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Charge Type Price  
Service Code ICD 041D0A4
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 02WA07Z
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 02104KC
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 02U93JZ
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 02160KQ
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 02RW0KZ
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 06BB4ZZ
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 02H433Z
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 05154KY
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 02UP47Z
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 041D0A9
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 02BD4ZZ
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 04BC0ZZ
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 02B44ZZ
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 041H09H
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 04140Z4
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 027L34Z
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 02100J9
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 041E4AD
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 06RC4JZ
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 06S23ZZ
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 041E4KP
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 02U008Z
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 041D0K8
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 04U337Z
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