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All Charges

Charge Type Setting Price  
Service Code ICD 047Y35Z
Hospital Charge Code 2399
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y36Z
Hospital Charge Code 2400
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y37Z
Hospital Charge Code 2401
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y3D1
Hospital Charge Code 4613
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y3D6
Hospital Charge Code 4614
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y3DZ
Hospital Charge Code 4615
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y3EZ
Hospital Charge Code 4616
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y3FZ
Hospital Charge Code 4617
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y3GZ
Hospital Charge Code 4618
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y441
Hospital Charge Code 2402
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y44Z
Hospital Charge Code 2403
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y45Z
Hospital Charge Code 2404
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y46Z
Hospital Charge Code 2405
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y47Z
Hospital Charge Code 2406
Min. Negotiated Rate $8,968.00
Max. Negotiated Rate $8,968.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $8,968.00
Service Code ICD 047Y4D1
Hospital Charge Code 4619
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y4D6
Hospital Charge Code 4620
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y4DZ
Hospital Charge Code 4621
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y4EZ
Hospital Charge Code 4622
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y4FZ
Hospital Charge Code 4623
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 047Y4GZ
Hospital Charge Code 4624
Min. Negotiated Rate $4,070.00
Max. Negotiated Rate $4,070.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $4,070.00
Service Code ICD 04C03ZZ
Hospital Charge Code 13001
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 04C03ZZ
Hospital Charge Code 2407
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 04C13ZZ
Hospital Charge Code 2408
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 04C23ZZ
Hospital Charge Code 2409
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00
Service Code ICD 04C33ZZ
Hospital Charge Code 2410
Min. Negotiated Rate $11,208.00
Max. Negotiated Rate $11,208.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,208.00