CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
IP
|
$34,005.88
|
|
Service Code
|
TRIS-DRG 325
|
Min. Negotiated Rate |
$34,005.88 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
|
Coronary Surgery
|
Facility
IP
|
$34,005.88
|
|
Service Code
|
ICD 041D4J2
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 065D4ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 02134J9
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04B73ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 03UP37Z
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04104K2
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 03UK47Z
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 0WPD40Z
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04100K4
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 041E4ZJ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 06R44KZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 02Q20ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 041D09K
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 041C0Z4
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 06BC4ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 041C097
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 065D3ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 02UQ47Z
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04104A5
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 02WY0DZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 041J0ZK
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04RF4KZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 04B70ZZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
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
|
$34,005.88
|
|
Service Code
|
ICD 05R04KZ
|
Min. Negotiated Rate |
$10,527.00 |
Max. Negotiated Rate |
$34,005.88 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
Rate for Payer: Blue Shield of California Commercial |
$14,669.00
|
Rate for Payer: Blue Shield of California EPN |
$10,527.00
|
|