|
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: Blue Cross Blue Shield of Arizona Health Choice |
$6,029.94
|
| Rate for Payer: Mercy Care Medicaid |
$6,029.94
|
| Rate for Payer: NaphCare Correctional Healthcare |
$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: Blue Cross Blue Shield of Arizona Health Choice |
$3,991.67
|
| Rate for Payer: Mercy Care Medicaid |
$3,991.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$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: Blue Cross Blue Shield of Arizona Health Choice |
$3,010.41
|
| Rate for Payer: Mercy Care Medicaid |
$3,010.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,010.41
|
|
|
CELLULITIS WITH MCC
|
Facility
|
IP
|
$18,369.09
|
|
|
Service Code
|
MSDRG 602
|
| Min. Negotiated Rate |
$18,369.09 |
| Max. Negotiated Rate |
$18,369.09 |
| Rate for Payer: Seven Corners Travel Insurance |
$18,369.09
|
|
|
CELLULITIS WITHOUT MCC
|
Facility
|
IP
|
$11,390.76
|
|
|
Service Code
|
MSDRG 603
|
| Min. Negotiated Rate |
$11,390.76 |
| Max. Negotiated Rate |
$11,390.76 |
| Rate for Payer: Seven Corners Travel Insurance |
$11,390.76
|
|
|
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 |
$0.84 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Aetna of AZ Commercial |
$0.84
|
| Rate for Payer: Cash Price |
$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 |
$0.15 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Aetna of AZ Commercial |
$0.84
|
| Rate for Payer: Arizona Complete Health Allwell |
$0.15
|
| Rate for Payer: Banner UC Health Medicare |
$0.15
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$0.63
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$0.15
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$0.15
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of AZ Commercial |
$0.60
|
| Rate for Payer: Devoted Health Medicare |
$0.17
|
| Rate for Payer: Humana of AZ Medicare |
$0.15
|
| Rate for Payer: Southwest Service Administrators UFCW |
$0.63
|
| Rate for Payer: TriWest Medicare |
$0.15
|
| Rate for Payer: United Healthcare Commercial |
$0.53
|
| Rate for Payer: United Healthcare Medicare |
$0.15
|
| Rate for Payer: Veterans Affairs TRICARE |
$0.15
|
|
|
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 |
$0.05 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna of AZ Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$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: Arizona Complete Health Allwell |
$0.01
|
| Rate for Payer: Banner UC Health Medicare |
$0.01
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$0.03
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$0.01
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$0.01
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cigna of AZ Commercial |
$0.03
|
| Rate for Payer: Devoted Health Medicare |
$0.01
|
| Rate for Payer: Humana of AZ Medicare |
$0.01
|
| Rate for Payer: Southwest Service Administrators UFCW |
$0.03
|
| Rate for Payer: TriWest Medicare |
$0.01
|
| Rate for Payer: United Healthcare Commercial |
$0.03
|
| Rate for Payer: United Healthcare Medicare |
$0.01
|
| Rate for Payer: Veterans Affairs TRICARE |
$0.01
|
|
|
cephalexin 500 mg Cap [CQCH]
|
Facility
|
IP
|
$0.29
|
|
|
Service Code
|
NDC 50268015215
|
| Hospital Charge Code |
105915922
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.26 |
| Rate for Payer: Aetna of AZ Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$0.23
|
|
|
cephalexin 500 mg Cap [CQCH]
|
Facility
|
OP
|
$0.29
|
|
|
Service Code
|
NDC 50268015215
|
| Hospital Charge Code |
105915922
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.26 |
| Rate for Payer: Aetna of AZ Commercial |
$0.26
|
| Rate for Payer: Arizona Complete Health Allwell |
$0.05
|
| Rate for Payer: Banner UC Health Medicare |
$0.05
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$0.05
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$0.05
|
| Rate for Payer: Cash Price |
$0.23
|
| Rate for Payer: Cigna of AZ Commercial |
$0.19
|
| Rate for Payer: Devoted Health Medicare |
$0.05
|
| Rate for Payer: Humana of AZ Medicare |
$0.05
|
| Rate for Payer: Southwest Service Administrators UFCW |
$0.20
|
| Rate for Payer: TriWest Medicare |
$0.05
|
| Rate for Payer: United Healthcare Commercial |
$0.17
|
| Rate for Payer: United Healthcare Medicare |
$0.05
|
| Rate for Payer: Veterans Affairs TRICARE |
$0.05
|
|
|
Ceruloplasmin LC
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
1906804
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of AZ Commercial |
$162.90
|
| Rate for Payer: Arizona Complete Health Allwell |
$28.96
|
| Rate for Payer: Banner UC Health Medicare |
$28.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$123.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$28.96
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$28.96
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cigna of AZ Commercial |
$117.65
|
| Rate for Payer: Devoted Health Medicare |
$32.58
|
| Rate for Payer: Humana of AZ Medicare |
$28.96
