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All Charges

Charge Type Setting Price  
Service Code ICD 021K4JQ
Hospital Charge Code 2921
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 021K4JQ
Hospital Charge Code 10357
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 021K4JR
Hospital Charge Code 10358
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 021K4JR
Hospital Charge Code 2922
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 021K4KP
Hospital Charge Code 2923
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 021K4KP
Hospital Charge Code 10359
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 021K4KQ
Hospital Charge Code 2924
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 021K4KQ
Hospital Charge Code 10360
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 021K4KR
Hospital Charge Code 2925
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 021K4KR
Hospital Charge Code 10361
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 021K4Z5
Hospital Charge Code 435
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 021K4Z5
Hospital Charge Code 10362
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 021K4Z8
Hospital Charge Code 10363
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 021K4Z8
Hospital Charge Code 436
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 021K4Z9
Hospital Charge Code 10364
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 021K4Z9
Hospital Charge Code 2926
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 021K4ZC
Hospital Charge Code 437
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 021K4ZC
Hospital Charge Code 10365
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 021K4ZF
Hospital Charge Code 2927
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 021K4ZF
Hospital Charge Code 10366
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 021K4ZP
Hospital Charge Code 438
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 021K4ZP
Hospital Charge Code 10367
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 021K4ZQ
Hospital Charge Code 10368
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 021K4ZQ
Hospital Charge Code 2928
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 021K4ZR
Hospital Charge Code 10369
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