Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$5,424.67

Service Code	APR-DRG 6361
Min. Negotiated Rate	$5,424.67
Max. Negotiated Rate	$5,424.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,424.67

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$21,003.49

Service Code	APR-DRG 6363
Min. Negotiated Rate	$21,003.49
Max. Negotiated Rate	$21,003.49
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$21,003.49

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$48,873.07

Service Code	APR-DRG 6364
Min. Negotiated Rate	$48,873.07
Max. Negotiated Rate	$48,873.07
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$48,873.07

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$2,050.73

Service Code	APR-DRG 6331
Min. Negotiated Rate	$2,050.73
Max. Negotiated Rate	$2,050.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2,050.73

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$77,028.24

Service Code	APR-DRG 6334
Min. Negotiated Rate	$77,028.24
Max. Negotiated Rate	$77,028.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$77,028.24

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$20,685.13

Service Code	APR-DRG 6333
Min. Negotiated Rate	$20,685.13
Max. Negotiated Rate	$20,685.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,685.13

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY

Facility

$5,827.60

Service Code	APR-DRG 6332
Min. Negotiated Rate	$5,827.60
Max. Negotiated Rate	$5,827.60
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,827.60

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$287,352.04

Service Code	APR-DRG 6304
Min. Negotiated Rate	$287,352.04
Max. Negotiated Rate	$287,352.04
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$287,352.04

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$96,417.86

Service Code	APR-DRG 6303
Min. Negotiated Rate	$96,417.86
Max. Negotiated Rate	$96,417.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$96,417.86

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$61,173.67

Service Code	APR-DRG 6302
Min. Negotiated Rate	$61,173.67
Max. Negotiated Rate	$61,173.67
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$61,173.67

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE

Facility

$24,266.76

Service Code	APR-DRG 6301
Min. Negotiated Rate	$24,266.76
Max. Negotiated Rate	$24,266.76
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,266.76

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$38,900.43

Service Code	APR-DRG 6312
Min. Negotiated Rate	$38,900.43
Max. Negotiated Rate	$38,900.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$38,900.43

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$237,839.64

Service Code	APR-DRG 6314
Min. Negotiated Rate	$237,839.64
Max. Negotiated Rate	$237,839.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$237,839.64

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$63,428.35

Service Code	APR-DRG 6313
Min. Negotiated Rate	$63,428.35
Max. Negotiated Rate	$63,428.35
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$63,428.35

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE

Facility

$5,022.98

Service Code	APR-DRG 6311
Min. Negotiated Rate	$5,022.98
Max. Negotiated Rate	$5,022.98
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,022.98

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$36,133.23

Service Code	APR-DRG 6394
Min. Negotiated Rate	$36,133.23
Max. Negotiated Rate	$36,133.23
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$36,133.23

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$16,991.58

Service Code	APR-DRG 6393
Min. Negotiated Rate	$16,991.58
Max. Negotiated Rate	$16,991.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16,991.58

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$3,794.29

Service Code	APR-DRG 6391
Min. Negotiated Rate	$3,794.29
Max. Negotiated Rate	$3,794.29
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3,794.29

NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION

Facility

$5,188.38

Service Code	APR-DRG 6392
Min. Negotiated Rate	$5,188.38
Max. Negotiated Rate	$5,188.38
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5,188.38

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

Facility

$14,101.41

Service Code	APR-DRG 6343
Min. Negotiated Rate	$14,101.41
Max. Negotiated Rate	$14,101.41
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,101.41

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

Facility

$59,035.93

Service Code	APR-DRG 6344
Min. Negotiated Rate	$59,035.93
Max. Negotiated Rate	$59,035.93
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$59,035.93

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

Facility

$12,488.43

Service Code	APR-DRG 6342
Min. Negotiated Rate	$12,488.43
Max. Negotiated Rate	$12,488.43
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,488.43

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

Facility

$6,087.52

Service Code	APR-DRG 6341
Min. Negotiated Rate	$6,087.52
Max. Negotiated Rate	$6,087.52
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$6,087.52

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$101,437.11

Service Code	APR-DRG 5913
Min. Negotiated Rate	$101,437.11
Max. Negotiated Rate	$101,437.11
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$101,437.11

NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$249,331.28

Service Code	APR-DRG 5914
Min. Negotiated Rate	$249,331.28
Max. Negotiated Rate	$249,331.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$249,331.28

Know your out-of-pocket cost for care.

All Charges