Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
Service Code
|
ICD 04100Z1
|
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 03S10ZZ
|
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 041E4ZJ
|
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 05UD47Z
|
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 03R40JZ
|
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 0W9D00Z
|
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 025R0ZZ
|
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 02124K3
|
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 04100JH
|
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 04100ZJ
|
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 041D0JR
|
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 041J0AK
|
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 021L0AQ
|
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 06SV4ZZ
|
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 041J09B
|
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 04100JF
|
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 04R907Z
|
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 027F0ZZ
|
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 021W09D
|
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 02HN02Z
|
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 05UY07Z
|
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 041J0KG
|
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 02160KR
|
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 041E4KG
|
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 05S63ZZ
|
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
|
|