Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

0213489

Facility

$11,208.00

Service Code	ICD 0213489
Hospital Charge Code	291
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

021348C

Facility

$11,208.00

Service Code	ICD 021348C
Hospital Charge Code	292
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

021348F

Facility

$11,208.00

Service Code	ICD 021348F
Hospital Charge Code	293
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

021348W

Facility

$11,208.00

Service Code	ICD 021348W
Hospital Charge Code	294
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

0213493

Facility

$11,208.00

Service Code	ICD 0213493
Hospital Charge Code	295
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

0213493

Facility

$11,208.00

Service Code	ICD 0213493
Hospital Charge Code	10237
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

0213498

Facility

$11,208.00

Service Code	ICD 0213498
Hospital Charge Code	296
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

0213498

Facility

$11,208.00

Service Code	ICD 0213498
Hospital Charge Code	10238
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

0213499

Facility

$11,208.00

Service Code	ICD 0213499
Hospital Charge Code	10239
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

0213499

Facility

$11,208.00

Service Code	ICD 0213499
Hospital Charge Code	2885
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

021349C

Facility

$11,208.00

Service Code	ICD 021349C
Hospital Charge Code	297
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

021349C

Facility

$11,208.00

Service Code	ICD 021349C
Hospital Charge Code	10240
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

021349F

Facility

$11,208.00

Service Code	ICD 021349F
Hospital Charge Code	10241
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

021349F

Facility

$11,208.00

Service Code	ICD 021349F
Hospital Charge Code	2886
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

021349W

Facility

$11,208.00

Service Code	ICD 021349W
Hospital Charge Code	2887
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

021349W

Facility

$11,208.00

Service Code	ICD 021349W
Hospital Charge Code	10242
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

02134A3

Facility

$11,208.00

Service Code	ICD 02134A3
Hospital Charge Code	10243
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

02134A3

Facility

$11,208.00

Service Code	ICD 02134A3
Hospital Charge Code	298
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

02134A8

Facility

$11,208.00

Service Code	ICD 02134A8
Hospital Charge Code	299
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

02134A8

Facility

$11,208.00

Service Code	ICD 02134A8
Hospital Charge Code	10244
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

02134A9

Facility

$11,208.00

Service Code	ICD 02134A9
Hospital Charge Code	2888
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

02134A9

Facility

$11,208.00

Service Code	ICD 02134A9
Hospital Charge Code	10245
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

02134AC

Facility

$11,208.00

Service Code	ICD 02134AC
Hospital Charge Code	300
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

02134AC

Facility

$11,208.00

Service Code	ICD 02134AC
Hospital Charge Code	10246
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

02134AF

Facility

$11,208.00

Service Code	ICD 02134AF
Hospital Charge Code	10247
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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