Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

05730DZ

Facility

$4,070.00

Service Code	ICD 05730DZ
Hospital Charge Code	4634
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05733D1

Facility

$4,070.00

Service Code	ICD 05733D1
Hospital Charge Code	4635
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05733DZ

Facility

$4,070.00

Service Code	ICD 05733DZ
Hospital Charge Code	4636
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05734D1

Facility

$4,070.00

Service Code	ICD 05734D1
Hospital Charge Code	4637
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05734DZ

Facility

$4,070.00

Service Code	ICD 05734DZ
Hospital Charge Code	4638
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05740D1

Facility

$4,070.00

Service Code	ICD 05740D1
Hospital Charge Code	4639
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05740DZ

Facility

$4,070.00

Service Code	ICD 05740DZ
Hospital Charge Code	4640
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05743D1

Facility

$4,070.00

Service Code	ICD 05743D1
Hospital Charge Code	4641
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05743DZ

Facility

$4,070.00

Service Code	ICD 05743DZ
Hospital Charge Code	4642
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05744D1

Facility

$4,070.00

Service Code	ICD 05744D1
Hospital Charge Code	4643
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05744DZ

Facility

$4,070.00

Service Code	ICD 05744DZ
Hospital Charge Code	4644
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05750D1

Facility

$4,070.00

Service Code	ICD 05750D1
Hospital Charge Code	4645
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05750DZ

Facility

$4,070.00

Service Code	ICD 05750DZ
Hospital Charge Code	4646
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05753D1

Facility

$4,070.00

Service Code	ICD 05753D1
Hospital Charge Code	4647
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05753DZ

Facility

$4,070.00

Service Code	ICD 05753DZ
Hospital Charge Code	4648
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05754D1

Facility

$4,070.00

Service Code	ICD 05754D1
Hospital Charge Code	4649
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05754DZ

Facility

$4,070.00

Service Code	ICD 05754DZ
Hospital Charge Code	4650
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05760D1

Facility

$4,070.00

Service Code	ICD 05760D1
Hospital Charge Code	4651
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05760DZ

Facility

$4,070.00

Service Code	ICD 05760DZ
Hospital Charge Code	4652
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05763D1

Facility

$4,070.00

Service Code	ICD 05763D1
Hospital Charge Code	4653
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05763DZ

Facility

$4,070.00

Service Code	ICD 05763DZ
Hospital Charge Code	4654
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05764D1

Facility

$4,070.00

Service Code	ICD 05764D1
Hospital Charge Code	4655
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05764DZ

Facility

$4,070.00

Service Code	ICD 05764DZ
Hospital Charge Code	4656
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05770D1

Facility

$4,070.00

Service Code	ICD 05770D1
Hospital Charge Code	4657
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

05770DZ

Facility

$4,070.00

Service Code	ICD 05770DZ
Hospital Charge Code	4658
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

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All Charges