|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0WHG01Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0BHK31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0UHG71Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0BHK01Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0WHM31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0FHB31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0HHX01Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0CH7X1Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0VH001Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0WH941Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0XHG41Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0YHD01Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0BH031Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0WHP31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0VH031Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0XH831Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0CH701Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0WHB41Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0YHF31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0XHH31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0JHW31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0YHK31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0YHK41Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0YHC31Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
|
Inpatient Brachytherapy
|
Facility
IP
|
$23,184.00
|
|
|
Service Code
|
ICD 0DH581Z
|
| Min. Negotiated Rate |
$8,040.00 |
| Max. Negotiated Rate |
$23,184.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$23,184.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,040.00
|
|
