|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02LH3ZZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02HL0YZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02VX4DZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021X4KA
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02WA0YZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02H430Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021V0AT
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02H730Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021V4ZS
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021X48A
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021X09R
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 03CG3Z7
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 03CA3ZZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 3E080GC
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021V08P
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 5A1213Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 06100KR
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 04CV3ZZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02LH3DZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 5A1522G
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$19,726.00
|
|
|
Service Code
|
ICD 02C03ZZ
|
| Min. Negotiated Rate |
$4,519.00 |
| Max. Negotiated Rate |
$19,726.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| 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
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02H43YZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02H74YZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 021V49S
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 06100JP
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
