|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RG83KJ
|
| 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 0QS00ZZ
|
| 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 0RG10KJ
|
| 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 0SG14K0
|
| 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 00QX4ZZ
|
| 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 00BY4ZZ
|
| 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 0RG44K1
|
| 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 01510ZZ
|
| 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 00WV40Z
|
| 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 0SB44ZZ
|
| 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 0RG20J1
|
| 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 0RGA4J0
|
| 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 0RG84K0
|
| 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 00SY4ZZ
|
| 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 0RG707J
|
| 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 00PU02Z
|
| 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 00SX3ZZ
|
| 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 0RGA0JJ
|
| 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 00WV4MZ
|
| 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 0RG04K0
|
| 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 0RG007J
|
| 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 00WV30Z
|
| 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 0SG34AJ
|
| 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 0SG30K0
|
| 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 0SG337J
|
| 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
|
|
