Loma Linda University Medical Center

All Charges

Charge

Type

Price

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$28,513.72

Service Code	APR-DRG 6132
Min. Negotiated Rate	$28,513.72
Max. Negotiated Rate	$28,513.72
Rate for Payer: IEHP Medi-Cal	$28,513.72

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$101,349.26

Service Code	APR-DRG 6134
Min. Negotiated Rate	$101,349.26
Max. Negotiated Rate	$101,349.26
Rate for Payer: IEHP Medi-Cal	$101,349.26

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$45,894.56

Service Code	APR-DRG 6133
Min. Negotiated Rate	$45,894.56
Max. Negotiated Rate	$45,894.56
Rate for Payer: IEHP Medi-Cal	$45,894.56

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility IP

$15,710.65

Service Code	APR-DRG 6131
Min. Negotiated Rate	$15,710.65
Max. Negotiated Rate	$15,710.65
Rate for Payer: IEHP Medi-Cal	$15,710.65

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$27,987.67

Service Code	APR-DRG 6112
Min. Negotiated Rate	$27,987.67
Max. Negotiated Rate	$27,987.67
Rate for Payer: IEHP Medi-Cal	$27,987.67

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$12,592.90

Service Code	APR-DRG 6111
Min. Negotiated Rate	$12,592.90
Max. Negotiated Rate	$12,592.90
Rate for Payer: IEHP Medi-Cal	$12,592.90

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$48,861.84

Service Code	APR-DRG 6113
Min. Negotiated Rate	$48,861.84
Max. Negotiated Rate	$48,861.84
Rate for Payer: IEHP Medi-Cal	$48,861.84

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility IP

$108,025.41

Service Code	APR-DRG 6114
Min. Negotiated Rate	$108,025.41
Max. Negotiated Rate	$108,025.41
Rate for Payer: IEHP Medi-Cal	$108,025.41

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility IP

$9,813.41

Service Code	APR-DRG 6141
Min. Negotiated Rate	$9,813.41
Max. Negotiated Rate	$9,813.41
Rate for Payer: IEHP Medi-Cal	$9,813.41

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility IP

$23,838.95

Service Code	APR-DRG 6142
Min. Negotiated Rate	$23,838.95
Max. Negotiated Rate	$23,838.95
Rate for Payer: IEHP Medi-Cal	$23,838.95

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility IP

$43,389.91

Service Code	APR-DRG 6143
Min. Negotiated Rate	$43,389.91
Max. Negotiated Rate	$43,389.91
Rate for Payer: IEHP Medi-Cal	$43,389.91

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility IP

$81,446.17

Service Code	APR-DRG 6144
Min. Negotiated Rate	$81,446.17
Max. Negotiated Rate	$81,446.17
Rate for Payer: IEHP Medi-Cal	$81,446.17

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility IP

$25,536.49

Service Code	APR-DRG 6121
Min. Negotiated Rate	$25,536.49
Max. Negotiated Rate	$25,536.49
Rate for Payer: IEHP Medi-Cal	$25,536.49

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility IP

$103,299.45

Service Code	APR-DRG 6124
Min. Negotiated Rate	$103,299.45
Max. Negotiated Rate	$103,299.45
Rate for Payer: IEHP Medi-Cal	$103,299.45

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility IP

$50,449.93

Service Code	APR-DRG 6123
Min. Negotiated Rate	$50,449.93
Max. Negotiated Rate	$50,449.93
Rate for Payer: IEHP Medi-Cal	$50,449.93

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility IP

$39,068.32

Service Code	APR-DRG 6122
Min. Negotiated Rate	$39,068.32
Max. Negotiated Rate	$39,068.32
Rate for Payer: IEHP Medi-Cal	$39,068.32

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility IP

$40,712.39

Service Code	APR-DRG 6092
Min. Negotiated Rate	$40,712.39
Max. Negotiated Rate	$40,712.39
Rate for Payer: IEHP Medi-Cal	$40,712.39

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility IP

$247,741.04

Service Code	APR-DRG 6094
Min. Negotiated Rate	$247,741.04
Max. Negotiated Rate	$247,741.04
Rate for Payer: IEHP Medi-Cal	$247,741.04

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility IP

$38,676.58

Service Code	APR-DRG 6091
Min. Negotiated Rate	$38,676.58
Max. Negotiated Rate	$38,676.58
Rate for Payer: IEHP Medi-Cal	$38,676.58

NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility IP

$85,711.53

Service Code	APR-DRG 6093
Min. Negotiated Rate	$85,711.53
Max. Negotiated Rate	$85,711.53
Rate for Payer: IEHP Medi-Cal	$85,711.53

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility IP

$173,430.27

Service Code	APR-DRG 5882
Min. Negotiated Rate	$173,430.27
Max. Negotiated Rate	$173,430.27
Rate for Payer: IEHP Medi-Cal	$173,430.27

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility IP

$177,116.36

Service Code	APR-DRG 5883
Min. Negotiated Rate	$177,116.36
Max. Negotiated Rate	$177,116.36
Rate for Payer: IEHP Medi-Cal	$177,116.36

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility IP

$114,159.34

Service Code	APR-DRG 5881
Min. Negotiated Rate	$114,159.34
Max. Negotiated Rate	$114,159.34
Rate for Payer: IEHP Medi-Cal	$114,159.34

NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility IP

$395,889.62

Service Code	APR-DRG 5884
Min. Negotiated Rate	$395,889.62
Max. Negotiated Rate	$395,889.62
Rate for Payer: IEHP Medi-Cal	$395,889.62

NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility IP

$1,607.75

Service Code	APR-DRG 6262
Min. Negotiated Rate	$1,607.75
Max. Negotiated Rate	$1,607.75
Rate for Payer: IEHP Medi-Cal	$1,607.75

Price Transparency.

All Charges