Loma Linda University Medical Center

All Charges

Charge

Type

Price

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRR0JA
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRA03Z
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SWH0JZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRR01A
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRH0KZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRT07Z
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SWN3JZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRD0J9
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0RRJ0J7
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0RRN0KZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0RRM0KZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SWM0JZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRM0KZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRS019
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRA019
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRB01A
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRR03A
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRB02Z
Min. Negotiated Rate	$10,175.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRV07Z
Min. Negotiated Rate	$8,448.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,448.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRV0J9
Min. Negotiated Rate	$8,448.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,448.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SWM3JZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRB04A
Min. Negotiated Rate	$7,368.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,175.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00
Rate for Payer: Kaiser Permanente of CA Medicare Advantage	$7,368.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRV0JA
Min. Negotiated Rate	$8,448.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,448.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRV0JZ
Min. Negotiated Rate	$8,448.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,448.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRF0KZ
Min. Negotiated Rate	$19,401.00
Max. Negotiated Rate	$22,635.00
Rate for Payer: Blue Shield of California Commercial	$22,635.00
Rate for Payer: Blue Shield of California EPN	$19,401.00

Price Transparency.

All Charges