|
Connective Tissue Disorders
|
Facility
|
IP
|
$5,984.34
|
|
|
Service Code
|
APR-DRG 3462
|
| Hospital Charge Code |
APRDRG3462
|
| Min. Negotiated Rate |
$5,984.34 |
| Max. Negotiated Rate |
$5,984.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,984.34
|
| Rate for Payer: Mercy Care Medicaid |
$5,984.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,984.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$22,866.34
|
|
|
Service Code
|
APR-DRG 3464
|
| Hospital Charge Code |
APRDRG3462
|
| Min. Negotiated Rate |
$22,866.34 |
| Max. Negotiated Rate |
$22,866.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$22,866.34
|
| Rate for Payer: Mercy Care Medicaid |
$22,866.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$22,866.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$4,388.66
|
|
|
Service Code
|
APR-DRG 3461
|
| Hospital Charge Code |
APRDRG3464
|
| Min. Negotiated Rate |
$4,388.66 |
| Max. Negotiated Rate |
$4,388.66 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,388.66
|
| Rate for Payer: Mercy Care Medicaid |
$4,388.66
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,388.66
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$5,984.34
|
|
|
Service Code
|
APR-DRG 3462
|
| Hospital Charge Code |
APRDRG3464
|
| Min. Negotiated Rate |
$5,984.34 |
| Max. Negotiated Rate |
$5,984.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,984.34
|
| Rate for Payer: Mercy Care Medicaid |
$5,984.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,984.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$22,866.34
|
|
|
Service Code
|
APR-DRG 3464
|
| Hospital Charge Code |
APRDRG3463
|
| Min. Negotiated Rate |
$22,866.34 |
| Max. Negotiated Rate |
$22,866.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$22,866.34
|
| Rate for Payer: Mercy Care Medicaid |
$22,866.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$22,866.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$5,984.34
|
|
|
Service Code
|
APR-DRG 3462
|
| Hospital Charge Code |
APRDRG3463
|
| Min. Negotiated Rate |
$5,984.34 |
| Max. Negotiated Rate |
$5,984.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,984.34
|
| Rate for Payer: Mercy Care Medicaid |
$5,984.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,984.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$5,984.34
|
|
|
Service Code
|
APR-DRG 3462
|
| Hospital Charge Code |
APRDRG3461
|
| Min. Negotiated Rate |
$5,984.34 |
| Max. Negotiated Rate |
$5,984.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,984.34
|
| Rate for Payer: Mercy Care Medicaid |
$5,984.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,984.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$22,866.34
|
|
|
Service Code
|
APR-DRG 3464
|
| Hospital Charge Code |
APRDRG3464
|
| Min. Negotiated Rate |
$22,866.34 |
| Max. Negotiated Rate |
$22,866.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$22,866.34
|
| Rate for Payer: Mercy Care Medicaid |
$22,866.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$22,866.34
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$9,961.98
|
|
|
Service Code
|
APR-DRG 3463
|
| Hospital Charge Code |
APRDRG3464
|
| Min. Negotiated Rate |
$9,961.98 |
| Max. Negotiated Rate |
$9,961.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,961.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,961.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,961.98
|
|
|
Connective Tissue Disorders
|
Facility
|
IP
|
$9,961.98
|
|
|
Service Code
|
APR-DRG 3463
|
| Hospital Charge Code |
APRDRG3461
|
| Min. Negotiated Rate |
$9,961.98 |
| Max. Negotiated Rate |
$9,961.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,961.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,961.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,961.98
|
|
|
CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$14,970.38
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$14,970.38 |
| Max. Negotiated Rate |
$14,970.38 |
| Rate for Payer: Seven Corners Travel Insurance |
$14,970.38
|
|
|
CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$32,073.85
|
|
|
Service Code
|
MSDRG 545
|
| Min. Negotiated Rate |
$32,073.85 |
| Max. Negotiated Rate |
$32,073.85 |
| Rate for Payer: Seven Corners Travel Insurance |
$32,073.85
|
|
|
CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$10,951.05
|
|
|
Service Code
|
MSDRG 547
|
| Min. Negotiated Rate |
$10,951.05 |
| Max. Negotiated Rate |
$10,951.05 |
| Rate for Payer: Seven Corners Travel Insurance |
$10,951.05
