Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021L4JP

Facility

$10,777.00

Service Code	ICD 021L4JP
Hospital Charge Code	2953
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

021L4JQ

Facility

$10,777.00

Service Code	ICD 021L4JQ
Hospital Charge Code	2954
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

021L4JR

Facility

$10,777.00

Service Code	ICD 021L4JR
Hospital Charge Code	2955
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

021L4KP

Facility

$10,777.00

Service Code	ICD 021L4KP
Hospital Charge Code	2956
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

021L4KQ

Facility

$10,777.00

Service Code	ICD 021L4KQ
Hospital Charge Code	2957
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

021L4KR

Facility

$10,777.00

Service Code	ICD 021L4KR
Hospital Charge Code	2958
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

021L4Z5

Facility

$10,777.00

Service Code	ICD 021L4Z5
Hospital Charge Code	450
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

021L4Z8

Facility

$10,777.00

Service Code	ICD 021L4Z8
Hospital Charge Code	451
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

021L4Z9

Facility

$10,777.00

Service Code	ICD 021L4Z9
Hospital Charge Code	2959
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

021L4ZC

Facility

$10,777.00

Service Code	ICD 021L4ZC
Hospital Charge Code	2960
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

021L4ZF

Facility

$10,777.00

Service Code	ICD 021L4ZF
Hospital Charge Code	2961
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

021L4ZP

Facility

$10,777.00

Service Code	ICD 021L4ZP
Hospital Charge Code	2962
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

021L4ZQ

Facility

$10,777.00

Service Code	ICD 021L4ZQ
Hospital Charge Code	2963
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

021L4ZR

Facility

$10,777.00

Service Code	ICD 021L4ZR
Hospital Charge Code	2964
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

021L4ZW

Facility

$10,777.00

Service Code	ICD 021L4ZW
Hospital Charge Code	452
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

021V08P

Facility

$10,777.00

Service Code	ICD 021V08P
Hospital Charge Code	454
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

021V08Q

Facility

$10,777.00

Service Code	ICD 021V08Q
Hospital Charge Code	455
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

021V08R

Facility

$10,777.00

Service Code	ICD 021V08R
Hospital Charge Code	456
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

021V08S

Facility

$10,777.00

Service Code	ICD 021V08S
Hospital Charge Code	457
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

021V08T

Facility

$10,777.00

Service Code	ICD 021V08T
Hospital Charge Code	458
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

021V08U

Facility

$10,777.00

Service Code	ICD 021V08U
Hospital Charge Code	459
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

021V09P

Facility

$10,777.00

Service Code	ICD 021V09P
Hospital Charge Code	2965
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

021V09Q

Facility

$10,777.00

Service Code	ICD 021V09Q
Hospital Charge Code	2966
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

021V09R

Facility

$10,777.00

Service Code	ICD 021V09R
Hospital Charge Code	2967
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

021V09S

Facility

$10,777.00

Service Code	ICD 021V09S
Hospital Charge Code	460
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

Know your out-of-pocket cost for care.

All Charges