Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021749T

Facility

$11,208.00

Service Code	ICD 021749T
Hospital Charge Code	392
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

021749U

Facility

$11,208.00

Service Code	ICD 021749U
Hospital Charge Code	393
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

02174AP

Facility

$11,208.00

Service Code	ICD 02174AP
Hospital Charge Code	10317
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

02174AP

Facility

$11,208.00

Service Code	ICD 02174AP
Hospital Charge Code	394
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

02174AQ

Facility

$11,208.00

Service Code	ICD 02174AQ
Hospital Charge Code	395
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

02174AQ

Facility

$11,208.00

Service Code	ICD 02174AQ
Hospital Charge Code	10318
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

02174AR

Facility

$11,208.00

Service Code	ICD 02174AR
Hospital Charge Code	396
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

02174AR

Facility

$11,208.00

Service Code	ICD 02174AR
Hospital Charge Code	10319
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

02174AS

Facility

$11,208.00

Service Code	ICD 02174AS
Hospital Charge Code	397
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

02174AT

Facility

$11,208.00

Service Code	ICD 02174AT
Hospital Charge Code	398
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

02174AU

Facility

$11,208.00

Service Code	ICD 02174AU
Hospital Charge Code	399
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

02174JP

Facility

$11,208.00

Service Code	ICD 02174JP
Hospital Charge Code	2904
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

02174JP

Facility

$11,208.00

Service Code	ICD 02174JP
Hospital Charge Code	10320
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

02174JQ

Facility

$11,208.00

Service Code	ICD 02174JQ
Hospital Charge Code	10321
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

02174JQ

Facility

$11,208.00

Service Code	ICD 02174JQ
Hospital Charge Code	2905
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

02174JR

Facility

$11,208.00

Service Code	ICD 02174JR
Hospital Charge Code	2906
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

02174JR

Facility

$11,208.00

Service Code	ICD 02174JR
Hospital Charge Code	10322
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

02174JS

Facility

$11,208.00

Service Code	ICD 02174JS
Hospital Charge Code	400
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

02174JT

Facility

$11,208.00

Service Code	ICD 02174JT
Hospital Charge Code	401
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

02174JU

Facility

$11,208.00

Service Code	ICD 02174JU
Hospital Charge Code	402
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

02174KP

Facility

$11,208.00

Service Code	ICD 02174KP
Hospital Charge Code	2907
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

02174KP

Facility

$11,208.00

Service Code	ICD 02174KP
Hospital Charge Code	10323
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

02174KQ

Facility

$11,208.00

Service Code	ICD 02174KQ
Hospital Charge Code	2908
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

02174KQ

Facility

$11,208.00

Service Code	ICD 02174KQ
Hospital Charge Code	10324
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

02174KR

Facility

$11,208.00

Service Code	ICD 02174KR
Hospital Charge Code	10325
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

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All Charges