|
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: IEHP Medi-Cal |
$40,072.42
|
|
|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$33,743.89
|
|
|
Service Code
|
APR-DRG 1662
|
| Min. Negotiated Rate |
$33,743.89 |
| Max. Negotiated Rate |
$33,743.89 |
| Rate for Payer: IEHP Medi-Cal |
$33,743.89
|
|
|
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS
|
Facility
IP
|
$58,826.21
|
|
|
Service Code
|
APR-DRG 1664
|
| Min. Negotiated Rate |
$58,826.21 |
| Max. Negotiated Rate |
$58,826.21 |
| Rate for Payer: IEHP Medi-Cal |
$58,826.21
|
|
|
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: IEHP Medi-Cal |
$30,304.53
|
|
|
Coronary Surgery
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 041E0AC
|
| 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
|
$3,588.00
|
|
|
Service Code
|
ICD 02720EZ
|
| Min. Negotiated Rate |
$3,588.00 |
| Max. Negotiated Rate |
$3,588.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,588.00
|
|
|
Coronary Surgery
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 02WF0JZ
|
| 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 041C4AD
|
| 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 06UM47Z
|
| 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 041C092
|
| 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 041D4A3
|
| 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 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 03UT07Z
|
| 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 04U707Z
|
| 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 041E09B
|
| 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 0211344
|
| 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 03R047Z
|
| 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 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 02170AR
|
| 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 021K0JP
|
| 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 02UN3KZ
|
| 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 021K0AQ
|
| 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 041D4JG
|
| 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 0273076
|
| 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 04104J8
|
| 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
|
|
