|
Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
|
Service Code
|
ICD 04733GZ
|
| 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 04794GZ
|
| 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 037G3DZ
|
| 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 047W4D1
|
| 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 047L4D6
|
| 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 047L4GZ
|
| 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 047W3GZ
|
| 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 037R0FZ
|
| 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 057B4DZ
|
| 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 047W4FZ
|
| 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 047M0D6
|
| 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 047W4EZ
|
| 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 047W3FZ
|
| 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 047R3D6
|
| 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 047R3D1
|
| 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 047R0GZ
|
| 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 03763GZ
|
| 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 057B0DZ
|
| 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 047W3D1
|
| 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 027W0DZ
|
| 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 057C3DZ
|
| 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 06784DZ
|
| 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 067C3DZ
|
| 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 047M0FZ
|
| 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 047R4FZ
|
| 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
|
|
