|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$4,552.79
|
|
|
Service Code
|
APR-DRG 2822
|
| Hospital Charge Code |
APRDRG2822
|
| Min. Negotiated Rate |
$4,552.79 |
| Max. Negotiated Rate |
$4,552.79 |
| Rate for Payer: AHCCCS Medicaid |
$4,552.79
|
| Rate for Payer: Allwell Medicaid |
$4,552.79
|
| Rate for Payer: AZCH Complete Medicaid |
$4,552.79
|
| Rate for Payer: Banner UC Health Medicaid |
$4,552.79
|
| Rate for Payer: Mercy Care Medicaid |
$4,552.79
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$3,455.80
|
|
|
Service Code
|
APR-DRG 2821
|
| Hospital Charge Code |
APRDRG2823
|
| Min. Negotiated Rate |
$3,455.80 |
| Max. Negotiated Rate |
$3,455.80 |
| Rate for Payer: AHCCCS Medicaid |
$3,455.80
|
| Rate for Payer: Allwell Medicaid |
$3,455.80
|
| Rate for Payer: AZCH Complete Medicaid |
$3,455.80
|
| Rate for Payer: Banner UC Health Medicaid |
$3,455.80
|
| Rate for Payer: Mercy Care Medicaid |
$3,455.80
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$3,455.80
|
|
|
Service Code
|
APR-DRG 2821
|
| Hospital Charge Code |
APRDRG2821
|
| Min. Negotiated Rate |
$3,455.80 |
| Max. Negotiated Rate |
$3,455.80 |
| Rate for Payer: AHCCCS Medicaid |
$3,455.80
|
| Rate for Payer: Allwell Medicaid |
$3,455.80
|
| Rate for Payer: AZCH Complete Medicaid |
$3,455.80
|
| Rate for Payer: Banner UC Health Medicaid |
$3,455.80
|
| Rate for Payer: Mercy Care Medicaid |
$3,455.80
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$3,455.80
|
|
|
Service Code
|
APR-DRG 2821
|
| Hospital Charge Code |
APRDRG2822
|
| Min. Negotiated Rate |
$3,455.80 |
| Max. Negotiated Rate |
$3,455.80 |
| Rate for Payer: AHCCCS Medicaid |
$3,455.80
|
| Rate for Payer: Allwell Medicaid |
$3,455.80
|
| Rate for Payer: AZCH Complete Medicaid |
$3,455.80
|
| Rate for Payer: Banner UC Health Medicaid |
$3,455.80
|
| Rate for Payer: Mercy Care Medicaid |
$3,455.80
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$18,963.75
|
|
|
Service Code
|
APR-DRG 2824
|
| Hospital Charge Code |
APRDRG2821
|
| Min. Negotiated Rate |
$18,963.75 |
| Max. Negotiated Rate |
$18,963.75 |
| Rate for Payer: AHCCCS Medicaid |
$18,963.75
|
| Rate for Payer: Allwell Medicaid |
$18,963.75
|
| Rate for Payer: AZCH Complete Medicaid |
$18,963.75
|
| Rate for Payer: Banner UC Health Medicaid |
$18,963.75
|
| Rate for Payer: Mercy Care Medicaid |
$18,963.75
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$3,455.80
|
|
|
Service Code
|
APR-DRG 2821
|
| Hospital Charge Code |
APRDRG2824
|
| Min. Negotiated Rate |
$3,455.80 |
| Max. Negotiated Rate |
$3,455.80 |
| Rate for Payer: AHCCCS Medicaid |
$3,455.80
|
| Rate for Payer: Allwell Medicaid |
$3,455.80
|
| Rate for Payer: AZCH Complete Medicaid |
$3,455.80
|
| Rate for Payer: Banner UC Health Medicaid |
$3,455.80
|
| Rate for Payer: Mercy Care Medicaid |
$3,455.80
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$18,963.75
|
|
|
Service Code
|
APR-DRG 2824
|
| Hospital Charge Code |
APRDRG2823
|
| Min. Negotiated Rate |
$18,963.75 |
