|
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 0RG13K0
|
| 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 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 0SG534Z
|
| 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 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
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RGA3J0
|
| 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 00WV33Z
|
| 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 00PU42Z
|
| 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 015R0ZZ
|
| 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 0SB33ZZ
|
| 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 0SG1370
|
| 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 00PU43Z
|
| 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 0PS44ZZ
|
| 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 009X40Z
|
| 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 015R4ZZ
|
| 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 0RG70JJ
|
| 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 0RG23J1
|
| 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 00DT4ZZ
|
| 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 009X3ZZ
|
| 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 00WU33Z
|
| 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 0SG3370
|
| 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 009T0ZZ
|
| 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 00UT47Z
|
| 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 00SY0ZZ
|
| 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 0RG60JJ
|
| 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
|
|
