|
FERNOTRAC TRACTION SPLINT ADULT
|
Facility
|
OP
|
$1,546.00
|
|
| Hospital Charge Code |
24335304
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$231.90 |
| Max. Negotiated Rate |
$1,391.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,391.40
|
| Rate for Payer: Aetna of AZ Medicare |
$432.88
|
| Rate for Payer: Allwell Medicare |
$231.90
|
| Rate for Payer: Amerigroup Medicare |
$231.90
|
| Rate for Payer: APIPA Medicare/Medicaid |
$577.43
|
| Rate for Payer: AZCH Complete Medicare |
$231.90
|
| Rate for Payer: Banner UC Health Medicare |
$231.90
|
| Rate for Payer: Bisbee Police All Plans |
$401.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,051.28
|
| Rate for Payer: Cash Price |
$1,236.80
|
| Rate for Payer: Cigna of AZ Commercial |
$1,082.20
|
| Rate for Payer: Copperpoint Commercial |
$382.64
|
| Rate for Payer: Health Net of AZ Commercial |
$927.60
|
| Rate for Payer: Health Net of AZ Medicare |
$432.88
|
| Rate for Payer: Humana of AZ Medicare |
$231.90
|
| Rate for Payer: Self Pay Self Pay |
$1,236.80
|
| Rate for Payer: TriWest Medicare |
$231.90
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$901.32
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$278.28
|
|
|
Fern Test
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
853209
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna of AZ Commercial |
$103.50
|
| Rate for Payer: Aetna of AZ Medicare |
$32.20
|
| Rate for Payer: AHCCCS Medicaid |
$7.33
|
| Rate for Payer: Allwell Medicaid |
$7.33
|
| Rate for Payer: Allwell Medicare |
$17.25
|
| Rate for Payer: Amerigroup Medicare |
$17.25
|
| Rate for Payer: APIPA Medicare/Medicaid |
$42.95
|
| Rate for Payer: AZCH Complete Medicaid |
$7.33
|
| Rate for Payer: AZCH Complete Medicare |
$17.25
|
| Rate for Payer: Banner UC Health Medicaid |
$7.33
|
| Rate for Payer: Banner UC Health Medicare |
$17.25
|
| Rate for Payer: Bisbee Police All Plans |
$29.90
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$78.20
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cigna of AZ Commercial |
$74.75
|
| Rate for Payer: Copperpoint Commercial |
$28.46
|
| Rate for Payer: Health Net of AZ Commercial |
$69.00
|
| Rate for Payer: Health Net of AZ Medicare |
$32.20
|
| Rate for Payer: Humana of AZ Medicare |
$17.25
|
| Rate for Payer: Mercy Care Medicaid |
$7.33
|
| Rate for Payer: Self Pay Self Pay |
$92.00
|
| Rate for Payer: TriWest Medicare |
$17.25
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$67.04
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$20.70
|
|
|
Fern Test
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
853209
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna of AZ Commercial |
$103.50
|
| Rate for Payer: Bisbee Police All Plans |
$29.90
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Self Pay Self Pay |
$92.00
|
|
|
ferric carboxymaltose (as elemental iron) 50 mg/mL Sol[CQCH]
|
Facility
|
OP
|
$57.54
|
|
|
Service Code
|
HCPCS J1439
|
| Hospital Charge Code |
193172985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$51.79 |
| Rate for Payer: Aetna of AZ Commercial |
$51.79
|
| Rate for Payer: Aetna of AZ Medicare |
$16.11
|
| Rate for Payer: AHCCCS Medicaid |
$1.76
|
| Rate for Payer: Allwell Medicaid |
$1.76
|
| Rate for Payer: Allwell Medicare |
$8.63
|
| Rate for Payer: Amerigroup Medicare |
$8.63
|
| Rate for Payer: APIPA Medicare/Medicaid |
$21.49
|
| Rate for Payer: AZCH Complete Medicaid |
$1.76
|
| Rate for Payer: AZCH Complete Medicare |
$8.63
|
| Rate for Payer: Banner UC Health Medicaid |
$1.76
|
| Rate for Payer: Banner UC Health Medicare |
$8.63
|
| Rate for Payer: Bisbee Police All Plans |
$14.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$39.13
|
| Rate for Payer: Cash Price |
$46.03
|
| Rate for Payer: Cash Price |
$46.03
|
| Rate for Payer: Cigna of AZ Commercial |
