Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

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

Facility

$16.58

Service Code	APR-DRG 5883
Min. Negotiated Rate	$16.58
Max. Negotiated Rate	$16.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16.58

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

Facility

$16.14

Service Code	APR-DRG 5882
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$16.14
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$16.14

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

Facility

$10.73

Service Code	APR-DRG 5881
Min. Negotiated Rate	$10.73
Max. Negotiated Rate	$10.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$10.73

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

Facility

$25.85

Service Code	APR-DRG 5884
Min. Negotiated Rate	$25.85
Max. Negotiated Rate	$25.85
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$25.85

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

Facility

$2.21

Service Code	APR-DRG 6264
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.21

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

Facility

$0.17

Service Code	APR-DRG 6262
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.17
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.17

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

Facility

$0.39

Service Code	APR-DRG 6263
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.39

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

Facility

$0.15

Service Code	APR-DRG 6261
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.15

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

Facility

$1.40

Service Code	APR-DRG 6232
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.40

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

Facility

$0.86

Service Code	APR-DRG 6231
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.86

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

Facility

$3.73

Service Code	APR-DRG 6234
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3.73

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

Facility

$3.15

Service Code	APR-DRG 6233
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3.15

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

Facility

$0.36

Service Code	APR-DRG 6211
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.36

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

Facility

$1.24

Service Code	APR-DRG 6212
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.24

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

Facility

$2.74

Service Code	APR-DRG 6213
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$2.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.74

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

Facility

$5.64

Service Code	APR-DRG 6214
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$5.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$5.64

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

Facility

$0.99

Service Code	APR-DRG 6251
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.99

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

Facility

$2.58

Service Code	APR-DRG 6253
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$2.58
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.58

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

Facility

$1.28

Service Code	APR-DRG 6252
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.28

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

Facility

$3.74

Service Code	APR-DRG 6254
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$3.74
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3.74

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

Facility

$2.08

Service Code	APR-DRG 6222
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$2.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.08

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

Facility

$2.34

Service Code	APR-DRG 6223
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$2.34

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

Facility

$3.89

Service Code	APR-DRG 6224
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$3.89
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$3.89

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

Facility

$1.39

Service Code	APR-DRG 6221
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$1.39

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

Facility

$0.13

Service Code	APR-DRG 6402
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$0.13

Know your out-of-pocket cost for care.

All Charges