Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021K4ZR

Facility

$11,208.00

Service Code	ICD 021K4ZR
Hospital Charge Code	10369
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

021K4ZW

Facility

$11,208.00

Service Code	ICD 021K4ZW
Hospital Charge Code	439
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

021K4ZW

Facility

$11,208.00

Service Code	ICD 021K4ZW
Hospital Charge Code	10370
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

021L08P

Facility

$11,208.00

Service Code	ICD 021L08P
Hospital Charge Code	440
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

021L08Q

Facility

$11,208.00

Service Code	ICD 021L08Q
Hospital Charge Code	441
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

021L08R

Facility

$11,208.00

Service Code	ICD 021L08R
Hospital Charge Code	442
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

021L09P

Facility

$11,208.00

Service Code	ICD 021L09P
Hospital Charge Code	10371
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

021L09P

Facility

$11,208.00

Service Code	ICD 021L09P
Hospital Charge Code	2930
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

021L09Q

Facility

$11,208.00

Service Code	ICD 021L09Q
Hospital Charge Code	10372
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

021L09Q

Facility

$11,208.00

Service Code	ICD 021L09Q
Hospital Charge Code	2931
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

021L09R

Facility

$11,208.00

Service Code	ICD 021L09R
Hospital Charge Code	2932
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

021L09R

Facility

$11,208.00

Service Code	ICD 021L09R
Hospital Charge Code	10373
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

021L0AP

Facility

$11,208.00

Service Code	ICD 021L0AP
Hospital Charge Code	10374
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

021L0AP

Facility

$11,208.00

Service Code	ICD 021L0AP
Hospital Charge Code	443
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

021L0AQ

Facility

$11,208.00

Service Code	ICD 021L0AQ
Hospital Charge Code	2933
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

021L0AQ

Facility

$11,208.00

Service Code	ICD 021L0AQ
Hospital Charge Code	10375
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

021L0AR

Facility

$11,208.00

Service Code	ICD 021L0AR
Hospital Charge Code	10376
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

021L0AR

Facility

$11,208.00

Service Code	ICD 021L0AR
Hospital Charge Code	2934
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

021L0JP

Facility

$11,208.00

Service Code	ICD 021L0JP
Hospital Charge Code	10377
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

021L0JP

Facility

$11,208.00

Service Code	ICD 021L0JP
Hospital Charge Code	2935
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

021L0JQ

Facility

$11,208.00

Service Code	ICD 021L0JQ
Hospital Charge Code	2936
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

021L0JQ

Facility

$11,208.00

Service Code	ICD 021L0JQ
Hospital Charge Code	10378
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

021L0JR

Facility

$11,208.00

Service Code	ICD 021L0JR
Hospital Charge Code	2937
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

021L0JR

Facility

$11,208.00

Service Code	ICD 021L0JR
Hospital Charge Code	10379
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

021L0KP

Facility

$11,208.00

Service Code	ICD 021L0KP
Hospital Charge Code	2938
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