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Charge Type Setting Price  
Service Code ICD 041D0K8
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
Service Code ICD 021V0KR
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
Service Code ICD 02US38Z
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
Service Code ICD 03B13ZZ
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
Service Code ICD 04BD4ZZ
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
Service Code ICD 05SF3ZZ
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
Service Code ICD 04B63ZZ
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
Service Code ICD 04104J4
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
Service Code ICD 02UK47Z
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
Service Code ICD 06S50ZZ
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
Service Code ICD 021L08Q
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
Service Code ICD 04UA37Z
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
Service Code ICD 02UQ08Z
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
Service Code ICD 02UK0JZ
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
Service Code ICD 0JH638Z
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
Service Code ICD 04RE07Z
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
Service Code ICD 041D498
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
Service Code ICD 04S13ZZ
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
Service Code ICD 041009K
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
Service Code ICD 041C4JJ
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
Service Code ICD 02100JW
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
Service Code ICD 04100J7
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
Service Code ICD 021L4AP
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
Service Code ICD 05154KY
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
Service Code ICD 02WA07Z
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