Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$42,523.14

Service Code	APR-DRG 6222
Min. Negotiated Rate	$26,856.72
Max. Negotiated Rate	$42,523.14
Rate for Payer: Adventist Health Medi-Cal	$26,856.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$32,004.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,523.14

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

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

Facility

$119,239.29

Service Code	APR-DRG 6224
Min. Negotiated Rate	$75,309.02
Max. Negotiated Rate	$119,239.29
Rate for Payer: Adventist Health Medi-Cal	$75,309.02
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$89,743.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$119,239.29

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

Facility

$4,087.83

Service Code	APR-DRG 6403
Min. Negotiated Rate	$2,581.79
Max. Negotiated Rate	$4,087.83
Rate for Payer: Adventist Health Medi-Cal	$2,581.79
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,076.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,087.83

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

Facility

$2,261.17

Service Code	APR-DRG 6402
Min. Negotiated Rate	$1,428.11
Max. Negotiated Rate	$2,261.17
Rate for Payer: Adventist Health Medi-Cal	$1,428.11
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,701.83
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,261.17

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

Facility

$1,709.62

Service Code	APR-DRG 6401
Min. Negotiated Rate	$1,079.76
Max. Negotiated Rate	$1,709.62
Rate for Payer: Adventist Health Medi-Cal	$1,079.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,286.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$1,709.62

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

Facility

$55,525.62

Service Code	APR-DRG 6404
Min. Negotiated Rate	$35,068.81
Max. Negotiated Rate	$55,525.62
Rate for Payer: Adventist Health Medi-Cal	$35,068.81
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$41,790.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$55,525.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$87,119.08

Service Code	APR-DRG 6364
Min. Negotiated Rate	$55,022.58
Max. Negotiated Rate	$87,119.08
Rate for Payer: Adventist Health Medi-Cal	$55,022.58
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$65,568.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$87,119.08

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$18,111.46

Service Code	APR-DRG 6362
Min. Negotiated Rate	$11,438.82
Max. Negotiated Rate	$18,111.46
Rate for Payer: Adventist Health Medi-Cal	$11,438.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$13,631.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$18,111.46

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$9,669.78

Service Code	APR-DRG 6361
Min. Negotiated Rate	$6,107.23
Max. Negotiated Rate	$9,669.78
Rate for Payer: Adventist Health Medi-Cal	$6,107.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,277.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,669.78

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$37,439.96

Service Code	APR-DRG 6363
Min. Negotiated Rate	$23,646.29
Max. Negotiated Rate	$37,439.96
Rate for Payer: Adventist Health Medi-Cal	$23,646.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,178.49
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,439.96

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$3,655.54

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,308.76
Max. Negotiated Rate	$3,655.54
Rate for Payer: Adventist Health Medi-Cal	$2,308.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$2,751.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$3,655.54

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$36,872.44

Service Code	APR-DRG 6333
Min. Negotiated Rate	$23,287.86
Max. Negotiated Rate	$36,872.44
Rate for Payer: Adventist Health Medi-Cal	$23,287.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,751.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,872.44

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$10,388.04

Service Code	APR-DRG 6332
Min. Negotiated Rate	$6,560.87
Max. Negotiated Rate	$10,388.04
Rate for Payer: Adventist Health Medi-Cal	$6,560.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,818.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,388.04

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$137,307.30

Service Code	APR-DRG 6334
Min. Negotiated Rate	$86,720.40
Max. Negotiated Rate	$137,307.30
Rate for Payer: Adventist Health Medi-Cal	$86,720.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$103,341.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,307.30

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$512,221.72

Service Code	APR-DRG 6304
Min. Negotiated Rate	$323,508.46
Max. Negotiated Rate	$512,221.72
Rate for Payer: Adventist Health Medi-Cal	$323,508.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$385,514.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$512,221.72

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$43,256.90

Service Code	APR-DRG 6301
Min. Negotiated Rate	$27,320.15
Max. Negotiated Rate	$43,256.90
Rate for Payer: Adventist Health Medi-Cal	$27,320.15
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$32,556.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$43,256.90

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$109,045.62

Service Code	APR-DRG 6302
Min. Negotiated Rate	$68,870.92
Max. Negotiated Rate	$109,045.62
Rate for Payer: Adventist Health Medi-Cal	$68,870.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$82,071.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,045.62

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$171,870.45

Service Code	APR-DRG 6303
Min. Negotiated Rate	$108,549.76
Max. Negotiated Rate	$171,870.45
Rate for Payer: Adventist Health Medi-Cal	$108,549.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$129,355.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$171,870.45

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$8,953.75

Service Code	APR-DRG 6311
Min. Negotiated Rate	$5,655.00
Max. Negotiated Rate	$8,953.75
Rate for Payer: Adventist Health Medi-Cal	$5,655.00
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,738.88
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$8,953.75

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$69,342.29

Service Code	APR-DRG 6312
Min. Negotiated Rate	$43,795.13
Max. Negotiated Rate	$69,342.29
Rate for Payer: Adventist Health Medi-Cal	$43,795.13
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,189.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,342.29

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$423,963.00

Service Code	APR-DRG 6314
Min. Negotiated Rate	$267,766.10
Max. Negotiated Rate	$423,963.00
Rate for Payer: Adventist Health Medi-Cal	$267,766.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$319,087.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$423,963.00

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$113,064.72

Service Code	APR-DRG 6313
Min. Negotiated Rate	$71,409.30
Max. Negotiated Rate	$113,064.72
Rate for Payer: Adventist Health Medi-Cal	$71,409.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$85,096.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$113,064.72

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$9,248.59

Service Code	APR-DRG 6392
Min. Negotiated Rate	$5,841.22
Max. Negotiated Rate	$9,248.59
Rate for Payer: Adventist Health Medi-Cal	$5,841.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,960.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,248.59

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$30,288.49

Service Code	APR-DRG 6393
Min. Negotiated Rate	$19,129.57
Max. Negotiated Rate	$30,288.49
Rate for Payer: Adventist Health Medi-Cal	$19,129.57
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,796.07
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$30,288.49

Know your out-of-pocket cost for care.

All Charges