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Charge Type Price  
Service Code ICD 041D098
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 06R24KZ
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 02UA48Z
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 04144A3
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 04100KJ
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 02RQ48Z
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 02104KW
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 02RH4JZ
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 02US3KZ
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 021W0KQ
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 041F4KK
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 02RQ47Z
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 02UD47Z
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 041C4JR
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 02BL3ZZ
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 041D4Z2
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 051549Y
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 02WA37Z
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 041D496
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 02174JQ
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 03S53ZZ
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 02WG4JZ
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 02120KC
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 04534ZZ
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 04100Z5
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