Loma Linda University Medical Center

All Charges

Charge

Type

Price

Coronary Surgery

Facility IP

$34,005.88

Service Code	ICD 04104ZD
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 041C0JJ
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 02US48Z
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 02H743Z
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 02120J9
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 041F0KP
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 02C20ZZ
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 04SY0ZZ
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 02104KW
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 04S03ZZ
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 0212444
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 02U737Z
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 041F0KK
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 02NG0ZZ
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 04SW3ZZ
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 02H632Z
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 041D0K4
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 041F0KJ
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 04144A5
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 041D0J9
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 0JH639Z
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 02100JC
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 04100KF
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 02100J9
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 041E0JJ
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