Loma Linda University Children's Hospital

All Charges

Charge

Type

Price

Outdated MS-DRG 226

Facility IP

$131,451.93

Service Code	MS-DRG 226
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$131,451.93
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$12,764.00
Rate for Payer: Multiplan WC	$131,451.93
Rate for Payer: Prime Health Services WC	$130,110.58
Rate for Payer: United Healthcare All Other Commercial	$94,610.00
Rate for Payer: United Healthcare All Other HMO	$94,610.00
Rate for Payer: United Healthcare HMO Rider	$94,610.00
Rate for Payer: United Healthcare Select/Navigate/Core	$94,610.00

Outdated MS-DRG 227

Facility IP

$107,228.00

Service Code	MS-DRG 227
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$107,228.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$12,764.00
Rate for Payer: Multiplan WC	$103,107.49
Rate for Payer: Prime Health Services WC	$102,055.37
Rate for Payer: United Healthcare All Other Commercial	$107,228.00
Rate for Payer: United Healthcare All Other HMO	$107,228.00
Rate for Payer: United Healthcare HMO Rider	$107,228.00
Rate for Payer: United Healthcare Select/Navigate/Core	$107,228.00

Outdated MS-DRG 228

Facility IP

$25,651.00

Service Code	MS-DRG 228
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$25,651.00
Rate for Payer: Heritage Provider Network Commercial	$25,651.00

Outdated MS-DRG 229

Facility IP

$25,651.00

Service Code	MS-DRG 229
Min. Negotiated Rate	$25,651.00
Max. Negotiated Rate	$25,651.00
Rate for Payer: Heritage Provider Network Commercial	$25,651.00

Outdated MS-DRG 230

Facility IP

$148,568.00

Service Code	MS-DRG 230
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$148,568.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$25,651.00
Rate for Payer: United Healthcare All Other Commercial	$148,568.00
Rate for Payer: United Healthcare All Other HMO	$148,568.00
Rate for Payer: United Healthcare HMO Rider	$148,568.00
Rate for Payer: United Healthcare Select/Navigate/Core	$148,568.00

Outdated MS-DRG 237

Facility IP

$86,600.00

Service Code	MS-DRG 237
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$86,600.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: United Healthcare All Other Commercial	$86,600.00
Rate for Payer: United Healthcare All Other HMO	$86,600.00
Rate for Payer: United Healthcare HMO Rider	$86,600.00
Rate for Payer: United Healthcare Select/Navigate/Core	$86,600.00

Outdated MS-DRG 238

Facility IP

$73,293.00

Service Code	MS-DRG 238
Min. Negotiated Rate	$11,745.00
Max. Negotiated Rate	$73,293.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: United Healthcare All Other Commercial	$73,293.00
Rate for Payer: United Healthcare All Other HMO	$73,293.00
Rate for Payer: United Healthcare HMO Rider	$73,293.00
Rate for Payer: United Healthcare Select/Navigate/Core	$73,293.00

Outdated MS-DRG 246

Facility IP

$61,514.96

Service Code	MS-DRG 246
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$61,514.96
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$7,978.00
Rate for Payer: Multiplan WC	$61,514.96
Rate for Payer: Prime Health Services WC	$60,887.26
Rate for Payer: United Healthcare All Other Commercial	$48,629.00
Rate for Payer: United Healthcare All Other HMO	$48,629.00
Rate for Payer: United Healthcare HMO Rider	$48,629.00
Rate for Payer: United Healthcare Select/Navigate/Core	$48,629.00

Outdated MS-DRG 247

Facility IP

$49,935.00

Service Code	MS-DRG 247
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$49,935.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$7,978.00
Rate for Payer: Multiplan WC	$39,214.41
Rate for Payer: Prime Health Services WC	$38,814.26
Rate for Payer: United Healthcare All Other Commercial	$49,935.00
Rate for Payer: United Healthcare All Other HMO	$49,935.00
Rate for Payer: United Healthcare HMO Rider	$49,935.00
Rate for Payer: United Healthcare Select/Navigate/Core	$49,935.00

