Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 04ST3ZZ
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 02R74KZ
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 05R04JZ
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 041C0J0
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 02CN3ZZ
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 02C10ZZ
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 02100AW
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 02134AF
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 041C09J
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 02RJ47Z
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 04B30ZZ
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 02BJ0ZZ
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 02U507Z
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 03R44JZ
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 04SW3ZZ
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 041F0ZQ
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 02CG0ZZ
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 041J4KG
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 04UU37Z
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 04RF07Z
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 04144J4
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 02104Z3
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 02Q14ZZ
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 02UW37Z
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 02HK4KZ
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