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Charge Type Setting Price  
Service Code APR-DRG 2012
Min. Negotiated Rate $6,992.62
Max. Negotiated Rate $9,115.59
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $6,992.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal $9,115.59
Service Code ICD B214YZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2170ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2100ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2131ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2061ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B21FYZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2040ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B21F1ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B205YZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B20FYZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B217YZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 4A023N8
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 4A020N6
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2111ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2140ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2010ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2110ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2171ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 4A023N6
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B202YZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2060ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B208YZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2021ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD B2121ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00