Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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 WITH CONGENITAL OR PERINATAL INFECTION

Facility

$14,494.11

Service Code	APR-DRG 6361
Min. Negotiated Rate	$9,154.18
Max. Negotiated Rate	$14,494.11
Rate for Payer: Adventist Health Medi-Cal	$9,154.18
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,908.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,494.11

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$87,497.62

Service Code	APR-DRG 6364
Min. Negotiated Rate	$55,261.66
Max. Negotiated Rate	$87,497.62
Rate for Payer: Adventist Health Medi-Cal	$55,261.66
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,853.47
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$87,497.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$59,220.72

Service Code	APR-DRG 6363
Min. Negotiated Rate	$37,402.56
Max. Negotiated Rate	$59,220.72
Rate for Payer: Adventist Health Medi-Cal	$37,402.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$44,571.38
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$59,220.72

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$22,879.69

Service Code	APR-DRG 6362
Min. Negotiated Rate	$14,450.33
Max. Negotiated Rate	$22,879.69
Rate for Payer: Adventist Health Medi-Cal	$14,450.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$17,219.97
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$22,879.69

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$58,536.89

Service Code	APR-DRG 6333
Min. Negotiated Rate	$36,970.67
Max. Negotiated Rate	$58,536.89
Rate for Payer: Adventist Health Medi-Cal	$36,970.67
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$44,056.71
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$58,536.89

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$238,065.78

Service Code	APR-DRG 6334
Min. Negotiated Rate	$150,357.34
Max. Negotiated Rate	$238,065.78
Rate for Payer: Adventist Health Medi-Cal	$150,357.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$179,175.83
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$238,065.78

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$5,033.46

Service Code	APR-DRG 6331
Min. Negotiated Rate	$3,179.03
Max. Negotiated Rate	$5,033.46
Rate for Payer: Adventist Health Medi-Cal	$3,179.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,788.34
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$5,033.46

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$17,380.95

Service Code	APR-DRG 6332
Min. Negotiated Rate	$10,977.44
Max. Negotiated Rate	$17,380.95
Rate for Payer: Adventist Health Medi-Cal	$10,977.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,081.45
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$17,380.95

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$108,427.38

Service Code	APR-DRG 6302
Min. Negotiated Rate	$68,480.45
Max. Negotiated Rate	$108,427.38
Rate for Payer: Adventist Health Medi-Cal	$68,480.45
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$81,605.87
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$108,427.38

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$608,215.48

Service Code	APR-DRG 6304
Min. Negotiated Rate	$384,136.09
Max. Negotiated Rate	$608,215.48
Rate for Payer: Adventist Health Medi-Cal	$384,136.09
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$457,762.18
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$608,215.48

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$61,638.75

Service Code	APR-DRG 6301
Min. Negotiated Rate	$38,929.74
Max. Negotiated Rate	$61,638.75
Rate for Payer: Adventist Health Medi-Cal	$38,929.74
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,391.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$61,638.75

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$275,268.28

Service Code	APR-DRG 6303
Min. Negotiated Rate	$173,853.65
Max. Negotiated Rate	$275,268.28
Rate for Payer: Adventist Health Medi-Cal	$173,853.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$207,175.60
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$275,268.28

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$164,958.63

Service Code	APR-DRG 6313
Min. Negotiated Rate	$104,184.40
Max. Negotiated Rate	$164,958.63
Rate for Payer: Adventist Health Medi-Cal	$104,184.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$124,153.07
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$164,958.63

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$87,412.31

Service Code	APR-DRG 6312
Min. Negotiated Rate	$55,207.78
Max. Negotiated Rate	$87,412.31
Rate for Payer: Adventist Health Medi-Cal	$55,207.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,789.27
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$87,412.31

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$715,770.81

Service Code	APR-DRG 6314
Min. Negotiated Rate	$452,065.78
Max. Negotiated Rate	$715,770.81
Rate for Payer: Adventist Health Medi-Cal	$452,065.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$538,711.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$715,770.81

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$11,762.37

Service Code	APR-DRG 6311
Min. Negotiated Rate	$7,428.86
Max. Negotiated Rate	$11,762.37
Rate for Payer: Adventist Health Medi-Cal	$7,428.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,852.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$11,762.37

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$44,106.22

Service Code	APR-DRG 6393
Min. Negotiated Rate	$27,856.56
Max. Negotiated Rate	$44,106.22
Rate for Payer: Adventist Health Medi-Cal	$27,856.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,195.73
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$44,106.22

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$75,861.45

Service Code	APR-DRG 6394
Min. Negotiated Rate	$47,912.50
Max. Negotiated Rate	$75,861.45
Rate for Payer: Adventist Health Medi-Cal	$47,912.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$57,095.72
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$75,861.45

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$12,509.64

Service Code	APR-DRG 6392
Min. Negotiated Rate	$7,900.82
Max. Negotiated Rate	$12,509.64
Rate for Payer: Adventist Health Medi-Cal	$7,900.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,415.15
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$12,509.64

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$7,032.03

Service Code	APR-DRG 6391
Min. Negotiated Rate	$4,441.28
Max. Negotiated Rate	$7,032.03
Rate for Payer: Adventist Health Medi-Cal	$4,441.28
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$5,292.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$7,032.03

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

Facility

$55,272.90

Service Code	APR-DRG 6343
Min. Negotiated Rate	$34,909.20
Max. Negotiated Rate	$55,272.90
Rate for Payer: Adventist Health Medi-Cal	$34,909.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$41,600.13
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$55,272.90

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

Facility

$134,850.22

Service Code	APR-DRG 6344
Min. Negotiated Rate	$85,168.56
Max. Negotiated Rate	$134,850.22
Rate for Payer: Adventist Health Medi-Cal	$85,168.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$101,492.53
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$134,850.22

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

Facility

$24,726.69

Service Code	APR-DRG 6342
Min. Negotiated Rate	$15,616.86
Max. Negotiated Rate	$24,726.69
Rate for Payer: Adventist Health Medi-Cal	$15,616.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$18,610.09
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$24,726.69

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

Facility

$14,786.67

Service Code	APR-DRG 6341
Min. Negotiated Rate	$9,338.95
Max. Negotiated Rate	$14,786.67
Rate for Payer: Adventist Health Medi-Cal	$9,338.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,128.92
Rate for Payer: Kaiser Foundation Hospitals Medi-Cal	$14,786.67

Know your out-of-pocket cost for care.

All Charges