Drug-Eluting Stents (IP) - #2071
|
Facility
IP
|
$7,906.00
|
|
Service Code
|
ICD 047V341
|
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 047F05Z
|
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 0270446
|
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 027044Z
|
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 0270456
|
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 027045Z
|
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 047W37Z
|
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 047W441
|
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 047F04Z
|
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 047E44Z
|
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 X27L385
|
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 0270466
|
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 027046Z
|
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 X27L395
|
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 0270476
|
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 047E441
|
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 047E37Z
|
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 X27L3B5
|
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 027047Z
|
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 047E36Z
|
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 047D041
|
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 027244Z
|
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 047F06Z
|
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 0272456
|
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 X27L3C5
|
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
|
|