Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021W0JP

Facility

$10,777.00

Service Code	ICD 021W0JP
Hospital Charge Code	504
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

021W0JQ

Facility

$10,777.00

Service Code	ICD 021W0JQ
Hospital Charge Code	3000
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

021W0JR

Facility

$10,777.00

Service Code	ICD 021W0JR
Hospital Charge Code	3001
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

021W0KA

Facility

$10,777.00

Service Code	ICD 021W0KA
Hospital Charge Code	505
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

021W0KP

Facility

$10,777.00

Service Code	ICD 021W0KP
Hospital Charge Code	506
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

021W0KQ

Facility

$10,777.00

Service Code	ICD 021W0KQ
Hospital Charge Code	3002
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

021W0KR

Facility

$10,777.00

Service Code	ICD 021W0KR
Hospital Charge Code	3003
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

021W0ZA

Facility

$10,777.00

Service Code	ICD 021W0ZA
Hospital Charge Code	507
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

021W0ZP

Facility

$10,777.00

Service Code	ICD 021W0ZP
Hospital Charge Code	508
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

021W0ZQ

Facility

$10,777.00

Service Code	ICD 021W0ZQ
Hospital Charge Code	3004
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

021W0ZR

Facility

$10,777.00

Service Code	ICD 021W0ZR
Hospital Charge Code	3005
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

021W48A

Facility

$10,777.00

Service Code	ICD 021W48A
Hospital Charge Code	509
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

021W48P

Facility

$10,777.00

Service Code	ICD 021W48P
Hospital Charge Code	510
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

021W48Q

Facility

$10,777.00

Service Code	ICD 021W48Q
Hospital Charge Code	3006
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

021W48R

Facility

$10,777.00

Service Code	ICD 021W48R
Hospital Charge Code	3007
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

021W49A

Facility

$10,777.00

Service Code	ICD 021W49A
Hospital Charge Code	511
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

021W49P

Facility

$10,777.00

Service Code	ICD 021W49P
Hospital Charge Code	512
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

021W49Q

Facility

$10,777.00

Service Code	ICD 021W49Q
Hospital Charge Code	3008
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

021W49R

Facility

$10,777.00

Service Code	ICD 021W49R
Hospital Charge Code	3009
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

021W4AA

Facility

$10,777.00

Service Code	ICD 021W4AA
Hospital Charge Code	513
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

021W4AP

Facility

$10,777.00

Service Code	ICD 021W4AP
Hospital Charge Code	514
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

021W4AQ

Facility

$10,777.00

Service Code	ICD 021W4AQ
Hospital Charge Code	3010
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

021W4AR

Facility

$10,777.00

Service Code	ICD 021W4AR
Hospital Charge Code	3011
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

021W4JA

Facility

$10,777.00

Service Code	ICD 021W4JA
Hospital Charge Code	515
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

021W4JP

Facility

$10,777.00

Service Code	ICD 021W4JP
Hospital Charge Code	516
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

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All Charges