|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02HK3NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02WAXNZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H60JZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HD46Z
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$24,272.00
|
|
|
Service Code
|
ICD 0UTC4ZZ
|
| Min. Negotiated Rate |
$24,272.00 |
| Max. Negotiated Rate |
$24,272.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,272.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$24,272.00
|
|
|
Service Code
|
ICD 0UT9FZZ
|
| Min. Negotiated Rate |
$24,272.00 |
| Max. Negotiated Rate |
$24,272.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,272.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$24,272.00
|
|
|
Service Code
|
ICD 0UT94ZZ
|
| Min. Negotiated Rate |
$24,272.00 |
| Max. Negotiated Rate |
$24,272.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,272.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H60NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H43NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HE0SZ
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02HK0NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02RJ3KH
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HD4SZ
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$25,108.00
|
|
|
Service Code
|
ICD 0VT30ZZ
|
| Min. Negotiated Rate |
$25,108.00 |
| Max. Negotiated Rate |
$25,108.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,108.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02RJ3JZ
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02HK4NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H64JZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HE3SZ
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02RJ3JH
|
| Min. Negotiated Rate |
$11,541.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HE06Z
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H64NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H73NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HE05Z
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$13,250.00
|
|
|
Service Code
|
ICD 02H74NZ
|
| Min. Negotiated Rate |
$13,250.00 |
| Max. Negotiated Rate |
$13,250.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,250.00
|
|
|
IA Pacemaker - #2632
|
Facility
IP
|
$27,899.00
|
|
|
Service Code
|
ICD 09HD3SZ
|
| Min. Negotiated Rate |
$27,899.00 |
| Max. Negotiated Rate |
$27,899.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,899.00
|
|
