Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2121ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2111ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2051ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2070ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$11,541.00

Service Code	ICD 4A020N6
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,541.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$11,541.00

Service Code	ICD 4A023N7
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,541.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B211YZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2120ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B207YZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2060ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B210YZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B21F0ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2050ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B216YZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B212YZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B2171ZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

Cardiac Catheterization

Facility

$10,022.00

Service Code	ICD B21FYZZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$10,022.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$17,112.12

Service Code	APR-DRG 1912
Min. Negotiated Rate	$13,126.80
Max. Negotiated Rate	$17,112.12
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$13,126.80
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$17,112.12

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$14,597.36

Service Code	APR-DRG 1911
Min. Negotiated Rate	$11,197.71
Max. Negotiated Rate	$14,597.36
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$11,197.71
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$14,597.36

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$31,869.08

Service Code	APR-DRG 1914
Min. Negotiated Rate	$24,446.94
Max. Negotiated Rate	$31,869.08
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$24,446.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$31,869.08

CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$22,221.45

Service Code	APR-DRG 1913
Min. Negotiated Rate	$17,046.19
Max. Negotiated Rate	$22,221.45
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$17,046.19
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$22,221.45

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$42,461.96

Service Code	APR-DRG 1924
Min. Negotiated Rate	$32,572.79
Max. Negotiated Rate	$42,461.96
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$32,572.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$42,461.96

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$15,659.65

Service Code	APR-DRG 1921
Min. Negotiated Rate	$12,012.60
Max. Negotiated Rate	$15,659.65
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$12,012.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$15,659.65

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$27,327.24

Service Code	APR-DRG 1923
Min. Negotiated Rate	$20,962.87
Max. Negotiated Rate	$27,327.24
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$20,962.87
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$27,327.24

CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$19,485.01

Service Code	APR-DRG 1922
Min. Negotiated Rate	$14,947.06
Max. Negotiated Rate	$19,485.01
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal	$14,947.06
Rate for Payer: Kaiser Permanente of CA Medi-Cal	$19,485.01

Know your out-of-pocket cost for care.

All Charges