Loma Linda University Medical Center

All Charges

Charge

Type

Price

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$6,960.78

Service Code	APR-DRG 6392
Min. Negotiated Rate	$5,841.22
Max. Negotiated Rate	$6,960.78
Rate for Payer: Adventist Health Medi-Cal	$5,841.22
Rate for Payer: IEHP medi-cal	$6,960.78

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility IP

$5,090.44

Service Code	APR-DRG 6391
Min. Negotiated Rate	$4,271.70
Max. Negotiated Rate	$5,090.44
Rate for Payer: Adventist Health Medi-Cal	$4,271.70
Rate for Payer: IEHP medi-cal	$5,090.44

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

Facility IP

$79,203.18

Service Code	APR-DRG 6344
Min. Negotiated Rate	$66,464.21
Max. Negotiated Rate	$79,203.18
Rate for Payer: Adventist Health Medi-Cal	$66,464.21
Rate for Payer: IEHP medi-cal	$79,203.18

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

Facility IP

$18,918.59

Service Code	APR-DRG 6343
Min. Negotiated Rate	$15,875.74
Max. Negotiated Rate	$18,918.59
Rate for Payer: Adventist Health Medi-Cal	$15,875.74
Rate for Payer: IEHP medi-cal	$18,918.59

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

Facility IP

$16,754.60

Service Code	APR-DRG 6342
Min. Negotiated Rate	$14,059.80
Max. Negotiated Rate	$16,754.60
Rate for Payer: Adventist Health Medi-Cal	$14,059.80
Rate for Payer: IEHP medi-cal	$16,754.60

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

Facility IP

$8,167.07

Service Code	APR-DRG 6341
Min. Negotiated Rate	$6,853.49
Max. Negotiated Rate	$8,167.07
Rate for Payer: Adventist Health Medi-Cal	$6,853.49
Rate for Payer: IEHP medi-cal	$8,167.07

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$1,967.11

Service Code	APR-DRG 5911
Min. Negotiated Rate	$1,650.72
Max. Negotiated Rate	$1,967.11
Rate for Payer: Adventist Health Medi-Cal	$1,650.72
Rate for Payer: IEHP medi-cal	$1,967.11

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$334,505.24

Service Code	APR-DRG 5914
Min. Negotiated Rate	$280,703.70
Max. Negotiated Rate	$334,505.24
Rate for Payer: Adventist Health Medi-Cal	$280,703.70
Rate for Payer: IEHP medi-cal	$334,505.24

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$136,089.00

Service Code	APR-DRG 5913
Min. Negotiated Rate	$114,200.56
Max. Negotiated Rate	$136,089.00
Rate for Payer: Adventist Health Medi-Cal	$114,200.56
Rate for Payer: IEHP medi-cal	$136,089.00

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$72,415.84

Service Code	APR-DRG 5912
Min. Negotiated Rate	$60,768.54
Max. Negotiated Rate	$72,415.84
Rate for Payer: Adventist Health Medi-Cal	$60,768.54
Rate for Payer: IEHP medi-cal	$72,415.84

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility IP

$59,824.04

Service Code	APR-DRG 5892
Min. Negotiated Rate	$50,201.99
Max. Negotiated Rate	$59,824.04
Rate for Payer: Adventist Health Medi-Cal	$50,201.99
Rate for Payer: IEHP medi-cal	$59,824.04

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility IP

$47,584.27

Service Code	APR-DRG 5893
Min. Negotiated Rate	$39,930.85
Max. Negotiated Rate	$47,584.27
Rate for Payer: Adventist Health Medi-Cal	$39,930.85
Rate for Payer: IEHP medi-cal	$47,584.27

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility IP

$72,062.13

Service Code	APR-DRG 5891
Min. Negotiated Rate	$60,471.72
Max. Negotiated Rate	$72,062.13
Rate for Payer: Adventist Health Medi-Cal	$60,471.72
Rate for Payer: IEHP medi-cal	$72,062.13

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility IP

$1,453.55

Service Code	APR-DRG 5894
Min. Negotiated Rate	$1,219.76
Max. Negotiated Rate	$1,453.55
Rate for Payer: Adventist Health Medi-Cal	$1,219.76
Rate for Payer: IEHP medi-cal	$1,453.55

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$122,607.90

Service Code	APR-DRG 5932
Min. Negotiated Rate	$102,887.75
Max. Negotiated Rate	$122,607.90
Rate for Payer: Adventist Health Medi-Cal	$102,887.75
Rate for Payer: IEHP medi-cal	$122,607.90

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$346,397.97

Service Code	APR-DRG 5934
Min. Negotiated Rate	$290,683.61
Max. Negotiated Rate	$346,397.97
Rate for Payer: Adventist Health Medi-Cal	$290,683.61
Rate for Payer: IEHP medi-cal	$346,397.97

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$2,270.77

Service Code	APR-DRG 5931
Min. Negotiated Rate	$1,905.54
Max. Negotiated Rate	$2,270.77
Rate for Payer: Adventist Health Medi-Cal	$1,905.54
Rate for Payer: IEHP medi-cal	$2,270.77

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility IP

$154,692.24

Service Code	APR-DRG 5933
Min. Negotiated Rate	$129,811.67
Max. Negotiated Rate	$154,692.24
Rate for Payer: Adventist Health Medi-Cal	$129,811.67
Rate for Payer: IEHP medi-cal	$154,692.24

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility IP

$2,310.81

Service Code	APR-DRG 5812
Min. Negotiated Rate	$1,939.14
Max. Negotiated Rate	$2,310.81
Rate for Payer: Adventist Health Medi-Cal	$1,939.14
Rate for Payer: IEHP medi-cal	$2,310.81

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility IP

$1,543.31

Service Code	APR-DRG 5811
Min. Negotiated Rate	$1,295.09
Max. Negotiated Rate	$1,543.31
Rate for Payer: Adventist Health Medi-Cal	$1,295.09
Rate for Payer: IEHP medi-cal	$1,543.31

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility IP

$8,538.74

Service Code	APR-DRG 5814
Min. Negotiated Rate	$7,165.38
Max. Negotiated Rate	$8,538.74
Rate for Payer: Adventist Health Medi-Cal	$7,165.38
Rate for Payer: IEHP medi-cal	$8,538.74

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility IP

$3,543.80

Service Code	APR-DRG 5813
Min. Negotiated Rate	$2,973.82
Max. Negotiated Rate	$3,543.80
Rate for Payer: Adventist Health Medi-Cal	$2,973.82
Rate for Payer: IEHP medi-cal	$3,543.80

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility IP

$4,431.41

Service Code	APR-DRG 5801
Min. Negotiated Rate	$3,718.67
Max. Negotiated Rate	$4,431.41
Rate for Payer: Adventist Health Medi-Cal	$3,718.67
Rate for Payer: IEHP medi-cal	$4,431.41

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility IP

$21,949.90

Service Code	APR-DRG 5804
Min. Negotiated Rate	$18,419.50
Max. Negotiated Rate	$21,949.90
Rate for Payer: Adventist Health Medi-Cal	$18,419.50
Rate for Payer: IEHP medi-cal	$21,949.90

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility IP

$9,296.62

Service Code	APR-DRG 5803
Min. Negotiated Rate	$7,801.36
Max. Negotiated Rate	$9,296.62
Rate for Payer: Adventist Health Medi-Cal	$7,801.36
Rate for Payer: IEHP medi-cal	$9,296.62

Price Transparency.

All Charges