|
Coronary Surgery
|
Facility
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02WY0KZ
|
| 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 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
|
|
|
Coronary Surgery
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02PA0CZ
|
| 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 02164AQ
|
| 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 02160JP
|
| 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 0212344
|
| 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 04104KQ
|
| 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 02HP3DZ
|
| 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 041D4ZQ
|
| 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 04570ZZ
|
| 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 02PY07Z
|
| 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 02WA42Z
|
| 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 027J04Z
|
| 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 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 041009H
|
| 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 02RM07Z
|
| 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 05S83ZZ
|
| 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 05U747Z
|
| 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 041D0K4
|
| 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 04100JQ
|
| 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 021K4KQ
|
| 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 02SS0ZZ
|
| 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 03SR0ZZ
|
| 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 041009C
|
| 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 05140AY
|
| 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
|
|
