Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02WA3QZ
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 02170JQ
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

$3,588.00

Service Code	ICD 02730G6
Min. Negotiated Rate	$3,588.00
Max. Negotiated Rate	$3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,588.00

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02730ZZ
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 041F499
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 05R447Z
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 04UV37Z
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 051607Y
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 021L4ZC
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 065H3ZZ
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 04R04JZ
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 02PA08Z
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 041J4JC
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 06R40JZ
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 03UU47Z
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 041E4AC
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 041E0KG
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 041E4JQ
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 02VW3DZ
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 02164AR
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 02UN38Z
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 02U73KZ
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 0WHD0YZ
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 05B44ZZ
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 02QB4ZZ
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