|
021V4KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2988
|
| 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
|
|
|
021V4KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2989
|
| 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
|
|
|
021V4KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2990
|
| 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
|
|
|
021V4KS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
491
|
| 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
|
|
|
021V4KT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
492
|
| 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
|
|
|
021V4KU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
493
|
| 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
|
|
|
021V4ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2991
|
| 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
|
|
|
021V4ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2992
|
| 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
|
|
|
021V4ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2993
|
| 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
|
|
|
021V4ZS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
494
|
| 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
|
|
|
021V4ZT
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
495
|
| 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
|
|
|
021V4ZU
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
496
|
| 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
|
|
|
021W08A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
497
|
| 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
|
|
|
021W08P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
498
|
| 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
|
|
|
021W08Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2994
|
| 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
|
|
|
021W08R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2995
|
| 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
|
|
|
021W09A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
499
|
| 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
|
|
|
021W09P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
500
|
| 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
|
|
|
021W09Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2996
|
| 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
|
|
|
021W09R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2997
|
| 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
|
|
|
021W0AA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
501
|
| 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
|
|
|
021W0AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
502
|
| 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
|
|
|
021W0AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2998
|
| 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
|
|
|
021W0AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2999
|
| 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
|
|
|
021W0JA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
503
|
| 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
|
|
