Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$98,117.24

Service Code	APR-DRG 6071
Min. Negotiated Rate	$61,968.78
Max. Negotiated Rate	$98,117.24
Rate for Payer: Adventist Health Medi-Cal	$61,968.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$73,846.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$98,117.24

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

Facility

$393,798.52

Service Code	APR-DRG 6074
Min. Negotiated Rate	$248,714.86
Max. Negotiated Rate	$393,798.52
Rate for Payer: Adventist Health Medi-Cal	$248,714.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$296,385.20
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$393,798.52

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

Facility

$156,974.88

Service Code	APR-DRG 6072
Min. Negotiated Rate	$99,142.03
Max. Negotiated Rate	$156,974.88
Rate for Payer: Adventist Health Medi-Cal	$99,142.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$118,144.25
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$156,974.88

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

Facility

$71,504.75

Service Code	APR-DRG 6132
Min. Negotiated Rate	$45,160.90
Max. Negotiated Rate	$71,504.75
Rate for Payer: Adventist Health Medi-Cal	$45,160.90
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$53,816.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$71,504.75

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

Facility

$130,157.96

Service Code	APR-DRG 6133
Min. Negotiated Rate	$82,205.03
Max. Negotiated Rate	$130,157.96
Rate for Payer: Adventist Health Medi-Cal	$82,205.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$97,960.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$130,157.96

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

Facility

$211,807.19

Service Code	APR-DRG 6134
Min. Negotiated Rate	$133,772.96
Max. Negotiated Rate	$211,807.19
Rate for Payer: Adventist Health Medi-Cal	$133,772.96
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$159,412.78
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$211,807.19

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

Facility

$44,296.56

Service Code	APR-DRG 6131
Min. Negotiated Rate	$27,976.78
Max. Negotiated Rate	$44,296.56
Rate for Payer: Adventist Health Medi-Cal	$27,976.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,338.99
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$44,296.56

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$30,828.18

Service Code	APR-DRG 6111
Min. Negotiated Rate	$19,470.43
Max. Negotiated Rate	$30,828.18
Rate for Payer: Adventist Health Medi-Cal	$19,470.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$23,202.26
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$30,828.18

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$70,390.90

Service Code	APR-DRG 6112
Min. Negotiated Rate	$44,457.41
Max. Negotiated Rate	$70,390.90
Rate for Payer: Adventist Health Medi-Cal	$44,457.41
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,978.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$70,390.90

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$331,848.89

Service Code	APR-DRG 6114
Min. Negotiated Rate	$209,588.77
Max. Negotiated Rate	$331,848.89
Rate for Payer: Adventist Health Medi-Cal	$209,588.77
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$249,759.95
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$331,848.89

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$120,217.94

Service Code	APR-DRG 6113
Min. Negotiated Rate	$75,927.12
Max. Negotiated Rate	$120,217.94
Rate for Payer: Adventist Health Medi-Cal	$75,927.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$90,479.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$120,217.94

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

Facility

$110,743.19

Service Code	APR-DRG 6143
Min. Negotiated Rate	$69,943.07
Max. Negotiated Rate	$110,743.19
Rate for Payer: Adventist Health Medi-Cal	$69,943.07
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$83,348.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$110,743.19

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

Facility

$23,182.83

Service Code	APR-DRG 6141
Min. Negotiated Rate	$14,641.79
Max. Negotiated Rate	$23,182.83
Rate for Payer: Adventist Health Medi-Cal	$14,641.79
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,448.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,182.83

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

Facility

$57,447.72

Service Code	APR-DRG 6142
Min. Negotiated Rate	$36,282.77
Max. Negotiated Rate	$57,447.72
Rate for Payer: Adventist Health Medi-Cal	$36,282.77
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$43,236.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$57,447.72

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

Facility

$160,330.53

Service Code	APR-DRG 6144
Min. Negotiated Rate	$101,261.39
Max. Negotiated Rate	$160,330.53
Rate for Payer: Adventist Health Medi-Cal	$101,261.39
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$120,669.82
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$160,330.53

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

Facility

$140,224.88

Service Code	APR-DRG 6123
Min. Negotiated Rate	$88,563.08
Max. Negotiated Rate	$140,224.88
Rate for Payer: Adventist Health Medi-Cal	$88,563.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$105,537.68
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$140,224.88

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

Facility

$243,192.29

Service Code	APR-DRG 6124
Min. Negotiated Rate	$153,595.13
Max. Negotiated Rate	$243,192.29
Rate for Payer: Adventist Health Medi-Cal	$153,595.13
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$183,034.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$243,192.29

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

Facility

$92,318.89

Service Code	APR-DRG 6122
Min. Negotiated Rate	$58,306.67
Max. Negotiated Rate	$92,318.89
Rate for Payer: Adventist Health Medi-Cal	$58,306.67
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$69,482.11
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$92,318.89

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

Facility

$62,061.73

Service Code	APR-DRG 6121
Min. Negotiated Rate	$39,196.88
Max. Negotiated Rate	$62,061.73
Rate for Payer: Adventist Health Medi-Cal	$39,196.88
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,709.62
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$62,061.73

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$214,612.96

Service Code	APR-DRG 6093
Min. Negotiated Rate	$135,545.03
Max. Negotiated Rate	$214,612.96
Rate for Payer: Adventist Health Medi-Cal	$135,545.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$161,524.49
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$214,612.96

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$137,426.16

Service Code	APR-DRG 6092
Min. Negotiated Rate	$86,795.47
Max. Negotiated Rate	$137,426.16
Rate for Payer: Adventist Health Medi-Cal	$86,795.47
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$103,431.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$137,426.16

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$110,616.29

Service Code	APR-DRG 6091
Min. Negotiated Rate	$69,862.92
Max. Negotiated Rate	$110,616.29
Rate for Payer: Adventist Health Medi-Cal	$69,862.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$83,253.31
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$110,616.29

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$838,638.02

Service Code	APR-DRG 6094
Min. Negotiated Rate	$529,666.12
Max. Negotiated Rate	$838,638.02
Rate for Payer: Adventist Health Medi-Cal	$529,666.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$631,185.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$838,638.02

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$412,676.81

Service Code	APR-DRG 5881
Min. Negotiated Rate	$260,637.98
Max. Negotiated Rate	$412,676.81
Rate for Payer: Adventist Health Medi-Cal	$260,637.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$310,593.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$412,676.81

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$620,462.16

Service Code	APR-DRG 5882
Min. Negotiated Rate	$391,870.84
Max. Negotiated Rate	$620,462.16
Rate for Payer: Adventist Health Medi-Cal	$391,870.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$466,979.41
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$620,462.16

Know your out-of-pocket cost for care.

All Charges