|
0UHC31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5149
|
| 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
|
|
|
0UHC41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5150
|
| 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
|
|
|
0UHC71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5151
|
| 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
|
|
|
0UHC81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5152
|
| 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
|
|
|
0UHG31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5153
|
| 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
|
|
|
0UHG41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5154
|
| 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
|
|
|
0UHG71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5155
|
| 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
|
|
|
0UHG81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5156
|
| 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
|
|
|
0UHGX1Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5157
|
| 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
|
|
|
0UQ90ZZ
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2680
|
| Min. Negotiated Rate |
$4,829.00 |
| Max. Negotiated Rate |
$4,829.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,829.00
|
|
|
0UQ98ZZ
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2681
|
| Min. Negotiated Rate |
$4,829.00 |
| Max. Negotiated Rate |
$4,829.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,829.00
|
|
|
0UQC0ZZ
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2682
|
| Min. Negotiated Rate |
$4,829.00 |
| Max. Negotiated Rate |
$4,829.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,829.00
|
|
|
0UQC8ZZ
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2683
|
| Min. Negotiated Rate |
$4,829.00 |
| Max. Negotiated Rate |
$4,829.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,829.00
|
|
|
0VH001Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5158
|
| 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
|
|
|
0VH031Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5159
|
| 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
|
|
|
0VH041Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5160
|
| 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
|
|
|
0VH071Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5161
|
| 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
|
|
|
0VH081Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5162
|
| 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
|
|
|
0VHD01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5163
|
| 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
|
|
|
0VHD31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5164
|
| 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
|
|
|
0VHD41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5165
|
| 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
|
|
|
0VHD71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5166
|
| 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
|
|
|
0VHD81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5167
|
| 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
|
|
|
0W8NXZZ
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2708
|
| Min. Negotiated Rate |
$4,829.00 |
| Max. Negotiated Rate |
$4,829.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,829.00
|
|
|
0W9D00Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5168
|
| 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
|
|
