Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02114K9

Facility

$11,208.00

Service Code	ICD 02114K9
Hospital Charge Code	10134
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KC

Facility

$11,208.00

Service Code	ICD 02114KC
Hospital Charge Code	10135
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KC

Facility

$11,208.00

Service Code	ICD 02114KC
Hospital Charge Code	188
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KF

Facility

$11,208.00

Service Code	ICD 02114KF
Hospital Charge Code	189
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KF

Facility

$11,208.00

Service Code	ICD 02114KF
Hospital Charge Code	10136
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KW

Facility

$11,208.00

Service Code	ICD 02114KW
Hospital Charge Code	10137
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114KW

Facility

$11,208.00

Service Code	ICD 02114KW
Hospital Charge Code	2866
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z3

Facility

$11,208.00

Service Code	ICD 02114Z3
Hospital Charge Code	10138
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z3

Facility

$11,208.00

Service Code	ICD 02114Z3
Hospital Charge Code	190
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z8

Facility

$11,208.00

Service Code	ICD 02114Z8
Hospital Charge Code	191
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z8

Facility

$11,208.00

Service Code	ICD 02114Z8
Hospital Charge Code	10139
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z9

Facility

$11,208.00

Service Code	ICD 02114Z9
Hospital Charge Code	192
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114Z9

Facility

$11,208.00

Service Code	ICD 02114Z9
Hospital Charge Code	10140
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114ZC

Facility

$11,208.00

Service Code	ICD 02114ZC
Hospital Charge Code	10141
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114ZC

Facility

$11,208.00

Service Code	ICD 02114ZC
Hospital Charge Code	193
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114ZF

Facility

$11,208.00

Service Code	ICD 02114ZF
Hospital Charge Code	10142
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

02114ZF

Facility

$11,208.00

Service Code	ICD 02114ZF
Hospital Charge Code	194
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

0212083

Facility

$11,208.00

Service Code	ICD 0212083
Hospital Charge Code	195
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

0212088

Facility

$11,208.00

Service Code	ICD 0212088
Hospital Charge Code	196
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

0212089

Facility

$11,208.00

Service Code	ICD 0212089
Hospital Charge Code	197
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

021208C

Facility

$11,208.00

Service Code	ICD 021208C
Hospital Charge Code	198
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

021208F

Facility

$11,208.00

Service Code	ICD 021208F
Hospital Charge Code	199
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

021208W

Facility

$11,208.00

Service Code	ICD 021208W
Hospital Charge Code	200
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

0212093

Facility

$11,208.00

Service Code	ICD 0212093
Hospital Charge Code	201
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

0212093

Facility

$11,208.00

Service Code	ICD 0212093
Hospital Charge Code	10143
Min. Negotiated Rate	$11,208.00
Max. Negotiated Rate	$11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$11,208.00

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All Charges