Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$46,613.29

Service Code	APR-DRG 4043
Min. Negotiated Rate	$37,229.30
Max. Negotiated Rate	$46,613.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,229.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,613.29
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,706.63

APR-DRG 41.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$19,549.58

Service Code	APR-DRG 4041
Min. Negotiated Rate	$15,613.94
Max. Negotiated Rate	$19,549.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,613.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,549.58
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,491.72

APR-DRG 41.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$28,409.16

Service Code	APR-DRG 4042
Min. Negotiated Rate	$22,689.95
Max. Negotiated Rate	$28,409.16
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$22,689.95
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,409.16
Rate for Payer: Molina Healthcare of CA Medi-Cal	$25,418.72

APR-DRG 41.00: TONSIL AND ADENOID PROCEDURES

Facility

$16,490.19

Service Code	APR-DRG 0972
Min. Negotiated Rate	$13,170.46
Max. Negotiated Rate	$16,490.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,170.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$16,490.19
Rate for Payer: Molina Healthcare of CA Medi-Cal	$14,754.39

APR-DRG 41.00: TONSIL AND ADENOID PROCEDURES

Facility

$26,226.95

Service Code	APR-DRG 0973
Min. Negotiated Rate	$20,947.05
Max. Negotiated Rate	$26,226.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,947.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$26,226.95
Rate for Payer: Molina Healthcare of CA Medi-Cal	$23,466.22

APR-DRG 41.00: TONSIL AND ADENOID PROCEDURES

Facility

$69,268.83

Service Code	APR-DRG 0974
Min. Negotiated Rate	$55,323.92
Max. Negotiated Rate	$69,268.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,323.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,268.83
Rate for Payer: Molina Healthcare of CA Medi-Cal	$61,977.38

APR-DRG 41.00: TONSIL AND ADENOID PROCEDURES

Facility

$11,205.82

Service Code	APR-DRG 0971
Min. Negotiated Rate	$8,949.91
Max. Negotiated Rate	$11,205.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,949.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,205.82
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,026.26

APR-DRG 41.00: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$15,427.62

Service Code	APR-DRG 8163
Min. Negotiated Rate	$12,321.80
Max. Negotiated Rate	$15,427.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,321.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,427.62
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,803.66

APR-DRG 41.00: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$11,624.20

Service Code	APR-DRG 8162
Min. Negotiated Rate	$9,284.07
Max. Negotiated Rate	$11,624.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$9,284.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,624.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$10,400.60

APR-DRG 41.00: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$40,604.84

Service Code	APR-DRG 8164
Min. Negotiated Rate	$32,430.45
Max. Negotiated Rate	$40,604.84
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,430.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,604.84
Rate for Payer: Molina Healthcare of CA Medi-Cal	$36,330.65

APR-DRG 41.00: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$10,732.78

Service Code	APR-DRG 8161
Min. Negotiated Rate	$8,572.10
Max. Negotiated Rate	$10,732.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,572.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,732.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$9,603.01

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$211,864.76

Service Code	APR-DRG 0043
Min. Negotiated Rate	$169,213.04
Max. Negotiated Rate	$211,864.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$169,213.04
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$211,864.76
Rate for Payer: Molina Healthcare of CA Medi-Cal	$189,563.21

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$448,773.14

Service Code	APR-DRG 0044
Min. Negotiated Rate	$358,428.02
Max. Negotiated Rate	$448,773.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$358,428.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$448,773.14
Rate for Payer: Molina Healthcare of CA Medi-Cal	$401,533.86

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$137,935.78

Service Code	APR-DRG 0042
Min. Negotiated Rate	$110,167.13
Max. Negotiated Rate	$137,935.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$110,167.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,935.78
Rate for Payer: Molina Healthcare of CA Medi-Cal	$123,416.23

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$99,837.40

Service Code	APR-DRG 0041
Min. Negotiated Rate	$79,738.55
Max. Negotiated Rate	$99,837.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$79,738.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$99,837.40
Rate for Payer: Molina Healthcare of CA Medi-Cal	$89,328.20

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$155,854.64

Service Code	APR-DRG 0053
Min. Negotiated Rate	$124,478.64
Max. Negotiated Rate	$155,854.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$124,478.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$155,854.64
Rate for Payer: Molina Healthcare of CA Medi-Cal	$139,448.89

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$87,259.97

Service Code	APR-DRG 0051
Min. Negotiated Rate	$69,693.16
Max. Negotiated Rate	$87,259.97
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$69,693.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,259.97
Rate for Payer: Molina Healthcare of CA Medi-Cal	$78,074.71

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$103,386.47

Service Code	APR-DRG 0052
Min. Negotiated Rate	$82,573.14
Max. Negotiated Rate	$103,386.47
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$82,573.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$103,386.47
Rate for Payer: Molina Healthcare of CA Medi-Cal	$92,503.68

APR-DRG 41.00: TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$308,132.18

Service Code	APR-DRG 0054
Min. Negotiated Rate	$246,100.30
Max. Negotiated Rate	$308,132.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$246,100.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$308,132.18
Rate for Payer: Molina Healthcare of CA Medi-Cal	$275,697.21

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$15,489.43

Service Code	APR-DRG 0472
Min. Negotiated Rate	$12,371.16
Max. Negotiated Rate	$15,489.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,371.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,489.43
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,858.96

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$46,402.20

Service Code	APR-DRG 0474
Min. Negotiated Rate	$37,060.70
Max. Negotiated Rate	$46,402.20
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$37,060.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,402.20
Rate for Payer: Molina Healthcare of CA Medi-Cal	$41,517.76

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$19,542.45

Service Code	APR-DRG 0473
Min. Negotiated Rate	$15,608.25
Max. Negotiated Rate	$19,542.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,608.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,542.45
Rate for Payer: Molina Healthcare of CA Medi-Cal	$17,485.35

APR-DRG 41.00: TRANSIENT ISCHEMIA

Facility

$13,514.03

Service Code	APR-DRG 0471
Min. Negotiated Rate	$10,793.45
Max. Negotiated Rate	$13,514.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10,793.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,514.03
Rate for Payer: Molina Healthcare of CA Medi-Cal	$12,091.50

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$78,567.24

Service Code	APR-DRG 4824
Min. Negotiated Rate	$62,750.42
Max. Negotiated Rate	$78,567.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$62,750.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$78,567.24
Rate for Payer: Molina Healthcare of CA Medi-Cal	$70,297.01

APR-DRG 41.00: TRANSURETHRAL PROSTATECTOMY

Facility

$14,814.32

Service Code	APR-DRG 4821
Min. Negotiated Rate	$11,831.96
Max. Negotiated Rate	$14,814.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,831.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,814.32
Rate for Payer: Molina Healthcare of CA Medi-Cal	$13,254.92

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All Charges