Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041D0KJ
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 041H4ZK
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

$334,691.00

Service Code	ICD 02WA4QZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$334,691.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$118,562.00
Rate for Payer: Blue Shield of California Commercial	$10,022.00
Rate for Payer: Blue Shield of California EPN	$7,205.00
Rate for Payer: United Healthcare All Other Commercial	$334,691.00
Rate for Payer: United Healthcare All Other HMO	$296,270.00
Rate for Payer: United Healthcare HMO Rider	$225,043.00
Rate for Payer: United Healthcare Select/Navigate/Core	$205,783.00

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 02UK37Z
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 041H49K
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 02134ZF
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 02RT48Z
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 0WWD3YZ
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 02UL38Z
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 03U037Z
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 041D4AR
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 04100JJ
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 041C0A7
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 05S73ZZ
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 027K0DZ
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 041E0JQ
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 02PY4CZ
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 041C4JK
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 041E4A9
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 02UR47Z
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

$41,843.00

Service Code	ICD 02H64KZ
Min. Negotiated Rate	$7,205.00
Max. Negotiated Rate	$41,843.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$41,843.00
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 03B03ZZ
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 06BG4ZZ
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 041C49G
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 04R20JZ
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