Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
Service Code
|
ICD 0RG037J
|
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 00BX3ZZ
|
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 00SW0ZZ
|
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 0RG84AJ
|
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 0SG0070
|
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 0RG4470
|
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 00HV42Z
|
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 0RG70J0
|
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 0QS14ZZ
|
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 0SG644Z
|
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 0QS004Z
|
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 0RG80J1
|
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 0RG10K0
|
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 0RG74JJ
|
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 0SG0370
|
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 0RGA4K0
|
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 0SG33K1
|
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 0RG00K0
|
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 0RG60AJ
|
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 009W00Z
|
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 0RGA3JJ
|
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 009W3ZZ
|
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 0QSS34Z
|
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 00WU42Z
|
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 0RGA4J1
|
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
|
|