|
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 047S44Z
|
| 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 047U341
|
| 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 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 047S06Z
|
| 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 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 047Q37Z
|
| 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 047Q44Z
|
| 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 047Q46Z
|
| 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 047R041
|
| 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
|
$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 0SP90JZ
|
| 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 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
|
$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 047S04Z
|
| 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 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
|
$10,581.00
|
|
|
Service Code
|
ICD 0UQC8ZZ
|
| 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 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 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 047J05Z
|
| 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 047L37Z
|
| 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 0SPB0JZ
|
| 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
|
|
