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Charge Type Price  
Service Code ICD 03R24KZ
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 02UL3KZ
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 02UD4KZ
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 051609Y
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 04UA37Z
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 041D0Z8
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 041D094
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 02UW38Z
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 03S30ZZ
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 041D0ZJ
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 041J0JK
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 041H4ZD
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 03U237Z
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 02UL0JZ
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 02UN07Z
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 041D0Z7
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 041F49C
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 04U307Z
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 041E4JQ
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 041C4ZG
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 02PY0KZ
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 02104AF
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 041D0Z5
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 0WWD41Z
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 02CL3ZZ
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