Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

0WWD33Z

Facility

$11,208.00

Service Code	ICD 0WWD33Z
Hospital Charge Code	13975
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

0WWD3YZ

Facility

$11,208.00

Service Code	ICD 0WWD3YZ
Hospital Charge Code	13976
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

0WWD3YZ

Facility

$11,208.00

Service Code	ICD 0WWD3YZ
Hospital Charge Code	5269
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

0WWD40Z

Facility

$11,208.00

Service Code	ICD 0WWD40Z
Hospital Charge Code	5270
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

0WWD40Z

Facility

$11,208.00

Service Code	ICD 0WWD40Z
Hospital Charge Code	13977
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

0WWD41Z

Facility

$11,208.00

Service Code	ICD 0WWD41Z
Hospital Charge Code	5271
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

0WWD41Z

Facility

$11,208.00

Service Code	ICD 0WWD41Z
Hospital Charge Code	13978
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

0WWD43Z

Facility

$11,208.00

Service Code	ICD 0WWD43Z
Hospital Charge Code	13979
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

0WWD43Z

Facility

$11,208.00

Service Code	ICD 0WWD43Z
Hospital Charge Code	5272
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

0WWD4YZ

Facility

$11,208.00

Service Code	ICD 0WWD4YZ
Hospital Charge Code	13980
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

0WWD4YZ

Facility

$11,208.00

Service Code	ICD 0WWD4YZ
Hospital Charge Code	5273
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

0XH201Z

Facility

$9,120.00

Service Code	ICD 0XH201Z
Hospital Charge Code	5274
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

0XH231Z

Facility

$9,120.00

Service Code	ICD 0XH231Z
Hospital Charge Code	5275
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

0XH241Z

Facility

$9,120.00

Service Code	ICD 0XH241Z
Hospital Charge Code	5276
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

0XH301Z

Facility

$9,120.00

Service Code	ICD 0XH301Z
Hospital Charge Code	5277
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

0XH331Z

Facility

$9,120.00

Service Code	ICD 0XH331Z
Hospital Charge Code	5278
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

0XH341Z

Facility

$9,120.00

Service Code	ICD 0XH341Z
Hospital Charge Code	5279
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

0XH401Z

Facility

$9,120.00

Service Code	ICD 0XH401Z
Hospital Charge Code	5280
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

0XH431Z

Facility

$9,120.00

Service Code	ICD 0XH431Z
Hospital Charge Code	5281
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

0XH441Z

Facility

$9,120.00

Service Code	ICD 0XH441Z
Hospital Charge Code	5282
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

0XH501Z

Facility

$9,120.00

Service Code	ICD 0XH501Z
Hospital Charge Code	5283
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

0XH531Z

Facility

$9,120.00

Service Code	ICD 0XH531Z
Hospital Charge Code	5284
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

0XH541Z

Facility

$9,120.00

Service Code	ICD 0XH541Z
Hospital Charge Code	5285
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

0XH601Z

Facility

$9,120.00

Service Code	ICD 0XH601Z
Hospital Charge Code	5286
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

0XH631Z

Facility

$9,120.00

Service Code	ICD 0XH631Z
Hospital Charge Code	5287
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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All Charges