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$13,242.43
|
|
|
Service Code
|
APR-DRG 3844
|
| Hospital Charge Code |
APRDRG3842
|
| Min. Negotiated Rate |
$13,242.43 |
| Max. Negotiated Rate |
$13,242.43 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,242.43
|
| Rate for Payer: Mercy Care Medicaid |
$13,242.43
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,242.43
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$4,782.85
|
|
|
Service Code
|
APR-DRG 3842
|
| Hospital Charge Code |
APRDRG3843
|
| Min. Negotiated Rate |
$4,782.85 |
| Max. Negotiated Rate |
$4,782.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,782.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,782.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,782.85
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$13,242.43
|
|
|
Service Code
|
APR-DRG 3844
|
| Hospital Charge Code |
APRDRG3841
|
| Min. Negotiated Rate |
$13,242.43 |
| Max. Negotiated Rate |
$13,242.43 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,242.43
|
| Rate for Payer: Mercy Care Medicaid |
$13,242.43
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,242.43
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$7,002.78
|
|
|
Service Code
|
APR-DRG 3843
|
| Hospital Charge Code |
APRDRG3841
|
| Min. Negotiated Rate |
$7,002.78 |
| Max. Negotiated Rate |
$7,002.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,002.78
|
| Rate for Payer: Mercy Care Medicaid |
$7,002.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,002.78
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
APR-DRG 3841
|
| Hospital Charge Code |
APRDRG3841
|
| Min. Negotiated Rate |
$3,958.00 |
| Max. Negotiated Rate |
$3,958.00 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,958.00
|
| Rate for Payer: Mercy Care Medicaid |
$3,958.00
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,958.00
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$7,002.78
|
|
|
Service Code
|
APR-DRG 3843
|
| Hospital Charge Code |
APRDRG3843
|
| Min. Negotiated Rate |
$7,002.78 |
| Max. Negotiated Rate |
$7,002.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,002.78
|
| Rate for Payer: Mercy Care Medicaid |
$7,002.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,002.78
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$4,782.85
|
|
|
Service Code
|
APR-DRG 3842
|
| Hospital Charge Code |
APRDRG3844
|
| Min. Negotiated Rate |
$4,782.85 |
| Max. Negotiated Rate |
$4,782.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,782.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,782.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,782.85
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$13,242.43
|
|
|
Service Code
|
APR-DRG 3844
|
| Hospital Charge Code |
APRDRG3844
|
| Min. Negotiated Rate |
$13,242.43 |
| Max. Negotiated Rate |
$13,242.43 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,242.43
|
| Rate for Payer: Mercy Care Medicaid |
$13,242.43
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,242.43
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$7,002.78
|
|
|
Service Code
|
APR-DRG 3843
|
| Hospital Charge Code |
APRDRG3844
|
| Min. Negotiated Rate |
$7,002.78 |
| Max. Negotiated Rate |
$7,002.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,002.78
|
| Rate for Payer: Mercy Care Medicaid |
$7,002.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,002.78
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
APR-DRG 3841
|
| Hospital Charge Code |
APRDRG3844
|
| Min. Negotiated Rate |
$3,958.00 |
| Max. Negotiated Rate |
$3,958.00 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,958.00
|
| Rate for Payer: Mercy Care Medicaid |
$3,958.00
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,958.00
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$7,002.78
|
|
|
Service Code
|
APR-DRG 3843
|
| Hospital Charge Code |
APRDRG3842
|
| Min. Negotiated Rate |
$7,002.78 |
| Max. Negotiated Rate |
$7,002.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,002.78
|
| Rate for Payer: Mercy Care Medicaid |
$7,002.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,002.78
|
|
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
Facility
|
IP
|
$13,242.43
|
|
|
Service Code
|
APR-DRG 3844
|
| Hospital Charge Code |
APRDRG3843
|
| Min. Negotiated Rate |
$13,242.43 |
| Max. Negotiated Rate |
$13,242.43 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,242.43
|
| Rate for Payer: Mercy Care Medicaid |
$13,242.43
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,242.43
|
|
