Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

04H042Z

Facility

$10,777.00

Service Code	ICD 04H042Z
Hospital Charge Code	2451
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

04U03JZ

Facility

$10,777.00

Service Code	ICD 04U03JZ
Hospital Charge Code	2452
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

04U04JZ

Facility

$10,777.00

Service Code	ICD 04U04JZ
Hospital Charge Code	2453
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

04V00DJ

Facility

$10,777.00

Service Code	ICD 04V00DJ
Hospital Charge Code	2454
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

04V00EZ

Facility

$10,777.00

Service Code	ICD 04V00EZ
Hospital Charge Code	2455
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

04V00FZ

Facility

$10,777.00

Service Code	ICD 04V00FZ
Hospital Charge Code	2456
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

04V03DJ

Facility

$10,777.00

Service Code	ICD 04V03DJ
Hospital Charge Code	2457
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

04V03DZ

Facility

$10,777.00

Service Code	ICD 04V03DZ
Hospital Charge Code	4625
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

04V03EZ

Facility

$10,777.00

Service Code	ICD 04V03EZ
Hospital Charge Code	2458
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

04V03FZ

Facility

$10,777.00

Service Code	ICD 04V03FZ
Hospital Charge Code	2459
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

04V04DJ

Facility

$10,777.00

Service Code	ICD 04V04DJ
Hospital Charge Code	2460
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

04V04DZ

Facility

$10,777.00

Service Code	ICD 04V04DZ
Hospital Charge Code	4626
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

04V04EZ

Facility

$10,777.00

Service Code	ICD 04V04EZ
Hospital Charge Code	2461
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

04V04FZ

Facility

$10,777.00

Service Code	ICD 04V04FZ
Hospital Charge Code	2462
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

05700DZ

Facility

$3,913.00

Service Code	ICD 05700DZ
Hospital Charge Code	4627
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05703DZ

Facility

$3,913.00

Service Code	ICD 05703DZ
Hospital Charge Code	4628
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05704DZ

Facility

$3,913.00

Service Code	ICD 05704DZ
Hospital Charge Code	4629
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05710DZ

Facility

$3,913.00

Service Code	ICD 05710DZ
Hospital Charge Code	4630
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05713DZ

Facility

$3,913.00

Service Code	ICD 05713DZ
Hospital Charge Code	4631
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05714DZ

Facility

$3,913.00

Service Code	ICD 05714DZ
Hospital Charge Code	4632
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05730D1

Facility

$3,913.00

Service Code	ICD 05730D1
Hospital Charge Code	4633
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05730DZ

Facility

$3,913.00

Service Code	ICD 05730DZ
Hospital Charge Code	4634
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05733D1

Facility

$3,913.00

Service Code	ICD 05733D1
Hospital Charge Code	4635
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05733DZ

Facility

$3,913.00

Service Code	ICD 05733DZ
Hospital Charge Code	4636
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

05734D1

Facility

$3,913.00

Service Code	ICD 05734D1
Hospital Charge Code	4637
Min. Negotiated Rate	$3,913.00
Max. Negotiated Rate	$3,913.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$3,913.00

Know your out-of-pocket cost for care.

All Charges