Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
Service Code
|
ICD 041E4KJ
|
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 041C0JR
|
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 041H0JD
|
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 02U608Z
|
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 02UJ0JZ
|
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 04SP4ZZ
|
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 02UG37Z
|
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 04UN47Z
|
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 03SG3ZZ
|
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 04BA4ZZ
|
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 02HS02Z
|
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 02124ZF
|
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 041C4K1
|
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 041C4AC
|
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 04SE4ZZ
|
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 03SC0ZZ
|
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 05UH37Z
|
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 05B03ZZ
|
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 0WWD33Z
|
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 02HQ0DZ
|
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 041C4KG
|
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 02160JQ
|
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 04534ZZ
|
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
|
|