Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02WA4CZ
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 02700T6
Min. Negotiated Rate	$3,588.00
Max. Negotiated Rate	$67,589.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,588.00
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

$7,906.00

Service Code	ICD 0270076
Min. Negotiated Rate	$7,906.00
Max. Negotiated Rate	$7,906.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$7,906.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02SR0ZZ
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 02QF3ZZ
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 02N93ZZ
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 041E4AP
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 041F0JF
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 041C0A2
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 06580ZZ
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 021309W
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 02R94KZ
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 02130KF
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 04BD3ZZ
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 05140AY
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 06U007Z
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 041D494
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 05114JY
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 02103D4
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 041F4AB
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 04U947Z
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 02160ZQ
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 02HK4DZ
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 02114KF
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 0410096
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

Know your out-of-pocket cost for care.

All Charges