Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

0211489

Facility

$10,777.00

Service Code	ICD 0211489
Hospital Charge Code	165
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

021148C

Facility

$10,777.00

Service Code	ICD 021148C
Hospital Charge Code	166
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

021148F

Facility

$10,777.00

Service Code	ICD 021148F
Hospital Charge Code	167
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

021148W

Facility

$10,777.00

Service Code	ICD 021148W
Hospital Charge Code	168
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

0211493

Facility

$10,777.00

Service Code	ICD 0211493
Hospital Charge Code	169
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

0211498

Facility

$10,777.00

Service Code	ICD 0211498
Hospital Charge Code	170
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

0211499

Facility

$10,777.00

Service Code	ICD 0211499
Hospital Charge Code	171
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

021149C

Facility

$10,777.00

Service Code	ICD 021149C
Hospital Charge Code	172
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

021149F

Facility

$10,777.00

Service Code	ICD 021149F
Hospital Charge Code	173
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

021149W

Facility

$10,777.00

Service Code	ICD 021149W
Hospital Charge Code	2863
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

02114A3

Facility

$10,777.00

Service Code	ICD 02114A3
Hospital Charge Code	174
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

02114A8

Facility

$10,777.00

Service Code	ICD 02114A8
Hospital Charge Code	175
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

02114A9

Facility

$10,777.00

Service Code	ICD 02114A9
Hospital Charge Code	176
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

02114AC

Facility

$10,777.00

Service Code	ICD 02114AC
Hospital Charge Code	177
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

02114AF

Facility

$10,777.00

Service Code	ICD 02114AF
Hospital Charge Code	178
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

02114AW

Facility

$10,777.00

Service Code	ICD 02114AW
Hospital Charge Code	2864
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

02114D4

Facility

$10,777.00

Service Code	ICD 02114D4
Hospital Charge Code	179
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

02114J3

Facility

$10,777.00

Service Code	ICD 02114J3
Hospital Charge Code	180
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

02114J8

Facility

$10,777.00

Service Code	ICD 02114J8
Hospital Charge Code	181
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

02114J9

Facility

$10,777.00

Service Code	ICD 02114J9
Hospital Charge Code	182
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

02114JC

Facility

$10,777.00

Service Code	ICD 02114JC
Hospital Charge Code	183
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

02114JF

Facility

$10,777.00

Service Code	ICD 02114JF
Hospital Charge Code	184
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

02114JW

Facility

$10,777.00

Service Code	ICD 02114JW
Hospital Charge Code	2865
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

02114K3

Facility

$10,777.00

Service Code	ICD 02114K3
Hospital Charge Code	185
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

02114K8

Facility

$10,777.00

Service Code	ICD 02114K8
Hospital Charge Code	186
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