|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047M45Z
|
| 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 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 047E36Z
|
| 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
|
$20,000.00
|
|
|
Service Code
|
LOCAL 362.50
|
| Min. Negotiated Rate |
$20,000.00 |
| Max. Negotiated Rate |
$20,000.00 |
| Rate for Payer: Networks By Design Commercial |
$20,000.00
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047H36Z
|
| 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 047Y07Z
|
| 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 047Q35Z
|
| 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 047T041
|
| 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 047D47Z
|
| 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 047V36Z
|
| 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 047P37Z
|
| 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 047Y47Z
|
| 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 047F341
|
| 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 047D341
|
| 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 047R05Z
|
| 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 047L07Z
|
| 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 047E47Z
|
| 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 047S35Z
|
| 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 047P45Z
|
| 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 047N05Z
|
| 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
|
|
