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Charge Type Setting Price  
Service Code ICD 03720D6
Hospital Charge Code 3608
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03720DZ
Hospital Charge Code 3609
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03720EZ
Hospital Charge Code 3610
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03720FZ
Hospital Charge Code 3611
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03720GZ
Hospital Charge Code 3612
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 037234Z
Hospital Charge Code 1579
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037235Z
Hospital Charge Code 1580
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037236Z
Hospital Charge Code 1581
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037237Z
Hospital Charge Code 1582
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 03723D1
Hospital Charge Code 3613
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03723D6
Hospital Charge Code 3614
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03723DZ
Hospital Charge Code 3615
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03723EZ
Hospital Charge Code 3616
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03723FZ
Hospital Charge Code 3617
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03723GZ
Hospital Charge Code 3618
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 037244Z
Hospital Charge Code 1583
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037245Z
Hospital Charge Code 1584
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037246Z
Hospital Charge Code 1585
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 037247Z
Hospital Charge Code 1586
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 03724D1
Hospital Charge Code 3619
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03724D6
Hospital Charge Code 3620
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03724DZ
Hospital Charge Code 3621
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03724EZ
Hospital Charge Code 3622
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03724FZ
Hospital Charge Code 3623
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 03724GZ
Hospital Charge Code 3624
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00