Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$14,669.00

Service Code	ICD 021W49B
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 02QK0ZZ
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 03UK37Z
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 02PY0DZ
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 021K4ZF
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 02C60ZZ
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 02113D4
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 041C0A0
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 04104A5
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 05UY07Z
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 045E4ZZ
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 041D4AH
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 05R60JZ
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 02N83ZZ
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 041C4A5
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 02H43DZ
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 0210493
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 05140ZY
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 02WG47Z
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 02WM0JZ
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 03ST0ZZ
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 02U548Z
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 04B60ZZ
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 06SQ0ZZ
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 041009B
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