|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02B74ZK
|
| 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 021W4JA
|
| 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 03CK3ZZ
|
| 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 0JH63AZ
|
| 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 06183JY
|
| 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 04V03DZ
|
| 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 04CK3ZZ
|
| 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 02HK3MZ
|
| 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 021X08A
|
| 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 06100ZP
|
| 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 4A133BC
|
| 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 06100JQ
|
| 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 02VX0EZ
|
| 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 02VW0EZ
|
| 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 04CD3ZZ
|
| 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 02PA0RS
|
| 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 04V04EZ
|
| 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 4A030BC
|
| 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 021X0JP
|
| 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 4A033B1
|
| 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 03CQ3Z7
|
| 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 4A030B1
|
| 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 021V0JT
|
| 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 02C33ZZ
|
| 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
|
|
