Loma Linda University Medical Center

All Charges

Charge

Type

Price

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0RG04K0
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 0RG04K1
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 0RG1070
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 0RG1071
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 0RG107J
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 0RG10A0
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 0RG10AJ
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 0RG10J0
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 0RG10K1
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 0RG10KJ
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 0RG1370
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 0RG13J0
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 0RG13J1
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 0RG13JJ
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 0RG13K0
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 0RG147J
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 0RG14A0
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 0RG14AJ
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 0RG20J1
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 0RG20JJ
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 0RG20K0
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 0RG20K1
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 0RG2371
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 0RG23J0
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 0RG23J1
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