Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

0210488

Facility

$10,777.00

Service Code	ICD 0210488
Hospital Charge Code	105
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

0210489

Facility

$10,777.00

Service Code	ICD 0210489
Hospital Charge Code	106
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

021048C

Facility

$10,777.00

Service Code	ICD 021048C
Hospital Charge Code	107
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

021048F

Facility

$10,777.00

Service Code	ICD 021048F
Hospital Charge Code	108
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

021048W

Facility

$10,777.00

Service Code	ICD 021048W
Hospital Charge Code	109
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

0210493

Facility

$10,777.00

Service Code	ICD 0210493
Hospital Charge Code	110
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

0210498

Facility

$10,777.00

Service Code	ICD 0210498
Hospital Charge Code	2848
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

0210499

Facility

$10,777.00

Service Code	ICD 0210499
Hospital Charge Code	2849
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

021049C

Facility

$10,777.00

Service Code	ICD 021049C
Hospital Charge Code	111
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

021049F

Facility

$10,777.00

Service Code	ICD 021049F
Hospital Charge Code	112
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

021049W

Facility

$10,777.00

Service Code	ICD 021049W
Hospital Charge Code	2850
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

02104A3

Facility

$10,777.00

Service Code	ICD 02104A3
Hospital Charge Code	113
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

02104A8

Facility

$10,777.00

Service Code	ICD 02104A8
Hospital Charge Code	114
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

02104A9

Facility

$10,777.00

Service Code	ICD 02104A9
Hospital Charge Code	2851
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

02104AC

Facility

$10,777.00

Service Code	ICD 02104AC
Hospital Charge Code	115
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

02104AF

Facility

$10,777.00

Service Code	ICD 02104AF
Hospital Charge Code	116
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

02104AW

Facility

$10,777.00

Service Code	ICD 02104AW
Hospital Charge Code	2852
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

02104D4

Facility

$10,777.00

Service Code	ICD 02104D4
Hospital Charge Code	117
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

02104J3

Facility

$10,777.00

Service Code	ICD 02104J3
Hospital Charge Code	118
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

02104J8

Facility

$10,777.00

Service Code	ICD 02104J8
Hospital Charge Code	119
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

02104J9

Facility

$10,777.00

Service Code	ICD 02104J9
Hospital Charge Code	120
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

02104JC

Facility

$10,777.00

Service Code	ICD 02104JC
Hospital Charge Code	121
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

02104JF

Facility

$10,777.00

Service Code	ICD 02104JF
Hospital Charge Code	122
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

02104JW

Facility

$10,777.00

Service Code	ICD 02104JW
Hospital Charge Code	2853
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

02104K3

Facility

$10,777.00

Service Code	ICD 02104K3
Hospital Charge Code	123
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