Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

024G072

Facility

$11,208.00

Service Code	ICD 024G072
Hospital Charge Code	549
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

024G082

Facility

$11,208.00

Service Code	ICD 024G082
Hospital Charge Code	550
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

024G0J2

Facility

$11,208.00

Service Code	ICD 024G0J2
Hospital Charge Code	551
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

024G0K2

Facility

$11,208.00

Service Code	ICD 024G0K2
Hospital Charge Code	552
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

024J072

Facility

$11,208.00

Service Code	ICD 024J072
Hospital Charge Code	553
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

024J082

Facility

$11,208.00

Service Code	ICD 024J082
Hospital Charge Code	554
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

024J0J2

Facility

$11,208.00

Service Code	ICD 024J0J2
Hospital Charge Code	555
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

024J0K2

Facility

$11,208.00

Service Code	ICD 024J0K2
Hospital Charge Code	556
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

02540ZZ

Facility

$11,208.00

Service Code	ICD 02540ZZ
Hospital Charge Code	557
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

02540ZZ

Facility

$11,208.00

Service Code	ICD 02540ZZ
Hospital Charge Code	10493
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

02543ZZ

Facility

$11,208.00

Service Code	ICD 02543ZZ
Hospital Charge Code	10494
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

02543ZZ

Facility

$11,208.00

Service Code	ICD 02543ZZ
Hospital Charge Code	3042
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

02544ZZ

Facility

$11,208.00

Service Code	ICD 02544ZZ
Hospital Charge Code	3043
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

02544ZZ

Facility

$11,208.00

Service Code	ICD 02544ZZ
Hospital Charge Code	10495
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

02550ZZ

Facility

$11,208.00

Service Code	ICD 02550ZZ
Hospital Charge Code	558
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

02550ZZ

Facility

$11,208.00

Service Code	ICD 02550ZZ
Hospital Charge Code	10496
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

02560ZZ

Facility

$11,208.00

Service Code	ICD 02560ZZ
Hospital Charge Code	10498
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

02560ZZ

Facility

$11,208.00

Service Code	ICD 02560ZZ
Hospital Charge Code	559
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

02570ZK

Facility

$11,208.00

Service Code	ICD 02570ZK
Hospital Charge Code	560
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

02570ZZ

Facility

$11,208.00

Service Code	ICD 02570ZZ
Hospital Charge Code	10500
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

02570ZZ

Facility

$11,208.00

Service Code	ICD 02570ZZ
Hospital Charge Code	561
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

02573ZK

Facility

$11,208.00

Service Code	ICD 02573ZK
Hospital Charge Code	562
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

02574ZK

Facility

$11,208.00

Service Code	ICD 02574ZK
Hospital Charge Code	563
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

02580ZZ

Facility

$11,208.00

Service Code	ICD 02580ZZ
Hospital Charge Code	10502
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

02580ZZ

Facility

$11,208.00

Service Code	ICD 02580ZZ
Hospital Charge Code	564
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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