Loma Linda University Medical Center

All Charges

Charge

Type

Price

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 0SRW0JZ
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 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 0SRA00A
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 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 0SWF4JZ
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 0SWH4JZ
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 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 0SRD07Z
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 0SRE019
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 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 0SRA0KZ
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 0SRA0JZ
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 0SRG0KZ
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 0SRG07Z
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 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 0SRM07Z
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 0SWQ4JZ
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 0SR903A
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 0SR9039
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 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 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 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 0SR9029
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 0SRA01Z
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