Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 02UK38Z
|
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 02WJ4JZ
|
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 05B00ZZ
|
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 02UG48Z
|
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 06RD0KZ
|
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 041H4AQ
|
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 03UN37Z
|
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 04584ZZ
|
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 02134JF
|
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 04B50ZZ
|
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 02130KC
|
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 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
|
|
Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 04RB0KZ
|
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 041C49G
|
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 02893ZZ
|
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 05S14ZZ
|
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 041C0J6
|
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 06US47Z
|
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 041D0A3
|
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 02PY03Z
|
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 041D099
|
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 021L0KR
|
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 02U60JZ
|
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 02130ZF
|
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
|
|