|
09HK01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4857
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HK31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4858
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HK41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4859
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HK71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4860
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HK81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4861
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HN71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4862
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HN81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4863
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HY01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4864
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HY31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4865
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HY41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4866
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HY71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4867
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09HY81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4868
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
09PD0SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2519
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
09PD7SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2520
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
09PD8SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2521
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
09PE0SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2522
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
09PE7SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2523
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
09PE8SZ
|
Facility
|
IP
|
$29,875.00
|
|
| Hospital Charge Code |
2524
|
| Min. Negotiated Rate |
$29,875.00 |
| Max. Negotiated Rate |
$29,875.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,875.00
|
|
|
0BH001Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4869
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BH031Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4870
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BH041Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4871
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BH071Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4872
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BH081Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4873
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BHK01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4874
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0BHK31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
4875
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
