|
Cardiovascular Surgery - #2075
|
Facility
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 06104KP
|
| 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 02L70ZK
|
| 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 03CJ3ZZ
|
| 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 03CQ3ZZ
|
| 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 03CR3ZZ
|
| 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 04CY3ZZ
|
| 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 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 021V4JU
|
| 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 06104ZP
|
| 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 021W4AA
|
| 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 021X0JQ
|
| 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 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 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
|
$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 02HX00Z
|
| 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 02LH4DZ
|
| 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 061009Q
|
| 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 4A033BF
|
| 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 02HL00Z
|
| 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 0JWT3PZ
|
| 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 02H03YZ
|
| 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 0JPT0FZ
|
| 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 4A02XFZ
|
| 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
|
|
