Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 047C4D1
|
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 047C3GZ
|
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 047B0GZ
|
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 067R0DZ
|
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 047B0FZ
|
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 04740FZ
|
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 04740DZ
|
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 04714GZ
|
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 04713DZ
|
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 04713D1
|
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 04710EZ
|
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 04704D1
|
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 04703GZ
|
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 037Y4FZ
|
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 037Y4EZ
|
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 037V4EZ
|
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 037V4DZ
|
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 02714GZ
|
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 02714T6
|
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 037J4DZ
|
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 037V4D6
|
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 047Y0FZ
|
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 047Y0GZ
|
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 047Y3D6
|
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 037V0FZ
|
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
|
|