Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 027035Z
|
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 0270366
|
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 027036Z
|
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 037A44Z
|
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 0270376
|
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 027037Z
|
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 0271346
|
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 027134Z
|
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 0271356
|
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 027135Z
|
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 037A45Z
|
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 027137Z
|
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 0271446
|
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 027144Z
|
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 037A46Z
|
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 037B46Z
|
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 0271456
|
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 027145Z
|
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 0271466
|
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 027146Z
|
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 0272346
|
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 027234Z
|
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 0272356
|
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 027236Z
|
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 0272376
|
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
|
|