$37.40
|
| Rate for Payer: Copperpoint Commercial |
$14.24
|
| Rate for Payer: Health Net of AZ Commercial |
$34.52
|
| Rate for Payer: Health Net of AZ Medicare |
$16.11
|
| Rate for Payer: Humana of AZ Medicare |
$8.63
|
| Rate for Payer: Mercy Care Medicaid |
$1.76
|
| Rate for Payer: Self Pay Self Pay |
$46.03
|
| Rate for Payer: TriWest Medicare |
$8.63
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$33.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$10.36
|
|
|
ferric carboxymaltose (as elemental iron) 50 mg/mL Sol[CQCH]
|
Facility
|
IP
|
$57.54
|
|
|
Service Code
|
HCPCS J1439
|
| Hospital Charge Code |
193172985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.96 |
| Max. Negotiated Rate |
$51.79 |
| Rate for Payer: Aetna of AZ Commercial |
$51.79
|
| Rate for Payer: Bisbee Police All Plans |
$14.96
|
| Rate for Payer: Cash Price |
$46.03
|
| Rate for Payer: Self Pay Self Pay |
$46.03
|
|
|
Ferritin
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
633726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna of AZ Commercial |
$169.20
|
| Rate for Payer: Aetna of AZ Medicare |
$52.64
|
| Rate for Payer: AHCCCS Medicaid |
$13.63
|
| Rate for Payer: Allwell Medicaid |
$13.63
|
| Rate for Payer: Allwell Medicare |
$28.20
|
| Rate for Payer: Amerigroup Medicare |
$28.20
|
| Rate for Payer: APIPA Medicare/Medicaid |
$70.22
|
| Rate for Payer: AZCH Complete Medicaid |
$13.63
|
| Rate for Payer: AZCH Complete Medicare |
$28.20
|
| Rate for Payer: Banner UC Health Medicaid |
$13.63
|
| Rate for Payer: Banner UC Health Medicare |
$28.20
|
| Rate for Payer: Bisbee Police All Plans |
$48.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$127.84
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cigna of AZ Commercial |
$122.20
|
| Rate for Payer: Copperpoint Commercial |
$46.53
|
| Rate for Payer: Health Net of AZ Commercial |
$112.80
|
| Rate for Payer: Health Net of AZ Medicare |
$52.64
|
| Rate for Payer: Humana of AZ Medicare |
$28.20
|
| Rate for Payer: Mercy Care Medicaid |
$13.63
|
| Rate for Payer: Self Pay Self Pay |
$150.40
|
| Rate for Payer: TriWest Medicare |
$28.20
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$109.60
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$33.84
|
|
|
Ferritin
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
633726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.88 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna of AZ Commercial |
$169.20
|
| Rate for Payer: Bisbee Police All Plans |
$48.88
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Self Pay Self Pay |
$150.40
|
|
|
ferrous gluconate 324 mg Tab [CQCH]
|
Facility
|
OP
|
$0.09
|
|
|
Service Code
|
NDC 574050811
|
| Hospital Charge Code |
105922585
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Aetna of AZ Commercial |
$0.08
|
| Rate for Payer: Aetna of AZ Medicare |
$0.03
|
| Rate for Payer: Allwell Medicare |
$0.01
|
| Rate for Payer: Amerigroup Medicare |
$0.01
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.03
|
| Rate for Payer: AZCH Complete Medicare |
$0.01
|
| Rate for Payer: Banner UC Health Medicare |
$0.01
|
| Rate for Payer: Bisbee Police All Plans |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Cigna of AZ Commercial |
$0.06
|
| Rate for Payer: Copperpoint Commercial |
$0.02
|
| Rate for Payer: Health Net of AZ Commercial |
$0.05
|
| Rate for Payer: Health Net of AZ Medicare |
$0.03
|
| Rate for Payer: Humana of AZ Medicare |
$0.01
|
| Rate for Payer: Self Pay Self Pay |
$0.07
|
| Rate for Payer: TriWest Medicare |
$0.01
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.05
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.02
|
|
|
ferrous gluconate 324 mg Tab [CQCH]
|
Facility
|
IP
|
$0.09
|
|
|
Service Code
|
NDC 574050811
|
| Hospital Charge Code |
