Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
Service Code
|
ICD 0210098
|
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 04100J0
|
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 041F0JG
|
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 041C0J8
|
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 06SR0ZZ
|
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 06RC0KZ
|
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 02RK4JZ
|
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 02UQ47Z
|
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 02UL38Z
|
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 02U707Z
|
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 05UG37Z
|
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 02UJ38Z
|
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 041F0ZB
|
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 041F09P
|
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 02QN3ZZ
|
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 05U747Z
|
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 02110Z8
|
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 041F0Z9
|
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 02Q60ZZ
|
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 02170ZR
|
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 05134JY
|
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 02RG3JZ
|
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 041F09F
|
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 0WPD4YZ
|
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 04S50ZZ
|
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
|
|