|
Coronary Surgery
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02UA3KZ
|
| 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 03UC47Z
|
| 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 06UR07Z
|
| 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 04104A3
|
| 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 021L4Z5
|
| 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 03SJ4ZZ
|
| 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 06SD3ZZ
|
| 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 027204Z
|
| 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 05B14ZZ
|
| 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 04R60JZ
|
| 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 04BC0ZZ
|
| 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 021K0AP
|
| 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 06574ZZ
|
| 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 041E49D
|
| 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 05B13ZZ
|
| 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 04140A4
|
| 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 03S13ZZ
|
| 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 02UK3KZ
|
| 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 04104JC
|
| 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 021649Q
|
| 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 04BD4ZZ
|
| 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 02130K8
|
| 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 02UK47Z
|
| 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 06BJ3ZZ
|
| 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 04UK47Z
|
| 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
|
|
