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Charge Type Setting Price  
Service Code ICD 0213088
Hospital Charge Code 264
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
Service Code ICD 0213089
Hospital Charge Code 265
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
Service Code ICD 021308C
Hospital Charge Code 266
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
Service Code ICD 021308F
Hospital Charge Code 267
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
Service Code ICD 021308W
Hospital Charge Code 268
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
Service Code ICD 0213093
Hospital Charge Code 10205
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
Service Code ICD 0213093
Hospital Charge Code 269
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
Service Code ICD 0213098
Hospital Charge Code 270
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
Service Code ICD 0213098
Hospital Charge Code 10206
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
Service Code ICD 02130A3
Hospital Charge Code 271
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
Service Code ICD 02130A3
Hospital Charge Code 10211
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
Service Code ICD 02130A8
Hospital Charge Code 272
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
Service Code ICD 02130A8
Hospital Charge Code 10212
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
Service Code ICD 02130A9
Hospital Charge Code 273
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
Service Code ICD 02130A9
Hospital Charge Code 10213
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
Service Code ICD 02130AC
Hospital Charge Code 10214
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
Service Code ICD 02130AC
Hospital Charge Code 274
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
Service Code ICD 02130J3
Hospital Charge Code 10217
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
Service Code ICD 02130J3
Hospital Charge Code 275
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
Service Code ICD 02130J8
Hospital Charge Code 276
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
Service Code ICD 02130J8
Hospital Charge Code 10218
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
Service Code ICD 02130J9
Hospital Charge Code 277
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
Service Code ICD 02130J9
Hospital Charge Code 10219
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
Service Code ICD 02130JC
Hospital Charge Code 10220
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
Service Code ICD 02130JC
Hospital Charge Code 278
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