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Charge Type Price  
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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