|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 5A1522F
|
| 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 06104AQ
|
| 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 04U03JZ
|
| 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 4A143B3
|
| 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 02H34YZ
|
| 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 02HN0YZ
|
| 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 04CU3ZZ
|
| 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 02VW4EZ
|
| 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 04C63ZZ
|
| 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 02C23ZZ
|
| 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 02H20YZ
|
| 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 021V48R
|
| 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 X2C1361
|
| 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 021X0KQ
|
| 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 B221Z2Z
|
| 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 021X0JR
|
| 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 021X4AP
|
| 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 02HW30Z
|
| 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 04CS3ZZ
|
| 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 06100AQ
|
| 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 02HT30Z
|
| 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 02H00YZ
|
| 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 03CU3ZZ
|
| 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
|
|
