Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 06RF4KZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02124ZF
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041H0KB
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02WY4DZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02U607Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041C0AD
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041D4KH
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 03UB07Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 04R507Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041F0AB
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02WA03Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 05UM37Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041H0KF
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 03130AN
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 06513ZZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 06S40ZZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 03UC37Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$11,541.00
|
|
Service Code
|
ICD 02164ZQ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041J0ZQ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041D0Z2
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$11,541.00
|
|
Service Code
|
ICD 02B80ZZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02U738Z
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 04R64JZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$11,541.00
|
|
Service Code
|
ICD 02HK0DZ
|
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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 021W4AD
|
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
|
|