|
0YHH31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5359
|
| 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
|
|
|
0YHH41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5360
|
| 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
|
|
|
0YHJ01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5361
|
| 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
|
|
|
0YHJ31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5362
|
| 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
|
|
|
0YHJ41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5363
|
| 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
|
|
|
0YHK01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5364
|
| 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
|
|
|
0YHK31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5365
|
| 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
|
|
|
0YHK41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5366
|
| 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
|
|
|
0YHL01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5367
|
| 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
|
|
|
0YHL31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5368
|
| 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
|
|
|
0YHL41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5369
|
| 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
|
|
|
0YHM01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5370
|
| 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
|
|
|
0YHM31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5371
|
| 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
|
|
|
0YHM41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5372
|
| 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
|
|
|
0YHN01Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5373
|
| 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
|
|
|
0YHN31Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5374
|
| 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
|
|
|
0YHN41Z
|
Facility
|
IP
|
$8,769.00
|
|
| Hospital Charge Code |
5375
|
| 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
|
|
|
10900ZC
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2719
|
| 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
|
|
|
10903ZC
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2720
|
| 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
|
|
|
10904ZC
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2721
|
| 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
|
|
|
10907ZA
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2722
|
| 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
|
|
|
10907ZC
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2723
|
| 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
|
|
|
10908ZA
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2724
|
| 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
|
|
|
10908ZC
|
Facility
|
IP
|
$4,829.00
|
|
| Hospital Charge Code |
2725
|
| 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
|
|
|
10D00Z0
|
Facility
|
IP
|
$5,139.00
|
|
| Hospital Charge Code |
2726
|
| Min. Negotiated Rate |
$5,139.00 |
| Max. Negotiated Rate |
$5,139.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,139.00
|
|
