Coronary Surgery
|
Facility
|
IP
|
$10,022.00
|
|
Service Code
|
ICD 03U807Z
|
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 041D4K3
|
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 04SP3ZZ
|
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 041C09R
|
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 041D4ZF
|
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 04104KC
|
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 06RJ4KZ
|
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 05UN47Z
|
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 041C09F
|
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 05UV07Z
|
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 041C4A5
|
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 06U607Z
|
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 02NL3ZZ
|
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 041H4AJ
|
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 041F09C
|
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 03SS0ZZ
|
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 02RQ4JZ
|
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 041J0JH
|
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 041J0AQ
|
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 02UF37Z
|
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 041C4Z1
|
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 02UH4JZ
|
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 0414494
|
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 02RH0KZ
|
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 041E4JC
|
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
|
|