|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D1687L
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DQ67ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D1607B
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D168JA
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D168J9
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D164ZB
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D164ZA
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,586.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D160ZB
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DT70ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D160ZL
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D160KL
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DB63ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D168JB
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D160J9
|
| Min. Negotiated Rate |
$11,586.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,586.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DT77ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DQ68ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DQ64ZZ
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D164JL
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D1647L
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D160K9
|
| Min. Negotiated Rate |
$11,586.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,586.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0DB67ZZ
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D164JA
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,586.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D168ZL
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D16879
|
| Min. Negotiated Rate |
$17,388.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
|
|
Bariatric Surgery
|
Facility
IP
|
$17,388.00
|
|
|
Service Code
|
ICD 0D164J9
|
| Min. Negotiated Rate |
$10,600.00 |
| Max. Negotiated Rate |
$17,388.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$17,388.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,600.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,586.00
|
|
