|
02C80ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3129
|
| 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
|
|
|
02C83ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3130
|
| 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
|
|
|
02C84ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3131
|
| 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
|
|
|
02C90ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3132
|
| 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
|
|
|
02C93ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3133
|
| 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
|
|
|
02C94ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3134
|
| 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
|
|
|
02CD0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1030
|
| 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
|
|
|
02CD3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3135
|
| 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
|
|
|
02CD4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3136
|
| 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
|
|
|
02CF0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1031
|
| 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
|
|
|
02CG0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1032
|
| 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
|
|
|
02CH0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1033
|
| 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
|
|
|
02CJ0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1034
|
| 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
|
|
|
02CK0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1035
|
| 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
|
|
|
02CK3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3137
|
| 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
|
|
|
02CK4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3138
|
| 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
|
|
|
02CL0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3139
|
| 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
|
|
|
02CL3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3140
|
| 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
|
|
|
02CL4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3141
|
| 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
|
|
|
02CM0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1036
|
| 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
|
|
|
02CM3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3142
|
| 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
|
|
|
02CM4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3143
|
| 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
|
|
|
02CN0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1037
|
| 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
|
|
|
02CN3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3144
|
| 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
|
|
|
02CN4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3145
|
| 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
|
|
