Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 041H0Z9
|
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 02WA4DZ
|
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 04UU47Z
|
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 04B74ZZ
|
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 04100J6
|
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 041H4ZP
|
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 041H4KQ
|
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 02U948Z
|
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 04RE4KZ
|
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 041D4A8
|
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 02170AQ
|
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 0212499
|
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 0410494
|
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 06U107Z
|
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 05UP07Z
|
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 02PA02Z
|
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 02PY08Z
|
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 05SN0ZZ
|
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 02WA03Z
|
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 041C0AB
|
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 05110AY
|
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 04573ZZ
|
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 041F0KJ
|
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 041E4AG
|
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
|
|