|
Coronary Surgery
|
Facility
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 021W0AD
|
| 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 03UR47Z
|
| 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 04UR37Z
|
| 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 05110JY
|
| 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 04RA07Z
|
| 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 02CK0ZZ
|
| 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 041D0JJ
|
| 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 02UK08Z
|
| 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 041F4KD
|
| 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 02Q93ZZ
|
| 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 04UW47Z
|
| 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 05530ZZ
|
| 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 041C4J2
|
| 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 06B23ZZ
|
| 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 021V0JR
|
| 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 0410093
|
| 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 045F0ZZ
|
| 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 04100A4
|
| 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 04U307Z
|
| 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 04R007Z
|
| 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 05SY4ZZ
|
| 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 027H04Z
|
| 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 041F0A9
|
| 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 021K4Z9
|
| 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
|
|
