Loma Linda University Medical Center

All Charges

Charge

Type

Price

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02170AQ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 027H0DZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 027R3DT
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 04100JC
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 04RC47Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02HW3DZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 05UD37Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 041C0Z5
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02RM07Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02104A3
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02UJ0KZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02174AP
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 03140ZN
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 041C49G
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 03UY37Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 04B50ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 06S80ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02C44ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 04100A4
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02H60DZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02UL3JZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 03U207Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02RM0JZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02HS0DZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 041C0J3
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$34,005.88
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$34,005.88
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Price Transparency.

All Charges