|
06100AQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100AQ
|
| Hospital Charge Code |
2470
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100AR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100AR
|
| Hospital Charge Code |
2471
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100JP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100JP
|
| Hospital Charge Code |
2472
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100JQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100JQ
|
| Hospital Charge Code |
2473
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100JR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100JR
|
| Hospital Charge Code |
2474
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100KP
|
| Hospital Charge Code |
2475
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100KQ
|
| Hospital Charge Code |
2476
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100KR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100KR
|
| Hospital Charge Code |
2477
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100ZP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100ZP
|
| Hospital Charge Code |
2478
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100ZQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100ZQ
|
| Hospital Charge Code |
2479
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06100ZR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06100ZR
|
| Hospital Charge Code |
2480
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061047P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061047P
|
| Hospital Charge Code |
2481
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061047Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061047Q
|
| Hospital Charge Code |
2482
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061047R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061047R
|
| Hospital Charge Code |
2483
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061049P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061049P
|
| Hospital Charge Code |
2484
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061049Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061049Q
|
| Hospital Charge Code |
2485
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
061049R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 061049R
|
| Hospital Charge Code |
2486
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104AP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104AP
|
| Hospital Charge Code |
2487
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104AQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104AQ
|
| Hospital Charge Code |
2488
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104AR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104AR
|
| Hospital Charge Code |
2489
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104JP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104JP
|
| Hospital Charge Code |
2490
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104JQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104JQ
|
| Hospital Charge Code |
2491
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104JR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104JR
|
| Hospital Charge Code |
2492
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104KP
|
| Hospital Charge Code |
2493
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
06104KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 06104KQ
|
| Hospital Charge Code |
2494
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|