Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037N4DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037K4DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047R3GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037H0D6
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037N4EZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047B0DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047U3GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037L3DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 04743FZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 04743GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047Y3GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 057T4DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 04733D1
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 06780DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 057F3D1
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 04734D6
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 057A3DZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$19,726.00
|
|
Service Code
|
ICD 02703D6
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$19,726.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
Rate for Payer: Blue Shield of California Commercial |
$19,726.00
|
Rate for Payer: Blue Shield of California EPN |
$16,911.00
|
Rate for Payer: Heritage Provider Network Commercial |
$4,968.00
|
Rate for Payer: Heritage Provider Network Senior |
$4,519.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037G4FZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047N0D1
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037K3GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047R0FZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047R4GZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 03783D6
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037B0EZ
|
Min. Negotiated Rate |
$3,588.00 |
Max. Negotiated Rate |
$3,588.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|