Loma Linda University Medical Center

All Charges

Charge

Type

Price

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

Facility IP

$103,744.38

Service Code	APR-DRG 6022
Min. Negotiated Rate	$87,058.22
Max. Negotiated Rate	$103,744.38
Rate for Payer: Adventist Health Medi-Cal	$87,058.22
Rate for Payer: IEHP medi-cal	$103,744.38

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

Facility IP

$7,986.88

Service Code	APR-DRG 6081
Min. Negotiated Rate	$6,702.28
Max. Negotiated Rate	$7,986.88
Rate for Payer: Adventist Health Medi-Cal	$6,702.28
Rate for Payer: IEHP medi-cal	$7,986.88

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

Facility IP

$79,863.81

Service Code	APR-DRG 6083
Min. Negotiated Rate	$67,018.58
Max. Negotiated Rate	$79,863.81
Rate for Payer: Adventist Health Medi-Cal	$67,018.58
Rate for Payer: IEHP medi-cal	$79,863.81

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

Facility IP

$120,753.25

Service Code	APR-DRG 6084
Min. Negotiated Rate	$101,331.40
Max. Negotiated Rate	$120,753.25
Rate for Payer: Adventist Health Medi-Cal	$101,331.40
Rate for Payer: IEHP medi-cal	$120,753.25

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

Facility IP

$58,956.44

Service Code	APR-DRG 6082
Min. Negotiated Rate	$49,473.94
Max. Negotiated Rate	$58,956.44
Rate for Payer: Adventist Health Medi-Cal	$49,473.94
Rate for Payer: IEHP medi-cal	$58,956.44

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

Facility IP

$103,031.94

Service Code	APR-DRG 6073
Min. Negotiated Rate	$86,460.37
Max. Negotiated Rate	$103,031.94
Rate for Payer: Adventist Health Medi-Cal	$86,460.37
Rate for Payer: IEHP medi-cal	$103,031.94

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

Facility IP

$79,780.39

Service Code	APR-DRG 6072
Min. Negotiated Rate	$66,948.58
Max. Negotiated Rate	$79,780.39
Rate for Payer: Adventist Health Medi-Cal	$66,948.58
Rate for Payer: IEHP medi-cal	$79,780.39

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

Facility IP

$190,713.74

Service Code	APR-DRG 6074
Min. Negotiated Rate	$160,039.50
Max. Negotiated Rate	$190,713.74
Rate for Payer: Adventist Health Medi-Cal	$160,039.50
Rate for Payer: IEHP medi-cal	$190,713.74

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

Facility IP

$33,022.02

Service Code	APR-DRG 6071
Min. Negotiated Rate	$27,710.78
Max. Negotiated Rate	$33,022.02
Rate for Payer: Adventist Health Medi-Cal	$27,710.78
Rate for Payer: IEHP medi-cal	$33,022.02

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

Facility IP

$135,971.14

Service Code	APR-DRG 6134
Min. Negotiated Rate	$114,101.65
Max. Negotiated Rate	$135,971.14
Rate for Payer: Adventist Health Medi-Cal	$114,101.65
Rate for Payer: IEHP medi-cal	$135,971.14

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

Facility IP

$61,572.57

Service Code	APR-DRG 6133
Min. Negotiated Rate	$51,669.29
Max. Negotiated Rate	$61,572.57
Rate for Payer: Adventist Health Medi-Cal	$51,669.29
Rate for Payer: IEHP medi-cal	$61,572.57

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

Facility IP

$38,254.27

Service Code	APR-DRG 6132
Min. Negotiated Rate	$32,101.49
Max. Negotiated Rate	$38,254.27
Rate for Payer: Adventist Health Medi-Cal	$32,101.49
Rate for Payer: IEHP medi-cal	$38,254.27

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

Facility IP

$21,077.56

Service Code	APR-DRG 6131
Min. Negotiated Rate	$17,687.46
Max. Negotiated Rate	$21,077.56
Rate for Payer: Adventist Health Medi-Cal	$17,687.46
Rate for Payer: IEHP medi-cal	$21,077.56

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$16,894.75

Service Code	APR-DRG 6111
Min. Negotiated Rate	$14,177.41
Max. Negotiated Rate	$16,894.75
Rate for Payer: Adventist Health Medi-Cal	$14,177.41
Rate for Payer: IEHP medi-cal	$16,894.75

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$65,553.50

Service Code	APR-DRG 6113
Min. Negotiated Rate	$55,009.93
Max. Negotiated Rate	$65,553.50
Rate for Payer: Adventist Health Medi-Cal	$55,009.93
Rate for Payer: IEHP medi-cal	$65,553.50

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$37,548.53

Service Code	APR-DRG 6112
Min. Negotiated Rate	$31,509.25
Max. Negotiated Rate	$37,548.53
Rate for Payer: Adventist Health Medi-Cal	$31,509.25
Rate for Payer: IEHP medi-cal	$37,548.53

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$144,927.93

Service Code	APR-DRG 6114
Min. Negotiated Rate	$121,617.84
Max. Negotiated Rate	$144,927.93
Rate for Payer: Adventist Health Medi-Cal	$121,617.84
Rate for Payer: IEHP medi-cal	$144,927.93

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

Facility IP

$31,982.56

Service Code	APR-DRG 6142
Min. Negotiated Rate	$26,838.52
Max. Negotiated Rate	$31,982.56
Rate for Payer: Adventist Health Medi-Cal	$26,838.52
Rate for Payer: IEHP medi-cal	$31,982.56

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

Facility IP

$58,212.31

Service Code	APR-DRG 6143
Min. Negotiated Rate	$48,849.49
Max. Negotiated Rate	$58,212.31
Rate for Payer: Adventist Health Medi-Cal	$48,849.49
Rate for Payer: IEHP medi-cal	$58,212.31

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

Facility IP

$109,268.96

Service Code	APR-DRG 6144
Min. Negotiated Rate	$91,694.23
Max. Negotiated Rate	$109,268.96
Rate for Payer: Adventist Health Medi-Cal	$91,694.23
Rate for Payer: IEHP medi-cal	$109,268.96

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

Facility IP

$13,165.75

Service Code	APR-DRG 6141
Min. Negotiated Rate	$11,048.18
Max. Negotiated Rate	$13,165.75
Rate for Payer: Adventist Health Medi-Cal	$11,048.18
Rate for Payer: IEHP medi-cal	$13,165.75

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

Facility IP

$67,684.12

Service Code	APR-DRG 6123
Min. Negotiated Rate	$56,797.86
Max. Negotiated Rate	$67,684.12
Rate for Payer: Adventist Health Medi-Cal	$56,797.86
Rate for Payer: IEHP medi-cal	$67,684.12

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

Facility IP

$138,587.53

Service Code	APR-DRG 6124
Min. Negotiated Rate	$116,297.23
Max. Negotiated Rate	$138,587.53
Rate for Payer: Adventist Health Medi-Cal	$116,297.23
Rate for Payer: IEHP medi-cal	$138,587.53

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

Facility IP

$52,414.43

Service Code	APR-DRG 6122
Min. Negotiated Rate	$43,984.14
Max. Negotiated Rate	$52,414.43
Rate for Payer: Adventist Health Medi-Cal	$43,984.14
Rate for Payer: IEHP medi-cal	$52,414.43

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

Facility IP

$34,260.00

Service Code	APR-DRG 6121
Min. Negotiated Rate	$28,749.65
Max. Negotiated Rate	$34,260.00
Rate for Payer: Adventist Health Medi-Cal	$28,749.65
Rate for Payer: IEHP medi-cal	$34,260.00

Price Transparency.

All Charges