|
021K4AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2918
|
| 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
|
|
|
021K4AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2919
|
| 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
|
|
|
021K4JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2920
|
| 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
|
|
|
021K4JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2921
|
| 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
|
|
|
021K4JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2922
|
| 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
|
|
|
021K4KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2923
|
| 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
|
|
|
021K4KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2924
|
| 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
|
|
|
021K4KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2925
|
| 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
|
|
|
021K4Z5
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
435
|
| 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
|
|
|
021K4Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
436
|
| 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
|
|
|
021K4Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2926
|
| 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
|
|
|
021K4ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
437
|
| 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
|
|
|
021K4ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2927
|
| 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
|
|
|
021K4ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
438
|
| 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
|
|
|
021K4ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2928
|
| 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
|
|
|
021K4ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2929
|
| 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
|
|
|
021K4ZW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
439
|
| 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
|
|
|
021L08P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
440
|
| 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
|
|
|
021L08Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
441
|
| 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
|
|
|
021L08R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
442
|
| 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
|
|
|
021L09P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2930
|
| 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
|
|
|
021L09Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2931
|
| 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
|
|
|
021L09R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2932
|
| 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
|
|
|
021L0AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
443
|
| 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
|
|
|
021L0AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2933
|
| 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
|
|
