Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
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 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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
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 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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$27,133.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$27,133.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|
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 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 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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
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
|
|