|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SWC0JZ
|
| Min. Negotiated Rate |
$8,448.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,448.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRS0JA
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SR9029
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SR90KZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRB039
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRB03A
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRB03Z
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRL07Z
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRP07Z
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRR01Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRR039
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SWH4JZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRB029
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRJ0JZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0RRK0JZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRD0J9
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRR07Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SWC4JZ
|
| Min. Negotiated Rate |
$8,448.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,448.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0RRM0KZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRV0KZ
|
| Min. Negotiated Rate |
$8,448.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,448.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SWQ4JZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRA019
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRS019
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SWM0JZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRQ0KZ
|
| Min. Negotiated Rate |
$19,401.00 |
| Max. Negotiated Rate |
$22,635.00 |
| Rate for Payer: Blue Shield of California Commercial |
$22,635.00
|
| Rate for Payer: Blue Shield of California EPN |
$19,401.00
|
|
