Negotiated Rate	$45,405.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,264.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,405.71
Rate for Payer: Molina Healthcare of CA Medi-Cal	$40,626.16

APR-DRG 41.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$30,085.06

Service Code	APR-DRG 4052
Min. Negotiated Rate	$24,028.46
Max. Negotiated Rate	$30,085.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,028.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,085.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$26,918.21

APR-DRG 41.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$26,357.69

Service Code	APR-DRG 4051
Min. Negotiated Rate	$21,051.47
Max. Negotiated Rate	$26,357.69
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,051.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,357.69
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,583.20

APR-DRG 41.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS

Facility

$124,839.65

Service Code	APR-DRG 4054
Min. Negotiated Rate	$99,707.46
Max. Negotiated Rate	$124,839.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$99,707.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$124,839.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$111,698.64

APR-DRG 41.00: OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$44,442.96

Service Code	APR-DRG 6513
Min. Negotiated Rate	$35,495.89
Max. Negotiated Rate	$44,442.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,495.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,442.96
Rate for Payer: Molina Healthcare of CA Medi-Cal	$39,764.75

APR-DRG 41.00: OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$31,608.80

Service Code	APR-DRG 6512
Min. Negotiated Rate	$25,245.45
Max. Negotiated Rate	$31,608.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25,245.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,608.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$28,281.56

APR-DRG 41.00: OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$123,804.65

Service Code	APR-DRG 6514
Min. Negotiated Rate	$98,880.82
Max. Negotiated Rate	$123,804.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$98,880.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$123,804.65
Rate for Payer: Molina Healthcare of CA Medi-Cal	$110,772.58

APR-DRG 41.00: OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS

Facility

$21,800.73

Service Code	APR-DRG 6511
Min. Negotiated Rate	$17,411.90
Max. Negotiated Rate	$21,800.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,411.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,800.73
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,505.92

APR-DRG 41.00: OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$35,913.80

Service Code	APR-DRG 1212
Min. Negotiated Rate	$28,683.78
Max. Negotiated Rate	$35,913.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,683.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$35,913.80
Rate for Payer: Molina Healthcare of CA Medi-Cal	$32,133.40

APR-DRG 41.00: OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$54,921.38

Service Code	APR-DRG 1213
Min. Negotiated Rate	$43,864.84
Max. Negotiated Rate	$54,921.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$43,864.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$54,921.38
Rate for Payer: Molina Healthcare of CA Medi-Cal	$49,140.18

APR-DRG 41.00: OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$135,204.74

Service Code	APR-DRG 1214
Min. Negotiated Rate	$107,985.89
Max. Negotiated Rate	$135,204.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$107,985.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$135,204.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$120,972.66

APR-DRG 41.00: OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$27,738.82

Service Code	APR-DRG 1211
Min. Negotiated Rate	$22,154.56
Max. Negotiated Rate	$27,738.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,154.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,738.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$24,818.95

APR-DRG 41.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$21,674.74

Service Code	APR-DRG 1433
Min. Negotiated Rate	$17,311.28
Max. Negotiated Rate	$21,674.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,311.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,674.74
Rate for Payer: Molina Healthcare of CA Medi-Cal	$19,393.19

APR-DRG 41.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$14,647.92

Service Code	APR-DRG 1432
Min. Negotiated Rate	$11,699.06
Max. Negotiated Rate	$14,647.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,699.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,647.92
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,106.03

APR-DRG 41.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$50,086.47

Service Code	APR-DRG 1434
Min. Negotiated Rate	$40,003.27
Max. Negotiated Rate	$50,086.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$40,003.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,086.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$44,814.21

APR-DRG 41.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$10,483.17

Service Code	APR-DRG 1431
Min. Negotiated Rate	$8,372.75
Max. Negotiated Rate	$10,483.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,372.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,483.17
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,379.68

APR-DRG 41.00: OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$29,010.59

Service Code	APR-DRG 3091
Min. Negotiated Rate	$23,170.30
Max. Negotiated Rate	$29,010.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,170.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$29,010.59
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,956.84

APR-DRG 41.00: OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$116,280.06

Service Code	APR-DRG 3094
Min. Negotiated Rate	$92,871.05
Max. Negotiated Rate	$116,280.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$92,871.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$116,280.06
Rate for Payer: Molina Healthcare of CA Medi-Cal	$104,040.05

APR-DRG 41.00: OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$52,974.51

Service Code	APR-DRG 3093
Min. Negotiated Rate	$42,309.90
Max. Negotiated Rate	$52,974.51
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,309.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$52,974.51
Rate for Payer: Molina Healthcare of CA Medi-Cal	$47,398.24

APR-DRG 41.00: OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$37,656.23

Service Code	APR-DRG 3092
Min. Negotiated Rate	$30,075.44
Max. Negotiated Rate	$37,656.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$30,075.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,656.23
Rate for Payer: Molina Healthcare of CA Medi-Cal	$33,692.42

APR-DRG 41.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$8,940.41

Service Code	APR-DRG 3851
Min. Negotiated Rate	$7,140.57
Max. Negotiated Rate	$8,940.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,140.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,940.41
Rate for Payer: Molina Healthcare of CA Medi-Cal	$7,999.32

Know your out-of-pocket cost for care.

All Charges