Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021W4JQ

Facility

$10,777.00

Service Code	ICD 021W4JQ
Hospital Charge Code	3012
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

021W4JR

Facility

$10,777.00

Service Code	ICD 021W4JR
Hospital Charge Code	3013
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

021W4KA

Facility

$10,777.00

Service Code	ICD 021W4KA
Hospital Charge Code	517
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

021W4KP

Facility

$10,777.00

Service Code	ICD 021W4KP
Hospital Charge Code	518
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

021W4KQ

Facility

$10,777.00

Service Code	ICD 021W4KQ
Hospital Charge Code	3014
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

021W4KR

Facility

$10,777.00

Service Code	ICD 021W4KR
Hospital Charge Code	3015
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

021W4ZA

Facility

$10,777.00

Service Code	ICD 021W4ZA
Hospital Charge Code	519
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

021W4ZP

Facility

$10,777.00

Service Code	ICD 021W4ZP
Hospital Charge Code	520
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

021W4ZQ

Facility

$10,777.00

Service Code	ICD 021W4ZQ
Hospital Charge Code	3016
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

021W4ZR

Facility

$10,777.00

Service Code	ICD 021W4ZR
Hospital Charge Code	3017
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

021X08A

Facility

$10,777.00

Service Code	ICD 021X08A
Hospital Charge Code	521
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

021X08P

Facility

$10,777.00

Service Code	ICD 021X08P
Hospital Charge Code	522
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

021X08Q

Facility

$10,777.00

Service Code	ICD 021X08Q
Hospital Charge Code	3018
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

021X08R

Facility

$10,777.00

Service Code	ICD 021X08R
Hospital Charge Code	3019
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

021X09A

Facility

$10,777.00

Service Code	ICD 021X09A
Hospital Charge Code	523
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

021X09P

Facility

$10,777.00

Service Code	ICD 021X09P
Hospital Charge Code	524
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

021X09Q

Facility

$10,777.00

Service Code	ICD 021X09Q
Hospital Charge Code	3020
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

021X09R

Facility

$10,777.00

Service Code	ICD 021X09R
Hospital Charge Code	3021
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

021X0AA

Facility

$10,777.00

Service Code	ICD 021X0AA
Hospital Charge Code	525
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

021X0AP

Facility

$10,777.00

Service Code	ICD 021X0AP
Hospital Charge Code	526
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

021X0AQ

Facility

$10,777.00

Service Code	ICD 021X0AQ
Hospital Charge Code	3022
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

021X0AR

Facility

$10,777.00

Service Code	ICD 021X0AR
Hospital Charge Code	3023
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

021X0JA

Facility

$10,777.00

Service Code	ICD 021X0JA
Hospital Charge Code	527
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

021X0JP

Facility

$10,777.00

Service Code	ICD 021X0JP
Hospital Charge Code	528
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

021X0JQ

Facility

$10,777.00

Service Code	ICD 021X0JQ
Hospital Charge Code	3024
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