|
02QG4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3260
|
| 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
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1285
|
| 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
|
|
|
02QH3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3261
|
| 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
|
|
|
02QH4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3262
|
| 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
|
|
|
02QJ0ZG
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1286
|
| 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
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1287
|
| 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
|
|
|
02QJ3ZG
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1288
|
| 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
|
|
|
02QJ3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3263
|
| 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
|
|
|
02QJ4ZG
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1289
|
| 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
|
|
|
02QJ4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3264
|
| 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
|
|
|
02QK0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1290
|
| 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
|
|
|
02QK3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3265
|
| 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
|
|
|
02QK4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3266
|
| 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
|
|
|
02QL0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3267
|
| 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
|
|
|
02QL3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3268
|
| 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
|
|
|
02QL4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3269
|
| 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
|
|
|
02QM0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1291
|
| 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
|
|
|
02QM3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3270
|
| 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
|
|
|
02QM4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3271
|
| 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
|
|
|
02QN0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1292
|
| 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
|
|
|
02QN3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3272
|
| 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
|
|
|
02QN4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3273
|
| 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
|
|
|
02R507Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3274
|
| 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
|
|
|
02R508Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3275
|
| 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
|
|
|
02R50JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1293
|
| 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
|
|
