Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$318,894.90

Service Code	APR-DRG 5881
Min. Negotiated Rate	$201,407.30
Max. Negotiated Rate	$318,894.90
Rate for Payer: Adventist Health Medi-Cal	$201,407.30
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$240,010.37
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$318,894.90

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

Facility

$492,559.53

Service Code	APR-DRG 5883
Min. Negotiated Rate	$311,090.23
Max. Negotiated Rate	$492,559.53
Rate for Payer: Adventist Health Medi-Cal	$311,090.23
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$370,715.86
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$492,559.53

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

Facility

$1,009,341.90

Service Code	APR-DRG 5884
Min. Negotiated Rate	$637,479.10
Max. Negotiated Rate	$1,009,341.90
Rate for Payer: Adventist Health Medi-Cal	$637,479.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$759,662.59
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$1,009,341.90

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

Facility

$479,460.55

Service Code	APR-DRG 5882
Min. Negotiated Rate	$302,817.19
Max. Negotiated Rate	$479,460.55
Rate for Payer: Adventist Health Medi-Cal	$302,817.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$360,857.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$479,460.55

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$86,157.72

Service Code	APR-DRG 6264
Min. Negotiated Rate	$54,415.40
Max. Negotiated Rate	$86,157.72
Rate for Payer: Adventist Health Medi-Cal	$54,415.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$64,845.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$86,157.72

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,871.58

Service Code	APR-DRG 6262
Min. Negotiated Rate	$1,813.63
Max. Negotiated Rate	$2,871.58
Rate for Payer: Adventist Health Medi-Cal	$1,813.63
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$2,161.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,871.58

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,525.48

Service Code	APR-DRG 6261
Min. Negotiated Rate	$1,595.04
Max. Negotiated Rate	$2,525.48
Rate for Payer: Adventist Health Medi-Cal	$1,595.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,900.76
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,525.48

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$11,794.40

Service Code	APR-DRG 6263
Min. Negotiated Rate	$7,449.10
Max. Negotiated Rate	$11,794.40
Rate for Payer: Adventist Health Medi-Cal	$7,449.10
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$8,876.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$11,794.40

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$93,506.60

Service Code	APR-DRG 6233
Min. Negotiated Rate	$59,056.80
Max. Negotiated Rate	$93,506.60
Rate for Payer: Adventist Health Medi-Cal	$59,056.80
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$70,376.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$93,506.60

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$41,623.21

Service Code	APR-DRG 6232
Min. Negotiated Rate	$26,288.34
Max. Negotiated Rate	$41,623.21
Rate for Payer: Adventist Health Medi-Cal	$26,288.34
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$31,326.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,623.21

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$25,565.64

Service Code	APR-DRG 6231
Min. Negotiated Rate	$16,146.72
Max. Negotiated Rate	$25,565.64
Rate for Payer: Adventist Health Medi-Cal	$16,146.72
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,241.51
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,565.64

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$145,433.28

Service Code	APR-DRG 6234
Min. Negotiated Rate	$91,852.60
Max. Negotiated Rate	$145,433.28
Rate for Payer: Adventist Health Medi-Cal	$91,852.60
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$109,457.68
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$145,433.28

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$220,481.21

Service Code	APR-DRG 6214
Min. Negotiated Rate	$139,251.29
Max. Negotiated Rate	$220,481.21
Rate for Payer: Adventist Health Medi-Cal	$139,251.29
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$165,941.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$220,481.21

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$10,553.06

Service Code	APR-DRG 6211
Min. Negotiated Rate	$6,665.09
Max. Negotiated Rate	$10,553.06
Rate for Payer: Adventist Health Medi-Cal	$6,665.09
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$7,942.56
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$10,553.06

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$36,860.84

Service Code	APR-DRG 6212
Min. Negotiated Rate	$23,280.53
Max. Negotiated Rate	$36,860.84
Rate for Payer: Adventist Health Medi-Cal	$23,280.53
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$27,742.63
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$36,860.84

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY

Facility

$81,672.26

Service Code	APR-DRG 6213
Min. Negotiated Rate	$51,582.48
Max. Negotiated Rate	$81,672.26
Rate for Payer: Adventist Health Medi-Cal	$51,582.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$61,469.12
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$81,672.26

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$76,703.57

Service Code	APR-DRG 6253
Min. Negotiated Rate	$48,444.36
Max. Negotiated Rate	$76,703.57
Rate for Payer: Adventist Health Medi-Cal	$48,444.36
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$57,729.53
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$76,703.57

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$37,862.57

Service Code	APR-DRG 6252
Min. Negotiated Rate	$23,913.20
Max. Negotiated Rate	$37,862.57
Rate for Payer: Adventist Health Medi-Cal	$23,913.20
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$28,496.57
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$37,862.57

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$29,409.47

Service Code	APR-DRG 6251
Min. Negotiated Rate	$18,574.40
Max. Negotiated Rate	$29,409.47
Rate for Payer: Adventist Health Medi-Cal	$18,574.40
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$22,134.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$29,409.47

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$146,071.87

Service Code	APR-DRG 6254
Min. Negotiated Rate	$92,255.92
Max. Negotiated Rate	$146,071.87
Rate for Payer: Adventist Health Medi-Cal	$92,255.92
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$109,938.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$146,071.87

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$41,283.75

Service Code	APR-DRG 6221
Min. Negotiated Rate	$26,073.95
Max. Negotiated Rate	$41,283.75
Rate for Payer: Adventist Health Medi-Cal	$26,073.95
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$31,071.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$41,283.75

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$61,987.20

Service Code	APR-DRG 6222
Min. Negotiated Rate	$39,149.81
Max. Negotiated Rate	$61,987.20
Rate for Payer: Adventist Health Medi-Cal	$39,149.81
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$46,653.52
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$61,987.20

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$69,521.76

Service Code	APR-DRG 6223
Min. Negotiated Rate	$43,908.48
Max. Negotiated Rate	$69,521.76
Rate for Payer: Adventist Health Medi-Cal	$43,908.48
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$52,324.27
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$69,521.76

APR-DRG 41.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$151,959.19

Service Code	APR-DRG 6224
Min. Negotiated Rate	$95,974.22
Max. Negotiated Rate	$151,959.19
Rate for Payer: Adventist Health Medi-Cal	$95,974.22
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$114,369.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$151,959.19

APR-DRG 41.00: NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$2,341.01

Service Code	APR-DRG 6402
Min. Negotiated Rate	$1,478.53
Max. Negotiated Rate	$2,341.01
Rate for Payer: Adventist Health Medi-Cal	$1,478.53
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,761.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$2,341.01

Know your out-of-pocket cost for care.

All Charges