Loma Linda University Medical Center

All Charges

Charge

Type

Setting

Price

02H643Z

Facility

$11,208.00

Service Code	ICD 02H643Z
Hospital Charge Code	10827
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

02H64DZ

Facility

$11,208.00

Service Code	ICD 02H64DZ
Hospital Charge Code	10828
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

02H64DZ

Facility

$11,208.00

Service Code	ICD 02H64DZ
Hospital Charge Code	1094
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

02H64KZ

Facility

$11,208.00

Service Code	ICD 02H64KZ
Hospital Charge Code	1097
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

02H64KZ

Facility

$11,208.00

Service Code	ICD 02H64KZ
Hospital Charge Code	1096
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

02H64KZ

Facility

$11,208.00

Service Code	ICD 02H64KZ
Hospital Charge Code	10829
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

02H64YZ

Facility

$11,208.00

Service Code	ICD 02H64YZ
Hospital Charge Code	1099
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

02H700Z

Facility

$11,208.00

Service Code	ICD 02H700Z
Hospital Charge Code	1100
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

02H702Z

Facility

$11,208.00

Service Code	ICD 02H702Z
Hospital Charge Code	10830
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

02H702Z

Facility

$11,208.00

Service Code	ICD 02H702Z
Hospital Charge Code	1101
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

02H703Z

Facility

$11,208.00

Service Code	ICD 02H703Z
Hospital Charge Code	10831
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

02H703Z

Facility

$11,208.00

Service Code	ICD 02H703Z
Hospital Charge Code	3168
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

02H70DZ

Facility

$11,208.00

Service Code	ICD 02H70DZ
Hospital Charge Code	10832
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

02H70DZ

Facility

$11,208.00

Service Code	ICD 02H70DZ
Hospital Charge Code	3169
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

02H70KZ

Facility

$11,208.00

Service Code	ICD 02H70KZ
Hospital Charge Code	10833
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

02H70KZ

Facility

$11,208.00

Service Code	ICD 02H70KZ
Hospital Charge Code	1102
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

02H70KZ

Facility

$11,208.00

Service Code	ICD 02H70KZ
Hospital Charge Code	1103
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

02H70YZ

Facility

$11,208.00

Service Code	ICD 02H70YZ
Hospital Charge Code	1105
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

02H730Z

Facility

$11,208.00

Service Code	ICD 02H730Z
Hospital Charge Code	1106
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

02H732Z

Facility

$11,208.00

Service Code	ICD 02H732Z
Hospital Charge Code	1107
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

02H732Z

Facility

$11,208.00

Service Code	ICD 02H732Z
Hospital Charge Code	10834
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

02H733Z

Facility

$11,208.00

Service Code	ICD 02H733Z
Hospital Charge Code	10835
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

02H733Z

Facility

$11,208.00

Service Code	ICD 02H733Z
Hospital Charge Code	3170
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

02H73DZ

Facility

$11,208.00

Service Code	ICD 02H73DZ
Hospital Charge Code	3171
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

02H73DZ

Facility

$11,208.00

Service Code	ICD 02H73DZ
Hospital Charge Code	10836
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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All Charges