|
02130AW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2878
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130J3
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
275
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130J8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
276
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130J9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
277
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130JC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
278
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130JF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2879
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130JW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2880
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130K3
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
279
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130K8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
280
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130K9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
281
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130KC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
282
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130KF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2881
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130KW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2882
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130Z3
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
283
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
284
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
285
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
286
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02130ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2883
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
0213344
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2884
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02133D4
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
287
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
0213444
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
288
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
0213483
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
289
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
0213488
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
290
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
0213489
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
291
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021348C
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
292
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
