Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$14,669.00

Service Code	ICD 021V4KR
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 02BF0ZZ
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 04140J5
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

$334,691.00

Service Code	ICD 02WA4QZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$334,691.00
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

$14,669.00

Service Code	ICD 02RH0KZ
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 02170AQ
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 05S40ZZ
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 04RE0KZ
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 06B24ZZ
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 02UK3KZ
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 021L4KP
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

$334,691.00

Service Code	ICD 02WA3QZ
Min. Negotiated Rate	$10,527.00
Max. Negotiated Rate	$334,691.00
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

$14,669.00

Service Code	ICD 041D0JC
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 041H0ZK
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 03S10ZZ
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 03UB07Z
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 0271046
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 041C0JK
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 02PY02Z
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 04UD37Z
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 041C0J8
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 041E4Z9
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 04574ZZ
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 041E09K
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 02CK3ZZ
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