|
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES
|
Facility
IP
|
$71,986.52
|
|
|
Service Code
|
APR-DRG 3214
|
| Min. Negotiated Rate |
$55,221.24 |
| Max. Negotiated Rate |
$71,986.52 |
| Rate for Payer: IEHP Medi-Cal |
$55,221.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71,986.52
|
|
|
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES
|
Facility
IP
|
$46,044.33
|
|
|
Service Code
|
APR-DRG 3213
|
| Min. Negotiated Rate |
$35,320.85 |
| Max. Negotiated Rate |
$46,044.33 |
| Rate for Payer: IEHP Medi-Cal |
$35,320.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46,044.33
|
|
|
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES
|
Facility
IP
|
$27,577.30
|
|
|
Service Code
|
APR-DRG 3211
|
| Min. Negotiated Rate |
$21,154.69 |
| Max. Negotiated Rate |
$27,577.30 |
| Rate for Payer: IEHP Medi-Cal |
$21,154.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27,577.30
|
|
|
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES
|
Facility
IP
|
$33,449.23
|
|
|
Service Code
|
APR-DRG 3212
|
| Min. Negotiated Rate |
$25,659.08 |
| Max. Negotiated Rate |
$33,449.23 |
| Rate for Payer: IEHP Medi-Cal |
$25,659.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33,449.23
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0TQB0ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10907ZC
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0DQR4ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0UQM0ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10908ZC
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0W8NXZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$41,843.00
|
|
|
Service Code
|
ICD 02QA1ZZ
|
| Min. Negotiated Rate |
$41,843.00 |
| Max. Negotiated Rate |
$41,843.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,843.00
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10903ZC
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$41,843.00
|
|
|
Service Code
|
ICD 02QA3ZZ
|
| Min. Negotiated Rate |
$41,843.00 |
| Max. Negotiated Rate |
$41,843.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,843.00
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0TQD7ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0Q820ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10908ZA
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0UQ90ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0UQC0ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10J07ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0WQNXZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10D00Z0
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0DQR0ZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10D07Z3
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 0UQMXZZ
|
| 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
|
|
|
Spinal Fusion Device - #2640
|
Facility
IP
|
$10,581.00
|
|
|
Service Code
|
ICD 10900ZC
|
| 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
|
|
