0WPD43Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5261
|
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
|
|
0WPD4YZ
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5262
|
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
|
|
0WQNXZZ
|
Facility
|
IP
|
$4,829.00
|
|
Hospital Charge Code |
2717
|
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
|
|
0WWD00Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5263
|
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
|
|
0WWD01Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5264
|
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
|
|
0WWD03Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5265
|
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
|
|
0WWD0YZ
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
2718
|
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
|
|
0WWD30Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5266
|
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
|
|
0WWD31Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5267
|
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
|
|
0WWD33Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5268
|
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
|
|
0WWD3YZ
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5269
|
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
|
|
0WWD40Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5270
|
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
|
|
0WWD41Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5271
|
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
|
|
0WWD43Z
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5272
|
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
|
|
0WWD4YZ
|
Facility
|
IP
|
$10,777.00
|
|
Hospital Charge Code |
5273
|
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
|
|
0XH201Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5274
|
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
|
|
0XH231Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5275
|
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
|
|
0XH241Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5276
|
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
|
|
0XH301Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5277
|
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
|
|
0XH331Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5278
|
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
|
|
0XH341Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5279
|
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
|
|
0XH401Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5280
|
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
|
|
0XH431Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5281
|
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
|
|
0XH441Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5282
|
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
|
|
0XH501Z
|
Facility
|
IP
|
$8,769.00
|
|
Hospital Charge Code |
5283
|
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
|
|