| Max. Negotiated Rate |
$18,963.75 |
| Rate for Payer: AHCCCS Medicaid |
$18,963.75
|
| Rate for Payer: Allwell Medicaid |
$18,963.75
|
| Rate for Payer: AZCH Complete Medicaid |
$18,963.75
|
| Rate for Payer: Banner UC Health Medicaid |
$18,963.75
|
| Rate for Payer: Mercy Care Medicaid |
$18,963.75
|
|
|
Disorders Of Pancreas Except Malignancy
|
Facility
|
IP
|
$7,508.49
|
|
|
Service Code
|
APR-DRG 2823
|
| Hospital Charge Code |
APRDRG2823
|
| Min. Negotiated Rate |
$7,508.49 |
| Max. Negotiated Rate |
$7,508.49 |
| Rate for Payer: AHCCCS Medicaid |
$7,508.49
|
| Rate for Payer: Allwell Medicaid |
$7,508.49
|
| Rate for Payer: AZCH Complete Medicaid |
$7,508.49
|
| Rate for Payer: Banner UC Health Medicaid |
$7,508.49
|
| Rate for Payer: Mercy Care Medicaid |
$7,508.49
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7524
|
| Hospital Charge Code |
APRDRG7521
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7524
|
| Hospital Charge Code |
APRDRG7524
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,814.02
|
|
|
Service Code
|
APR-DRG 7522
|
| Hospital Charge Code |
APRDRG7522
|
| Min. Negotiated Rate |
$2,814.02 |
| Max. Negotiated Rate |
$2,814.02 |
| Rate for Payer: AHCCCS Medicaid |
$2,814.02
|
| Rate for Payer: Allwell Medicaid |
$2,814.02
|
| Rate for Payer: AZCH Complete Medicaid |
$2,814.02
|
| Rate for Payer: Banner UC Health Medicaid |
$2,814.02
|
| Rate for Payer: Mercy Care Medicaid |
$2,814.02
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,814.02
|
|
|
Service Code
|
APR-DRG 7522
|
| Hospital Charge Code |
APRDRG7523
|
| Min. Negotiated Rate |
$2,814.02 |
| Max. Negotiated Rate |
$2,814.02 |
| Rate for Payer: AHCCCS Medicaid |
$2,814.02
|
| Rate for Payer: Allwell Medicaid |
$2,814.02
|
| Rate for Payer: AZCH Complete Medicaid |
$2,814.02
|
| Rate for Payer: Banner UC Health Medicaid |
$2,814.02
|
| Rate for Payer: Mercy Care Medicaid |
$2,814.02
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7523
|
| Hospital Charge Code |
APRDRG7524
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7524
|
| Hospital Charge Code |
APRDRG7522
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,814.02
|
|
|
Service Code
|
APR-DRG 7522
|
| Hospital Charge Code |
APRDRG7521
|
| Min. Negotiated Rate |
$2,814.02 |
| Max. Negotiated Rate |
$2,814.02 |
| Rate for Payer: AHCCCS Medicaid |
$2,814.02
|
| Rate for Payer: Allwell Medicaid |
$2,814.02
|
| Rate for Payer: AZCH Complete Medicaid |
$2,814.02
|
| Rate for Payer: Banner UC Health Medicaid |
$2,814.02
|
| Rate for Payer: Mercy Care Medicaid |
$2,814.02
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7524
|
| Hospital Charge Code |
APRDRG7523
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7523
|
| Hospital Charge Code |
APRDRG7523
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7523
|
| Hospital Charge Code |
APRDRG7521
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,166.62
|
|
|
Service Code
|
APR-DRG 7521
|
| Hospital Charge Code |
APRDRG7522
|
