Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
Service Code
|
ICD 02TD0ZZ
|
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 041C0J6
|
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 041C4K4
|
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 03UN47Z
|
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 041D4KQ
|
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 05UL37Z
|
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 06540ZZ
|
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 02130AW
|
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 025Q3ZZ
|
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 02RG48Z
|
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 041E09B
|
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 04594ZZ
|
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 04104Z0
|
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 02UR47Z
|
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 021V0ZR
|
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 041C0AC
|
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 025N0ZZ
|
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 02RM07Z
|
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 04100K1
|
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 04104JR
|
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 04104AD
|
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 041F0KJ
|
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 021K0JP
|
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 041F4JK
|
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 02CN4ZZ
|
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
|
|