Loma Linda University Children's Hospital

All Charges

Charge

Type

Setting

Price

09HE3SZ

Facility

$30,379.00

Service Code	ICD 09HE3SZ
Hospital Charge Code	2515
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09HE45Z

Facility

$30,379.00

Service Code	ICD 09HE45Z
Hospital Charge Code	2516
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09HE46Z

Facility

$30,379.00

Service Code	ICD 09HE46Z
Hospital Charge Code	2517
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09HE4SZ

Facility

$30,379.00

Service Code	ICD 09HE4SZ
Hospital Charge Code	2518
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PD0SZ

Facility

$30,379.00

Service Code	ICD 09PD0SZ
Hospital Charge Code	2519
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PD7SZ

Facility

$30,379.00

Service Code	ICD 09PD7SZ
Hospital Charge Code	2520
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PD8SZ

Facility

$30,379.00

Service Code	ICD 09PD8SZ
Hospital Charge Code	2521
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PE0SZ

Facility

$30,379.00

Service Code	ICD 09PE0SZ
Hospital Charge Code	2522
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PE7SZ

Facility

$30,379.00

Service Code	ICD 09PE7SZ
Hospital Charge Code	2523
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

09PE8SZ

Facility

$30,379.00

Service Code	ICD 09PE8SZ
Hospital Charge Code	2524
Min. Negotiated Rate	$30,379.00
Max. Negotiated Rate	$30,379.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$30,379.00

0DH60MZ

Facility

$30,092.00

Service Code	ICD 0DH60MZ
Hospital Charge Code	2525
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

0DH63MZ

Facility

$30,092.00

Service Code	ICD 0DH63MZ
Hospital Charge Code	2526
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

0DH64MZ

Facility

$30,092.00

Service Code	ICD 0DH64MZ
Hospital Charge Code	2527
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

0DQP0ZZ

Facility

$11,523.00

Service Code	ICD 0DQP0ZZ
Hospital Charge Code	2528
Min. Negotiated Rate	$11,523.00
Max. Negotiated Rate	$11,523.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,523.00

0DQP8ZZ

Facility

$11,523.00

Service Code	ICD 0DQP8ZZ
Hospital Charge Code	2529
Min. Negotiated Rate	$11,523.00
Max. Negotiated Rate	$11,523.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,523.00

0DQR0ZZ

Facility

$11,523.00

Service Code	ICD 0DQR0ZZ
Hospital Charge Code	2530
Min. Negotiated Rate	$11,523.00
Max. Negotiated Rate	$11,523.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,523.00

0DQR4ZZ

Facility

$11,523.00

Service Code	ICD 0DQR4ZZ
Hospital Charge Code	2531
Min. Negotiated Rate	$11,523.00
Max. Negotiated Rate	$11,523.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,523.00

0JH604Z

Facility

$14,428.00

Service Code	ICD 0JH604Z
Hospital Charge Code	2532
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

0JH605Z

Facility

$14,428.00

Service Code	ICD 0JH605Z
Hospital Charge Code	2533
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

0JH606Z

Facility

$14,428.00

Service Code	ICD 0JH606Z
Hospital Charge Code	2534
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

0JH607Z

Facility

$14,428.00

Service Code	ICD 0JH607Z
Hospital Charge Code	2535
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

0JH608Z

Facility

$45,565.00

Service Code	ICD 0JH608Z
Hospital Charge Code	2536
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

0JH608Z

Facility

$45,565.00

Service Code	ICD 0JH608Z
Hospital Charge Code	2537
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

0JH609Z

Facility

$45,565.00

Service Code	ICD 0JH609Z
Hospital Charge Code	2538
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

0JH609Z

Facility

$45,565.00

Service Code	ICD 0JH609Z
Hospital Charge Code	2539
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

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All Charges