Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

067N0DZ

Facility

$4,070.00

Service Code	ICD 067N0DZ
Hospital Charge Code	4795
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

067N3DZ

Facility

$4,070.00

Service Code	ICD 067N3DZ
Hospital Charge Code	4796
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

067N4DZ

Facility

$4,070.00

Service Code	ICD 067N4DZ
Hospital Charge Code	4797
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

067P0DZ

Facility

$4,070.00

Service Code	ICD 067P0DZ
Hospital Charge Code	4798
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

067P3DZ

Facility

$4,070.00

Service Code	ICD 067P3DZ
Hospital Charge Code	4799
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

067P4DZ

Facility

$4,070.00

Service Code	ICD 067P4DZ
Hospital Charge Code	4800
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

067Q0DZ

Facility

$4,070.00

Service Code	ICD 067Q0DZ
Hospital Charge Code	4801
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

067Q3DZ

Facility

$4,070.00

Service Code	ICD 067Q3DZ
Hospital Charge Code	4802
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

067Q4DZ

Facility

$4,070.00

Service Code	ICD 067Q4DZ
Hospital Charge Code	4803
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

067R0DZ

Facility

$4,070.00

Service Code	ICD 067R0DZ
Hospital Charge Code	4804
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

067R3DZ

Facility

$4,070.00

Service Code	ICD 067R3DZ
Hospital Charge Code	4805
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

067R4DZ

Facility

$4,070.00

Service Code	ICD 067R4DZ
Hospital Charge Code	4806
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

067S0DZ

Facility

$4,070.00

Service Code	ICD 067S0DZ
Hospital Charge Code	4807
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

067S3DZ

Facility

$4,070.00

Service Code	ICD 067S3DZ
Hospital Charge Code	4808
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

067S4DZ

Facility

$4,070.00

Service Code	ICD 067S4DZ
Hospital Charge Code	4809
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

067T0DZ

Facility

$4,070.00

Service Code	ICD 067T0DZ
Hospital Charge Code	4810
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

067T3DZ

Facility

$4,070.00

Service Code	ICD 067T3DZ
Hospital Charge Code	4811
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

067T4DZ

Facility

$4,070.00

Service Code	ICD 067T4DZ
Hospital Charge Code	4812
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

067V0DZ

Facility

$4,070.00

Service Code	ICD 067V0DZ
Hospital Charge Code	4813
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

067V3DZ

Facility

$4,070.00

Service Code	ICD 067V3DZ
Hospital Charge Code	4814
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

067V4DZ

Facility

$4,070.00

Service Code	ICD 067V4DZ
Hospital Charge Code	4815
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

067Y0DZ

Facility

$4,070.00

Service Code	ICD 067Y0DZ
Hospital Charge Code	4816
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

067Y3DZ

Facility

$4,070.00

Service Code	ICD 067Y3DZ
Hospital Charge Code	4817
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

067Y4DZ

Facility

$4,070.00

Service Code	ICD 067Y4DZ
Hospital Charge Code	4818
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

07HK01Z

Facility

$9,120.00

Service Code	ICD 07HK01Z
Hospital Charge Code	4819
Min. Negotiated Rate	$9,120.00
Max. Negotiated Rate	$9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$9,120.00

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