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Charge Type Price  
Service Code ICD 00CT0ZZ
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 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 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
Service Code ICD 0RG707J
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 0SG13JJ
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 009T00Z
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 009X30Z
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 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
Service Code ICD 00BW4ZZ
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 00BY3ZZ
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 00CX3ZZ
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 00FU4ZZ
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 00FUXZZ
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 00HU02Z
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 00HU0MZ
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
Service Code ICD 00HU32Z
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 00HU3MZ
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
Service Code ICD 00HU42Z
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 00PU3JZ
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 00PU3MZ
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 00PU40Z
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 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
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
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 00SW3ZZ
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