Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
Service Code
|
ICD 00PU02Z
|
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 0RG13K1
|
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 0RG13KJ
|
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 0RG40KJ
|
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 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
|
|
Spine Surgery
|
Facility
IP
|
$19,930.00
|
|
Service Code
|
ICD 0RG44A0
|
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 00CW0ZZ
|
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 0RG1470
|
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 0RG70A0
|
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 0RG04J1
|
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 0RG03A0
|
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 0RG70AJ
|
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 0RG43K1
|
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 0RG447J
|
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 0SB03ZZ
|
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 0RGA070
|
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 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 0RGA3JJ
|
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 0RGA3K1
|
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 0RG1471
|
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 0RGA3KJ
|
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 0SG137J
|
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 0SG13A0
|
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
|
|