|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$40,072.42
|
|
|
Service Code
|
APR-DRG 1663
|
| Min. Negotiated Rate |
$40,072.42 |
| Max. Negotiated Rate |
$40,072.42 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40,072.42
|
|
|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$30,304.53
|
|
|
Service Code
|
APR-DRG 1661
|
| Min. Negotiated Rate |
$30,304.53 |
| Max. Negotiated Rate |
$30,304.53 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30,304.53
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 051407Y
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02U338Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 04B30ZZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 0JH838Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 03SP4ZZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041D0ZH
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 02170JP
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041C0J9
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 02UV4KZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 021L0Z9
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041C0JR
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$7,906.00
|
|
|
Service Code
|
ICD 027107Z
|
| Min. Negotiated Rate |
$7,906.00 |
| Max. Negotiated Rate |
$7,906.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 04UV07Z
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02U108Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02CR3ZZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 06R647Z
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041H49G
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041C0JB
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 06R14JZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 02U53JZ
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$9,881.00
|
|
|
Service Code
|
ICD 02U148Z
|
| Min. Negotiated Rate |
$9,881.00 |
| Max. Negotiated Rate |
$9,881.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,881.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 06ST4ZZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 05S80ZZ
|
| Min. Negotiated Rate |
$57,931.00 |
| Max. Negotiated Rate |
$67,589.00 |
| Rate for Payer: Blue Shield of California Commercial |
$67,589.00
|
| Rate for Payer: Blue Shield of California EPN |
$57,931.00
|
|
