Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021L0KP

Facility

$11,208.00

Service Code	ICD 021L0KP
Hospital Charge Code	10380
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

021L0KQ

Facility

$11,208.00

Service Code	ICD 021L0KQ
Hospital Charge Code	2939
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

021L0KQ

Facility

$11,208.00

Service Code	ICD 021L0KQ
Hospital Charge Code	10381
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

021L0KR

Facility

$11,208.00

Service Code	ICD 021L0KR
Hospital Charge Code	2940
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

021L0KR

Facility

$11,208.00

Service Code	ICD 021L0KR
Hospital Charge Code	10382
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

021L0Z5

Facility

$11,208.00

Service Code	ICD 021L0Z5
Hospital Charge Code	10383
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

021L0Z5

Facility

$11,208.00

Service Code	ICD 021L0Z5
Hospital Charge Code	444
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

021L0Z8

Facility

$11,208.00

Service Code	ICD 021L0Z8
Hospital Charge Code	10384
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

021L0Z8

Facility

$11,208.00

Service Code	ICD 021L0Z8
Hospital Charge Code	445
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

021L0Z9

Facility

$11,208.00

Service Code	ICD 021L0Z9
Hospital Charge Code	10385
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

021L0Z9

Facility

$11,208.00

Service Code	ICD 021L0Z9
Hospital Charge Code	2941
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

021L0ZC

Facility

$11,208.00

Service Code	ICD 021L0ZC
Hospital Charge Code	10386
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

021L0ZC

Facility

$11,208.00

Service Code	ICD 021L0ZC
Hospital Charge Code	2942
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

021L0ZF

Facility

$11,208.00

Service Code	ICD 021L0ZF
Hospital Charge Code	2943
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

021L0ZF

Facility

$11,208.00

Service Code	ICD 021L0ZF
Hospital Charge Code	10387
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

021L0ZP

Facility

$11,208.00

Service Code	ICD 021L0ZP
Hospital Charge Code	10388
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

021L0ZP

Facility

$11,208.00

Service Code	ICD 021L0ZP
Hospital Charge Code	2944
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

021L0ZQ

Facility

$11,208.00

Service Code	ICD 021L0ZQ
Hospital Charge Code	10389
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

021L0ZQ

Facility

$11,208.00

Service Code	ICD 021L0ZQ
Hospital Charge Code	2945
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

021L0ZR

Facility

$11,208.00

Service Code	ICD 021L0ZR
Hospital Charge Code	2946
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

021L0ZR

Facility

$11,208.00

Service Code	ICD 021L0ZR
Hospital Charge Code	10390
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

021L0ZW

Facility

$11,208.00

Service Code	ICD 021L0ZW
Hospital Charge Code	10391
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

021L0ZW

Facility

$11,208.00

Service Code	ICD 021L0ZW
Hospital Charge Code	446
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

021L48P

Facility

$11,208.00

Service Code	ICD 021L48P
Hospital Charge Code	447
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

021L48Q

Facility

$11,208.00

Service Code	ICD 021L48Q
Hospital Charge Code	448
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