Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$14,669.00

Service Code	ICD 041H0ZD
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 04SD4ZZ
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 041C4K3
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 02PY4CZ
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 06553ZZ
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 05U647Z
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 02U63JZ
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 06SH4ZZ
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 02UH47Z
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 03SG0ZZ
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 05UV07Z
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 021L4KR
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 041F0JP
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 041H4ZB
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 02PA02Z
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 02UA38Z
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 02590ZZ
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 04140K3
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 041D4JQ
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 041F4KD
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 041E0JD
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 02UA07Z
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 041E0AC
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 05UL47Z
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 041E4KD
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