Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$6,029.94
|
|
Service Code
|
APR-DRG 3833
|
Hospital Charge Code |
APRDRG3833
|
Min. Negotiated Rate |
$6,029.94 |
Max. Negotiated Rate |
$6,029.94 |
Rate for Payer: AHCCCS Medicaid |
$6,029.94
|
Rate for Payer: Allwell Medicaid |
$6,029.94
|
Rate for Payer: AZCH Complete Medicaid |
$6,029.94
|
Rate for Payer: Banner UC Health Medicaid |
$6,029.94
|
Rate for Payer: Mercy Care Medicaid |
$6,029.94
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$12,128.61
|
|
Service Code
|
APR-DRG 3834
|
Hospital Charge Code |
APRDRG3834
|
Min. Negotiated Rate |
$12,128.61 |
Max. Negotiated Rate |
$12,128.61 |
Rate for Payer: AHCCCS Medicaid |
$12,128.61
|
Rate for Payer: Allwell Medicaid |
$12,128.61
|
Rate for Payer: AZCH Complete Medicaid |
$12,128.61
|
Rate for Payer: Banner UC Health Medicaid |
$12,128.61
|
Rate for Payer: Mercy Care Medicaid |
$12,128.61
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,991.67
|
|
Service Code
|
APR-DRG 3832
|
Hospital Charge Code |
APRDRG3834
|
Min. Negotiated Rate |
$3,991.67 |
Max. Negotiated Rate |
$3,991.67 |
Rate for Payer: AHCCCS Medicaid |
$3,991.67
|
Rate for Payer: Allwell Medicaid |
$3,991.67
|
Rate for Payer: AZCH Complete Medicaid |
$3,991.67
|
Rate for Payer: Banner UC Health Medicaid |
$3,991.67
|
Rate for Payer: Mercy Care Medicaid |
$3,991.67
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,010.41
|
|
Service Code
|
APR-DRG 3831
|
Hospital Charge Code |
APRDRG3833
|
Min. Negotiated Rate |
$3,010.41 |
Max. Negotiated Rate |
$3,010.41 |
Rate for Payer: AHCCCS Medicaid |
$3,010.41
|
Rate for Payer: Allwell Medicaid |
$3,010.41
|
Rate for Payer: AZCH Complete Medicaid |
$3,010.41
|
Rate for Payer: Banner UC Health Medicaid |
$3,010.41
|
Rate for Payer: Mercy Care Medicaid |
$3,010.41
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$6,029.94
|
|
Service Code
|
APR-DRG 3833
|
Hospital Charge Code |
APRDRG3831
|
Min. Negotiated Rate |
$6,029.94 |
Max. Negotiated Rate |
$6,029.94 |
Rate for Payer: AHCCCS Medicaid |
$6,029.94
|
Rate for Payer: Allwell Medicaid |
$6,029.94
|
Rate for Payer: AZCH Complete Medicaid |
$6,029.94
|
Rate for Payer: Banner UC Health Medicaid |
$6,029.94
|
Rate for Payer: Mercy Care Medicaid |
$6,029.94
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$12,128.61
|
|
Service Code
|
APR-DRG 3834
|
Hospital Charge Code |
APRDRG3832
|
Min. Negotiated Rate |
$12,128.61 |
Max. Negotiated Rate |
$12,128.61 |
Rate for Payer: AHCCCS Medicaid |
$12,128.61
|
Rate for Payer: Allwell Medicaid |
$12,128.61
|
Rate for Payer: AZCH Complete Medicaid |
$12,128.61
|
Rate for Payer: Banner UC Health Medicaid |
$12,128.61
|
Rate for Payer: Mercy Care Medicaid |
$12,128.61
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$6,029.94
|
|
Service Code
|
APR-DRG 3833
|
Hospital Charge Code |
APRDRG3834
|
Min. Negotiated Rate |
$6,029.94 |
Max. Negotiated Rate |
$6,029.94 |
Rate for Payer: AHCCCS Medicaid |
$6,029.94
|
Rate for Payer: Allwell Medicaid |
$6,029.94
|
Rate for Payer: AZCH Complete Medicaid |
$6,029.94
|
Rate for Payer: Banner UC Health Medicaid |
$6,029.94
|
Rate for Payer: Mercy Care Medicaid |
$6,029.94
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,991.67
|
|
Service Code
|
APR-DRG 3832
|
Hospital Charge Code |
APRDRG3831
|
Min. Negotiated Rate |
$3,991.67 |
Max. Negotiated Rate |
$3,991.67 |
Rate for Payer: AHCCCS Medicaid |
$3,991.67
|
Rate for Payer: Allwell Medicaid |
$3,991.67
|
Rate for Payer: AZCH Complete Medicaid |
$3,991.67
|
