|
02880ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
955
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02880ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
954
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02881ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
956
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02882ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
957
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02883ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
958
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02884ZZ
|
Facility
|
IP
|
$45,565.00
|
|
| Hospital Charge Code |
959
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02890ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
960
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
028D0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
961
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B43ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
962
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B44ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
963
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B50ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
964
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B53ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
965
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B54ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
966
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B60ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
967
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B63ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
968
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B64ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
969
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B70ZK
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
970
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B70ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
971
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B73ZK
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
972
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B73ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
973
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B74ZK
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
974
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B74ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
975
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B80ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
976
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02B90ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
977
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02BD0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
978
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
