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Charge Type Price  
Service Code ICD 0RG7471
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 00WU32Z
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 0SG13J0
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 0SB83ZZ
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 0RG73KJ
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 00BT0ZZ
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 0RG1371
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 009Y30Z
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 0RG63K1
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 0RG44JJ
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 0SB84ZZ
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 0RG60A0
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 0RG83K1
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 00NT0ZZ
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 0RG70KJ
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 00CX0ZZ
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 00PU0JZ
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 00UT07Z
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 005Y0ZZ
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 0RGA3J1
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 0RG70J1
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 0PS40ZZ
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 00QY0ZZ
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 0RG0370
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 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