|
Cardiac Catheterization
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 4A023N6
|
| 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 B217YZZ
|
| 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 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 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 B203YZZ
|
| 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 B204YZZ
|
| 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 B2010ZZ
|
| 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 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 B2021ZZ
|
| 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 B207YZZ
|
| 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 B2000ZZ
|
| 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 B2180ZZ
|
| 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 B201YZZ
|
| 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 B2040ZZ
|
| 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
|
$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
|
$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
|
$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
|
|
