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Charge Type Setting Price  
Service Code ICD 02UG4KE
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 04UU47Z
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 02QC0ZZ
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 05R54JZ
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 02HT4DZ
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 041H49G
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 02U508Z
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 02104JC
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 06583ZZ
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 041049D
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 041C4Z4
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 04SL4ZZ
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 041C4K6
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 041C09J
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 021L49R
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 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
Service Code ICD 041C0K0
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 02N13ZZ
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 04RJ4JZ
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 041D0JJ
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 041D4AD
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 0WPD0YZ
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 03U147Z
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 03S30ZZ
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 041D094
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