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Charge Type Setting Price  
Service Code ICD 02UA4KZ
Hospital Charge Code 1413
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UA4KZ
Hospital Charge Code 11290
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD07Z
Hospital Charge Code 3419
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD07Z
Hospital Charge Code 11291
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD08Z
Hospital Charge Code 3420
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD08Z
Hospital Charge Code 11292
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD0JZ
Hospital Charge Code 11293
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD0JZ
Hospital Charge Code 1414
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD0KZ
Hospital Charge Code 11294
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD0KZ
Hospital Charge Code 3421
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD37Z
Hospital Charge Code 3422
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD37Z
Hospital Charge Code 11295
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD38Z
Hospital Charge Code 11296
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD38Z
Hospital Charge Code 3423
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD3JZ
Hospital Charge Code 11297
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD3JZ
Hospital Charge Code 3424
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD3KZ
Hospital Charge Code 3425
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD3KZ
Hospital Charge Code 11298
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD47Z
Hospital Charge Code 11299
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD47Z
Hospital Charge Code 3426
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD48Z
Hospital Charge Code 11300
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD48Z
Hospital Charge Code 3427
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD4JZ
Hospital Charge Code 3428
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD4JZ
Hospital Charge Code 11301
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 02UD4KZ
Hospital Charge Code 3429
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00