Loma Linda University Medical Center

All Charges

Charge

Type

Price

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02C24ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02734Z6
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027G3DZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027G3ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027H4ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J34Z
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J3DZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J3ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J44Z
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$9,066.00

Service Code	ICD 02C14Z6
Min. Negotiated Rate	$9,066.00
Max. Negotiated Rate	$9,066.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J4DZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027J4ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$9,066.00

Service Code	ICD 02C04Z6
Min. Negotiated Rate	$9,066.00
Max. Negotiated Rate	$9,066.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02C04ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02724ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02733Z6
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02733ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02703Z6
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027H4DZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 027H3ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02C34ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02704Z6
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02713Z6
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

PTCA/Angioplasty - #2076

Facility IP

$9,066.00

Service Code	ICD 02C24Z6
Min. Negotiated Rate	$9,066.00
Max. Negotiated Rate	$9,066.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00

PTCA/Angioplasty - #2076

Facility IP

$19,726.00

Service Code	ICD 02713ZZ
Min. Negotiated Rate	$4,519.00
Max. Negotiated Rate	$19,726.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,066.00
Rate for Payer: Blue Shield of California Commercial	$19,726.00
Rate for Payer: Blue Shield of California EPN	$16,911.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$4,519.00

Price Transparency.

All Charges