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 041F0AQ
|
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 041F09G
|
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 05R507Z
|
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 02114Z3
|
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 02WH0JZ
|
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 06UF07Z
|
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 02RL4KZ
|
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 02U607Z
|
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 065F3ZZ
|
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 041D0KG
|
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 02UR48Z
|
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 02CK0ZZ
|
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 05SL0ZZ
|
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 041H4AC
|
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 03U037Z
|
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 06R20JZ
|
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 04100JQ
|
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 02RF47Z
|
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 041D4Z5
|
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 041F4ZB
|
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 041H4KQ
|
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 02WJ37Z
|
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 06B53ZZ
|
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
|
|