Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$4,210.38

Service Code	APR-DRG 6403
Min. Negotiated Rate	$2,659.19
Max. Negotiated Rate	$4,210.38
Rate for Payer: Adventist Health Medi-Cal	$2,659.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,168.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$4,210.38

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

Facility

$1,768.60

Service Code	APR-DRG 6401
Min. Negotiated Rate	$1,117.01
Max. Negotiated Rate	$1,768.60
Rate for Payer: Adventist Health Medi-Cal	$1,117.01
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$1,331.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$1,768.60

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

Facility

$74,846.74

Service Code	APR-DRG 6404
Min. Negotiated Rate	$47,271.62
Max. Negotiated Rate	$74,846.74
Rate for Payer: Adventist Health Medi-Cal	$47,271.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$56,332.02
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$74,846.74

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

Facility

$25,419.21

Service Code	APR-DRG 6362
Min. Negotiated Rate	$16,054.24
Max. Negotiated Rate	$25,419.21
Rate for Payer: Adventist Health Medi-Cal	$16,054.24
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$19,131.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$25,419.21

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

Facility

$14,566.62

Service Code	APR-DRG 6361
Min. Negotiated Rate	$9,199.97
Max. Negotiated Rate	$14,566.62
Rate for Payer: Adventist Health Medi-Cal	$9,199.97
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,963.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,566.62

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

Facility

$56,635.77

Service Code	APR-DRG 6363
Min. Negotiated Rate	$35,769.96
Max. Negotiated Rate	$56,635.77
Rate for Payer: Adventist Health Medi-Cal	$35,769.96
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$42,625.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$56,635.77

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

Facility

$111,412.83

Service Code	APR-DRG 6364
Min. Negotiated Rate	$70,366.00
Max. Negotiated Rate	$111,412.83
Rate for Payer: Adventist Health Medi-Cal	$70,366.00
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$83,852.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$111,412.83

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

Facility

$55,184.78

Service Code	APR-DRG 6333
Min. Negotiated Rate	$34,853.54
Max. Negotiated Rate	$55,184.78
Rate for Payer: Adventist Health Medi-Cal	$34,853.54
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$41,533.81
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$55,184.78

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

Facility

$15,095.77

Service Code	APR-DRG 6332
Min. Negotiated Rate	$9,534.17
Max. Negotiated Rate	$15,095.77
Rate for Payer: Adventist Health Medi-Cal	$9,534.17
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,361.55
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,095.77

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

Facility

$207,481.88

Service Code	APR-DRG 6334
Min. Negotiated Rate	$131,041.19
Max. Negotiated Rate	$207,481.88
Rate for Payer: Adventist Health Medi-Cal	$131,041.19
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$156,157.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$207,481.88

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

Facility

$5,161.71

Service Code	APR-DRG 6331
Min. Negotiated Rate	$3,260.03
Max. Negotiated Rate	$5,161.71
Rate for Payer: Adventist Health Medi-Cal	$3,260.03
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$3,884.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$5,161.71

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

Facility

$63,481.45

Service Code	APR-DRG 6301
Min. Negotiated Rate	$40,093.55
Max. Negotiated Rate	$63,481.45
Rate for Payer: Adventist Health Medi-Cal	$40,093.55
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$47,778.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$63,481.45

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

Facility

$137,955.28

Service Code	APR-DRG 6302
Min. Negotiated Rate	$87,129.65
Max. Negotiated Rate	$137,955.28
Rate for Payer: Adventist Health Medi-Cal	$87,129.65
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$103,829.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$137,955.28

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

Facility

$686,047.02

Service Code	APR-DRG 6304
Min. Negotiated Rate	$433,292.86
Max. Negotiated Rate	$686,047.02
Rate for Payer: Adventist Health Medi-Cal	$433,292.86
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$516,340.65
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$686,047.02

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

Facility

$282,762.88

Service Code	APR-DRG 6303
Min. Negotiated Rate	$178,587.08
Max. Negotiated Rate	$282,762.88
Rate for Payer: Adventist Health Medi-Cal	$178,587.08
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$212,816.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$282,762.88

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

Facility

$645,347.58

Service Code	APR-DRG 6314
Min. Negotiated Rate	$407,587.94
Max. Negotiated Rate	$645,347.58
Rate for Payer: Adventist Health Medi-Cal	$407,587.94
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$485,708.97
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$645,347.58

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

Facility

$161,031.57

Service Code	APR-DRG 6313
Min. Negotiated Rate	$101,704.15
Max. Negotiated Rate	$161,031.57
Rate for Payer: Adventist Health Medi-Cal	$101,704.15
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$121,197.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$161,031.57

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

Facility

$12,143.85

Service Code	APR-DRG 6311
Min. Negotiated Rate	$7,669.80
Max. Negotiated Rate	$12,143.85
Rate for Payer: Adventist Health Medi-Cal	$7,669.80
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$9,139.84
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$12,143.85

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

Facility

$93,955.89

Service Code	APR-DRG 6312
Min. Negotiated Rate	$59,340.56
Max. Negotiated Rate	$93,955.89
Rate for Payer: Adventist Health Medi-Cal	$59,340.56
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$70,714.17
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$93,955.89

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

Facility

$9,112.04

Service Code	APR-DRG 6391
Min. Negotiated Rate	$5,754.97
Max. Negotiated Rate	$9,112.04
Rate for Payer: Adventist Health Medi-Cal	$5,754.97
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$6,858.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$9,112.04

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

Facility

$44,282.27

Service Code	APR-DRG 6393
Min. Negotiated Rate	$27,967.75
Max. Negotiated Rate	$44,282.27
Rate for Payer: Adventist Health Medi-Cal	$27,967.75
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$33,328.24
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$44,282.27

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

Facility

$13,458.40

Service Code	APR-DRG 6392
Min. Negotiated Rate	$8,500.04
Max. Negotiated Rate	$13,458.40
Rate for Payer: Adventist Health Medi-Cal	$8,500.04
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$10,129.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$13,458.40

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

Facility

$97,092.57

Service Code	APR-DRG 6394
Min. Negotiated Rate	$61,321.62
Max. Negotiated Rate	$97,092.57
Rate for Payer: Adventist Health Medi-Cal	$61,321.62
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$73,074.93
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$97,092.57

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

Facility

$15,721.44

Service Code	APR-DRG 6341
Min. Negotiated Rate	$9,929.33
Max. Negotiated Rate	$15,721.44
Rate for Payer: Adventist Health Medi-Cal	$9,929.33
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$11,832.45
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,721.44

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

Facility

$134,581.54

Service Code	APR-DRG 6344
Min. Negotiated Rate	$84,998.87
Max. Negotiated Rate	$134,581.54
Rate for Payer: Adventist Health Medi-Cal	$84,998.87
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal	$101,290.32
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$134,581.54

Know your out-of-pocket cost for care.

All Charges