Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021248C

Facility

$10,777.00

Service Code	ICD 021248C
Hospital Charge Code	234
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

021248F

Facility

$10,777.00

Service Code	ICD 021248F
Hospital Charge Code	235
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

021248W

Facility

$10,777.00

Service Code	ICD 021248W
Hospital Charge Code	236
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

0212493

Facility

$10,777.00

Service Code	ICD 0212493
Hospital Charge Code	237
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

0212498

Facility

$10,777.00

Service Code	ICD 0212498
Hospital Charge Code	238
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

0212499

Facility

$10,777.00

Service Code	ICD 0212499
Hospital Charge Code	239
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

021249C

Facility

$10,777.00

Service Code	ICD 021249C
Hospital Charge Code	240
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

021249F

Facility

$10,777.00

Service Code	ICD 021249F
Hospital Charge Code	241
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

021249W

Facility

$10,777.00

Service Code	ICD 021249W
Hospital Charge Code	242
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124A3

Facility

$10,777.00

Service Code	ICD 02124A3
Hospital Charge Code	243
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124A8

Facility

$10,777.00

Service Code	ICD 02124A8
Hospital Charge Code	244
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124A9

Facility

$10,777.00

Service Code	ICD 02124A9
Hospital Charge Code	245
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124AC

Facility

$10,777.00

Service Code	ICD 02124AC
Hospital Charge Code	246
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124AF

Facility

$10,777.00

Service Code	ICD 02124AF
Hospital Charge Code	247
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124AW

Facility

$10,777.00

Service Code	ICD 02124AW
Hospital Charge Code	248
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124D4

Facility

$10,777.00

Service Code	ICD 02124D4
Hospital Charge Code	249
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124J3

Facility

$10,777.00

Service Code	ICD 02124J3
Hospital Charge Code	250
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124J8

Facility

$10,777.00

Service Code	ICD 02124J8
Hospital Charge Code	251
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124J9

Facility

$10,777.00

Service Code	ICD 02124J9
Hospital Charge Code	252
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124JC

Facility

$10,777.00

Service Code	ICD 02124JC
Hospital Charge Code	253
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124JF

Facility

$10,777.00

Service Code	ICD 02124JF
Hospital Charge Code	2869
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124JW

Facility

$10,777.00

Service Code	ICD 02124JW
Hospital Charge Code	254
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124K3

Facility

$10,777.00

Service Code	ICD 02124K3
Hospital Charge Code	255
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124K8

Facility

$10,777.00

Service Code	ICD 02124K8
Hospital Charge Code	256
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

02124K9

Facility

$10,777.00

Service Code	ICD 02124K9
Hospital Charge Code	257
Min. Negotiated Rate	$10,777.00
Max. Negotiated Rate	$10,777.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$10,777.00

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All Charges