Loma Linda University Medical Center

All Charges

Charge

Type

Price

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG1471
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG14J0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG14J1
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG14JJ
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG307J
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG30A0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG30J0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG30J1
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG3370
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG3371
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG337J
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG33AJ
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG33J0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG3470
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG3471
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG347J
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34A0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34AJ
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34J0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34J1
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34JJ
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG34K0
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG537Z
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG53JZ
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG547Z
Min. Negotiated Rate	$13,963.00
Max. Negotiated Rate	$19,930.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$13,963.00
Rate for Payer: Blue Shield of California Commercial	$19,930.00
Rate for Payer: Blue Shield of California EPN	$17,082.00

Price Transparency.

All Charges