Loma Linda University Medical Center

All Charges

Charge

Type

Price

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 02170ZQ
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 02UQ48Z
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 04R047Z
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 041J4AF
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 02UJ08Z
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 06RH07Z
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 02R708Z
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 02124A3
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 021V0JP
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 05154ZY
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 05SR0ZZ
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 02RP47Z
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 041D094
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 041J49F
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 04554ZZ
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 02QJ0ZZ
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 06B90ZZ
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 025D3ZZ
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 06R24JZ
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 021W0KQ
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

$334,691.00

Service Code	ICD 02RL0JZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$334,691.00
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
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 IP

$34,005.88

Service Code	ICD 041E0KC
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 041E0JC
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 02BD0ZZ
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 04RB4KZ
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