|
PTCA / Angioplasty
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02704E6
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02733E6
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047T36Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047F36Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047T34Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047J44Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047S46Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0Q834ZZ
|
| Min. Negotiated Rate |
$10,581.00 |
| Max. Negotiated Rate |
$10,581.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,581.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047W06Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047U46Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047K47Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047Y441
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047Q041
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047V34Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047J341
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047H05Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047T07Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047Q06Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$8,368.00
|
|
|
Service Code
|
ICD 0SRB029
|
| Min. Negotiated Rate |
$8,368.00 |
| Max. Negotiated Rate |
$8,368.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,368.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047U06Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047Y34Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047N35Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047P06Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 0SG847Z
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047P34Z
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
