|
Coronary Surgery
|
Facility
IP
|
$14,669.00
|
|
|
Service Code
|
ICD 04R90JZ
|
| 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 02100KF
|
| 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 041H4JG
|
| 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 02130JW
|
| 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 041F0ZG
|
| 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 0W9D0ZZ
|
| 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 0WPD43Z
|
| 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 04100KD
|
| 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 03U447Z
|
| 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 06B43ZZ
|
| 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 02US4KZ
|
| 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 04SR0ZZ
|
| 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 05S00ZZ
|
| 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 041H09J
|
| 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 04RH4JZ
|
| 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 045A0ZZ
|
| 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 02UJ3JZ
|
| 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 02UQ3KZ
|
| 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 02WH48Z
|
| 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 04UY47Z
|
| 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 02130KC
|
| 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 02R90KZ
|
| 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 06RB4JZ
|
| 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
|
|
