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Charge Type Price  
Service Code APR-DRG 1631
Min. Negotiated Rate $33,977.69
Max. Negotiated Rate $33,977.69
Rate for Payer: IEHP Medi-Cal $33,977.69
Service Code APR-DRG 1632
Min. Negotiated Rate $37,598.12
Max. Negotiated Rate $37,598.12
Rate for Payer: IEHP Medi-Cal $37,598.12
Service Code APR-DRG 1633
Min. Negotiated Rate $47,508.27
Max. Negotiated Rate $47,508.27
Rate for Payer: IEHP Medi-Cal $47,508.27
Service Code APR-DRG 1634
Min. Negotiated Rate $71,362.89
Max. Negotiated Rate $71,362.89
Rate for Payer: IEHP Medi-Cal $71,362.89
Service Code APR-DRG 2051
Min. Negotiated Rate $4,364.60
Max. Negotiated Rate $4,364.60
Rate for Payer: IEHP Medi-Cal $4,364.60
Service Code APR-DRG 2052
Min. Negotiated Rate $5,438.10
Max. Negotiated Rate $5,438.10
Rate for Payer: IEHP Medi-Cal $5,438.10
Service Code APR-DRG 2053
Min. Negotiated Rate $8,049.70
Max. Negotiated Rate $8,049.70
Rate for Payer: IEHP Medi-Cal $8,049.70
Service Code APR-DRG 2054
Min. Negotiated Rate $14,467.78
Max. Negotiated Rate $14,467.78
Rate for Payer: IEHP Medi-Cal $14,467.78
Service Code ICD 021V4AT
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 06100KP
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 02LH0ZZ
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 0JH80AZ
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 04H042Z
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 021W4AA
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 02HL30Z
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 061047R
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 061009P
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 021V0ZU
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 021X4AP
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 06104JP
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 02H03YZ
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 021W08P
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 021W0ZA
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 03C83ZZ
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00
Service Code ICD 04CC3ZZ
Min. Negotiated Rate $9,881.00
Max. Negotiated Rate $9,881.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,881.00