|
| Rate for Payer: Seven Corners Travel Insurance |
$15.57
|
| Rate for Payer: Southwest Service Administrators UFCW |
$123.08
|
| Rate for Payer: TriWest Medicare |
$28.96
|
| Rate for Payer: United Healthcare Commercial |
$103.53
|
| Rate for Payer: United Healthcare Medicare |
$28.96
|
| Rate for Payer: Veterans Affairs TRICARE |
$28.67
|
|
|
Ceruloplasmin LC
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
1906804
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$162.90 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of AZ Commercial |
$162.90
|
| Rate for Payer: Cash Price |
$144.80
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$13,705.36
|
|
|
Service Code
|
APR-DRG 3212
|
| Hospital Charge Code |
APRDRG3212
|
| Min. Negotiated Rate |
$13,705.36 |
| Max. Negotiated Rate |
$13,705.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,705.36
|
| Rate for Payer: Mercy Care Medicaid |
$13,705.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,705.36
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$13,705.36
|
|
|
Service Code
|
APR-DRG 3212
|
| Hospital Charge Code |
APRDRG3213
|
| Min. Negotiated Rate |
$13,705.36 |
| Max. Negotiated Rate |
$13,705.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,705.36
|
| Rate for Payer: Mercy Care Medicaid |
$13,705.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,705.36
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$21,234.18
|
|
|
Service Code
|
APR-DRG 3213
|
| Hospital Charge Code |
APRDRG3213
|
| Min. Negotiated Rate |
$21,234.18 |
| Max. Negotiated Rate |
$21,234.18 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,234.18
|
| Rate for Payer: Mercy Care Medicaid |
$21,234.18
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,234.18
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$21,234.18
|
|
|
Service Code
|
APR-DRG 3213
|
| Hospital Charge Code |
APRDRG3212
|
| Min. Negotiated Rate |
$21,234.18 |
| Max. Negotiated Rate |
$21,234.18 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,234.18
|
| Rate for Payer: Mercy Care Medicaid |
$21,234.18
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,234.18
|
|
|
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: Blue Cross Blue Shield of Arizona Health Choice |
$35,817.69
|
| Rate for Payer: Mercy Care Medicaid |
$35,817.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$35,817.69
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$10,860.48
|
|
|
Service Code
|
APR-DRG 3211
|
| Hospital Charge Code |
APRDRG3213
|
| Min. Negotiated Rate |
$10,860.48 |
| Max. Negotiated Rate |
$10,860.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,860.48
|
| Rate for Payer: Mercy Care Medicaid |
$10,860.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,860.48
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$21,234.18
|
|
|
Service Code
|
APR-DRG 3213
|
| Hospital Charge Code |
APRDRG3214
|
| Min. Negotiated Rate |
$21,234.18 |
| Max. Negotiated Rate |
$21,234.18 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,234.18
|
| Rate for Payer: Mercy Care Medicaid |
$21,234.18
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,234.18
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$21,234.18
|
|
|
Service Code
|
APR-DRG 3213
|
| Hospital Charge Code |
APRDRG3211
|
| Min. Negotiated Rate |
$21,234.18 |
| Max. Negotiated Rate |
$21,234.18 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,234.18
|
| Rate for Payer: Mercy Care Medicaid |
$21,234.18
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,234.18
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$10,860.48
|
|
|
Service Code
|
APR-DRG 3211
|
| Hospital Charge Code |
APRDRG3212
|
| Min. Negotiated Rate |
$10,860.48 |
| Max. Negotiated Rate |
$10,860.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,860.48
|
| Rate for Payer: Mercy Care Medicaid |
$10,860.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,860.48
|
|
|
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 |
APRDRG3214
|
| Min. Negotiated Rate |
$35,817.69 |
| Max. Negotiated Rate |
$35,817.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$35,817.69
|
| Rate for Payer: Mercy Care Medicaid |
$35,817.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$35,817.69
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$10,860.48
|
|
|
Service Code
|
APR-DRG 3211
|
| Hospital Charge Code |
APRDRG3214
|
| Min. Negotiated Rate |
$10,860.48 |
| Max. Negotiated Rate |
$10,860.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,860.48
|
| Rate for Payer: Mercy Care Medicaid |
$10,860.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,860.48
|
|
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression
|
Facility
|
IP
|
$13,705.36
|
|
|
Service Code
|
APR-DRG 3212
|
| Hospital Charge Code |
APRDRG3211
|
| Min. Negotiated Rate |
$13,705.36 |
| Max. Negotiated Rate |
$13,705.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,705.36
|
| Rate for Payer: Mercy Care Medicaid |
$13,705.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,705.36
|
|
