Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021K4AQ

Facility

$10,777.00

Service Code	ICD 021K4AQ
Hospital Charge Code	2918
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

021K4AR

Facility

$10,777.00

Service Code	ICD 021K4AR
Hospital Charge Code	2919
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

021K4JP

Facility

$10,777.00

Service Code	ICD 021K4JP
Hospital Charge Code	2920
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

021K4JQ

Facility

$10,777.00

Service Code	ICD 021K4JQ
Hospital Charge Code	2921
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

021K4JR

Facility

$10,777.00

Service Code	ICD 021K4JR
Hospital Charge Code	2922
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

021K4KP

Facility

$10,777.00

Service Code	ICD 021K4KP
Hospital Charge Code	2923
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

021K4KQ

Facility

$10,777.00

Service Code	ICD 021K4KQ
Hospital Charge Code	2924
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

021K4KR

Facility

$10,777.00

Service Code	ICD 021K4KR
Hospital Charge Code	2925
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

021K4Z5

Facility

$10,777.00

Service Code	ICD 021K4Z5
Hospital Charge Code	435
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

021K4Z8

Facility

$10,777.00

Service Code	ICD 021K4Z8
Hospital Charge Code	436
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

021K4Z9

Facility

$10,777.00

Service Code	ICD 021K4Z9
Hospital Charge Code	2926
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

021K4ZC

Facility

$10,777.00

Service Code	ICD 021K4ZC
Hospital Charge Code	437
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

021K4ZF

Facility

$10,777.00

Service Code	ICD 021K4ZF
Hospital Charge Code	2927
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

021K4ZP

Facility

$10,777.00

Service Code	ICD 021K4ZP
Hospital Charge Code	438
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

021K4ZQ

Facility

$10,777.00

Service Code	ICD 021K4ZQ
Hospital Charge Code	2928
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

021K4ZR

Facility

$10,777.00

Service Code	ICD 021K4ZR
Hospital Charge Code	2929
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

021K4ZW

Facility

$10,777.00

Service Code	ICD 021K4ZW
Hospital Charge Code	439
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

021L08P

Facility

$10,777.00

Service Code	ICD 021L08P
Hospital Charge Code	440
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

021L08Q

Facility

$10,777.00

Service Code	ICD 021L08Q
Hospital Charge Code	441
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

021L08R

Facility

$10,777.00

Service Code	ICD 021L08R
Hospital Charge Code	442
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

021L09P

Facility

$10,777.00

Service Code	ICD 021L09P
Hospital Charge Code	2930
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

021L09Q

Facility

$10,777.00

Service Code	ICD 021L09Q
Hospital Charge Code	2931
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

021L09R

Facility

$10,777.00

Service Code	ICD 021L09R
Hospital Charge Code	2932
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

021L0AP

Facility

$10,777.00

Service Code	ICD 021L0AP
Hospital Charge Code	443
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

021L0AQ

Facility

$10,777.00

Service Code	ICD 021L0AQ
Hospital Charge Code	2933
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

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