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Charge Type Setting Price  
Service Code ICD 06713DZ
Hospital Charge Code 4745
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 06714DZ
Hospital Charge Code 4746
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 06720DZ
Hospital Charge Code 4747
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 06723DZ
Hospital Charge Code 4748
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 06724DZ
Hospital Charge Code 4749
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 06730DZ
Hospital Charge Code 4750
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 06733DZ
Hospital Charge Code 4751
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 06734DZ
Hospital Charge Code 4752
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 06740DZ
Hospital Charge Code 4753
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 06743DZ
Hospital Charge Code 4754
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 06744DZ
Hospital Charge Code 4755
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 06750DZ
Hospital Charge Code 4756
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 06753DZ
Hospital Charge Code 4757
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 06754DZ
Hospital Charge Code 4758
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 06760DZ
Hospital Charge Code 4759
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 06763DZ
Hospital Charge Code 4760
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 06764DZ
Hospital Charge Code 4761
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 06770DZ
Hospital Charge Code 4762
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 06773DZ
Hospital Charge Code 4763
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 06774DZ
Hospital Charge Code 4764
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 06780DZ
Hospital Charge Code 4765
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 06783DZ
Hospital Charge Code 4766
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 06784DZ
Hospital Charge Code 4767
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 06790DZ
Hospital Charge Code 4768
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 06793DZ
Hospital Charge Code 4769
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