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Charge Type Price  
Service Code ICD 041E099
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 041J4JG
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 02110KW
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 05U807Z
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 04100K0
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 06B53ZZ
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 04B03ZZ
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 04S73ZZ
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 04S70ZZ
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 02700Z6
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 02UT07Z
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 04RH0KZ
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 03U407Z
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 041C0K8
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 06SF3ZZ
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 02104KF
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 041D495
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 06UJ37Z
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 02QB4ZZ
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 021W4JP
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 06RF4KZ
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 041H09C
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 02UT3KZ
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 02RN08Z
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