|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0RRJ0JZ
|
| 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 0SWN3JZ
|
| 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 0RRE0JZ
|
| 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 0SRK07Z
|
| 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 0RRP0JZ
|
| 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 0SRR0KZ
|
| 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 0SWL3JZ
|
| 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 0SRE01Z
|
| 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 0SRE01A
|
| 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 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 0SRA03A
|
| 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 0SR90JZ
|
| 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 0SRE03A
|
| 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 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 0SRA009
|
| 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 0RRN0JZ
|
| 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 0SRD0JA
|
| 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 0SRC07Z
|
| 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 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 0SRU07Z
|
| 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 0SRS01Z
|
| 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 0SRS01A
|
| 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 0SRB04Z
|
| Min. Negotiated Rate |
$10,175.00 |
| 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
|
|
|
Joint Surgery
|
Facility
IP
|
$22,635.00
|
|
|
Service Code
|
ICD 0SRB07Z
|
| 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
|
|
