|
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 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 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 B2071ZZ
|
| 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 B2020ZZ
|
| 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 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 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 B20F0ZZ
|
| 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 4A020N6
|
| 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 B210YZZ
|
| 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 B2160ZZ
|
| 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 B200YZZ
|
| 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 B2061ZZ
|
| 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 4A020N8
|
| 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 4A023N8
|
| 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 4A020N7
|
| 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 B20F1ZZ
|
| 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 B2151ZZ
|
| 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
|
$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
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
|
IP
|
$14,597.36
|
|
|
Service Code
|
APR-DRG 1911
|
| Min. Negotiated Rate |
$9,219.38 |
| Max. Negotiated Rate |
$14,597.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,219.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,986.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,597.36
|
|
|
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
|
|
