Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$21,645.26

Service Code	APR-DRG 6081
Min. Negotiated Rate	$13,670.69
Max. Negotiated Rate	$21,645.26
Rate for Payer: Adventist Health Medi-Cal	$13,670.69
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$16,290.90
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$21,645.26

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$372,191.08

Service Code	APR-DRG 6074
Min. Negotiated Rate	$235,068.05
Max. Negotiated Rate	$372,191.08
Rate for Payer: Adventist Health Medi-Cal	$235,068.05
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$280,122.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$372,191.08

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$62,902.39

Service Code	APR-DRG 6071
Min. Negotiated Rate	$39,727.82
Max. Negotiated Rate	$62,902.39
Rate for Payer: Adventist Health Medi-Cal	$39,727.82
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,342.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$62,902.39

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$155,037.85

Service Code	APR-DRG 6072
Min. Negotiated Rate	$97,918.64
Max. Negotiated Rate	$155,037.85
Rate for Payer: Adventist Health Medi-Cal	$97,918.64
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$116,686.38
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$155,037.85

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$213,104.67

Service Code	APR-DRG 6073
Min. Negotiated Rate	$134,592.42
Max. Negotiated Rate	$213,104.67
Rate for Payer: Adventist Health Medi-Cal	$134,592.42
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$160,389.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$213,104.67

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$70,892.90

Service Code	APR-DRG 6132
Min. Negotiated Rate	$44,774.46
Max. Negotiated Rate	$70,892.90
Rate for Payer: Adventist Health Medi-Cal	$44,774.46
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$53,356.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$70,892.90

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$125,548.52

Service Code	APR-DRG 6133
Min. Negotiated Rate	$79,293.80
Max. Negotiated Rate	$125,548.52
Rate for Payer: Adventist Health Medi-Cal	$79,293.80
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$94,491.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$125,548.52

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$229,981.40

Service Code	APR-DRG 6134
Min. Negotiated Rate	$145,251.41
Max. Negotiated Rate	$229,981.40
Rate for Payer: Adventist Health Medi-Cal	$145,251.41
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$173,091.26
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$229,981.40

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$45,646.74

Service Code	APR-DRG 6131
Min. Negotiated Rate	$28,829.52
Max. Negotiated Rate	$45,646.74
Rate for Payer: Adventist Health Medi-Cal	$28,829.52
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$34,355.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$45,646.74

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$128,863.21

Service Code	APR-DRG 6113
Min. Negotiated Rate	$81,387.29
Max. Negotiated Rate	$128,863.21
Rate for Payer: Adventist Health Medi-Cal	$81,387.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$96,986.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$128,863.21

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$32,135.10

Service Code	APR-DRG 6111
Min. Negotiated Rate	$20,295.85
Max. Negotiated Rate	$32,135.10
Rate for Payer: Adventist Health Medi-Cal	$20,295.85
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$24,185.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$32,135.10

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$72,729.95

Service Code	APR-DRG 6112
Min. Negotiated Rate	$45,934.70
Max. Negotiated Rate	$72,729.95
Rate for Payer: Adventist Health Medi-Cal	$45,934.70
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$54,738.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$72,729.95

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$282,284.88

Service Code	APR-DRG 6114
Min. Negotiated Rate	$178,285.19
Max. Negotiated Rate	$282,284.88
Rate for Payer: Adventist Health Medi-Cal	$178,285.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$212,456.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$282,284.88

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$192,606.14

Service Code	APR-DRG 6144
Min. Negotiated Rate	$121,645.98
Max. Negotiated Rate	$192,606.14
Rate for Payer: Adventist Health Medi-Cal	$121,645.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$144,961.46
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$192,606.14

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$25,425.86

Service Code	APR-DRG 6141
Min. Negotiated Rate	$16,058.44
Max. Negotiated Rate	$25,425.86
Rate for Payer: Adventist Health Medi-Cal	$16,058.44
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,136.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,425.86

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$113,640.96

Service Code	APR-DRG 6143
Min. Negotiated Rate	$71,773.24
Max. Negotiated Rate	$113,640.96
Rate for Payer: Adventist Health Medi-Cal	$71,773.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$85,529.77
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$113,640.96

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$60,692.59

Service Code	APR-DRG 6142
Min. Negotiated Rate	$38,332.16
Max. Negotiated Rate	$60,692.59
Rate for Payer: Adventist Health Medi-Cal	$38,332.16
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$45,679.16
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$60,692.59

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$129,838.30

Service Code	APR-DRG 6123
Min. Negotiated Rate	$82,003.14
Max. Negotiated Rate	$129,838.30
Rate for Payer: Adventist Health Medi-Cal	$82,003.14
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$97,720.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$129,838.30

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$271,332.56

Service Code	APR-DRG 6124
Min. Negotiated Rate	$171,367.93
Max. Negotiated Rate	$271,332.56
Rate for Payer: Adventist Health Medi-Cal	$171,367.93
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$204,213.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$271,332.56

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$65,970.79

Service Code	APR-DRG 6121
Min. Negotiated Rate	$41,665.76
Max. Negotiated Rate	$65,970.79
Rate for Payer: Adventist Health Medi-Cal	$41,665.76
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$49,651.70
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$65,970.79

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$101,743.38

Service Code	APR-DRG 6122
Min. Negotiated Rate	$64,258.98
Max. Negotiated Rate	$101,743.38
Rate for Payer: Adventist Health Medi-Cal	$64,258.98
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$76,575.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$101,743.38

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$120,300.27

Service Code	APR-DRG 6092
Min. Negotiated Rate	$75,979.12
Max. Negotiated Rate	$120,300.27
Rate for Payer: Adventist Health Medi-Cal	$75,979.12
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$90,541.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$120,300.27

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$109,124.87

Service Code	APR-DRG 6091
Min. Negotiated Rate	$68,920.97
Max. Negotiated Rate	$109,124.87
Rate for Payer: Adventist Health Medi-Cal	$68,920.97
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$82,130.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$109,124.87

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$211,720.23

Service Code	APR-DRG 6093
Min. Negotiated Rate	$133,718.04
Max. Negotiated Rate	$211,720.23
Rate for Payer: Adventist Health Medi-Cal	$133,718.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$159,347.33
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$211,720.23

APR-DRG 41.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$637,968.74

Service Code	APR-DRG 6094
Min. Negotiated Rate	$402,927.62
Max. Negotiated Rate	$637,968.74
Rate for Payer: Adventist Health Medi-Cal	$402,927.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$480,155.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$637,968.74

Know your out-of-pocket cost for care.

All Charges