057L4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4713
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057M0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4714
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057M3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4715
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057M4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4716
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057N0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4717
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057N3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4718
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057N4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4719
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057P0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4720
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057P3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4721
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057P4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4722
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057Q0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4723
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057Q3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4724
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057Q4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4725
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057R0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4726
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057R3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4727
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057R4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4728
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057S0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4729
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057S3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4730
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057S4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4731
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057T0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4732
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057T3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4733
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057T4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4734
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057V0DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4735
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057V3DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4736
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
057V4DZ
|
Facility
|
IP
|
$3,913.00
|
|
Hospital Charge Code |
4737
|
Min. Negotiated Rate |
$3,913.00 |
Max. Negotiated Rate |
$3,913.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|