Rate for Payer: Banner UC Health Medicaid |
$3,991.67
|
Rate for Payer: Mercy Care Medicaid |
$3,991.67
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,991.67
|
|
Service Code
|
APR-DRG 3832
|
Hospital Charge Code |
APRDRG3833
|
Min. Negotiated Rate |
$3,991.67 |
Max. Negotiated Rate |
$3,991.67 |
Rate for Payer: AHCCCS Medicaid |
$3,991.67
|
Rate for Payer: Allwell Medicaid |
$3,991.67
|
Rate for Payer: AZCH Complete Medicaid |
$3,991.67
|
Rate for Payer: Banner UC Health Medicaid |
$3,991.67
|
Rate for Payer: Mercy Care Medicaid |
$3,991.67
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,010.41
|
|
Service Code
|
APR-DRG 3831
|
Hospital Charge Code |
APRDRG3834
|
Min. Negotiated Rate |
$3,010.41 |
Max. Negotiated Rate |
$3,010.41 |
Rate for Payer: AHCCCS Medicaid |
$3,010.41
|
Rate for Payer: Allwell Medicaid |
$3,010.41
|
Rate for Payer: AZCH Complete Medicaid |
$3,010.41
|
Rate for Payer: Banner UC Health Medicaid |
$3,010.41
|
Rate for Payer: Mercy Care Medicaid |
$3,010.41
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,010.41
|
|
Service Code
|
APR-DRG 3831
|
Hospital Charge Code |
APRDRG3831
|
Min. Negotiated Rate |
$3,010.41 |
Max. Negotiated Rate |
$3,010.41 |
Rate for Payer: AHCCCS Medicaid |
$3,010.41
|
Rate for Payer: Allwell Medicaid |
$3,010.41
|
Rate for Payer: AZCH Complete Medicaid |
$3,010.41
|
Rate for Payer: Banner UC Health Medicaid |
$3,010.41
|
Rate for Payer: Mercy Care Medicaid |
$3,010.41
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$12,128.61
|
|
Service Code
|
APR-DRG 3834
|
Hospital Charge Code |
APRDRG3831
|
Min. Negotiated Rate |
$12,128.61 |
Max. Negotiated Rate |
$12,128.61 |
Rate for Payer: AHCCCS Medicaid |
$12,128.61
|
Rate for Payer: Allwell Medicaid |
$12,128.61
|
Rate for Payer: AZCH Complete Medicaid |
$12,128.61
|
Rate for Payer: Banner UC Health Medicaid |
$12,128.61
|
Rate for Payer: Mercy Care Medicaid |
$12,128.61
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$3,991.67
|
|
Service Code
|
APR-DRG 3832
|
Hospital Charge Code |
APRDRG3832
|
Min. Negotiated Rate |
$3,991.67 |
Max. Negotiated Rate |
$3,991.67 |
Rate for Payer: AHCCCS Medicaid |
$3,991.67
|
Rate for Payer: Allwell Medicaid |
$3,991.67
|
Rate for Payer: AZCH Complete Medicaid |
$3,991.67
|
Rate for Payer: Banner UC Health Medicaid |
$3,991.67
|
Rate for Payer: Mercy Care Medicaid |
$3,991.67
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$12,128.61
|
|
Service Code
|
APR-DRG 3834
|
Hospital Charge Code |
APRDRG3833
|
Min. Negotiated Rate |
$12,128.61 |
Max. Negotiated Rate |
$12,128.61 |
Rate for Payer: AHCCCS Medicaid |
$12,128.61
|
Rate for Payer: Allwell Medicaid |
$12,128.61
|
Rate for Payer: AZCH Complete Medicaid |
$12,128.61
|
Rate for Payer: Banner UC Health Medicaid |
$12,128.61
|
Rate for Payer: Mercy Care Medicaid |
$12,128.61
|
|
Cellulitis And Other Skin Infections
|
Facility
|
IP
|
$6,029.94
|
|
Service Code
|
APR-DRG 3833
|
Hospital Charge Code |
APRDRG3832
|
Min. Negotiated Rate |
$6,029.94 |
Max. Negotiated Rate |
$6,029.94 |
Rate for Payer: AHCCCS Medicaid |
$6,029.94
|
Rate for Payer: Allwell Medicaid |
$6,029.94
|
Rate for Payer: AZCH Complete Medicaid |
$6,029.94
|
Rate for Payer: Banner UC Health Medicaid |
$6,029.94
|
Rate for Payer: Mercy Care Medicaid |
$6,029.94
|
|
Cepacol oral lozenge-8 pack [CQCH]
|
Facility
|
IP
|
$0.93
|
|
Service Code
|
NDC 63824071316
|
Hospital Charge Code |
105930625
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.24 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: Aetna of AZ Commercial |
