Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 05US37Z
|
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 04B80ZZ
|
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 041E4JG
|
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 05R50JZ
|
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 041J0ZF
|
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 041C4Z7
|
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 02S10ZZ
|
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 06U807Z
|
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 04S73ZZ
|
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 02110ZF
|
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 021K4KR
|
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 02104J3
|
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 04SB0ZZ
|
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 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
|
|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
Service Code
|
ICD 041C4K4
|
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 02N23ZZ
|
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 0WPD30Z
|
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 041D0K6
|
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 02RH4KZ
|
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 02BP3ZZ
|
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 02UF08J
|
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 041H4JC
|
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 02WH3KZ
|
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 041H0JG
|
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
|
|