Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 021L4Z5
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 04C04ZZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 06BJ4ZZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$9,881.00

Service Code	ICD 02163Z7
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 04UA47Z
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 06R807Z
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041H4JQ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02160KQ
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 03SM3ZZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02TD4ZZ
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041D0Z7
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 021V49P
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041D0K6
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 05R00KZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041F4JB
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 03SP4ZZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041D0J8
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$9,881.00

Service Code	ICD 02TH0ZZ
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 04SQ3ZZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 0272046
Min. Negotiated Rate	$7,906.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$7,906.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 021W0ZR
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041C498
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 041E0KH
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02WA4RZ
Min. Negotiated Rate	$57,931.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 021K4ZF
Min. Negotiated Rate	$9,881.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,881.00
Rate for Payer: Blue Shield of California Commercial	$67,589.00
Rate for Payer: Blue Shield of California EPN	$57,931.00

Know your out-of-pocket cost for care.

All Charges