Loma Linda University Children's Hospital

All Charges

Charge

Type

Price

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$18,111.46

Service Code	APR-DRG 6362
Min. Negotiated Rate	$13,893.40
Max. Negotiated Rate	$18,111.46
Rate for Payer: 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 IP

$37,439.96

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

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$9,669.78

Service Code	APR-DRG 6361
Min. Negotiated Rate	$7,417.74
Max. Negotiated Rate	$9,669.78
Rate for Payer: 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 IP

$87,119.08

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

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility IP

$10,388.04

Service Code	APR-DRG 6332
Min. Negotiated Rate	$7,968.72
Max. Negotiated Rate	$10,388.04
Rate for Payer: 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 ANOMALY

Facility IP

$36,872.44

Service Code	APR-DRG 6333
Min. Negotiated Rate	$28,285.05
Max. Negotiated Rate	$36,872.44
Rate for Payer: 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 IP

$3,655.54

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,804.19
Max. Negotiated Rate	$3,655.54
Rate for Payer: 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 IP

$137,307.30

Service Code	APR-DRG 6334
Min. Negotiated Rate	$105,329.15
Max. Negotiated Rate	$137,307.30
Rate for Payer: 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 CARDIOVASCULAR PROCEDURE

Facility IP

$109,045.62

Service Code	APR-DRG 6302
Min. Negotiated Rate	$83,649.47
Max. Negotiated Rate	$109,045.62
Rate for Payer: 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 IP

$171,870.45

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

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility IP

$512,221.72

Service Code	APR-DRG 6304
Min. Negotiated Rate	$392,927.98
Max. Negotiated Rate	$512,221.72
Rate for Payer: 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 IP

$43,256.90

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

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility IP

$423,963.00

Service Code	APR-DRG 6314
Min. Negotiated Rate	$325,224.25
Max. Negotiated Rate	$423,963.00
Rate for Payer: IEHP Medi-Cal	$325,224.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$423,963.00

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility IP

$113,064.72

Service Code	APR-DRG 6313
Min. Negotiated Rate	$86,732.55
Max. Negotiated Rate	$113,064.72
Rate for Payer: IEHP Medi-Cal	$86,732.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$113,064.72

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility IP

$8,953.75

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

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility IP

$69,342.29

Service Code	APR-DRG 6312
Min. Negotiated Rate	$53,192.83
Max. Negotiated Rate	$69,342.29
Rate for Payer: IEHP Medi-Cal	$53,192.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,342.29

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$64,409.58

Service Code	APR-DRG 6394
Min. Negotiated Rate	$49,408.93
Max. Negotiated Rate	$64,409.58
Rate for Payer: IEHP Medi-Cal	$49,408.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$64,409.58

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$6,763.52

Service Code	APR-DRG 6391
Min. Negotiated Rate	$5,188.34
Max. Negotiated Rate	$6,763.52
Rate for Payer: IEHP Medi-Cal	$5,188.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$6,763.52

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$30,288.49

Service Code	APR-DRG 6393
Min. Negotiated Rate	$23,234.46
Max. Negotiated Rate	$30,288.49
Rate for Payer: IEHP Medi-Cal	$23,234.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,288.49

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$9,248.59

Service Code	APR-DRG 6392
Min. Negotiated Rate	$7,094.64
Max. Negotiated Rate	$9,248.59
Rate for Payer: IEHP Medi-Cal	$7,094.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,248.59

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

Facility IP

$10,851.36

Service Code	APR-DRG 6341
Min. Negotiated Rate	$8,324.13
Max. Negotiated Rate	$10,851.36
Rate for Payer: IEHP Medi-Cal	$8,324.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,851.36

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

Facility IP

$22,261.35

Service Code	APR-DRG 6342
Min. Negotiated Rate	$17,076.80
Max. Negotiated Rate	$22,261.35
Rate for Payer: IEHP Medi-Cal	$17,076.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,261.35

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

Facility IP

$25,136.58

Service Code	APR-DRG 6343
Min. Negotiated Rate	$19,282.40
Max. Negotiated Rate	$25,136.58
Rate for Payer: IEHP Medi-Cal	$19,282.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,136.58

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

Facility IP

$105,235.00

Service Code	APR-DRG 6344
Min. Negotiated Rate	$80,726.32
Max. Negotiated Rate	$105,235.00
Rate for Payer: IEHP Medi-Cal	$80,726.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$105,235.00

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$180,817.55

Service Code	APR-DRG 5913
Min. Negotiated Rate	$138,706.09
Max. Negotiated Rate	$180,817.55
Rate for Payer: IEHP Medi-Cal	$138,706.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$180,817.55

Price Transparency.

All Charges