|
Cardiac Catheterization
|
Facility
IP
|
$12,471.00
|
|
|
Service Code
|
ICD 4A023N7
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$12,471.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,918.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12,471.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,688.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$12,471.00
|
|
|
Service Code
|
ICD B2151ZZ
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$12,471.00 |
| Rate for Payer: Blue Shield of California Commercial |
$12,471.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,688.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$12,471.00
|
|
|
Service Code
|
ICD B20F1ZZ
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$12,471.00 |
| Rate for Payer: Blue Shield of California Commercial |
$12,471.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,688.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$12,471.00
|
|
|
Service Code
|
ICD B2120ZZ
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$12,471.00 |
| Rate for Payer: Blue Shield of California Commercial |
$12,471.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,688.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
|
|
Cardiac Catheterization
|
Facility
IP
|
$12,471.00
|
|
|
Service Code
|
ICD B218YZZ
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$12,471.00 |
| Rate for Payer: Blue Shield of California Commercial |
$12,471.00
|
| Rate for Payer: Blue Shield of California EPN |
$10,688.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$12,466.05
|
|
|
Service Code
|
APR-DRG 1913
|
| Min. Negotiated Rate |
$12,466.05 |
| Max. Negotiated Rate |
$12,466.05 |
| Rate for Payer: IEHP Medi-Cal |
$12,466.05
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$8,188.99
|
|
|
Service Code
|
APR-DRG 1911
|
| Min. Negotiated Rate |
$8,188.99 |
| Max. Negotiated Rate |
$8,188.99 |
| Rate for Payer: IEHP Medi-Cal |
$8,188.99
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$17,878.28
|
|
|
Service Code
|
APR-DRG 1914
|
| Min. Negotiated Rate |
$17,878.28 |
| Max. Negotiated Rate |
$17,878.28 |
| Rate for Payer: IEHP Medi-Cal |
$17,878.28
|
|
|
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE
|
Facility
IP
|
$9,599.75
|
|
|
Service Code
|
APR-DRG 1912
|
| Min. Negotiated Rate |
$9,599.75 |
| Max. Negotiated Rate |
$9,599.75 |
| Rate for Payer: IEHP Medi-Cal |
$9,599.75
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
IP
|
$15,330.35
|
|
|
Service Code
|
APR-DRG 1923
|
| Min. Negotiated Rate |
$15,330.35 |
| Max. Negotiated Rate |
$15,330.35 |
| Rate for Payer: IEHP Medi-Cal |
$15,330.35
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
IP
|
$23,820.79
|
|
|
Service Code
|
APR-DRG 1924
|
| Min. Negotiated Rate |
$23,820.79 |
| Max. Negotiated Rate |
$23,820.79 |
| Rate for Payer: IEHP Medi-Cal |
$23,820.79
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
IP
|
$10,930.92
|
|
|
Service Code
|
APR-DRG 1922
|
| Min. Negotiated Rate |
$10,930.92 |
| Max. Negotiated Rate |
$10,930.92 |
| Rate for Payer: IEHP Medi-Cal |
$10,930.92
|
|
|
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS
|
Facility
IP
|
$8,784.94
|
|
|
Service Code
|
APR-DRG 1921
|
| Min. Negotiated Rate |
$8,784.94 |
| Max. Negotiated Rate |
$8,784.94 |
| Rate for Payer: IEHP Medi-Cal |
$8,784.94
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
IP
|
$20,417.26
|
|
|
Service Code
|
APR-DRG 1773
|
| Min. Negotiated Rate |
$20,417.26 |
| Max. Negotiated Rate |
$20,417.26 |
| Rate for Payer: IEHP Medi-Cal |
$20,417.26
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
IP
|
$10,526.00
|
|
|
Service Code
|
APR-DRG 1771
|
| Min. Negotiated Rate |
$10,526.00 |
| Max. Negotiated Rate |
$10,526.00 |
| Rate for Payer: IEHP Medi-Cal |
$10,526.00
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
IP
|
$15,195.05
|
|
|
Service Code
|
APR-DRG 1772
|
| Min. Negotiated Rate |
$15,195.05 |
| Max. Negotiated Rate |
$15,195.05 |
| Rate for Payer: IEHP Medi-Cal |
$15,195.05
|
|
|
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
|
Facility
IP
|
$28,170.48
|
|
|
Service Code
|
APR-DRG 1774
|
| Min. Negotiated Rate |
$28,170.48 |
| Max. Negotiated Rate |
$28,170.48 |
| Rate for Payer: IEHP Medi-Cal |
$28,170.48
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
IP
|
$8,162.12
|
|
|
Service Code
|
APR-DRG 2003
|
| Min. Negotiated Rate |
$8,162.12 |
| Max. Negotiated Rate |
$8,162.12 |
| Rate for Payer: IEHP Medi-Cal |
$8,162.12
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
IP
|
$3,811.45
|
|
|
Service Code
|
APR-DRG 2001
|
| Min. Negotiated Rate |
$3,811.45 |
| Max. Negotiated Rate |
$3,811.45 |
| Rate for Payer: IEHP Medi-Cal |
$3,811.45
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
IP
|
$12,666.02
|
|
|
Service Code
|
APR-DRG 2004
|
| Min. Negotiated Rate |
$12,666.02 |
| Max. Negotiated Rate |
$12,666.02 |
| Rate for Payer: IEHP Medi-Cal |
$12,666.02
|
|
|
CARDIAC STRUCTURAL AND VALVULAR DISORDERS
|
Facility
IP
|
$5,644.05
|
|
|
Service Code
|
APR-DRG 2002
|
| Min. Negotiated Rate |
$5,644.05 |
| Max. Negotiated Rate |
$5,644.05 |
| Rate for Payer: IEHP Medi-Cal |
$5,644.05
|
|
|
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$38,847.71
|
|
|
Service Code
|
APR-DRG 1621
|
| Min. Negotiated Rate |
$38,847.71 |
| Max. Negotiated Rate |
$38,847.71 |
| Rate for Payer: IEHP Medi-Cal |
$38,847.71
|
|
|
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$83,863.76
|
|
|
Service Code
|
APR-DRG 1624
|
| Min. Negotiated Rate |
$83,863.76 |
| Max. Negotiated Rate |
$83,863.76 |
| Rate for Payer: IEHP Medi-Cal |
$83,863.76
|
|
|
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$57,440.32
|
|
|
Service Code
|
APR-DRG 1623
|
| Min. Negotiated Rate |
$57,440.32 |
| Max. Negotiated Rate |
$57,440.32 |
| Rate for Payer: IEHP Medi-Cal |
$57,440.32
|
|
|
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$45,523.46
|
|
|
Service Code
|
APR-DRG 1622
|
| Min. Negotiated Rate |
$45,523.46 |
| Max. Negotiated Rate |
$45,523.46 |
| Rate for Payer: IEHP Medi-Cal |
$45,523.46
|
|
