Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 041C4AJ
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 03R04JZ
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 041F499
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 04R307Z
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 04UC47Z
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 041C4K0
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 05SM0ZZ
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 03U047Z
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 025Q3ZZ
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 02QC4ZZ
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 04B90ZZ
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 04BB0ZZ
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 041H4KH
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 051307Y
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 06R60KZ
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 041D49G
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 021L0AR
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 02700Z6
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

$334,691.00

Service Code	ICD 02HA0RZ
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 04RA4JZ
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 04UH37Z
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 04100A5
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 041009C
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 02110KC
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 02UF07Z
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