Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$72,572.19

Service Code	APR-DRG 6092
Min. Negotiated Rate	$45,835.07
Max. Negotiated Rate	$72,572.19
Rate for Payer: Adventist Health Medi-Cal	$45,835.07
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$54,620.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$72,572.19

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$152,785.80

Service Code	APR-DRG 6093
Min. Negotiated Rate	$96,496.30
Max. Negotiated Rate	$152,785.80
Rate for Payer: Adventist Health Medi-Cal	$96,496.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$114,991.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$152,785.80

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$441,612.82

Service Code	APR-DRG 6094
Min. Negotiated Rate	$278,913.36
Max. Negotiated Rate	$441,612.82
Rate for Payer: Adventist Health Medi-Cal	$278,913.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$332,371.75
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$441,612.82

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$68,943.27

Service Code	APR-DRG 6091
Min. Negotiated Rate	$43,543.12
Max. Negotiated Rate	$68,943.27
Rate for Payer: Adventist Health Medi-Cal	$43,543.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$51,888.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$68,943.27

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$309,149.55

Service Code	APR-DRG 5882
Min. Negotiated Rate	$195,252.35
Max. Negotiated Rate	$309,149.55
Rate for Payer: Adventist Health Medi-Cal	$195,252.35
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$232,675.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$309,149.55

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$315,720.23

Service Code	APR-DRG 5883
Min. Negotiated Rate	$199,402.25
Max. Negotiated Rate	$315,720.23
Rate for Payer: Adventist Health Medi-Cal	$199,402.25
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$237,621.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$315,720.23

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$203,495.66

Service Code	APR-DRG 5881
Min. Negotiated Rate	$128,523.58
Max. Negotiated Rate	$203,495.66
Rate for Payer: Adventist Health Medi-Cal	$128,523.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$153,157.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$203,495.66

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$705,696.27

Service Code	APR-DRG 5884
Min. Negotiated Rate	$445,702.91
Max. Negotiated Rate	$705,696.27
Rate for Payer: Adventist Health Medi-Cal	$445,702.91
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$531,129.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$705,696.27

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

Facility

$2,456.24

Service Code	APR-DRG 6261
Min. Negotiated Rate	$1,551.31
Max. Negotiated Rate	$2,456.24
Rate for Payer: Adventist Health Medi-Cal	$1,551.31
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,848.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,456.24

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

Facility

$67,292.17

Service Code	APR-DRG 6264
Min. Negotiated Rate	$42,500.32
Max. Negotiated Rate	$67,292.17
Rate for Payer: Adventist Health Medi-Cal	$42,500.32
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$50,646.21
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$67,292.17

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

Facility

$2,865.90

Service Code	APR-DRG 6262
Min. Negotiated Rate	$1,810.04
Max. Negotiated Rate	$2,865.90
Rate for Payer: Adventist Health Medi-Cal	$1,810.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$2,156.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,865.90

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

Facility

$8,481.58

Service Code	APR-DRG 6263
Min. Negotiated Rate	$5,356.79
Max. Negotiated Rate	$8,481.58
Rate for Payer: Adventist Health Medi-Cal	$5,356.79
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,383.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,481.58

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

Facility

$62,667.43

Service Code	APR-DRG 6233
Min. Negotiated Rate	$39,579.43
Max. Negotiated Rate	$62,667.43
Rate for Payer: Adventist Health Medi-Cal	$39,579.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,165.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,667.43

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

Facility

$17,559.48

Service Code	APR-DRG 6231
Min. Negotiated Rate	$11,090.20
Max. Negotiated Rate	$17,559.48
Rate for Payer: Adventist Health Medi-Cal	$11,090.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,215.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,559.48

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

Facility

$28,481.76

Service Code	APR-DRG 6232
Min. Negotiated Rate	$17,988.48
Max. Negotiated Rate	$28,481.76
Rate for Payer: Adventist Health Medi-Cal	$17,988.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$21,436.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$28,481.76

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

Facility

$109,432.76

Service Code	APR-DRG 6234
Min. Negotiated Rate	$69,115.43
Max. Negotiated Rate	$109,432.76
Rate for Payer: Adventist Health Medi-Cal	$69,115.43
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$82,362.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,432.76

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$25,894.74

Service Code	APR-DRG 6212
Min. Negotiated Rate	$16,354.57
Max. Negotiated Rate	$25,894.74
Rate for Payer: Adventist Health Medi-Cal	$16,354.57
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,489.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,894.74

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$7,996.09

Service Code	APR-DRG 6211
Min. Negotiated Rate	$5,050.16
Max. Negotiated Rate	$7,996.09
Rate for Payer: Adventist Health Medi-Cal	$5,050.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,018.11
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$7,996.09

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$151,069.00

Service Code	APR-DRG 6214
Min. Negotiated Rate	$95,412.00
Max. Negotiated Rate	$151,069.00
Rate for Payer: Adventist Health Medi-Cal	$95,412.00
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$113,699.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$151,069.00

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$61,581.18

Service Code	APR-DRG 6213
Min. Negotiated Rate	$38,893.38
Max. Negotiated Rate	$61,581.18
Rate for Payer: Adventist Health Medi-Cal	$38,893.38
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,347.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,581.18

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$100,813.75

Service Code	APR-DRG 6254
Min. Negotiated Rate	$63,671.84
Max. Negotiated Rate	$100,813.75
Rate for Payer: Adventist Health Medi-Cal	$63,671.84
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$75,875.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$100,813.75

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$20,288.39

Service Code	APR-DRG 6251
Min. Negotiated Rate	$12,813.72
Max. Negotiated Rate	$20,288.39
Rate for Payer: Adventist Health Medi-Cal	$12,813.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$15,269.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$20,288.39

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$27,588.38

Service Code	APR-DRG 6252
Min. Negotiated Rate	$17,424.24
Max. Negotiated Rate	$27,588.38
Rate for Payer: Adventist Health Medi-Cal	$17,424.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$20,763.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,588.38

NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$49,894.08

Service Code	APR-DRG 6253
Min. Negotiated Rate	$31,512.05
Max. Negotiated Rate	$49,894.08
Rate for Payer: Adventist Health Medi-Cal	$31,512.05
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$37,551.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$49,894.08

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

Facility

$48,222.59

Service Code	APR-DRG 6223
Min. Negotiated Rate	$30,456.37
Max. Negotiated Rate	$48,222.59
Rate for Payer: Adventist Health Medi-Cal	$30,456.37
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$36,293.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$48,222.59

Know your out-of-pocket cost for care.

All Charges