|
021L0AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2934
|
| 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
|
|
|
021L0JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2935
|
| 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
|
|
|
021L0JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2936
|
| 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
|
|
|
021L0JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2937
|
| 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
|
|
|
021L0KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2938
|
| 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
|
|
|
021L0KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2939
|
| 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
|
|
|
021L0KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2940
|
| 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
|
|
|
021L0Z5
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
444
|
| 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
|
|
|
021L0Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
445
|
| 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
|
|
|
021L0Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2941
|
| 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
|
|
|
021L0ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2942
|
| 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
|
|
|
021L0ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2943
|
| 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
|
|
|
021L0ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2944
|
| 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
|
|
|
021L0ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2945
|
| 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
|
|
|
021L0ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2946
|
| 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
|
|
|
021L0ZW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
446
|
| 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
|
|
|
021L48P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
447
|
| 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
|
|
|
021L48Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
448
|
| 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
|
|
|
021L48R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
449
|
| 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
|
|
|
021L49P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2947
|
| 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
|
|
|
021L49Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2948
|
| 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
|
|
|
021L49R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2949
|
| 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
|
|
|
021L4AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2950
|
| 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
|
|
|
021L4AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2951
|
| 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
|
|
|
021L4AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2952
|
| 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
|
|
