Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$46,056.76

Service Code	APR-DRG 9113
Min. Negotiated Rate	$35,330.38
Max. Negotiated Rate	$46,056.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,330.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,056.76

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$21,570.59

Service Code	APR-DRG 7921
Min. Negotiated Rate	$16,546.91
Max. Negotiated Rate	$21,570.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,546.91
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,570.59

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$40,651.24

Service Code	APR-DRG 7923
Min. Negotiated Rate	$31,183.78
Max. Negotiated Rate	$40,651.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$31,183.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$40,651.24

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$76,308.45

Service Code	APR-DRG 7924
Min. Negotiated Rate	$58,536.61
Max. Negotiated Rate	$76,308.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$58,536.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$76,308.45

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$27,282.92

Service Code	APR-DRG 7922
Min. Negotiated Rate	$20,928.87
Max. Negotiated Rate	$27,282.92
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,928.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,282.92

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$22,721.57

Service Code	APR-DRG 9501
Min. Negotiated Rate	$17,429.83
Max. Negotiated Rate	$22,721.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,429.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,721.57

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$85,317.62

Service Code	APR-DRG 9504
Min. Negotiated Rate	$65,447.59
Max. Negotiated Rate	$85,317.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$65,447.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$85,317.62

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$46,762.59

Service Code	APR-DRG 9503
Min. Negotiated Rate	$35,871.83
Max. Negotiated Rate	$46,762.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$35,871.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$46,762.59

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$30,884.80

Service Code	APR-DRG 9502
Min. Negotiated Rate	$23,691.90
Max. Negotiated Rate	$30,884.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,691.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,884.80

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$31,058.60

Service Code	APR-DRG 8434
Min. Negotiated Rate	$23,825.21
Max. Negotiated Rate	$31,058.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$23,825.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,058.60

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$11,130.24

Service Code	APR-DRG 8432
Min. Negotiated Rate	$8,538.06
Max. Negotiated Rate	$11,130.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,538.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,130.24

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$7,251.67

Service Code	APR-DRG 8431
Min. Negotiated Rate	$5,562.80
Max. Negotiated Rate	$7,251.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,562.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,251.67

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$15,083.28

Service Code	APR-DRG 8433
Min. Negotiated Rate	$11,570.47
Max. Negotiated Rate	$15,083.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,570.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,083.28

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$264,344.85

Service Code	APR-DRG 8414
Min. Negotiated Rate	$202,780.33
Max. Negotiated Rate	$264,344.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$202,780.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$264,344.85

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$97,011.82

Service Code	APR-DRG 8413
Min. Negotiated Rate	$74,418.27
Max. Negotiated Rate	$97,011.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$74,418.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$97,011.82

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$28,400.19

Service Code	APR-DRG 8412
Min. Negotiated Rate	$21,785.94
Max. Negotiated Rate	$28,400.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,785.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,400.19

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$24,950.80

Service Code	APR-DRG 8411
Min. Negotiated Rate	$19,139.89
Max. Negotiated Rate	$24,950.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,139.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$24,950.80

EXTERNAL HEART ASSIST SYSTEMS

Facility

$87,094.61

Service Code	APR-DRG 1782
Min. Negotiated Rate	$66,810.74
Max. Negotiated Rate	$87,094.61
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$66,810.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,094.61

EXTERNAL HEART ASSIST SYSTEMS

Facility

$126,360.79

Service Code	APR-DRG 1784
Min. Negotiated Rate	$96,932.03
Max. Negotiated Rate	$126,360.79
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$96,932.03
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$126,360.79

EXTERNAL HEART ASSIST SYSTEMS

Facility

$93,480.86

Service Code	APR-DRG 1783
Min. Negotiated Rate	$71,709.66
Max. Negotiated Rate	$93,480.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$71,709.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$93,480.86

EXTERNAL HEART ASSIST SYSTEMS

Facility

$77,681.10

Service Code	APR-DRG 1781
Min. Negotiated Rate	$59,589.58
Max. Negotiated Rate	$77,681.10
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$59,589.58
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$77,681.10

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$63,445.54

Service Code	APR-DRG 0091
Min. Negotiated Rate	$48,669.41
Max. Negotiated Rate	$63,445.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,669.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$63,445.54

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$229,973.44

Service Code	APR-DRG 0094
Min. Negotiated Rate	$176,413.83
Max. Negotiated Rate	$229,973.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$176,413.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$229,973.44

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$77,306.90

Service Code	APR-DRG 0092
Min. Negotiated Rate	$59,302.53
Max. Negotiated Rate	$77,306.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$59,302.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$77,306.90

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$105,992.60

Service Code	APR-DRG 0093
Min. Negotiated Rate	$81,307.48
Max. Negotiated Rate	$105,992.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,307.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$105,992.60

Know your out-of-pocket cost for care.

All Charges