|
021V09T
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
461
|
| 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
|
|
|
021V09U
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
462
|
| 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
|
|
|
021V0AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
463
|
| 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
|
|
|
021V0AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2968
|
| 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
|
|
|
021V0AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2969
|
| 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
|
|
|
021V0AS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
464
|
| 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
|
|
|
021V0AT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
465
|
| 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
|
|
|
021V0AU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
466
|
| 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
|
|
|
021V0JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2970
|
| 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
|
|
|
021V0JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2971
|
| 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
|
|
|
021V0JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2972
|
| 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
|
|
|
021V0JS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
467
|
| 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
|
|
|
021V0JT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
468
|
| 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
|
|
|
021V0JU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
469
|
| 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
|
|
|
021V0KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2973
|
| 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
|
|
|
021V0KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2974
|
| 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
|
|
|
021V0KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2975
|
| 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
|
|
|
021V0KS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
470
|
| 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
|
|
|
021V0KT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
471
|
| 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
|
|
|
021V0KU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
472
|
| 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
|
|
|
021V0ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2976
|
| 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
|
|
|
021V0ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2977
|
| 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
|
|
|
021V0ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2978
|
| 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
|
|
|
021V0ZS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
473
|
| 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
|
|
|
021V0ZT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
474
|
| 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
|
|
