Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02130K9

Facility

$11,208.00

Service Code	ICD 02130K9
Hospital Charge Code	281
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

02130KC

Facility

$11,208.00

Service Code	ICD 02130KC
Hospital Charge Code	282
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

02130KC

Facility

$11,208.00

Service Code	ICD 02130KC
Hospital Charge Code	10226
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

02130KF

Facility

$11,208.00

Service Code	ICD 02130KF
Hospital Charge Code	2881
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

02130KF

Facility

$11,208.00

Service Code	ICD 02130KF
Hospital Charge Code	10227
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

02130KW

Facility

$11,208.00

Service Code	ICD 02130KW
Hospital Charge Code	2882
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

02130KW

Facility

$11,208.00

Service Code	ICD 02130KW
Hospital Charge Code	10228
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

02130Z3

Facility

$11,208.00

Service Code	ICD 02130Z3
Hospital Charge Code	10229
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

02130Z3

Facility

$11,208.00

Service Code	ICD 02130Z3
Hospital Charge Code	283
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

02130Z8

Facility

$11,208.00

Service Code	ICD 02130Z8
Hospital Charge Code	10230
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

02130Z8

Facility

$11,208.00

Service Code	ICD 02130Z8
Hospital Charge Code	284
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

02130Z9

Facility

$11,208.00

Service Code	ICD 02130Z9
Hospital Charge Code	285
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

02130Z9

Facility

$11,208.00

Service Code	ICD 02130Z9
Hospital Charge Code	10231
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

02130ZC

Facility

$11,208.00

Service Code	ICD 02130ZC
Hospital Charge Code	286
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

02130ZC

Facility

$11,208.00

Service Code	ICD 02130ZC
Hospital Charge Code	10232
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

02130ZF

Facility

$11,208.00

Service Code	ICD 02130ZF
Hospital Charge Code	2883
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

02130ZF

Facility

$11,208.00

Service Code	ICD 02130ZF
Hospital Charge Code	10233
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

0213344

Facility

$11,208.00

Service Code	ICD 0213344
Hospital Charge Code	10234
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

0213344

Facility

$11,208.00

Service Code	ICD 0213344
Hospital Charge Code	2884
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

02133D4

Facility

$11,208.00

Service Code	ICD 02133D4
Hospital Charge Code	10235
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

02133D4

Facility

$11,208.00

Service Code	ICD 02133D4
Hospital Charge Code	287
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

0213444

Facility

$11,208.00

Service Code	ICD 0213444
Hospital Charge Code	10236
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

0213444

Facility

$11,208.00

Service Code	ICD 0213444
Hospital Charge Code	288
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

0213483

Facility

$11,208.00

Service Code	ICD 0213483
Hospital Charge Code	289
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

0213488

Facility

$11,208.00

Service Code	ICD 0213488
Hospital Charge Code	290
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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