Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 04R84JZ
|
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 04R807Z
|
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 0WPD03Z
|
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 041E4KD
|
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 041D0AF
|
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 05UV07Z
|
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 041E4KF
|
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 02N60ZZ
|
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 041E4JJ
|
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 02CD4ZZ
|
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 041E0JQ
|
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 04563ZZ
|
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 02120A3
|
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 021L4JQ
|
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 06UT07Z
|
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 06UG47Z
|
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 04104A7
|
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 02120ZC
|
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 04144Z3
|
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 05UV47Z
|
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 04UT37Z
|
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 041C0K4
|
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 041D0JC
|
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 027F0DZ
|
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
|
$11,541.00
|
|
Service Code
|
ICD 02HN00Z
|
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
|
|