| Min. Negotiated Rate |
$2,166.62 |
| Max. Negotiated Rate |
$2,166.62 |
| Rate for Payer: AHCCCS Medicaid |
$2,166.62
|
| Rate for Payer: Allwell Medicaid |
$2,166.62
|
| Rate for Payer: AZCH Complete Medicaid |
$2,166.62
|
| Rate for Payer: Banner UC Health Medicaid |
$2,166.62
|
| Rate for Payer: Mercy Care Medicaid |
$2,166.62
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,166.62
|
|
|
Service Code
|
APR-DRG 7521
|
| Hospital Charge Code |
APRDRG7521
|
| Min. Negotiated Rate |
$2,166.62 |
| Max. Negotiated Rate |
$2,166.62 |
| Rate for Payer: AHCCCS Medicaid |
$2,166.62
|
| Rate for Payer: Allwell Medicaid |
$2,166.62
|
| Rate for Payer: AZCH Complete Medicaid |
$2,166.62
|
| Rate for Payer: Banner UC Health Medicaid |
$2,166.62
|
| Rate for Payer: Mercy Care Medicaid |
$2,166.62
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$6,509.69
|
|
|
Service Code
|
APR-DRG 7523
|
| Hospital Charge Code |
APRDRG7522
|
| Min. Negotiated Rate |
$6,509.69 |
| Max. Negotiated Rate |
$6,509.69 |
| Rate for Payer: AHCCCS Medicaid |
$6,509.69
|
| Rate for Payer: Allwell Medicaid |
$6,509.69
|
| Rate for Payer: AZCH Complete Medicaid |
$6,509.69
|
| Rate for Payer: Banner UC Health Medicaid |
$6,509.69
|
| Rate for Payer: Mercy Care Medicaid |
$6,509.69
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,814.02
|
|
|
Service Code
|
APR-DRG 7522
|
| Hospital Charge Code |
APRDRG7524
|
| Min. Negotiated Rate |
$2,814.02 |
| Max. Negotiated Rate |
$2,814.02 |
| Rate for Payer: AHCCCS Medicaid |
$2,814.02
|
| Rate for Payer: Allwell Medicaid |
$2,814.02
|
| Rate for Payer: AZCH Complete Medicaid |
$2,814.02
|
| Rate for Payer: Banner UC Health Medicaid |
$2,814.02
|
| Rate for Payer: Mercy Care Medicaid |
$2,814.02
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,166.62
|
|
|
Service Code
|
APR-DRG 7521
|
| Hospital Charge Code |
APRDRG7524
|
| Min. Negotiated Rate |
$2,166.62 |
| Max. Negotiated Rate |
$2,166.62 |
| Rate for Payer: AHCCCS Medicaid |
$2,166.62
|
| Rate for Payer: Allwell Medicaid |
$2,166.62
|
| Rate for Payer: AZCH Complete Medicaid |
$2,166.62
|
| Rate for Payer: Banner UC Health Medicaid |
$2,166.62
|
| Rate for Payer: Mercy Care Medicaid |
$2,166.62
|
|
|
Disorders Of Personality And Impulse Control
|
Facility
|
IP
|
$2,166.62
|
|
|
Service Code
|
APR-DRG 7521
|
| Hospital Charge Code |
APRDRG7523
|
| Min. Negotiated Rate |
$2,166.62 |
| Max. Negotiated Rate |
$2,166.62 |
| Rate for Payer: AHCCCS Medicaid |
$2,166.62
|
| Rate for Payer: Allwell Medicaid |
$2,166.62
|
| Rate for Payer: AZCH Complete Medicaid |
$2,166.62
|
| Rate for Payer: Banner UC Health Medicaid |
$2,166.62
|
| Rate for Payer: Mercy Care Medicaid |
$2,166.62
|
|
|
DISP BIOPSY FORCEP 2.8MM
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
22355304
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Aetna of AZ Commercial |
$36.90
|
| Rate for Payer: Bisbee Police All Plans |
$10.66
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Self Pay Self Pay |
$32.80
|
|
