Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$137,842.19

Service Code	APR-DRG 6022
Min. Negotiated Rate	$87,058.22
Max. Negotiated Rate	$137,842.19
Rate for Payer: Adventist Health Medi-Cal	$87,058.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$103,744.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,842.19

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$160,441.38

Service Code	APR-DRG 6084
Min. Negotiated Rate	$101,331.40
Max. Negotiated Rate	$160,441.38
Rate for Payer: Adventist Health Medi-Cal	$101,331.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$120,753.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$160,441.38

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$106,112.76

Service Code	APR-DRG 6083
Min. Negotiated Rate	$67,018.58
Max. Negotiated Rate	$106,112.76
Rate for Payer: Adventist Health Medi-Cal	$67,018.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$79,863.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$106,112.76

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$78,333.73

Service Code	APR-DRG 6082
Min. Negotiated Rate	$49,473.94
Max. Negotiated Rate	$78,333.73
Rate for Payer: Adventist Health Medi-Cal	$49,473.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$58,956.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$78,333.73

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$10,611.94

Service Code	APR-DRG 6081
Min. Negotiated Rate	$6,702.28
Max. Negotiated Rate	$10,611.94
Rate for Payer: Adventist Health Medi-Cal	$6,702.28
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,986.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,611.94

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

Facility

$43,875.41

Service Code	APR-DRG 6071
Min. Negotiated Rate	$27,710.78
Max. Negotiated Rate	$43,875.41
Rate for Payer: Adventist Health Medi-Cal	$27,710.78
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,022.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,875.41

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

Facility

$253,395.88

Service Code	APR-DRG 6074
Min. Negotiated Rate	$160,039.50
Max. Negotiated Rate	$253,395.88
Rate for Payer: Adventist Health Medi-Cal	$160,039.50
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$190,713.74
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$253,395.88

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

Facility

$106,001.91

Service Code	APR-DRG 6072
Min. Negotiated Rate	$66,948.58
Max. Negotiated Rate	$106,001.91
Rate for Payer: Adventist Health Medi-Cal	$66,948.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$79,780.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$106,001.91

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

Facility

$136,895.59

Service Code	APR-DRG 6073
Min. Negotiated Rate	$86,460.37
Max. Negotiated Rate	$136,895.59
Rate for Payer: Adventist Health Medi-Cal	$86,460.37
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$103,031.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$136,895.59

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

Facility

$180,660.95

Service Code	APR-DRG 6134
Min. Negotiated Rate	$114,101.65
Max. Negotiated Rate	$180,660.95
Rate for Payer: Adventist Health Medi-Cal	$114,101.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$135,971.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$180,660.95

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

Facility

$50,827.36

Service Code	APR-DRG 6132
Min. Negotiated Rate	$32,101.49
Max. Negotiated Rate	$50,827.36
Rate for Payer: Adventist Health Medi-Cal	$32,101.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$38,254.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$50,827.36

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

Facility

$28,005.14

Service Code	APR-DRG 6131
Min. Negotiated Rate	$17,687.46
Max. Negotiated Rate	$28,005.14
Rate for Payer: Adventist Health Medi-Cal	$17,687.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,077.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,005.14

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

Facility

$81,809.71

Service Code	APR-DRG 6133
Min. Negotiated Rate	$51,669.29
Max. Negotiated Rate	$81,809.71
Rate for Payer: Adventist Health Medi-Cal	$51,669.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$61,572.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$81,809.71

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$192,561.58

Service Code	APR-DRG 6114
Min. Negotiated Rate	$121,617.84
Max. Negotiated Rate	$192,561.58
Rate for Payer: Adventist Health Medi-Cal	$121,617.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$144,927.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$192,561.58

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$49,889.65

Service Code	APR-DRG 6112
Min. Negotiated Rate	$31,509.25
Max. Negotiated Rate	$49,889.65
Rate for Payer: Adventist Health Medi-Cal	$31,509.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$37,548.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,889.65

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$87,099.06

Service Code	APR-DRG 6113
Min. Negotiated Rate	$55,009.93
Max. Negotiated Rate	$87,099.06
Rate for Payer: Adventist Health Medi-Cal	$55,009.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,553.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,099.06

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$22,447.57

Service Code	APR-DRG 6111
Min. Negotiated Rate	$14,177.41
Max. Negotiated Rate	$22,447.57
Rate for Payer: Adventist Health Medi-Cal	$14,177.41
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,894.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,447.57

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

Facility

$17,492.96

Service Code	APR-DRG 6141
Min. Negotiated Rate	$11,048.18
Max. Negotiated Rate	$17,492.96
Rate for Payer: Adventist Health Medi-Cal	$11,048.18
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,165.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,492.96

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

Facility

$145,182.53

Service Code	APR-DRG 6144
Min. Negotiated Rate	$91,694.23
Max. Negotiated Rate	$145,182.53
Rate for Payer: Adventist Health Medi-Cal	$91,694.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$109,268.96
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$145,182.53

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

Facility

$42,494.32

Service Code	APR-DRG 6142
Min. Negotiated Rate	$26,838.52
Max. Negotiated Rate	$42,494.32
Rate for Payer: Adventist Health Medi-Cal	$26,838.52
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$31,982.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,494.32

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

Facility

$77,345.03

Service Code	APR-DRG 6143
Min. Negotiated Rate	$48,849.49
Max. Negotiated Rate	$77,345.03
Rate for Payer: Adventist Health Medi-Cal	$48,849.49
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$58,212.31
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$77,345.03

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

Facility

$184,137.28

Service Code	APR-DRG 6124
Min. Negotiated Rate	$116,297.23
Max. Negotiated Rate	$184,137.28
Rate for Payer: Adventist Health Medi-Cal	$116,297.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$138,587.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$184,137.28

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

Facility

$69,641.56

Service Code	APR-DRG 6122
Min. Negotiated Rate	$43,984.14
Max. Negotiated Rate	$69,641.56
Rate for Payer: Adventist Health Medi-Cal	$43,984.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,414.43
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,641.56

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

Facility

$45,520.28

Service Code	APR-DRG 6121
Min. Negotiated Rate	$28,749.65
Max. Negotiated Rate	$45,520.28
Rate for Payer: Adventist Health Medi-Cal	$28,749.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$34,260.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,520.28

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

Facility

$89,929.94

Service Code	APR-DRG 6123
Min. Negotiated Rate	$56,797.86
Max. Negotiated Rate	$89,929.94
Rate for Payer: Adventist Health Medi-Cal	$56,797.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$67,684.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$89,929.94

Know your out-of-pocket cost for care.

All Charges