|
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 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 047V07Z
|
| 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 047T441
|
| 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 047E05Z
|
| 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 047W35Z
|
| 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 0RG8471
|
| 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 047D36Z
|
| 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 047S37Z
|
| 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 047F44Z
|
| 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 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
|
|
|
PTCA / Angioplasty - #2636
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 047W04Z
|
| 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 047V47Z
|
| 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 047W37Z
|
| 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 047R441
|
| 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 047E44Z
|
| 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
|
$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 047M05Z
|
| 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 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 047V45Z
|
| 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 047T05Z
|
| 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
|
|
