Loma Linda University Medical Center

All Charges

Charge

Type

Price

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0SG1071
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 0SG04KJ
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 0SG0471
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 0RG20AJ
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 0SG0470
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 0SG0371
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 0SG0370
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 0SG00KJ
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 0RG20KJ
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 0RG237J
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 0SB84ZZ
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 0SB83ZZ
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 0RG23K0
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 0SB73ZZ
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 0SB63ZZ
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 0SB60ZZ
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 0RG23K1
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 0RG23KJ
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 0RG2471
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 0RG247J
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 0RG23A0
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 0S523ZZ
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 0S520ZZ
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 0RG24JJ
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