|
04C83ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2415
|
| 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
|
|
|
04C93ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2416
|
| 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
|
|
|
04CA3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2417
|
| 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
|
|
|
04CB3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2418
|
| 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
|
|
|
04CC3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2419
|
| 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
|
|
|
04CD3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2420
|
| 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
|
|
|
04CE3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2421
|
| 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
|
|
|
04CF3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2422
|
| 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
|
|
|
04CH3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2423
|
| 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
|
|
|
04CJ3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2424
|
| 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
|
|
|
04CK3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2425
|
| 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
|
|
|
04CL3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2426
|
| 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
|
|
|
04CM3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2427
|
| 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
|
|
|
04CN3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2428
|
| 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
|
|
|
04CP3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2429
|
| 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
|
|
|
04CQ3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2430
|
| 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
|
|
|
04CR3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2431
|
| 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
|
|
|
04CS3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2432
|
| 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
|
|
|
04CT3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2433
|
| 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
|
|
|
04CU3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2434
|
| 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
|
|
|
04CV3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2435
|
| 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
|
|
|
04CW3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2436
|
| 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
|
|
|
04CY3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2437
|
| 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
|
|
|
04H002Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2438
|
| 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
|
|
|
04H032Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2450
|
| 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
|
|