$0.84
|
Rate for Payer: Bisbee Police All Plans |
$0.24
|
Rate for Payer: Cash Price |
$0.74
|
Rate for Payer: Self Pay Self Pay |
$0.74
|
|
Cepacol oral lozenge-8 pack [CQCH]
|
Facility
|
OP
|
$0.93
|
|
Service Code
|
NDC 63824071316
|
Hospital Charge Code |
105930625
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.14 |
Max. Negotiated Rate |
$0.84 |
Rate for Payer: Aetna of AZ Commercial |
$0.84
|
Rate for Payer: Aetna of AZ Medicare |
$0.26
|
Rate for Payer: Allwell Medicare |
$0.14
|
Rate for Payer: Amerigroup Medicare |
$0.14
|
Rate for Payer: APIPA Medicare/Medicaid |
$0.35
|
Rate for Payer: AZCH Complete Medicare |
$0.14
|
Rate for Payer: Banner UC Health Medicare |
$0.14
|
Rate for Payer: Bisbee Police All Plans |
$0.24
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.63
|
Rate for Payer: Cash Price |
$0.74
|
Rate for Payer: Cigna of AZ Commercial |
$0.60
|
Rate for Payer: Copperpoint Commercial |
$0.23
|
Rate for Payer: Health Net of AZ Commercial |
$0.56
|
Rate for Payer: Health Net of AZ Medicare |
$0.26
|
Rate for Payer: Humana of AZ Medicare |
$0.14
|
Rate for Payer: Self Pay Self Pay |
$0.74
|
Rate for Payer: TriWest Medicare |
$0.14
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.54
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.17
|
|
cephalexin 250 mg/5 mL Oral Liq (200 mL after reconst) [CQCH]
|
Facility
|
IP
|
$0.05
|
|
Service Code
|
NDC 68180044102
|
Hospital Charge Code |
105915857
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of AZ Commercial |
$0.05
|
Rate for Payer: Bisbee Police All Plans |
$0.01
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Self Pay Self Pay |
$0.04
|
|
cephalexin 250 mg/5 mL Oral Liq (200 mL after reconst) [CQCH]
|
Facility
|
OP
|
$0.05
|
|
Service Code
|
NDC 68180044102
|
Hospital Charge Code |
105915857
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of AZ Commercial |
$0.05
|
Rate for Payer: Aetna of AZ Medicare |
$0.01
|
Rate for Payer: Allwell Medicare |
$0.01
|
Rate for Payer: Amerigroup Medicare |
$0.01
|
Rate for Payer: APIPA Medicare/Medicaid |
$0.02
|
Rate for Payer: AZCH Complete Medicare |
$0.01
|
Rate for Payer: Banner UC Health Medicare |
$0.01
|
Rate for Payer: Bisbee Police All Plans |
$0.01
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.03
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of AZ Commercial |
$0.03
|
Rate for Payer: Copperpoint Commercial |
$0.01
|
Rate for Payer: Health Net of AZ Commercial |
$0.03
|
Rate for Payer: Health Net of AZ Medicare |
$0.01
|
Rate for Payer: Humana of AZ Medicare |
$0.01
|
Rate for Payer: Self Pay Self Pay |
$0.04
|
Rate for Payer: TriWest Medicare |
$0.01
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.03
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.01
|
|
cephalexin 500 mg Cap [CQCH]
|
Facility
|
OP
|
$0.29
|
|
Service Code
|
NDC 50268015215
|
Hospital Charge Code |
105915922
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.04 |
Max. Negotiated Rate |
$0.26 |
Rate for Payer: Aetna of AZ Commercial |
$0.26
|
Rate for Payer: Aetna of AZ Medicare |
$0.08
|
Rate for Payer: Allwell Medicare |
$0.04
|
Rate for Payer: Amerigroup Medicare |
$0.04
|
Rate for Payer: APIPA Medicare/Medicaid |
$0.11
|
Rate for Payer: AZCH Complete Medicare |
$0.04
|
Rate for Payer: Banner UC Health Medicare |
$0.04
|
Rate for Payer: Bisbee Police All Plans |
$0.08
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.20
|
Rate for Payer: Cash Price |
$0.23
|
Rate for Payer: Cigna of AZ Commercial |
$0.19
|
