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Charge Type Price  
Service Code ICD 041D4Z0
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 03S20ZZ
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 041D0Z4
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 02RP4KZ
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 0WPD03Z
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 04563ZZ
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 02R947Z
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 02US07Z
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 02WA0RS
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 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
Service Code ICD 021K4AP
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 021V4KR
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 02UF08Z
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 02RK47Z
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 04U037Z
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 021L0KP
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 02RJ4KZ
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 06R10JZ
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 041D0AB
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 02U948Z
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 02134KC
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 02134JW
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 02UM3JZ
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 0JH808Z
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 041E4AK
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