Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02W54JZ

Facility

$11,208.00

Service Code	ICD 02W54JZ
Hospital Charge Code	11474
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

02W54JZ

Facility

$11,208.00

Service Code	ICD 02W54JZ
Hospital Charge Code	3516
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

02WA02Z

Facility

$11,208.00

Service Code	ICD 02WA02Z
Hospital Charge Code	11475
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

02WA02Z

Facility

$11,208.00

Service Code	ICD 02WA02Z
Hospital Charge Code	1495
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

02WA03Z

Facility

$11,208.00

Service Code	ICD 02WA03Z
Hospital Charge Code	3517
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

02WA03Z

Facility

$11,208.00

Service Code	ICD 02WA03Z
Hospital Charge Code	11476
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

02WA07Z

Facility

$11,208.00

Service Code	ICD 02WA07Z
Hospital Charge Code	3518
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

02WA07Z

Facility

$11,208.00

Service Code	ICD 02WA07Z
Hospital Charge Code	11477
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

02WA08Z

Facility

$11,208.00

Service Code	ICD 02WA08Z
Hospital Charge Code	3519
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

02WA08Z

Facility

$11,208.00

Service Code	ICD 02WA08Z
Hospital Charge Code	11478
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

02WA0CZ

Facility

$11,208.00

Service Code	ICD 02WA0CZ
Hospital Charge Code	11479
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

02WA0CZ

Facility

$11,208.00

Service Code	ICD 02WA0CZ
Hospital Charge Code	1496
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

02WA0DZ

Facility

$11,208.00

Service Code	ICD 02WA0DZ
Hospital Charge Code	11480
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

02WA0DZ

Facility

$11,208.00

Service Code	ICD 02WA0DZ
Hospital Charge Code	3520
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

02WA0JZ

Facility

$11,208.00

Service Code	ICD 02WA0JZ
Hospital Charge Code	1497
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

02WA0KZ

Facility

$11,208.00

Service Code	ICD 02WA0KZ
Hospital Charge Code	11481
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

02WA0KZ

Facility

$11,208.00

Service Code	ICD 02WA0KZ
Hospital Charge Code	1498
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

02WA0QZ

Facility

$11,208.00

Service Code	ICD 02WA0QZ
Hospital Charge Code	11482
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

02WA0QZ

Facility

$11,208.00

Service Code	ICD 02WA0QZ
Hospital Charge Code	1501
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

02WA0QZ

Facility

$11,208.00

Service Code	ICD 02WA0QZ
Hospital Charge Code	1500
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

02WA0RS

Facility

$11,208.00

Service Code	ICD 02WA0RS
Hospital Charge Code	1502
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

02WA0RS

Facility

$11,208.00

Service Code	ICD 02WA0RS
Hospital Charge Code	1503
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

02WA0RZ

Facility

$11,208.00

Service Code	ICD 02WA0RZ
Hospital Charge Code	1504
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

02WA0RZ

Facility

$11,208.00

Service Code	ICD 02WA0RZ
Hospital Charge Code	11483
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

02WA0YZ

Facility

$11,208.00

Service Code	ICD 02WA0YZ
Hospital Charge Code	1505
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