105922585
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Aetna of AZ Commercial |
$0.08
|
| Rate for Payer: Bisbee Police All Plans |
$0.02
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Self Pay Self Pay |
$0.07
|
|
|
ferrous sulfate 300 mg/5 mL Oral Liq UD [CQCH]
|
Facility
|
OP
|
$0.18
|
|
|
Service Code
|
NDC 121053005
|
| Hospital Charge Code |
105922715
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.16 |
| Rate for Payer: Aetna of AZ Commercial |
$0.16
|
| Rate for Payer: Aetna of AZ Medicare |
$0.05
|
| Rate for Payer: Allwell Medicare |
$0.03
|
| Rate for Payer: Amerigroup Medicare |
$0.03
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.07
|
| Rate for Payer: AZCH Complete Medicare |
$0.03
|
| Rate for Payer: Banner UC Health Medicare |
$0.03
|
| Rate for Payer: Bisbee Police All Plans |
$0.05
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.12
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cigna of AZ Commercial |
$0.12
|
| Rate for Payer: Copperpoint Commercial |
$0.04
|
| Rate for Payer: Health Net of AZ Commercial |
$0.11
|
| Rate for Payer: Health Net of AZ Medicare |
$0.05
|
| Rate for Payer: Humana of AZ Medicare |
$0.03
|
| Rate for Payer: Self Pay Self Pay |
$0.14
|
| Rate for Payer: TriWest Medicare |
$0.03
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.10
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.03
|
|
|
ferrous sulfate 300 mg/5 mL Oral Liq UD [CQCH]
|
Facility
|
IP
|
$0.18
|
|
|
Service Code
|
NDC 121053005
|
| Hospital Charge Code |
105922715
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.16 |
| Rate for Payer: Aetna of AZ Commercial |
$0.16
|
| Rate for Payer: Bisbee Police All Plans |
$0.05
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Self Pay Self Pay |
$0.14
|
|
|
ferrous sulfate 325 mg Tab [CQCH]
|
Facility
|
IP
|
$0.03
|
|
|
Service Code
|
NDC 904759161
|
| Hospital Charge Code |
105922650
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of AZ Commercial |
$0.03
|
| Rate for Payer: Bisbee Police All Plans |
$0.01
|
| Rate for Payer: Cash Price |
$0.02
|
| Rate for Payer: Self Pay Self Pay |
$0.02
|
|
|
ferrous sulfate 325 mg Tab [CQCH]
|
Facility
|
OP
|
$0.03
|
|
|
Service Code
|
NDC 904759161
|
| Hospital Charge Code |
105922650
|
|
Hospital Revenue Code
|
251
|
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna of AZ Commercial |
$0.03
|
| Rate for Payer: Aetna of AZ Medicare |
$0.01
|
| Rate for Payer: Allwell Medicare |
$0.00
|
| Rate for Payer: Amerigroup Medicare |
$0.00
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.01
|
| Rate for Payer: AZCH Complete Medicare |
$0.00
|
| Rate for Payer: Banner UC Health Medicare |
$0.00
|
| Rate for Payer: Bisbee Police All Plans |
$0.01
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$0.02
|
| Rate for Payer: Cigna of AZ Commercial |
$0.02
|
| Rate for Payer: Copperpoint Commercial |
$0.01
|
| Rate for Payer: Health Net of AZ Commercial |
$0.02
|
| Rate for Payer: Health Net of AZ Medicare |
$0.01
|
| Rate for Payer: Humana of AZ Medicare |
$0.00
|
| Rate for Payer: Self Pay Self Pay |
$0.02
|
| Rate for Payer: TriWest Medicare |
$0.00
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.02
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.01
|
|
|
ferumoxytol 30 mg/mL Sol[CQCH]
|
Facility
|
IP
|
$14.79
|
|
|
Service Code
|
HCPCS Q0138
|
| Hospital Charge Code |
199592805
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$13.31 |
| Rate for Payer: Aetna of AZ Commercial |
$13.31
|
| Rate for Payer: Bisbee Police All Plans |
$3.85
|
| Rate for Payer: Cash Price |
$11.83
|
| Rate for Payer: Self Pay Self Pay |
$11.83
|
|
|
ferumoxytol 30 mg/mL Sol[CQCH]
|
Facility
|
OP
|
$14.79
|
|
|
Service Code
|
HCPCS Q0138
|
| Hospital Charge Code |
199592805
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$13.31 |