Outdated MS-DRG 248

Facility IP

$61,810.69

Service Code	MS-DRG 248
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$61,810.69
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$7,978.00
Rate for Payer: Multiplan WC	$61,810.69
Rate for Payer: Prime Health Services WC	$61,179.97
Rate for Payer: United Healthcare All Other Commercial	$27,797.00
Rate for Payer: United Healthcare All Other HMO	$27,797.00
Rate for Payer: United Healthcare HMO Rider	$27,797.00
Rate for Payer: United Healthcare Select/Navigate/Core	$27,797.00

Outdated MS-DRG 249

Facility IP

$40,735.00

Service Code	MS-DRG 249
Min. Negotiated Rate	$7,978.00
Max. Negotiated Rate	$40,735.00
Rate for Payer: Cigna of CA HMO	$11,745.00
Rate for Payer: Cigna of CA PPO	$14,790.00
Rate for Payer: Heritage Provider Network Commercial	$7,978.00
Rate for Payer: Multiplan WC	$37,308.62
Rate for Payer: Prime Health Services WC	$36,927.92
Rate for Payer: United Healthcare All Other Commercial	$40,735.00
Rate for Payer: United Healthcare All Other HMO	$40,735.00
Rate for Payer: United Healthcare HMO Rider	$40,735.00
Rate for Payer: United Healthcare Select/Navigate/Core	$40,735.00

Outdated MS-DRG 338

Facility IP

$54,555.15

Service Code	MS-DRG 338
Min. Negotiated Rate	$53,998.46
Max. Negotiated Rate	$54,555.15
Rate for Payer: Multiplan WC	$54,555.15
Rate for Payer: Prime Health Services WC	$53,998.46

Outdated MS-DRG 339

Facility IP

$33,441.60

Service Code	MS-DRG 339
Min. Negotiated Rate	$33,100.36
Max. Negotiated Rate	$33,441.60
Rate for Payer: Multiplan WC	$33,441.60
Rate for Payer: Prime Health Services WC	$33,100.36

Outdated MS-DRG 340

Facility IP

$24,641.72

Service Code	MS-DRG 340
Min. Negotiated Rate	$24,390.27
Max. Negotiated Rate	$24,641.72
Rate for Payer: Multiplan WC	$24,641.72
Rate for Payer: Prime Health Services WC	$24,390.27

Outdated MS-DRG 341

Facility IP

$46,391.90

Service Code	MS-DRG 341
Min. Negotiated Rate	$45,918.51
Max. Negotiated Rate	$46,391.90
Rate for Payer: Multiplan WC	$46,391.90
Rate for Payer: Prime Health Services WC	$45,918.51

Outdated MS-DRG 342

Facility IP

$29,843.61

Service Code	MS-DRG 343
Min. Negotiated Rate	$29,539.08
Max. Negotiated Rate	$29,843.61
Rate for Payer: Multiplan WC	$29,843.61
Rate for Payer: Prime Health Services WC	$29,539.08

Outdated MS-DRG 343

Facility IP

$22,440.21

Service Code	MS-DRG 343
Min. Negotiated Rate	$22,211.22
Max. Negotiated Rate	$22,440.21
Rate for Payer: Multiplan WC	$22,440.21
Rate for Payer: Prime Health Services WC	$22,211.22

Outdated MS-DRG 691

Facility IP

$7,890.00

Service Code	MS-DRG 691
Min. Negotiated Rate	$6,240.00
Max. Negotiated Rate	$7,890.00
Rate for Payer: Cigna of CA HMO	$6,240.00
Rate for Payer: Cigna of CA PPO	$7,890.00

Outdated MS-DRG 692

Facility IP

$7,890.00

Service Code	MS-DRG 692
Min. Negotiated Rate	$6,240.00
Max. Negotiated Rate	$7,890.00
Rate for Payer: Cigna of CA HMO	$6,240.00
Rate for Payer: Cigna of CA PPO	$7,890.00

