|
Coronary Surgery
|
Facility
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 03U637Z
|
| 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 021V09P
|
| 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 041F0JQ
|
| 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 02RF3JH
|
| 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 021W4JD
|
| 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 021W4KD
|
| 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 02UW38Z
|
| 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 041H0KG
|
| 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 06UC37Z
|
| 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 021648Q
|
| 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 02PA0DZ
|
| 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 02RR0JZ
|
| 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 051347Y
|
| 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 02RQ4JZ
|
| 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 02R547Z
|
| 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 06UT47Z
|
| 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 021K49P
|
| 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 05UC37Z
|
| 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 02HS0DZ
|
| 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 02RQ48Z
|
| 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 02PA03Z
|
| 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 02Q74ZZ
|
| 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 04R14JZ
|
| 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 02NJ0ZZ
|
| 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
|
|
