Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

027L34Z

Facility

$11,208.00

Service Code	ICD 027L34Z
Hospital Charge Code	915
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

027L3DZ

Facility

$11,208.00

Service Code	ICD 027L3DZ
Hospital Charge Code	916
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

027L3ZZ

Facility

$11,208.00

Service Code	ICD 027L3ZZ
Hospital Charge Code	917
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

027L44Z

Facility

$11,208.00

Service Code	ICD 027L44Z
Hospital Charge Code	918
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

027L4DZ

Facility

$11,208.00

Service Code	ICD 027L4DZ
Hospital Charge Code	919
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

027L4ZZ

Facility

$11,208.00

Service Code	ICD 027L4ZZ
Hospital Charge Code	920
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

027P04Z

Facility

$8,968.00

Service Code	ICD 027P04Z
Hospital Charge Code	921
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027P0DZ

Facility

$4,070.00

Service Code	ICD 027P0DZ
Hospital Charge Code	3092
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

027P34Z

Facility

$8,968.00

Service Code	ICD 027P34Z
Hospital Charge Code	922
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027P3DZ

Facility

$4,070.00

Service Code	ICD 027P3DZ
Hospital Charge Code	3093
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

027P44Z

Facility

$8,968.00

Service Code	ICD 027P44Z
Hospital Charge Code	923
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027P4DZ

Facility

$4,070.00

Service Code	ICD 027P4DZ
Hospital Charge Code	3094
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

027Q04Z

Facility

$8,968.00

Service Code	ICD 027Q04Z
Hospital Charge Code	924
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027Q0DZ

Facility

$4,070.00

Service Code	ICD 027Q0DZ
Hospital Charge Code	3095
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

027Q34Z

Facility

$8,968.00

Service Code	ICD 027Q34Z
Hospital Charge Code	925
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027Q3DZ

Facility

$4,070.00

Service Code	ICD 027Q3DZ
Hospital Charge Code	3096
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

027Q44Z

Facility

$8,968.00

Service Code	ICD 027Q44Z
Hospital Charge Code	926
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027Q4DZ

Facility

$4,070.00

Service Code	ICD 027Q4DZ
Hospital Charge Code	3097
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

027R04T

Facility

$11,208.00

Service Code	ICD 027R04T
Hospital Charge Code	927
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

027R04T

Facility

$11,208.00

Service Code	ICD 027R04T
Hospital Charge Code	10688
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

027R04Z

Facility

$8,968.00

Service Code	ICD 027R04Z
Hospital Charge Code	928
Min. Negotiated Rate	$8,968.00
Max. Negotiated Rate	$8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO	$8,968.00

027R0DT

Facility

$11,208.00

Service Code	ICD 027R0DT
Hospital Charge Code	10689
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

027R0DT

Facility

$11,208.00

Service Code	ICD 027R0DT
Hospital Charge Code	929
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

027R0DZ

Facility

$4,070.00

Service Code	ICD 027R0DZ
Hospital Charge Code	3098
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

027R0ZT

Facility

$11,208.00

Service Code	ICD 027R0ZT
Hospital Charge Code	10690
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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