037J47Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1758
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037J4D6
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3882
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037J4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3883
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037J4EZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3884
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037J4FZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3885
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037J4GZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3886
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K04Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1759
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K05Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1760
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K06Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1761
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K07Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1762
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K0D6
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3887
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3888
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K0EZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3889
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K0FZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3890
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K0GZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3891
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K34Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1763
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K35Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1764
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K36Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1765
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K37Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1766
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
037K3D6
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3892
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3893
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K3EZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3894
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K3FZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3895
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K3GZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
3896
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
037K44Z
|
Facility
|
IP
|
$8,623.00
|
|
Hospital Charge Code |
1767
|
Min. Negotiated Rate |
$8,623.00 |
Max. Negotiated Rate |
$8,623.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|