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All Charges

Charge Type Price  
Service Code ICD 047Y0D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 05743D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 04784GZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 047J3FZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 037B3D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03783D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03780GZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 037B0GZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03754D6
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03754D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03750D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03744GZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03720GZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 03744FZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 047R4D1
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 057Q0DZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code ICD 02734EZ
Min. Negotiated Rate $3,588.00
Max. Negotiated Rate $3,588.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $3,588.00
Service Code APR-DRG 3234
Min. Negotiated Rate $30,859.68
Max. Negotiated Rate $30,859.68
Rate for Payer: IEHP Medi-Cal $30,859.68
Service Code APR-DRG 3233
Min. Negotiated Rate $22,124.50
Max. Negotiated Rate $22,124.50
Rate for Payer: IEHP Medi-Cal $22,124.50
Service Code APR-DRG 3232
Min. Negotiated Rate $16,623.72
Max. Negotiated Rate $16,623.72
Rate for Payer: IEHP Medi-Cal $16,623.72
Service Code APR-DRG 3231
Min. Negotiated Rate $14,804.06
Max. Negotiated Rate $14,804.06
Rate for Payer: IEHP Medi-Cal $14,804.06
Service Code APR-DRG 3253
Min. Negotiated Rate $28,264.99
Max. Negotiated Rate $28,264.99
Rate for Payer: IEHP Medi-Cal $28,264.99
Service Code APR-DRG 3251
Min. Negotiated Rate $18,395.63
Max. Negotiated Rate $18,395.63
Rate for Payer: IEHP Medi-Cal $18,395.63
Service Code APR-DRG 3252
Min. Negotiated Rate $21,414.14
Max. Negotiated Rate $21,414.14
Rate for Payer: IEHP Medi-Cal $21,414.14
Service Code APR-DRG 3254
Min. Negotiated Rate $39,345.16
Max. Negotiated Rate $39,345.16
Rate for Payer: IEHP Medi-Cal $39,345.16