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All Charges

Charge Type Setting Price  
Service Code ICD 0211498
Hospital Charge Code 170
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 0211498
Hospital Charge Code 10114
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 0211499
Hospital Charge Code 171
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 0211499
Hospital Charge Code 10115
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 021149C
Hospital Charge Code 10116
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 021149C
Hospital Charge Code 172
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 021149F
Hospital Charge Code 173
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 021149F
Hospital Charge Code 10117
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 02114A3
Hospital Charge Code 10119
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 02114A3
Hospital Charge Code 174
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 02114A8
Hospital Charge Code 10120
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 02114A8
Hospital Charge Code 175
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 02114A9
Hospital Charge Code 10121
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 02114A9
Hospital Charge Code 176
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 02114AC
Hospital Charge Code 177
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 02114AC
Hospital Charge Code 10122
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 02114AF
Hospital Charge Code 10123
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 02114AF
Hospital Charge Code 178
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 02114D4
Hospital Charge Code 10125
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 02114D4
Hospital Charge Code 179
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 02114J3
Hospital Charge Code 180
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 02114J3
Hospital Charge Code 10126
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 02114J8
Hospital Charge Code 10127
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 02114J8
Hospital Charge Code 181
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 02114J9
Hospital Charge Code 10128
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