Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 041D497
|
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 05104AY
|
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 041C097
|
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 05UG37Z
|
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 024G0J2
|
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 02RV07Z
|
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 0WHD33Z
|
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 02QD3ZZ
|
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 05R447Z
|
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 03534ZZ
|
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 06590ZZ
|
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 02H702Z
|
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 02RN07Z
|
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 06UG07Z
|
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 0414095
|
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 06SC4ZZ
|
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 05SG0ZZ
|
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 05S43ZZ
|
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 04580ZZ
|
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 05U837Z
|
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 06B54ZZ
|
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 02UH4JZ
|
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 02Q43ZZ
|
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 02160ZP
|
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 02104J9
|
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
|
|