Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

4A033BC

Facility

$10,777.00

Service Code	ICD 4A033BC
Hospital Charge Code	2756
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

4A033BF

Facility

$10,777.00

Service Code	ICD 4A033BF
Hospital Charge Code	2757
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

4A040B1

Facility

$10,777.00

Service Code	ICD 4A040B1
Hospital Charge Code	2758
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

4A040B3

Facility

$10,777.00

Service Code	ICD 4A040B3
Hospital Charge Code	2759
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

4A043B1

Facility

$10,777.00

Service Code	ICD 4A043B1
Hospital Charge Code	2760
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

4A043B3

Facility

$10,777.00

Service Code	ICD 4A043B3
Hospital Charge Code	2761
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

4A130BC

Facility

$10,777.00

Service Code	ICD 4A130BC
Hospital Charge Code	2762
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

4A133BC

Facility

$10,777.00

Service Code	ICD 4A133BC
Hospital Charge Code	2763
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

4A140B1

Facility

$10,777.00

Service Code	ICD 4A140B1
Hospital Charge Code	2764
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

4A140B3

Facility

$10,777.00

Service Code	ICD 4A140B3
Hospital Charge Code	2765
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

4A143B1

Facility

$10,777.00

Service Code	ICD 4A143B1
Hospital Charge Code	2766
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

4A143B3

Facility

$10,777.00

Service Code	ICD 4A143B3
Hospital Charge Code	2767
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

5A02116

Facility

$10,777.00

Service Code	ICD 5A02116
Hospital Charge Code	2769
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

5A02116

Facility

$10,777.00

Service Code	ICD 5A02116
Hospital Charge Code	2768
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

5A0211D

Facility

$10,777.00

Service Code	ICD 5A0211D
Hospital Charge Code	2770
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

5A02210

Facility

$10,777.00

Service Code	ICD 5A02210
Hospital Charge Code	5378
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

5A02216

Facility

$10,777.00

Service Code	ICD 5A02216
Hospital Charge Code	2772
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

5A02216

Facility

$10,777.00

Service Code	ICD 5A02216
Hospital Charge Code	2771
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

5A0221D

Facility

$10,777.00

Service Code	ICD 5A0221D
Hospital Charge Code	5379
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

5A1213Z

Facility

$10,777.00

Service Code	ICD 5A1213Z
Hospital Charge Code	2773
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

5A1221Z

Facility

$10,777.00

Service Code	ICD 5A1221Z
Hospital Charge Code	5380
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

5A1223Z

Facility

$10,777.00

Service Code	ICD 5A1223Z
Hospital Charge Code	5381
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

5A1522F

Facility

$10,777.00

Service Code	ICD 5A1522F
Hospital Charge Code	5382
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

5A1522G

Facility

$10,777.00

Service Code	ICD 5A1522G
Hospital Charge Code	5383
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

5A1522H

Facility

$10,777.00

Service Code	ICD 5A1522H
Hospital Charge Code	5384
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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All Charges