Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02120Z9

Facility

$11,208.00

Service Code	ICD 02120Z9
Hospital Charge Code	10169
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

02120Z9

Facility

$11,208.00

Service Code	ICD 02120Z9
Hospital Charge Code	227
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

02120ZC

Facility

$11,208.00

Service Code	ICD 02120ZC
Hospital Charge Code	228
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

02120ZC

Facility

$11,208.00

Service Code	ICD 02120ZC
Hospital Charge Code	10170
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

02120ZF

Facility

$11,208.00

Service Code	ICD 02120ZF
Hospital Charge Code	2867
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

02120ZF

Facility

$11,208.00

Service Code	ICD 02120ZF
Hospital Charge Code	10171
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

0212344

Facility

$11,208.00

Service Code	ICD 0212344
Hospital Charge Code	2868
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

0212344

Facility

$11,208.00

Service Code	ICD 0212344
Hospital Charge Code	10172
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

02123D4

Facility

$11,208.00

Service Code	ICD 02123D4
Hospital Charge Code	229
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

02123D4

Facility

$11,208.00

Service Code	ICD 02123D4
Hospital Charge Code	10173
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

0212444

Facility

$11,208.00

Service Code	ICD 0212444
Hospital Charge Code	230
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

0212444

Facility

$11,208.00

Service Code	ICD 0212444
Hospital Charge Code	10174
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

0212483

Facility

$11,208.00

Service Code	ICD 0212483
Hospital Charge Code	231
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

0212488

Facility

$11,208.00

Service Code	ICD 0212488
Hospital Charge Code	232
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

0212489

Facility

$11,208.00

Service Code	ICD 0212489
Hospital Charge Code	233
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

021248C

Facility

$11,208.00

Service Code	ICD 021248C
Hospital Charge Code	234
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

021248F

Facility

$11,208.00

Service Code	ICD 021248F
Hospital Charge Code	235
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

021248W

Facility

$11,208.00

Service Code	ICD 021248W
Hospital Charge Code	236
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

0212493

Facility

$11,208.00

Service Code	ICD 0212493
Hospital Charge Code	237
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

0212493

Facility

$11,208.00

Service Code	ICD 0212493
Hospital Charge Code	10175
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

0212498

Facility

$11,208.00

Service Code	ICD 0212498
Hospital Charge Code	10176
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

0212498

Facility

$11,208.00

Service Code	ICD 0212498
Hospital Charge Code	238
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

0212499

Facility

$11,208.00

Service Code	ICD 0212499
Hospital Charge Code	239
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

0212499

Facility

$11,208.00

Service Code	ICD 0212499
Hospital Charge Code	10177
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

021249C

Facility

$11,208.00

Service Code	ICD 021249C
Hospital Charge Code	240
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