Coronary Surgery
|
Facility
|
IP
|
$14,669.00
|
|
Service Code
|
ICD 02B43ZZ
|
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 041J49Q
|
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 05SM4ZZ
|
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 02RG4KZ
|
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 06R50KZ
|
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 04100K1
|
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 0WWD3YZ
|
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 04100JH
|
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 02R947Z
|
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 06UM07Z
|
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 05UF37Z
|
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 02QN0ZZ
|
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 06R54JZ
|
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 05U437Z
|
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 04100J4
|
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 04R00KZ
|
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 05564ZZ
|
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 02134J3
|
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 041C493
|
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 041E4KH
|
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 021L4JR
|
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 041F4JQ
|
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 04SD4ZZ
|
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 02HQ3DZ
|
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
|
|