|
0WHP01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5237
|
| 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
|
|
|
0WHP31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5238
|
| 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
|
|
|
0WHP41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5239
|
| 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
|
|
|
0WHP71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5240
|
| 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
|
|
|
0WHP81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5241
|
| 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
|
|
|
0WHQ01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5242
|
| 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
|
|
|
0WHQ31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5243
|
| 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
|
|
|
0WHQ41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5244
|
| 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
|
|
|
0WHQ71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5245
|
| 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
|
|
|
0WHQ81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5246
|
| 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
|
|
|
0WHR01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5247
|
| 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
|
|
|
0WHR31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5248
|
| 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
|
|
|
0WHR41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5249
|
| 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
|
|
|
0WHR71Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5250
|
| 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
|
|
|
0WHR81Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5251
|
| 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
|
|
|
0WPD00Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5252
|
| 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
|
|
|
0WPD01Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5253
|
| 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
|
|
|
0WPD03Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5254
|
| 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
|
|
|
0WPD0YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2716
|
| 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
|
|
|
0WPD30Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5255
|
| 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
|
|
|
0WPD31Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5256
|
| 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
|
|
|
0WPD33Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5257
|
| 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
|
|
|
0WPD3YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5258
|
| 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
|
|
|
0WPD40Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5259
|
| 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
|
|
|
0WPD41Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
5260
|
| 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
|
|
