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Charge Type Price  
Service Code ICD 027R34T
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
Service Code ICD 025F0ZZ
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
Service Code ICD 02H743Z
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
Service Code ICD 03SM4ZZ
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
Service Code ICD 02124JF
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
Service Code ICD 021K0KQ
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
Service Code ICD 02UP3KZ
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
Service Code ICD 02104A8
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
Service Code ICD 041D4J3
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
Service Code ICD 02WM0JZ
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
Service Code ICD 021V0ZQ
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
Service Code ICD 04144A4
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
Service Code ICD 04100A6
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
Service Code ICD 04100ZH
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
Service Code ICD 021V4JR
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
Service Code ICD 041D0J2
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
Service Code ICD 041C4K2
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
Service Code ICD 041F0KC
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
Service Code ICD 02160ZR
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
Service Code ICD 05B43ZZ
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
Service Code ICD 041F499
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
Service Code ICD 02U738Z
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
Service Code ICD 04S13ZZ
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
Service Code ICD 02FN4ZZ
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
Service Code ICD 04B74ZZ
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