|
021W0JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
504
|
| 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
|
|
|
021W0JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3000
|
| 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
|
|
|
021W0JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3001
|
| 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
|
|
|
021W0KA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
505
|
| 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
|
|
|
021W0KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
506
|
| 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
|
|
|
021W0KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3002
|
| 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
|
|
|
021W0KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3003
|
| 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
|
|
|
021W0ZA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
507
|
| 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
|
|
|
021W0ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
508
|
| 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
|
|
|
021W0ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3004
|
| 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
|
|
|
021W0ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3005
|
| 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
|
|
|
021W48A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
509
|
| 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
|
|
|
021W48P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
510
|
| 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
|
|
|
021W48Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3006
|
| 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
|
|
|
021W48R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3007
|
| 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
|
|
|
021W49A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
511
|
| 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
|
|
|
021W49P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
512
|
| 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
|
|
|
021W49Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3008
|
| 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
|
|
|
021W49R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3009
|
| 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
|
|
|
021W4AA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
513
|
| 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
|
|
|
021W4AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
514
|
| 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
|
|
|
021W4AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3010
|
| 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
|
|
|
021W4AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3011
|
| 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
|
|
|
021W4JA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
515
|
| 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
|
|
|
021W4JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
516
|
| 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
|
|
