Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021X0JR

Facility

$10,777.00

Service Code	ICD 021X0JR
Hospital Charge Code	3025
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

021X0KA

Facility

$10,777.00

Service Code	ICD 021X0KA
Hospital Charge Code	529
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

021X0KP

Facility

$10,777.00

Service Code	ICD 021X0KP
Hospital Charge Code	530
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

021X0KQ

Facility

$10,777.00

Service Code	ICD 021X0KQ
Hospital Charge Code	3026
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

021X0KR

Facility

$10,777.00

Service Code	ICD 021X0KR
Hospital Charge Code	3027
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

021X0ZA

Facility

$10,777.00

Service Code	ICD 021X0ZA
Hospital Charge Code	531
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

021X0ZP

Facility

$10,777.00

Service Code	ICD 021X0ZP
Hospital Charge Code	532
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

021X0ZQ

Facility

$10,777.00

Service Code	ICD 021X0ZQ
Hospital Charge Code	3028
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

021X0ZR

Facility

$10,777.00

Service Code	ICD 021X0ZR
Hospital Charge Code	3029
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

021X48A

Facility

$10,777.00

Service Code	ICD 021X48A
Hospital Charge Code	533
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

021X48P

Facility

$10,777.00

Service Code	ICD 021X48P
Hospital Charge Code	534
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

021X48Q

Facility

$10,777.00

Service Code	ICD 021X48Q
Hospital Charge Code	3030
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

021X48R

Facility

$10,777.00

Service Code	ICD 021X48R
Hospital Charge Code	3031
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

021X49A

Facility

$10,777.00

Service Code	ICD 021X49A
Hospital Charge Code	535
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

021X49P

Facility

$10,777.00

Service Code	ICD 021X49P
Hospital Charge Code	536
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

021X49Q

Facility

$10,777.00

Service Code	ICD 021X49Q
Hospital Charge Code	3032
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

021X49R

Facility

$10,777.00

Service Code	ICD 021X49R
Hospital Charge Code	3033
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

021X4AA

Facility

$10,777.00

Service Code	ICD 021X4AA
Hospital Charge Code	537
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

021X4AP

Facility

$10,777.00

Service Code	ICD 021X4AP
Hospital Charge Code	538
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

021X4AQ

Facility

$10,777.00

Service Code	ICD 021X4AQ
Hospital Charge Code	3034
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

021X4AR

Facility

$10,777.00

Service Code	ICD 021X4AR
Hospital Charge Code	3035
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

021X4JA

Facility

$10,777.00

Service Code	ICD 021X4JA
Hospital Charge Code	539
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

021X4JP

Facility

$10,777.00

Service Code	ICD 021X4JP
Hospital Charge Code	540
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

021X4JQ

Facility

$10,777.00

Service Code	ICD 021X4JQ
Hospital Charge Code	3036
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

021X4JR

Facility

$10,777.00

Service Code	ICD 021X4JR
Hospital Charge Code	3037
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