Loma Linda University Medical Center

All Charges

Charge

Type

Price

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0PS4XZZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 0SG14A0
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 00NT3ZZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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

$27,133.00

Service Code	ICD 00PV4MZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$27,133.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$27,133.00
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 0RGA0A0
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 00CX3ZZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 0SG60KZ
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 0RG70K0
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 0RG43K0
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 0RG40KJ
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 0RGA0AJ
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 0RG44KJ
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 0RG0371
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 0RG44K0
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 0RG2370
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 0RG84A0
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 0RG43J1
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 0RG20J0
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 0RG13KJ
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 00FU4ZZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 0RG607J
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 00SX0ZZ
Min. Negotiated Rate	$17,082.00
Max. Negotiated Rate	$19,930.00
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 0SG13K0
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