|
021V0ZU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
475
|
| 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
|
|
|
021V48P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
476
|
| 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
|
|
|
021V48Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
477
|
| 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
|
|
|
021V48R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
478
|
| 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
|
|
|
021V48S
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
479
|
| 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
|
|
|
021V48T
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
480
|
| 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
|
|
|
021V48U
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
481
|
| 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
|
|
|
021V49P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2979
|
| 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
|
|
|
021V49Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2980
|
| 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
|
|
|
021V49R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2981
|
| 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
|
|
|
021V49S
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
482
|
| 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
|
|
|
021V49T
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
483
|
| 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
|
|
|
021V49U
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
484
|
| 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
|
|
|
021V4AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2982
|
| 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
|
|
|
021V4AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2983
|
| 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
|
|
|
021V4AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2984
|
| 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
|
|
|
021V4AS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
485
|
| 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
|
|
|
021V4AT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
486
|
| 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
|
|
|
021V4AU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
487
|
| 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
|
|
|
021V4JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2985
|
| 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
|
|
|
021V4JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2986
|
| 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
|
|
|
021V4JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2987
|
| 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
|
|
|
021V4JS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
488
|
| 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
|
|
|
021V4JT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
489
|
| 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
|
|
|
021V4JU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
490
|
| 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
|
|
