Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02124ZC

Facility

$11,208.00

Service Code	ICD 02124ZC
Hospital Charge Code	10203
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

02124ZF

Facility

$11,208.00

Service Code	ICD 02124ZF
Hospital Charge Code	2872
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

02124ZF

Facility

$11,208.00

Service Code	ICD 02124ZF
Hospital Charge Code	10204
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

0213083

Facility

$11,208.00

Service Code	ICD 0213083
Hospital Charge Code	263
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

0213088

Facility

$11,208.00

Service Code	ICD 0213088
Hospital Charge Code	264
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

0213089

Facility

$11,208.00

Service Code	ICD 0213089
Hospital Charge Code	265
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

021308C

Facility

$11,208.00

Service Code	ICD 021308C
Hospital Charge Code	266
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

021308F

Facility

$11,208.00

Service Code	ICD 021308F
Hospital Charge Code	267
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

021308W

Facility

$11,208.00

Service Code	ICD 021308W
Hospital Charge Code	268
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

0213093

Facility

$11,208.00

Service Code	ICD 0213093
Hospital Charge Code	269
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

0213093

Facility

$11,208.00

Service Code	ICD 0213093
Hospital Charge Code	10205
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

0213098

Facility

$11,208.00

Service Code	ICD 0213098
Hospital Charge Code	270
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

0213098

Facility

$11,208.00

Service Code	ICD 0213098
Hospital Charge Code	10206
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

0213099

Facility

$11,208.00

Service Code	ICD 0213099
Hospital Charge Code	10207
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

0213099

Facility

$11,208.00

Service Code	ICD 0213099
Hospital Charge Code	2873
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

021309C

Facility

$11,208.00

Service Code	ICD 021309C
Hospital Charge Code	10208
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

021309C

Facility

$11,208.00

Service Code	ICD 021309C
Hospital Charge Code	2874
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

021309F

Facility

$11,208.00

Service Code	ICD 021309F
Hospital Charge Code	10209
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

021309F

Facility

$11,208.00

Service Code	ICD 021309F
Hospital Charge Code	2875
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

021309W

Facility

$11,208.00

Service Code	ICD 021309W
Hospital Charge Code	10210
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

021309W

Facility

$11,208.00

Service Code	ICD 021309W
Hospital Charge Code	2876
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

02130A3

Facility

$11,208.00

Service Code	ICD 02130A3
Hospital Charge Code	10211
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

02130A3

Facility

$11,208.00

Service Code	ICD 02130A3
Hospital Charge Code	271
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

02130A8

Facility

$11,208.00

Service Code	ICD 02130A8
Hospital Charge Code	272
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

02130A8

Facility

$11,208.00

Service Code	ICD 02130A8
Hospital Charge Code	10212
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