|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 009Y40Z
|
| 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 0RG00AJ
|
| 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 0QS034Z
|
| 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 0RG24J0
|
| 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 0RG60J0
|
| 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 0RG10A0
|
| 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 0RGA0KJ
|
| 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 0RG63KJ
|
| 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 0RG0070
|
| 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 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 0SB73ZZ
|
| 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 0RG7470
|
| 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
|
$27,133.00
|
|
|
Service Code
|
ICD 00PV0MZ
|
| Min. Negotiated Rate |
$17,082.00 |
| Max. Negotiated Rate |
$27,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,133.00
|
| 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 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
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
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
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RG73J0
|
| 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 0RG60J1
|
| 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 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
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 00CW4ZZ
|
| 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 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
|
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
|
Service Code
|
ICD 0RB93ZZ
|
| 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 00UT37Z
|
| 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 0RB90ZZ
|
| 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 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
|
|