Rate for Payer: Copperpoint Commercial |
$0.07
|
Rate for Payer: Health Net of AZ Commercial |
$0.17
|
Rate for Payer: Health Net of AZ Medicare |
$0.08
|
Rate for Payer: Humana of AZ Medicare |
$0.04
|
Rate for Payer: Self Pay Self Pay |
$0.23
|
Rate for Payer: TriWest Medicare |
$0.04
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.17
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.05
|
|
cephalexin 500 mg Cap [CQCH]
|
Facility
|
IP
|
$0.29
|
|
Service Code
|
NDC 50268015215
|
Hospital Charge Code |
105915922
|
Hospital Revenue Code
|
251
|
Min. Negotiated Rate |
$0.08 |
Max. Negotiated Rate |
$0.26 |
Rate for Payer: Aetna of AZ Commercial |
$0.26
|
Rate for Payer: Bisbee Police All Plans |
$0.08
|
Rate for Payer: Cash Price |
$0.23
|
Rate for Payer: Self Pay Self Pay |
$0.23
|
|
Ceruloplasmin LC
|
Facility
|
OP
|
$190.00
|
|
Service Code
|
CPT 82390
|
Hospital Charge Code |
1906804
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$10.74 |
Max. Negotiated Rate |
$171.00 |
Rate for Payer: Aetna of AZ Commercial |
$171.00
|
Rate for Payer: Aetna of AZ Medicare |
$53.20
|
Rate for Payer: AHCCCS Medicaid |
$10.74
|
Rate for Payer: Allwell Medicaid |
$10.74
|
Rate for Payer: Allwell Medicare |
$28.50
|
Rate for Payer: Amerigroup Medicare |
$28.50
|
Rate for Payer: APIPA Medicare/Medicaid |
$70.96
|
Rate for Payer: AZCH Complete Medicaid |
$10.74
|
Rate for Payer: AZCH Complete Medicare |
$28.50
|
Rate for Payer: Banner UC Health Medicaid |
$10.74
|
Rate for Payer: Banner UC Health Medicare |
$28.50
|
Rate for Payer: Bisbee Police All Plans |
$49.40
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$129.20
|
Rate for Payer: Cash Price |
$152.00
|
Rate for Payer: Cash Price |
$152.00
|
Rate for Payer: Cigna of AZ Commercial |
$123.50
|
Rate for Payer: Copperpoint Commercial |
$47.02
|
Rate for Payer: Health Net of AZ Commercial |
$114.00
|
Rate for Payer: Health Net of AZ Medicare |
$53.20
|
Rate for Payer: Humana of AZ Medicare |
$28.50
|
Rate for Payer: Mercy Care Medicaid |
$10.74
|
Rate for Payer: Self Pay Self Pay |
$152.00
|
Rate for Payer: TriWest Medicare |
$28.50
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$110.77
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$34.20
|
|
Ceruloplasmin LC
|
Facility
|
IP
|
$190.00
|
|
Service Code
|
CPT 82390
|
Hospital Charge Code |
1906804
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$49.40 |
Max. Negotiated Rate |
$171.00 |
Rate for Payer: Aetna of AZ Commercial |
$171.00
|
Rate for Payer: Bisbee Police All Plans |
$49.40
|
Rate for Payer: Cash Price |
$152.00
|
Rate for Payer: Self Pay Self Pay |
$152.00
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$35,817.69
|
|
Service Code
|
APR-DRG 3214
|
Hospital Charge Code |
APRDRG3212
|
Min. Negotiated Rate |
$35,817.69 |
Max. Negotiated Rate |
$35,817.69 |
Rate for Payer: AHCCCS Medicaid |
$35,817.69
|
Rate for Payer: Allwell Medicaid |
$35,817.69
|
Rate for Payer: AZCH Complete Medicaid |
$35,817.69
|
Rate for Payer: Banner UC Health Medicaid |
$35,817.69
|
Rate for Payer: Mercy Care Medicaid |
$35,817.69
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$35,817.69
|
|
Service Code
|
APR-DRG 3214
|
Hospital Charge Code |
APRDRG3211
|
Min. Negotiated Rate |
$35,817.69 |
Max. Negotiated Rate |
$35,817.69 |
Rate for Payer: AHCCCS Medicaid |
$35,817.69
|
Rate for Payer: Allwell Medicaid |
$35,817.69
|
Rate for Payer: AZCH Complete Medicaid |
$35,817.69
|
Rate for Payer: Banner UC Health Medicaid |
$35,817.69
|
Rate for Payer: Mercy Care Medicaid |
$35,817.69
|
|