|
021X0JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3025
|
| 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
|
|
|
021X0KA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
529
|
| 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
|
|
|
021X0KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
530
|
| 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
|
|
|
021X0KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3026
|
| 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
|
|
|
021X0KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3027
|
| 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
|
|
|
021X0ZA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
531
|
| 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
|
|
|
021X0ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
532
|
| 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
|
|
|
021X0ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3028
|
| 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
|
|
|
021X0ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3029
|
| 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
|
|
|
021X48A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
533
|
| 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
|
|
|
021X48P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
534
|
| 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
|
|
|
021X48Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3030
|
| 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
|
|
|
021X48R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3031
|
| 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
|
|
|
021X49A
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
535
|
| 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
|
|
|
021X49P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
536
|
| 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
|
|
|
021X49Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3032
|
| 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
|
|
|
021X49R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3033
|
| 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
|
|
|
021X4AA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
537
|
| 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
|
|
|
021X4AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
538
|
| 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
|
|
|
021X4AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3034
|
| 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
|
|
|
021X4AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3035
|
| 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
|
|
|
021X4JA
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
539
|
| 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
|
|
|
021X4JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
540
|
| 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
|
|
|
021X4JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3036
|
| 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
|
|
|
021X4JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3037
|
| 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
|
|
