Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

021V0JU

Facility

$11,208.00

Service Code	ICD 021V0JU
Hospital Charge Code	469
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

021V0KP

Facility

$11,208.00

Service Code	ICD 021V0KP
Hospital Charge Code	10422
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

021V0KP

Facility

$11,208.00

Service Code	ICD 021V0KP
Hospital Charge Code	2973
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

021V0KQ

Facility

$11,208.00

Service Code	ICD 021V0KQ
Hospital Charge Code	2974
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

021V0KQ

Facility

$11,208.00

Service Code	ICD 021V0KQ
Hospital Charge Code	10423
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

021V0KR

Facility

$11,208.00

Service Code	ICD 021V0KR
Hospital Charge Code	10424
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

021V0KR

Facility

$11,208.00

Service Code	ICD 021V0KR
Hospital Charge Code	2975
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

021V0KS

Facility

$11,208.00

Service Code	ICD 021V0KS
Hospital Charge Code	470
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

021V0KT

Facility

$11,208.00

Service Code	ICD 021V0KT
Hospital Charge Code	471
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

021V0KU

Facility

$11,208.00

Service Code	ICD 021V0KU
Hospital Charge Code	472
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

021V0ZP

Facility

$11,208.00

Service Code	ICD 021V0ZP
Hospital Charge Code	10425
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

021V0ZP

Facility

$11,208.00

Service Code	ICD 021V0ZP
Hospital Charge Code	2976
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

021V0ZQ

Facility

$11,208.00

Service Code	ICD 021V0ZQ
Hospital Charge Code	10426
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

021V0ZQ

Facility

$11,208.00

Service Code	ICD 021V0ZQ
Hospital Charge Code	2977
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

021V0ZR

Facility

$11,208.00

Service Code	ICD 021V0ZR
Hospital Charge Code	10427
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

021V0ZR

Facility

$11,208.00

Service Code	ICD 021V0ZR
Hospital Charge Code	2978
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

021V0ZS

Facility

$11,208.00

Service Code	ICD 021V0ZS
Hospital Charge Code	473
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

021V0ZT

Facility

$11,208.00

Service Code	ICD 021V0ZT
Hospital Charge Code	474
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

021V0ZU

Facility

$11,208.00

Service Code	ICD 021V0ZU
Hospital Charge Code	475
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

021V48P

Facility

$11,208.00

Service Code	ICD 021V48P
Hospital Charge Code	476
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

021V48Q

Facility

$11,208.00

Service Code	ICD 021V48Q
Hospital Charge Code	477
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

021V48R

Facility

$11,208.00

Service Code	ICD 021V48R
Hospital Charge Code	478
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

021V48S

Facility

$11,208.00

Service Code	ICD 021V48S
Hospital Charge Code	479
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

021V48T

Facility

$11,208.00

Service Code	ICD 021V48T
Hospital Charge Code	480
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

021V48U

Facility

$11,208.00

Service Code	ICD 021V48U
Hospital Charge Code	481
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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