|
021L4JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2953
|
| 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
|
|
|
021L4JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2954
|
| 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
|
|
|
021L4JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2955
|
| 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
|
|
|
021L4KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2956
|
| 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
|
|
|
021L4KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2957
|
| 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
|
|
|
021L4KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2958
|
| 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
|
|
|
021L4Z5
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
450
|
| 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
|
|
|
021L4Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
451
|
| 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
|
|
|
021L4Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2959
|
| 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
|
|
|
021L4ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2960
|
| 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
|
|
|
021L4ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2961
|
| 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
|
|
|
021L4ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2962
|
| 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
|
|
|
021L4ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2963
|
| 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
|
|
|
021L4ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2964
|
| 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
|
|
|
021L4ZW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
452
|
| 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
|
|
|
021V08P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
454
|
| 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
|
|
|
021V08Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
455
|
| 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
|
|
|
021V08R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
456
|
| 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
|
|
|
021V08S
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
457
|
| 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
|
|
|
021V08T
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
458
|
| 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
|
|
|
021V08U
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
459
|
| 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
|
|
|
021V09P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2965
|
| 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
|
|
|
021V09Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2966
|
| 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
|
|
|
021V09R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2967
|
| 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
|
|
|
021V09S
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
460
|
| 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
|
|
