|
021K0AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
415
|
| 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
|
|
|
021K0AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
416
|
| 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
|
|
|
021K0AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
417
|
| 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
|
|
|
021K0JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
418
|
| 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
|
|
|
021K0JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
419
|
| 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
|
|
|
021K0JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
420
|
| 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
|
|
|
021K0KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
421
|
| 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
|
|
|
021K0KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
422
|
| 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
|
|
|
021K0KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
423
|
| 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
|
|
|
021K0Z5
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
424
|
| 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
|
|
|
021K0Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
425
|
| 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
|
|
|
021K0Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2913
|
| 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
|
|
|
021K0ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
426
|
| 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
|
|
|
021K0ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2914
|
| 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
|
|
|
021K0ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
427
|
| 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
|
|
|
021K0ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
428
|
| 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
|
|
|
021K0ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
429
|
| 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
|
|
|
021K0ZW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
430
|
| 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
|
|
|
021K48P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
431
|
| 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
|
|
|
021K48Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
432
|
| 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
|
|
|
021K48R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
433
|
| 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
|
|
|
021K49P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
434
|
| 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
|
|
|
021K49Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2915
|
| 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
|
|
|
021K49R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2916
|
| 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
|
|
|
021K4AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2917
|
| 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
|
|
