Non Drug-Eluting Stents (IP) - #2073
|
Facility
IP
|
$3,588.00
|
|
Service Code
|
ICD 037T3EZ
|
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 05703DZ
|
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 04794FZ
|
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 067H0DZ
|
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 03714FZ
|
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 047T4DZ
|
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 04773EZ
|
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 037M3DZ
|
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 03730D6
|
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 05764D1
|
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 04703DZ
|
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 047P0DZ
|
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 037V3D6
|
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 047Q4GZ
|
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 047L3D6
|
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 047N4GZ
|
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 037T0D6
|
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 057B3D1
|
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 047E3FZ
|
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 037Q3DZ
|
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 047P0FZ
|
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 04703D1
|
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 04703FZ
|
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
|
|