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Charge Type Setting Price  
Service Code ICD 037905Z
Hospital Charge Code 1660
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 037906Z
Hospital Charge Code 1661
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 037907Z
Hospital Charge Code 1662
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 037934Z
Hospital Charge Code 1663
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 037935Z
Hospital Charge Code 1664
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 037936Z
Hospital Charge Code 1665
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 037937Z
Hospital Charge Code 1666
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 037944Z
Hospital Charge Code 1667
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 037945Z
Hospital Charge Code 1668
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 037946Z
Hospital Charge Code 1669
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 037947Z
Hospital Charge Code 1670
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 037A04Z
Hospital Charge Code 1671
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 037A05Z
Hospital Charge Code 1672
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 037A06Z
Hospital Charge Code 1673
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 037A07Z
Hospital Charge Code 1674
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 037A34Z
Hospital Charge Code 1675
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 037A35Z
Hospital Charge Code 1676
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 037A36Z
Hospital Charge Code 1677
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 037A37Z
Hospital Charge Code 1678
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 037A44Z
Hospital Charge Code 1679
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 037A45Z
Hospital Charge Code 1680
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 037A46Z
Hospital Charge Code 1681
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 037A47Z
Hospital Charge Code 1682
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 037B04Z
Hospital Charge Code 1683
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 037B05Z
Hospital Charge Code 1684
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