Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$42,494.32

Service Code	APR-DRG 6142
Min. Negotiated Rate	$32,597.61
Max. Negotiated Rate	$42,494.32
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,597.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,494.32

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$45,520.28

Service Code	APR-DRG 6121
Min. Negotiated Rate	$34,918.84
Max. Negotiated Rate	$45,520.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$34,918.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,520.28

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$69,641.56

Service Code	APR-DRG 6122
Min. Negotiated Rate	$53,422.40
Max. Negotiated Rate	$69,641.56
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$53,422.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,641.56

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$184,137.28

Service Code	APR-DRG 6124
Min. Negotiated Rate	$141,252.68
Max. Negotiated Rate	$184,137.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$141,252.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$184,137.28

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$89,929.94

Service Code	APR-DRG 6123
Min. Negotiated Rate	$68,985.73
Max. Negotiated Rate	$89,929.94
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$68,985.73
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$89,929.94

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$152,785.80

Service Code	APR-DRG 6093
Min. Negotiated Rate	$117,202.79
Max. Negotiated Rate	$152,785.80
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$117,202.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$152,785.80

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$68,943.27

Service Code	APR-DRG 6091
Min. Negotiated Rate	$52,886.74
Max. Negotiated Rate	$68,943.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$52,886.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$68,943.27

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$441,612.82

Service Code	APR-DRG 6094
Min. Negotiated Rate	$338,763.52
Max. Negotiated Rate	$441,612.82
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$338,763.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$441,612.82

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$72,572.19

Service Code	APR-DRG 6092
Min. Negotiated Rate	$55,670.51
Max. Negotiated Rate	$72,572.19
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$55,670.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$72,572.19

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$309,149.55

Service Code	APR-DRG 5882
Min. Negotiated Rate	$237,150.25
Max. Negotiated Rate	$309,149.55
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$237,150.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$309,149.55

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$203,495.66

Service Code	APR-DRG 5881
Min. Negotiated Rate	$156,102.59
Max. Negotiated Rate	$203,495.66
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$156,102.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$203,495.66

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$705,696.27

Service Code	APR-DRG 5884
Min. Negotiated Rate	$541,343.32
Max. Negotiated Rate	$705,696.27
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$541,343.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$705,696.27

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$315,720.23

Service Code	APR-DRG 5883
Min. Negotiated Rate	$242,190.65
Max. Negotiated Rate	$315,720.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$242,190.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$315,720.23

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,865.90

Service Code	APR-DRG 6262
Min. Negotiated Rate	$2,198.45
Max. Negotiated Rate	$2,865.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,198.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,865.90

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$8,481.58

Service Code	APR-DRG 6263
Min. Negotiated Rate	$6,506.27
Max. Negotiated Rate	$8,481.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,506.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,481.58

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$67,292.17

Service Code	APR-DRG 6264
Min. Negotiated Rate	$51,620.18
Max. Negotiated Rate	$67,292.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$51,620.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$67,292.17

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,456.24

Service Code	APR-DRG 6261
Min. Negotiated Rate	$1,884.20
Max. Negotiated Rate	$2,456.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1,884.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,456.24

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$28,481.76

Service Code	APR-DRG 6232
Min. Negotiated Rate	$21,848.51
Max. Negotiated Rate	$28,481.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,848.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,481.76

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$17,559.48

Service Code	APR-DRG 6231
Min. Negotiated Rate	$13,469.97
Max. Negotiated Rate	$17,559.48
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,469.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,559.48

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$62,667.43

Service Code	APR-DRG 6233
Min. Negotiated Rate	$48,072.52
Max. Negotiated Rate	$62,667.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,072.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,667.43

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$109,432.76

Service Code	APR-DRG 6234
Min. Negotiated Rate	$83,946.45
Max. Negotiated Rate	$109,432.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$83,946.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,432.76

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$25,894.74

Service Code	APR-DRG 6212
Min. Negotiated Rate	$19,863.99
Max. Negotiated Rate	$25,894.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$19,863.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,894.74

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$151,069.00

Service Code	APR-DRG 6214
Min. Negotiated Rate	$115,885.82
Max. Negotiated Rate	$151,069.00
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$115,885.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$151,069.00

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$61,581.18

Service Code	APR-DRG 6213
Min. Negotiated Rate	$47,239.25
Max. Negotiated Rate	$61,581.18
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$47,239.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,581.18

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$7,996.09

Service Code	APR-DRG 6211
Min. Negotiated Rate	$6,133.85
Max. Negotiated Rate	$7,996.09
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,133.85
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,996.09

Know your out-of-pocket cost for care.

All Charges