Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 02RK4KZ
|
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 02WJ07Z
|
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 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
|
|
Coronary Surgery
|
Facility
|
IP
|
$9,881.00
|
|
Service Code
|
ICD 021308W
|
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 041J09C
|
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 06590ZZ
|
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 06R007Z
|
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 04100AG
|
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 05SS3ZZ
|
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 03U837Z
|
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
|
$9,881.00
|
|
Service Code
|
ICD 02UJ0JG
|
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 02160AP
|
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 06R107Z
|
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 041D0JH
|
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 02WF07Z
|
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 045C4ZZ
|
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 02CW4ZZ
|
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 02UV47Z
|
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 05104ZY
|
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 041E4AQ
|
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 02RM4KZ
|
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 04B03ZZ
|
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 06UB07Z
|
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 04UV07Z
|
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 06R70JZ
|
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
|
|