Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

Coronary Surgery

Facility

$67,589.00

Service Code	ICD 02160AR
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 041C4AK
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 03R24KZ
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 02124KF
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 06B14ZZ
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 03B23ZZ
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 05S94ZZ
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 021L0AQ
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 02174AR
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 0212498
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 02134J8
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 04104JC
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 04R24JZ
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 041H4KB
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 041C0AG
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 02UT38Z
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 02NH0ZZ
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 041C4J2
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 02H44DZ
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 041J0AJ
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 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 02700D6
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

$67,589.00

Service Code	ICD 02UJ4JZ
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 02UT07Z
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 045F4ZZ
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