|
Coronary Surgery
|
Facility
|
IP
|
$67,589.00
|
|
|
Service Code
|
ICD 03SB4ZZ
|
| 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 02RW4JZ
|
| 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 04100KH
|
| 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 04RE0KZ
|
| 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 041D4J9
|
| 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 02UG0JE
|
| 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 0WHD0YZ
|
| 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 02RL08Z
|
| 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 041D0Z5
|
| 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 02CR3ZZ
|
| 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
|
$9,881.00
|
|
|
Service Code
|
ICD 021709T
|
| 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 02US0KZ
|
| 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 041D4AF
|
| 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 03SS4ZZ
|
| 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 04SP3ZZ
|
| 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 02HL43Z
|
| 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 06R10KZ
|
| 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 04R847Z
|
| 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 041J49B
|
| 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 06SS4ZZ
|
| 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 05SV3ZZ
|
| 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 02RQ4KZ
|
| 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 02U00JZ
|
| 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 02W50JZ
|
| 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 04140J4
|
| 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
|
|
