|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD B2151ZZ
|
| 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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD B2041ZZ
|
| 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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$11,541.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$11,541.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD B2150ZZ
|
| 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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
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
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD B2181ZZ
|
| 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
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$14,597.36
|
|
|
Service Code
|
APR-DRG 1911
|
| Min. Negotiated Rate |
$11,197.71 |
| Max. Negotiated Rate |
$14,597.36 |
| Rate for Payer: IEHP Medi-Cal |
$11,197.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,597.36
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$22,221.45
|
|
|
Service Code
|
APR-DRG 1913
|
| Min. Negotiated Rate |
$17,046.19 |
| Max. Negotiated Rate |
$22,221.45 |
| Rate for Payer: IEHP Medi-Cal |
$17,046.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,221.45
|
|
