Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$14,669.00

Service Code	ICD 04SY0ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 06RG4KZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 041F4ZJ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02700TZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 0211498
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02VW3DZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 06U307Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 04U947Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02PA4CZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02RR0JZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02PY42Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 025R4ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 041E0AG
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02QK3ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 06S70ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 041C092
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02110AF
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 03UQ47Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 041D490
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02WA0KZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 02US08Z
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 021L4AP
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 041F49D
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 05SM3ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
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

$14,669.00

Service Code	ICD 03SN3ZZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$14,669.00
Rate for Payer: Blue Shield of California Commercial	$14,669.00
Rate for Payer: Blue Shield of California EPN	$10,527.00

Know your out-of-pocket cost for care.

All Charges