Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 021W4AB
|
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 021W0JD
|
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 04U237Z
|
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 06R80JZ
|
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 041J49H
|
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 02R94KZ
|
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 02HK0DZ
|
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 041C0ZC
|
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 02R50JZ
|
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 04S74ZZ
|
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 02WG4KZ
|
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
|
$9,881.00
|
|
Service Code
|
ICD 02U248Z
|
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 041J0JP
|
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 02WA32Z
|
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 02CK3ZZ
|
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 021K0JR
|
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
|
$7,906.00
|
|
Service Code
|
ICD 027106Z
|
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 065G4ZZ
|
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 041D492
|
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 03533ZZ
|
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 06R547Z
|
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 02N94ZZ
|
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 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
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 04100K5
|
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 041J49D
|
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
|
|