|
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 BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$54,019.58
|
|
|
Service Code
|
APR-DRG 1661
|
| Min. Negotiated Rate |
$34,117.63 |
| Max. Negotiated Rate |
$54,019.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$34,117.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,656.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54,019.58
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 05S83ZZ
|
| 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 041J0ZK
|
| 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 04580ZZ
|
| 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 041F49B
|
| 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 021V0KP
|
| 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 04R14KZ
|
| 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 065D4ZZ
|
| 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 02CW4ZZ
|
| 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 041F0ZB
|
| 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 03UD37Z
|
| 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 02710T6
|
| 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 041D4AQ
|
| 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 04UT37Z
|
| 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 06B74ZZ
|
| 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 045A0ZZ
|
| 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 06ST0ZZ
|
| 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 04R50KZ
|
| 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 02120Z3
|
| 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 02QK3ZZ
|
| 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 04B90ZZ
|
| 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 041D0K0
|
| 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 02UD4KZ
|
| 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 02100Z9
|
| 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
|
|
