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Charge Type Setting Price  
Service Code APR-DRG 2013
Min. Negotiated Rate $10,445.39
Max. Negotiated Rate $13,616.64
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal $10,445.39
Rate for Payer: Kaiser Permanente of CA Medi-Cal $13,616.64
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 B2001ZZ
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 B2000ZZ
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 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 4A023N7
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 B2020ZZ
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 B201YZZ
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 B20F0ZZ
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 B20F1ZZ
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 B2161ZZ
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 4A020N8
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 B2141ZZ
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 B2071ZZ
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 B203YZZ
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 B218YZZ
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 B212YZZ
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 B2101ZZ
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 B2031ZZ
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 B2120ZZ
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