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All Charges

Charge Type Setting Price  
Service Code ICD 03734D6
Hospital Charge Code 3638
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 03734DZ
Hospital Charge Code 3639
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 03734EZ
Hospital Charge Code 3640
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 03734FZ
Hospital Charge Code 3641
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 03734GZ
Hospital Charge Code 3642
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 037404Z
Hospital Charge Code 1599
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 037405Z
Hospital Charge Code 1600
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 037406Z
Hospital Charge Code 1601
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 037407Z
Hospital Charge Code 1602
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 03740D1
Hospital Charge Code 3643
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 03740D6
Hospital Charge Code 3644
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 03740DZ
Hospital Charge Code 3645
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 03740EZ
Hospital Charge Code 3646
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 03740FZ
Hospital Charge Code 3647
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 03740GZ
Hospital Charge Code 3648
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 037434Z
Hospital Charge Code 1603
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 037435Z
Hospital Charge Code 1604
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 037436Z
Hospital Charge Code 1605
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 037437Z
Hospital Charge Code 1606
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 03743D1
Hospital Charge Code 3649
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 03743D6
Hospital Charge Code 3650
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 03743DZ
Hospital Charge Code 3651
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 03743EZ
Hospital Charge Code 3652
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 03743FZ
Hospital Charge Code 3653
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 03743GZ
Hospital Charge Code 3654
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