Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 03U807Z
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 03UU07Z
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 04104J9
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041J09C
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 02BL4ZZ
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 02124D4
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 045H3ZZ
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 06U307Z
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041E4JH
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041C0AC
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 02UN08Z
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 021L4Z8
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 02700DZ
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 06S40ZZ
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 0W9D0ZX
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 02UK38Z
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 02UH48Z
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 04100JG
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 04UN47Z
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 02QG0ZZ
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 05U347Z
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

Coronary Surgery

Facility

$11,541.00

Service Code	ICD 02114A8
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041F4AF
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 0410093
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

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 04SV4ZZ
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

Know your out-of-pocket cost for care.

All Charges