|
027304Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
807
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027304Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
808
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
0273056
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
810
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027305Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
812
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027305Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
811
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
0273066
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
814
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027306Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
815
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027306Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
816
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
0273076
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
817
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
0273076
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
818
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027307Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
820
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
027307Z
|
Facility
|
IP
|
$8,623.00
|
|
| Hospital Charge Code |
819
|
| Min. Negotiated Rate |
$8,623.00 |
| Max. Negotiated Rate |
$8,623.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,623.00
|
|
|
02730D6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
821
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730D6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
822
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730DZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
823
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730DZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
824
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730E6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
3069
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730E6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
3070
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730E6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
3071
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730EZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
828
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730EZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
827
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730F6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
829
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730F6
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
830
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730FZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
832
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
|
02730FZ
|
Facility
|
IP
|
$3,913.00
|
|
| Hospital Charge Code |
831
|
| Min. Negotiated Rate |
$3,913.00 |
| Max. Negotiated Rate |
$3,913.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,913.00
|
|
