Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

0JH60AZ

Facility

$12,567.00

Service Code	ICD 0JH60AZ
Hospital Charge Code	2540
Min. Negotiated Rate	$12,567.00
Max. Negotiated Rate	$12,567.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$12,567.00

0JH60BZ

Facility

$30,092.00

Service Code	ICD 0JH60BZ
Hospital Charge Code	2541
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH60CZ

Facility

$30,092.00

Service Code	ICD 0JH60CZ
Hospital Charge Code	2542
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH60DZ

Facility

$30,092.00

Service Code	ICD 0JH60DZ
Hospital Charge Code	2543
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH60EZ

Facility

$30,092.00

Service Code	ICD 0JH60EZ
Hospital Charge Code	2544
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH60FZ

Facility

$12,567.00

Service Code	ICD 0JH60FZ
Hospital Charge Code	2545
Min. Negotiated Rate	$12,567.00
Max. Negotiated Rate	$12,567.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$12,567.00

0JH60MZ

Facility

$30,092.00

Service Code	ICD 0JH60MZ
Hospital Charge Code	2546
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH60PZ

Facility

$14,428.00

Service Code	ICD 0JH60PZ
Hospital Charge Code	2547
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH634Z

Facility

$14,428.00

Service Code	ICD 0JH634Z
Hospital Charge Code	2548
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH635Z

Facility

$14,428.00

Service Code	ICD 0JH635Z
Hospital Charge Code	2549
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH636Z

Facility

$14,428.00

Service Code	ICD 0JH636Z
Hospital Charge Code	2550
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH637Z

Facility

$14,428.00

Service Code	ICD 0JH637Z
Hospital Charge Code	2551
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH638Z

Facility

$45,565.00

Service Code	ICD 0JH638Z
Hospital Charge Code	2552
Min. Negotiated Rate	$45,565.00
Max. Negotiated Rate	$45,565.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$45,565.00

0JH638Z

Facility

$45,565.00

Service Code	ICD 0JH638Z
Hospital Charge Code	2553
Min. Negotiated Rate	$45,565.00
Max. Negotiated Rate	$45,565.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$45,565.00

0JH639Z

Facility

$45,565.00

Service Code	ICD 0JH639Z
Hospital Charge Code	2555
Min. Negotiated Rate	$45,565.00
Max. Negotiated Rate	$45,565.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$45,565.00

0JH639Z

Facility

$45,565.00

Service Code	ICD 0JH639Z
Hospital Charge Code	2554
Min. Negotiated Rate	$45,565.00
Max. Negotiated Rate	$45,565.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$45,565.00

0JH63AZ

Facility

$12,567.00

Service Code	ICD 0JH63AZ
Hospital Charge Code	2556
Min. Negotiated Rate	$12,567.00
Max. Negotiated Rate	$12,567.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$12,567.00

0JH63BZ

Facility

$30,092.00

Service Code	ICD 0JH63BZ
Hospital Charge Code	2557
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH63CZ

Facility

$30,092.00

Service Code	ICD 0JH63CZ
Hospital Charge Code	2558
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH63DZ

Facility

$30,092.00

Service Code	ICD 0JH63DZ
Hospital Charge Code	2559
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH63EZ

Facility

$30,092.00

Service Code	ICD 0JH63EZ
Hospital Charge Code	2560
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH63FZ

Facility

$12,567.00

Service Code	ICD 0JH63FZ
Hospital Charge Code	2561
Min. Negotiated Rate	$12,567.00
Max. Negotiated Rate	$12,567.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$12,567.00

0JH63MZ

Facility

$30,092.00

Service Code	ICD 0JH63MZ
Hospital Charge Code	2562
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

0JH63PZ

Facility

$14,428.00

Service Code	ICD 0JH63PZ
Hospital Charge Code	2563
Min. Negotiated Rate	$14,428.00
Max. Negotiated Rate	$14,428.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$14,428.00

0JH70BZ

Facility

$30,092.00

Service Code	ICD 0JH70BZ
Hospital Charge Code	2564
Min. Negotiated Rate	$30,092.00
Max. Negotiated Rate	$30,092.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,092.00

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