|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$104,861.15
|
|
|
Service Code
|
APR-DRG 1664
|
| Min. Negotiated Rate |
$66,228.10 |
| Max. Negotiated Rate |
$104,861.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$66,228.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78,921.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104,861.15
|
|
|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$71,431.43
|
|
|
Service Code
|
APR-DRG 1663
|
| Min. Negotiated Rate |
$45,114.59 |
| Max. Negotiated Rate |
$71,431.43 |
| Rate for Payer: Adventist Health Medi-Cal |
$45,114.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53,761.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71,431.43
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 041C49D
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02RM47Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 041H09P
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 025V0ZZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02RH4JZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02RL0KZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 041049K
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02134Z9
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 04RC07Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 05UQ47Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02WY03Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 041D499
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 06SN3ZZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 03SY0ZZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 041J0KB
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 03SH4ZZ
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 03UB07Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 03UN07Z
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 051549Y
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 04144A3
|
| 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
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 06BC4ZZ
|
| 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
|
|
