|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWA0JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$7,368.00
|
|
|
Service Code
|
ICD 0SPB08Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$7,368.00 |
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$7,368.00
|
|
|
Service Code
|
ICD 0SP908Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$7,368.00 |
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWA4JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWE0JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWE3JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SUE09Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWE4JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWR0JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SREOJA
|
| Min. Negotiated Rate |
$10,175.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SUB09Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$7,368.00
|
|
|
Service Code
|
ICD 0SPB0BZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$7,368.00 |
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SUS09Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWS0JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWS4JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SUA09Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SU909Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWA3JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWR3JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWR4JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SUR09Z
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
Hip Implant - #2069
|
Facility
IP
|
$10,175.00
|
|
|
Service Code
|
ICD 0SWS3JZ
|
| Min. Negotiated Rate |
$7,368.00 |
| Max. Negotiated Rate |
$10,175.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,175.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,368.00
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
IP
|
$13,879.79
|
|
|
Service Code
|
APR-DRG 8924
|
| Min. Negotiated Rate |
$13,879.79 |
| Max. Negotiated Rate |
$13,879.79 |
| Rate for Payer: IEHP Medi-Cal |
$13,879.79
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
IP
|
$6,062.89
|
|
|
Service Code
|
APR-DRG 8921
|
| Min. Negotiated Rate |
$6,062.89 |
| Max. Negotiated Rate |
$6,062.89 |
| Rate for Payer: IEHP Medi-Cal |
$6,062.89
|
|
|
HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
IP
|
$8,923.22
|
|
|
Service Code
|
APR-DRG 8923
|
| Min. Negotiated Rate |
$8,923.22 |
| Max. Negotiated Rate |
$8,923.22 |
| Rate for Payer: IEHP Medi-Cal |
$8,923.22
|
|
