Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$10,022.00

Service Code	ICD 05UP37Z
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 02BT0ZZ
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 041D0ZJ
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 04104Z4
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 02104JF
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 02RP4KZ
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 02B50ZZ
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 041C0JG
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 03SS4ZZ
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 02100J9
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 06BH0ZZ
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 06R247Z
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 02VA0ZZ
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 0WHD0YZ
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 02BM0ZZ
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 02UG48Z
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 041009B
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 041C49F
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 041J0JQ
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 041D0K0
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 06B93ZZ
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 06SR3ZZ
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 02SQ0ZZ
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 04R907Z
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