Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

$1,192,591.83

Service Code	APR-DRG 5884
Min. Negotiated Rate	$753,215.89
Max. Negotiated Rate	$1,192,591.83
Rate for Payer: Adventist Health Medi-Cal	$753,215.89
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$897,582.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$1,192,591.83

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

Facility

$2,481.48

Service Code	APR-DRG 6261
Min. Negotiated Rate	$1,567.25
Max. Negotiated Rate	$2,481.48
Rate for Payer: Adventist Health Medi-Cal	$1,567.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,867.64
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$2,481.48

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

Facility

$18,484.23

Service Code	APR-DRG 6263
Min. Negotiated Rate	$11,674.25
Max. Negotiated Rate	$18,484.23
Rate for Payer: Adventist Health Medi-Cal	$11,674.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,911.81
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$18,484.23

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

Facility

$4,105.52

Service Code	APR-DRG 6262
Min. Negotiated Rate	$2,592.96
Max. Negotiated Rate	$4,105.52
Rate for Payer: Adventist Health Medi-Cal	$2,592.96
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,089.94
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$4,105.52

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

Facility

$70,278.11

Service Code	APR-DRG 6264
Min. Negotiated Rate	$44,386.18
Max. Negotiated Rate	$70,278.11
Rate for Payer: Adventist Health Medi-Cal	$44,386.18
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,893.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$70,278.11

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

Facility

$136,525.22

Service Code	APR-DRG 6234
Min. Negotiated Rate	$86,226.46
Max. Negotiated Rate	$136,525.22
Rate for Payer: Adventist Health Medi-Cal	$86,226.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$102,753.19
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$136,525.22

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

Facility

$23,017.15

Service Code	APR-DRG 6231
Min. Negotiated Rate	$14,537.15
Max. Negotiated Rate	$23,017.15
Rate for Payer: Adventist Health Medi-Cal	$14,537.15
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,323.43
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$23,017.15

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

Facility

$42,794.99

Service Code	APR-DRG 6232
Min. Negotiated Rate	$27,028.42
Max. Negotiated Rate	$42,794.99
Rate for Payer: Adventist Health Medi-Cal	$27,028.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$32,208.86
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$42,794.99

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

Facility

$86,136.33

Service Code	APR-DRG 6233
Min. Negotiated Rate	$54,401.89
Max. Negotiated Rate	$86,136.33
Rate for Payer: Adventist Health Medi-Cal	$54,401.89
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$64,828.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$86,136.33

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$34,973.39

Service Code	APR-DRG 6212
Min. Negotiated Rate	$22,088.46
Max. Negotiated Rate	$34,973.39
Rate for Payer: Adventist Health Medi-Cal	$22,088.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$26,322.08
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$34,973.39

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$82,058.09

Service Code	APR-DRG 6213
Min. Negotiated Rate	$51,826.16
Max. Negotiated Rate	$82,058.09
Rate for Payer: Adventist Health Medi-Cal	$51,826.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$61,759.51
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$82,058.09

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$227,207.89

Service Code	APR-DRG 6214
Min. Negotiated Rate	$143,499.72
Max. Negotiated Rate	$227,207.89
Rate for Payer: Adventist Health Medi-Cal	$143,499.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$171,003.83
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$227,207.89

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$9,266.79

Service Code	APR-DRG 6211
Min. Negotiated Rate	$5,852.71
Max. Negotiated Rate	$9,266.79
Rate for Payer: Adventist Health Medi-Cal	$5,852.71
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,974.48
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$9,266.79

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$24,381.28

Service Code	APR-DRG 6251
Min. Negotiated Rate	$15,398.70
Max. Negotiated Rate	$24,381.28
Rate for Payer: Adventist Health Medi-Cal	$15,398.70
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,350.12
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,381.28

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$74,409.21

Service Code	APR-DRG 6253
Min. Negotiated Rate	$46,995.29
Max. Negotiated Rate	$74,409.21
Rate for Payer: Adventist Health Medi-Cal	$46,995.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$56,002.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$74,409.21

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$36,820.40

Service Code	APR-DRG 6252
Min. Negotiated Rate	$23,254.99
Max. Negotiated Rate	$36,820.40
Rate for Payer: Adventist Health Medi-Cal	$23,254.99
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,712.20
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$36,820.40

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$129,685.64

Service Code	APR-DRG 6254
Min. Negotiated Rate	$81,906.72
Max. Negotiated Rate	$129,685.64
Rate for Payer: Adventist Health Medi-Cal	$81,906.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$97,605.51
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$129,685.64

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

Facility

$142,032.43

Service Code	APR-DRG 6224
Min. Negotiated Rate	$89,704.69
Max. Negotiated Rate	$142,032.43
Rate for Payer: Adventist Health Medi-Cal	$89,704.69
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$106,898.09
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$142,032.43

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

Facility

$36,104.86

Service Code	APR-DRG 6221
Min. Negotiated Rate	$22,803.07
Max. Negotiated Rate	$36,104.86
Rate for Payer: Adventist Health Medi-Cal	$22,803.07
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,173.66
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$36,104.86

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

Facility

$83,742.98

Service Code	APR-DRG 6223
Min. Negotiated Rate	$52,890.30
Max. Negotiated Rate	$83,742.98
Rate for Payer: Adventist Health Medi-Cal	$52,890.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$63,027.61
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$83,742.98

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

Facility

$55,047.31

Service Code	APR-DRG 6222
Min. Negotiated Rate	$34,766.72
Max. Negotiated Rate	$55,047.31
Rate for Payer: Adventist Health Medi-Cal	$34,766.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$41,430.35
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$55,047.31

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

Facility

$1,863.33

Service Code	APR-DRG 6401
Min. Negotiated Rate	$1,176.84
Max. Negotiated Rate	$1,863.33
Rate for Payer: Adventist Health Medi-Cal	$1,176.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,402.40
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$1,863.33

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

Facility

$65,460.38

Service Code	APR-DRG 6404
Min. Negotiated Rate	$41,343.40
Max. Negotiated Rate	$65,460.38
Rate for Payer: Adventist Health Medi-Cal	$41,343.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$49,267.55
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$65,460.38

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

Facility

$4,779.07

Service Code	APR-DRG 6403
Min. Negotiated Rate	$3,018.36
Max. Negotiated Rate	$4,779.07
Rate for Payer: Adventist Health Medi-Cal	$3,018.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,596.88
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$4,779.07

Know your out-of-pocket cost for care.

All Charges