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Charge Type Price  
Service Code ICD 05R647Z
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 05R507Z
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 041D4K9
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 025W0ZZ
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 05R44KZ
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 05B53ZZ
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 05B50ZZ
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 05B44ZZ
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 04R50KZ
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 02RH47Z
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 041J0A9
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 041H4JQ
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 041J09Q
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 06R247Z
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 05164ZY
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 04UT07Z
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 04UJ07Z
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 04R00KZ
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 04100K2
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 04R94JZ
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 04R907Z
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 041D4K8
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 04UH37Z
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