|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2121ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2150ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B206YZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2041ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2050ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B21FYZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2161ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2001ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B20FYZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2031ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2120ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2131ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2030ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B215YZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B205YZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2130ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2141ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2081ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B214YZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B21F1ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B21F0ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD B2080ZZ
|
| Min. Negotiated Rate |
$10,527.00 |
| Max. Negotiated Rate |
$14,669.00 |
| Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$22,221.45
|
|
|
Service Code
|
APR-DRG 1913
|
| Min. Negotiated Rate |
$14,034.60 |
| Max. Negotiated Rate |
$22,221.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$14,034.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,724.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,221.45
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$31,869.08
|
|
|
Service Code
|
APR-DRG 1914
|
| Min. Negotiated Rate |
$20,127.84 |
| Max. Negotiated Rate |
$31,869.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$20,127.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23,985.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,869.08
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$17,112.12
|
|
|
Service Code
|
APR-DRG 1912
|
| Min. Negotiated Rate |
$10,807.66 |
| Max. Negotiated Rate |
$17,112.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,807.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,879.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,112.12
|
|
