Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02720E6

Facility

$4,070.00

Service Code	ICD 02720E6
Hospital Charge Code	3064
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720E6

Facility

$4,070.00

Service Code	ICD 02720E6
Hospital Charge Code	3062
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720EZ

Facility

$4,070.00

Service Code	ICD 02720EZ
Hospital Charge Code	749
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720EZ

Facility

$4,070.00

Service Code	ICD 02720EZ
Hospital Charge Code	750
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720F6

Facility

$4,070.00

Service Code	ICD 02720F6
Hospital Charge Code	751
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720F6

Facility

$4,070.00

Service Code	ICD 02720F6
Hospital Charge Code	752
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720FZ

Facility

$4,070.00

Service Code	ICD 02720FZ
Hospital Charge Code	753
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720FZ

Facility

$4,070.00

Service Code	ICD 02720FZ
Hospital Charge Code	754
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720G6

Facility

$4,070.00

Service Code	ICD 02720G6
Hospital Charge Code	756
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720G6

Facility

$4,070.00

Service Code	ICD 02720G6
Hospital Charge Code	755
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720GZ

Facility

$4,070.00

Service Code	ICD 02720GZ
Hospital Charge Code	757
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720GZ

Facility

$4,070.00

Service Code	ICD 02720GZ
Hospital Charge Code	758
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720T6

Facility

$4,070.00

Service Code	ICD 02720T6
Hospital Charge Code	10599
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720T6

Facility

$4,070.00

Service Code	ICD 02720T6
Hospital Charge Code	759
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720T6

Facility

$4,070.00

Service Code	ICD 02720T6
Hospital Charge Code	760
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720TZ

Facility

$4,070.00

Service Code	ICD 02720TZ
Hospital Charge Code	762
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720TZ

Facility

$4,070.00

Service Code	ICD 02720TZ
Hospital Charge Code	761
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720TZ

Facility

$4,070.00

Service Code	ICD 02720TZ
Hospital Charge Code	10600
Min. Negotiated Rate	$4,070.00
Max. Negotiated Rate	$4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$4,070.00

02720Z6

Facility

$11,208.00

Service Code	ICD 02720Z6
Hospital Charge Code	10601
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

02720Z6

Facility

$11,208.00

Service Code	ICD 02720Z6
Hospital Charge Code	763
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

02720ZZ

Facility

$11,208.00

Service Code	ICD 02720ZZ
Hospital Charge Code	10602
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

02720ZZ

Facility

$11,208.00

Service Code	ICD 02720ZZ
Hospital Charge Code	764
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

0272346

Facility

$8,968.00

Service Code	ICD 0272346
Hospital Charge Code	10603
Min. Negotiated Rate	$4,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$7,183.00

0272346

Facility

$8,968.00

Service Code	ICD 0272346
Hospital Charge Code	765
Min. Negotiated Rate	$4,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$7,183.00

027234Z

Facility

$8,968.00

Service Code	ICD 027234Z
Hospital Charge Code	766
Min. Negotiated Rate	$4,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00
Rate for Payer: Heritage Provider Network Commercial	$4,968.00
Rate for Payer: Heritage Provider Network Senior	$7,183.00

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All Charges