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Charge Type Price  
Service Code ICD 02QJ3ZG
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 05B63ZZ
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 02UH38Z
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 06S04ZZ
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 02WF08Z
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 021V49Q
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 0210099
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 027307Z
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
Service Code ICD 02RW0JZ
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 03R00JZ
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 04100JH
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 04100JB
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 02UF4JJ
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 02W50JZ
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 041D09K
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 041D0A0
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 03S03ZZ
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 03S23ZZ
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 05500ZZ
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 03C23ZZ
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 02H743Z
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 041C4J7
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 02160AR
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 05R147Z
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 02RF37Z
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