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Charge Type Setting Price  
Service Code ICD 0HHU71Z
Hospital Charge Code 4983
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHUX1Z
Hospital Charge Code 4984
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHV01Z
Hospital Charge Code 4985
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHV31Z
Hospital Charge Code 4986
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHV71Z
Hospital Charge Code 4987
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHVX1Z
Hospital Charge Code 4988
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHW01Z
Hospital Charge Code 4989
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHW31Z
Hospital Charge Code 4990
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHW71Z
Hospital Charge Code 4991
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHWX1Z
Hospital Charge Code 4992
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHX01Z
Hospital Charge Code 4993
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHX31Z
Hospital Charge Code 4994
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHX71Z
Hospital Charge Code 4995
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHX81Z
Hospital Charge Code 4996
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0HHXX1Z
Hospital Charge Code 4997
Min. Negotiated Rate $9,120.00
Max. Negotiated Rate $9,120.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $9,120.00
Service Code ICD 0JH608Z
Hospital Charge Code 2536
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 0JH608Z
Hospital Charge Code 2537
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 0JH608Z
Hospital Charge Code 13933
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 0JH609Z
Hospital Charge Code 2538
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 0JH609Z
Hospital Charge Code 2539
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 0JH609Z
Hospital Charge Code 13934
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 0JH60AZ
Hospital Charge Code 2540
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 0JH60BZ
Hospital Charge Code 2541
Min. Negotiated Rate $30,778.00
Max. Negotiated Rate $30,778.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $30,778.00
Service Code ICD 0JH60CZ
Hospital Charge Code 2542
Min. Negotiated Rate $30,778.00
Max. Negotiated Rate $30,778.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $30,778.00
Service Code ICD 0JH60DZ
Hospital Charge Code 2543
Min. Negotiated Rate $30,778.00
Max. Negotiated Rate $30,778.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $30,778.00