Outdated MS-DRG 765

Facility IP

$16,694.00

Service Code	MS-DRG 765
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$16,694.00
Rate for Payer: Cigna of CA HMO	$5,000.00
Rate for Payer: Cigna of CA PPO	$6,000.00
Rate for Payer: Heritage Provider Network Commercial	$10,246.00
Rate for Payer: United Healthcare All Other Commercial	$16,694.00
Rate for Payer: United Healthcare All Other HMO	$11,719.00
Rate for Payer: United Healthcare HMO Rider	$10,206.00
Rate for Payer: United Healthcare Select/Navigate/Core	$9,332.00

Outdated MS-DRG 766

Facility IP

$16,694.00

Service Code	MS-DRG 766
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$16,694.00
Rate for Payer: Cigna of CA HMO	$5,000.00
Rate for Payer: Cigna of CA PPO	$6,000.00
Rate for Payer: Heritage Provider Network Commercial	$10,246.00
Rate for Payer: United Healthcare All Other Commercial	$16,694.00
Rate for Payer: United Healthcare All Other HMO	$11,719.00
Rate for Payer: United Healthcare HMO Rider	$10,206.00
Rate for Payer: United Healthcare Select/Navigate/Core	$9,332.00

Outdated MS-DRG 767

Facility IP

$10,210.00

Service Code	MS-DRG 767
Min. Negotiated Rate	$4,760.00
Max. Negotiated Rate	$10,210.00
Rate for Payer: Cigna of CA HMO	$4,760.00
Rate for Payer: Cigna of CA PPO	$6,000.00
Rate for Payer: United Healthcare All Other Commercial	$10,210.00
Rate for Payer: United Healthcare All Other HMO	$7,461.00
Rate for Payer: United Healthcare HMO Rider	$5,443.00
Rate for Payer: United Healthcare Select/Navigate/Core	$4,977.00

Outdated MS-DRG 774

Facility IP

$10,210.00

Service Code	MS-DRG 774
Min. Negotiated Rate	$4,760.00
Max. Negotiated Rate	$10,210.00
Rate for Payer: Cigna of CA HMO	$4,760.00
Rate for Payer: Cigna of CA PPO	$6,000.00
Rate for Payer: Heritage Provider Network Commercial	$7,387.00
Rate for Payer: United Healthcare All Other Commercial	$10,210.00
Rate for Payer: United Healthcare All Other HMO	$7,461.00
Rate for Payer: United Healthcare HMO Rider	$5,443.00
Rate for Payer: United Healthcare Select/Navigate/Core	$4,977.00

Outdated MS-DRG 775

Facility IP

$10,210.00

Service Code	MS-DRG 775
Min. Negotiated Rate	$4,760.00
Max. Negotiated Rate	$10,210.00
Rate for Payer: Cigna of CA HMO	$4,760.00
Rate for Payer: Cigna of CA PPO	$6,000.00
Rate for Payer: Heritage Provider Network Commercial	$7,387.00
Rate for Payer: United Healthcare All Other Commercial	$10,210.00
Rate for Payer: United Healthcare All Other HMO	$7,461.00
Rate for Payer: United Healthcare HMO Rider	$5,443.00
Rate for Payer: United Healthcare Select/Navigate/Core	$4,977.00

Outdated MS-DRG 780

Facility IP

$4,847.00

Service Code	MS-DRG 780
Min. Negotiated Rate	$2,860.00
Max. Negotiated Rate	$4,847.00
Rate for Payer: United Healthcare All Other Commercial	$4,847.00
Rate for Payer: United Healthcare All Other HMO	$3,623.00
Rate for Payer: United Healthcare HMO Rider	$3,128.00
Rate for Payer: United Healthcare Select/Navigate/Core	$2,860.00

Price Transparency.

All Charges