Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047T06Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047T07Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037446Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037606Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047W07Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047W341
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$19,726.00
|
|
Service Code
|
ICD 0272446
|
Min. Negotiated Rate |
$4,519.00 |
Max. Negotiated Rate |
$19,726.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
Rate for Payer: Blue Shield of California Commercial |
$19,726.00
|
Rate for Payer: Blue Shield of California EPN |
$16,911.00
|
Rate for Payer: Heritage Provider Network Commercial |
$4,968.00
|
Rate for Payer: Heritage Provider Network Senior |
$4,519.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047904Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD X27K3C5
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037607Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037634Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037635Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037737Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037744Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037906Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047C441
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037907Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037934Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037945Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 037946Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047C05Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047D04Z
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$19,726.00
|
|
Service Code
|
ICD 0270346
|
Min. Negotiated Rate |
$4,519.00 |
Max. Negotiated Rate |
$19,726.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
Rate for Payer: Blue Shield of California Commercial |
$19,726.00
|
Rate for Payer: Blue Shield of California EPN |
$16,911.00
|
Rate for Payer: Heritage Provider Network Commercial |
$4,968.00
|
Rate for Payer: Heritage Provider Network Senior |
$4,519.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$19,726.00
|
|
Service Code
|
ICD 027034Z
|
Min. Negotiated Rate |
$4,519.00 |
Max. Negotiated Rate |
$19,726.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
Rate for Payer: Blue Shield of California Commercial |
$19,726.00
|
Rate for Payer: Blue Shield of California EPN |
$16,911.00
|
Rate for Payer: Heritage Provider Network Commercial |
$4,968.00
|
Rate for Payer: Heritage Provider Network Senior |
$4,519.00
|
|
Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 0270356
|
Min. Negotiated Rate |
$7,906.00 |
Max. Negotiated Rate |
$7,906.00 |
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,906.00
|
|