Loma Linda University Medical Center

All Charges

Charge

Type

Price

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0RG63JJ
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 0RG6371
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 0RG6370
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 0RG60KJ
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 0RG6070
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 0RG43JJ
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 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 0RB04ZZ
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 0RG40JJ
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 0RG40J1
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 0RG40J0
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 0RG40AJ
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 0RG40A0
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 0RG407J
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 0RG24KJ
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 0RG24K1
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 0RG24K0
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 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

Spine Surgery

Facility IP

$19,930.00

Service Code	ICD 0RB10ZZ
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 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 00BT3ZZ
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 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 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 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

Price Transparency.

All Charges