Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$100,813.75

Service Code	APR-DRG 6254
Min. Negotiated Rate	$77,334.76
Max. Negotiated Rate	$100,813.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$77,334.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$100,813.75

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$20,288.39

Service Code	APR-DRG 6251
Min. Negotiated Rate	$15,563.33
Max. Negotiated Rate	$20,288.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$15,563.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,288.39

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$27,588.38

Service Code	APR-DRG 6252
Min. Negotiated Rate	$21,163.19
Max. Negotiated Rate	$27,588.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,163.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,588.38

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$49,894.08

Service Code	APR-DRG 6253
Min. Negotiated Rate	$38,274.01
Max. Negotiated Rate	$49,894.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,274.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,894.08

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$119,239.29

Service Code	APR-DRG 6224
Min. Negotiated Rate	$91,469.09
Max. Negotiated Rate	$119,239.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$91,469.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$119,239.29

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$48,222.59

Service Code	APR-DRG 6223
Min. Negotiated Rate	$36,991.80
Max. Negotiated Rate	$48,222.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,991.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,222.59

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$42,523.14

Service Code	APR-DRG 6222
Min. Negotiated Rate	$32,619.72
Max. Negotiated Rate	$42,523.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,619.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,523.14

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$28,430.78

Service Code	APR-DRG 6221
Min. Negotiated Rate	$21,809.40
Max. Negotiated Rate	$28,430.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,809.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,430.78

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

Facility

$4,087.83

Service Code	APR-DRG 6403
Min. Negotiated Rate	$3,135.80
Max. Negotiated Rate	$4,087.83
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,135.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,087.83

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

Facility

$2,261.17

Service Code	APR-DRG 6402
Min. Negotiated Rate	$1,734.56
Max. Negotiated Rate	$2,261.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1,734.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,261.17

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

Facility

$1,709.62

Service Code	APR-DRG 6401
Min. Negotiated Rate	$1,311.46
Max. Negotiated Rate	$1,709.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1,311.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$1,709.62

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

Facility

$55,525.62

Service Code	APR-DRG 6404
Min. Negotiated Rate	$42,593.99
Max. Negotiated Rate	$55,525.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$42,593.99
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$55,525.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$9,669.78

Service Code	APR-DRG 6361
Min. Negotiated Rate	$7,417.74
Max. Negotiated Rate	$9,669.78
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,417.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,669.78

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$87,119.08

Service Code	APR-DRG 6364
Min. Negotiated Rate	$66,829.51
Max. Negotiated Rate	$87,119.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$66,829.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,119.08

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$18,111.46

Service Code	APR-DRG 6362
Min. Negotiated Rate	$13,893.40
Max. Negotiated Rate	$18,111.46
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,893.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,111.46

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$37,439.96

Service Code	APR-DRG 6363
Min. Negotiated Rate	$28,720.39
Max. Negotiated Rate	$37,439.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,720.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,439.96

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$36,872.44

Service Code	APR-DRG 6333
Min. Negotiated Rate	$28,285.05
Max. Negotiated Rate	$36,872.44
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$28,285.05
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,872.44

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$3,655.54

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,804.19
Max. Negotiated Rate	$3,655.54
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,804.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$3,655.54

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$137,307.30

Service Code	APR-DRG 6334
Min. Negotiated Rate	$105,329.15
Max. Negotiated Rate	$137,307.30
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$105,329.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,307.30

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$10,388.04

Service Code	APR-DRG 6332
Min. Negotiated Rate	$7,968.72
Max. Negotiated Rate	$10,388.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$7,968.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,388.04

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$512,221.72

Service Code	APR-DRG 6304
Min. Negotiated Rate	$392,927.98
Max. Negotiated Rate	$512,221.72
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$392,927.98
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$512,221.72

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$43,256.90

Service Code	APR-DRG 6301
Min. Negotiated Rate	$33,182.60
Max. Negotiated Rate	$43,256.90
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$33,182.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,256.90

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$109,045.62

Service Code	APR-DRG 6302
Min. Negotiated Rate	$83,649.47
Max. Negotiated Rate	$109,045.62
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$83,649.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,045.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$171,870.45

Service Code	APR-DRG 6303
Min. Negotiated Rate	$131,842.72
Max. Negotiated Rate	$171,870.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$131,842.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$171,870.45

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$8,953.75

Service Code	APR-DRG 6311
Min. Negotiated Rate	$6,868.47
Max. Negotiated Rate	$8,953.75
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,868.47
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,953.75

Know your out-of-pocket cost for care.

All Charges