|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRGD0F3
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRGD092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG8092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG40F3
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG2092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG10F3
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG1092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG20F3
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG00F3
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG4092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
Spinal Fusion Device - #2070
|
Facility
IP
|
$13,963.00
|
|
|
Service Code
|
ICD XRG0092
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$13,963.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
|
|
SPINAL PROCEDURES
|
Facility
IP
|
$52,094.74
|
|
|
Service Code
|
APR-DRG 0234
|
| Min. Negotiated Rate |
$52,094.74 |
| Max. Negotiated Rate |
$52,094.74 |
| Rate for Payer: IEHP Medi-Cal |
$52,094.74
|
|
|
SPINAL PROCEDURES
|
Facility
IP
|
$13,860.89
|
|
|
Service Code
|
APR-DRG 0231
|
| Min. Negotiated Rate |
$13,860.89 |
| Max. Negotiated Rate |
$13,860.89 |
| Rate for Payer: IEHP Medi-Cal |
$13,860.89
|
|
|
SPINAL PROCEDURES
|
Facility
IP
|
$19,002.51
|
|
|
Service Code
|
APR-DRG 0232
|
| Min. Negotiated Rate |
$19,002.51 |
| Max. Negotiated Rate |
$19,002.51 |
| Rate for Payer: IEHP Medi-Cal |
$19,002.51
|
|
|
SPINAL PROCEDURES
|
Facility
IP
|
$32,011.77
|
|
|
Service Code
|
APR-DRG 0233
|
| Min. Negotiated Rate |
$32,011.77 |
| Max. Negotiated Rate |
$32,011.77 |
| Rate for Payer: IEHP Medi-Cal |
$32,011.77
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0SG03K1
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 00JU0ZZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 005T4ZZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 00JV0ZZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 00QW3ZZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RG20A0
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RG247J
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RG43J1
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RGA3A0
|
| Min. Negotiated Rate |
$13,963.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,963.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RTB0ZZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$19,930.00 |
| Rate for Payer: Blue Shield of California Commercial |
$19,930.00
|
| Rate for Payer: Blue Shield of California EPN |
$17,082.00
|
|
