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Charge Type Setting Price  
Service Code ICD 04104J0
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 02164Z7
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 04S30ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041F0JB
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 03U947Z
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041E0JG
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 02BT4ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041D4ZH
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 06S10ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 02110AF
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041C0K7
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 04UU07Z
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 03SV3ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 025V3ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 021K0KR
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041E4AH
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 04SS3ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041E0JC
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 045J4ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 04104AF
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 02N90ZZ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $11,541.00
Rate for Payer: Anthem Blue Cross of CA HMO/PPO $11,541.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041C4ZR
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 06R747Z
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 041C4KQ
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00
Service Code ICD 02HS32Z
Min. Negotiated Rate $7,205.00
Max. Negotiated Rate $10,022.00
Rate for Payer: Blue Shield of California Commercial $10,022.00
Rate for Payer: Blue Shield of California EPN $7,205.00