Loma Linda University Medical Center

All Charges

Charge

Type

Price

Joint Surgery

Facility IP

$22,635.00

Service Code	ICD 0SRR0J9
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 0SRA00Z
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 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 0SRE039
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 0SR90JA
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 0SWG4JZ
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 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 0SWG3JZ
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 0SWG0JZ
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 0SRU0KZ
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 0SRN0JZ
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 0SRB0JA
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 0SRB0J9
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 0SRB07Z
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 0SWL3JZ
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 0SRA009
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 0SWC3JZ
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 0SRE0JZ
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 0SWC4JZ
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 0SRE0JA
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 0SRJ07Z
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 0SRB029
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 0SRE009
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 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 0SRE03Z
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

Price Transparency.

All Charges