Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021V09P

Facility

$11,208.00

Service Code	ICD 021V09P
Hospital Charge Code	2965
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

021V09Q

Facility

$11,208.00

Service Code	ICD 021V09Q
Hospital Charge Code	10414
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

021V09Q

Facility

$11,208.00

Service Code	ICD 021V09Q
Hospital Charge Code	2966
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

021V09R

Facility

$11,208.00

Service Code	ICD 021V09R
Hospital Charge Code	2967
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

021V09R

Facility

$11,208.00

Service Code	ICD 021V09R
Hospital Charge Code	10415
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

021V09S

Facility

$11,208.00

Service Code	ICD 021V09S
Hospital Charge Code	460
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

021V09T

Facility

$11,208.00

Service Code	ICD 021V09T
Hospital Charge Code	461
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

021V09U

Facility

$11,208.00

Service Code	ICD 021V09U
Hospital Charge Code	462
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

021V0AP

Facility

$11,208.00

Service Code	ICD 021V0AP
Hospital Charge Code	10416
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

021V0AP

Facility

$11,208.00

Service Code	ICD 021V0AP
Hospital Charge Code	463
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

021V0AQ

Facility

$11,208.00

Service Code	ICD 021V0AQ
Hospital Charge Code	10417
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

021V0AQ

Facility

$11,208.00

Service Code	ICD 021V0AQ
Hospital Charge Code	2968
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

021V0AR

Facility

$11,208.00

Service Code	ICD 021V0AR
Hospital Charge Code	2969
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

021V0AR

Facility

$11,208.00

Service Code	ICD 021V0AR
Hospital Charge Code	10418
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

021V0AS

Facility

$11,208.00

Service Code	ICD 021V0AS
Hospital Charge Code	464
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

021V0AT

Facility

$11,208.00

Service Code	ICD 021V0AT
Hospital Charge Code	465
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

021V0AU

Facility

$11,208.00

Service Code	ICD 021V0AU
Hospital Charge Code	466
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

021V0JP

Facility

$11,208.00

Service Code	ICD 021V0JP
Hospital Charge Code	10419
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

021V0JP

Facility

$11,208.00

Service Code	ICD 021V0JP
Hospital Charge Code	2970
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

021V0JQ

Facility

$11,208.00

Service Code	ICD 021V0JQ
Hospital Charge Code	2971
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

021V0JQ

Facility

$11,208.00

Service Code	ICD 021V0JQ
Hospital Charge Code	10420
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

021V0JR

Facility

$11,208.00

Service Code	ICD 021V0JR
Hospital Charge Code	10421
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

021V0JR

Facility

$11,208.00

Service Code	ICD 021V0JR
Hospital Charge Code	2972
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

021V0JS

Facility

$11,208.00

Service Code	ICD 021V0JS
Hospital Charge Code	467
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

021V0JT

Facility

$11,208.00

Service Code	ICD 021V0JT
Hospital Charge Code	468
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