|
Coronary Surgery
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 041F4Z9
|
| 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 06R70KZ
|
| 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 021109F
|
| 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 05SB0ZZ
|
| 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 02134JW
|
| 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 04RC0JZ
|
| 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 041C0Z8
|
| 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 041H4KH
|
| 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 04UT47Z
|
| 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 04U847Z
|
| 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 02160ZP
|
| 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 02100K8
|
| 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 041H0JH
|
| 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 041F0JD
|
| 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 04UP47Z
|
| 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 02U54JZ
|
| 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 04100AB
|
| 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 03B14ZZ
|
| 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 02110J9
|
| 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 021L0ZF
|
| 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 041E4ZP
|
| 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 021L0Z5
|
| 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 045E3ZZ
|
| 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 021W49P
|
| 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 02Q93ZZ
|
| 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
|
|
