Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$125,024.50

Service Code	APR-DRG 6033
Min. Negotiated Rate	$95,906.95
Max. Negotiated Rate	$125,024.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$95,906.95
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$125,024.50

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$61,685.38

Service Code	APR-DRG 6032
Min. Negotiated Rate	$47,319.18
Max. Negotiated Rate	$61,685.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,319.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,685.38

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$137,842.19

Service Code	APR-DRG 6022
Min. Negotiated Rate	$105,739.47
Max. Negotiated Rate	$137,842.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$105,739.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,842.19

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$180,653.50

Service Code	APR-DRG 6023
Min. Negotiated Rate	$138,580.25
Max. Negotiated Rate	$180,653.50
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$138,580.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$180,653.50

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$27,105.12

Service Code	APR-DRG 6021
Min. Negotiated Rate	$20,792.48
Max. Negotiated Rate	$27,105.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,792.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,105.12

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$329,907.18

Service Code	APR-DRG 6024
Min. Negotiated Rate	$253,073.54
Max. Negotiated Rate	$329,907.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$253,073.54
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$329,907.18

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$78,333.73

Service Code	APR-DRG 6082
Min. Negotiated Rate	$60,090.22
Max. Negotiated Rate	$78,333.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$60,090.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$78,333.73

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$106,112.76

Service Code	APR-DRG 6083
Min. Negotiated Rate	$81,399.66
Max. Negotiated Rate	$106,112.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,399.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$106,112.76

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$160,441.38

Service Code	APR-DRG 6084
Min. Negotiated Rate	$123,075.42
Max. Negotiated Rate	$160,441.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$123,075.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$160,441.38

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$10,611.94

Service Code	APR-DRG 6081
Min. Negotiated Rate	$8,140.47
Max. Negotiated Rate	$10,611.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$8,140.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,611.94

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$253,395.88

Service Code	APR-DRG 6074
Min. Negotiated Rate	$194,381.31
Max. Negotiated Rate	$253,395.88
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$194,381.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$253,395.88

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$43,875.41

Service Code	APR-DRG 6071
Min. Negotiated Rate	$33,657.06
Max. Negotiated Rate	$43,875.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,657.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,875.41

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$106,001.91

Service Code	APR-DRG 6072
Min. Negotiated Rate	$81,314.62
Max. Negotiated Rate	$106,001.91
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$81,314.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$106,001.91

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$136,895.59

Service Code	APR-DRG 6073
Min. Negotiated Rate	$105,013.33
Max. Negotiated Rate	$136,895.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$105,013.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$136,895.59

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$28,005.14

Service Code	APR-DRG 6131
Min. Negotiated Rate	$21,482.89
Max. Negotiated Rate	$28,005.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,482.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,005.14

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$50,827.36

Service Code	APR-DRG 6132
Min. Negotiated Rate	$38,989.93
Max. Negotiated Rate	$50,827.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,989.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,827.36

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$81,809.71

Service Code	APR-DRG 6133
Min. Negotiated Rate	$62,756.66
Max. Negotiated Rate	$81,809.71
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$62,756.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$81,809.71

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$180,660.95

Service Code	APR-DRG 6134
Min. Negotiated Rate	$138,585.96
Max. Negotiated Rate	$180,660.95
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$138,585.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$180,660.95

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$49,889.65

Service Code	APR-DRG 6112
Min. Negotiated Rate	$38,270.61
Max. Negotiated Rate	$49,889.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,270.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,889.65

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$192,561.58

Service Code	APR-DRG 6114
Min. Negotiated Rate	$147,715.00
Max. Negotiated Rate	$192,561.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$147,715.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$192,561.58

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$22,447.57

Service Code	APR-DRG 6111
Min. Negotiated Rate	$17,219.65
Max. Negotiated Rate	$22,447.57
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,219.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,447.57

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$87,099.06

Service Code	APR-DRG 6113
Min. Negotiated Rate	$66,814.15
Max. Negotiated Rate	$87,099.06
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$66,814.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,099.06

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$145,182.53

Service Code	APR-DRG 6144
Min. Negotiated Rate	$111,370.29
Max. Negotiated Rate	$145,182.53
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$111,370.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$145,182.53

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$17,492.96

Service Code	APR-DRG 6141
Min. Negotiated Rate	$13,418.94
Max. Negotiated Rate	$17,492.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,418.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,492.96

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$77,345.03

Service Code	APR-DRG 6143
Min. Negotiated Rate	$59,331.78
Max. Negotiated Rate	$77,345.03
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$59,331.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$77,345.03

Know your out-of-pocket cost for care.

All Charges