| Rate for Payer: Aetna of AZ Commercial |
$13.31
|
| Rate for Payer: Aetna of AZ Medicare |
$4.14
|
| Rate for Payer: AHCCCS Medicaid |
$0.88
|
| Rate for Payer: Allwell Medicaid |
$0.88
|
| Rate for Payer: Allwell Medicare |
$2.22
|
| Rate for Payer: Amerigroup Medicare |
$2.22
|
| Rate for Payer: APIPA Medicare/Medicaid |
$5.52
|
| Rate for Payer: AZCH Complete Medicaid |
$0.88
|
| Rate for Payer: AZCH Complete Medicare |
$2.22
|
| Rate for Payer: Banner UC Health Medicaid |
$0.88
|
| Rate for Payer: Banner UC Health Medicare |
$2.22
|
| Rate for Payer: Bisbee Police All Plans |
$3.85
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$10.06
|
| Rate for Payer: Cash Price |
$11.83
|
| Rate for Payer: Cash Price |
$11.83
|
| Rate for Payer: Cigna of AZ Commercial |
$9.61
|
| Rate for Payer: Copperpoint Commercial |
$3.66
|
| Rate for Payer: Health Net of AZ Commercial |
$8.87
|
| Rate for Payer: Health Net of AZ Medicare |
$4.14
|
| Rate for Payer: Humana of AZ Medicare |
$2.22
|
| Rate for Payer: Mercy Care Medicaid |
$0.88
|
| Rate for Payer: Self Pay Self Pay |
$11.83
|
| Rate for Payer: TriWest Medicare |
$2.22
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$8.62
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$2.66
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$8,982.13
|
|
|
Service Code
|
APR-DRG 7224
|
| Hospital Charge Code |
APRDRG7223
|
| Min. Negotiated Rate |
$8,982.13 |
| Max. Negotiated Rate |
$8,982.13 |
| Rate for Payer: AHCCCS Medicaid |
$8,982.13
|
| Rate for Payer: Allwell Medicaid |
$8,982.13
|
| Rate for Payer: AZCH Complete Medicaid |
$8,982.13
|
| Rate for Payer: Banner UC Health Medicaid |
$8,982.13
|
| Rate for Payer: Mercy Care Medicaid |
$8,982.13
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$3,953.09
|
|
|
Service Code
|
APR-DRG 7222
|
| Hospital Charge Code |
APRDRG7221
|
| Min. Negotiated Rate |
$3,953.09 |
| Max. Negotiated Rate |
$3,953.09 |
| Rate for Payer: AHCCCS Medicaid |
$3,953.09
|
| Rate for Payer: Allwell Medicaid |
$3,953.09
|
| Rate for Payer: AZCH Complete Medicaid |
$3,953.09
|
| Rate for Payer: Banner UC Health Medicaid |
$3,953.09
|
| Rate for Payer: Mercy Care Medicaid |
$3,953.09
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$5,346.07
|
|
|
Service Code
|
APR-DRG 7223
|
| Hospital Charge Code |
APRDRG7221
|
| Min. Negotiated Rate |
$5,346.07 |
| Max. Negotiated Rate |
$5,346.07 |
| Rate for Payer: AHCCCS Medicaid |
$5,346.07
|
| Rate for Payer: Allwell Medicaid |
$5,346.07
|
| Rate for Payer: AZCH Complete Medicaid |
$5,346.07
|
| Rate for Payer: Banner UC Health Medicaid |
$5,346.07
|
| Rate for Payer: Mercy Care Medicaid |
$5,346.07
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$5,346.07
|
|
|
Service Code
|
APR-DRG 7223
|
| Hospital Charge Code |
APRDRG7223
|
| Min. Negotiated Rate |
$5,346.07 |
| Max. Negotiated Rate |
$5,346.07 |
| Rate for Payer: AHCCCS Medicaid |
$5,346.07
|
| Rate for Payer: Allwell Medicaid |
$5,346.07
|
| Rate for Payer: AZCH Complete Medicaid |
$5,346.07
|
| Rate for Payer: Banner UC Health Medicaid |
$5,346.07
|
| Rate for Payer: Mercy Care Medicaid |
$5,346.07
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$8,982.13
|
|
|
Service Code
|
APR-DRG 7224
|
| Hospital Charge Code |
APRDRG7222
|
| Min. Negotiated Rate |
$8,982.13 |
| Max. Negotiated Rate |
$8,982.13 |
| Rate for Payer: AHCCCS Medicaid |
$8,982.13
|
| Rate for Payer: Allwell Medicaid |
$8,982.13
|
| Rate for Payer: AZCH Complete Medicaid |
$8,982.13
|
| Rate for Payer: Banner UC Health Medicaid |
$8,982.13
|
| Rate for Payer: Mercy Care Medicaid |
$8,982.13
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$3,953.09
|
|
|
Service Code
|
APR-DRG 7222
|
| Hospital Charge Code |
APRDRG7224
|
| Min. Negotiated Rate |
$3,953.09 |
| Max. Negotiated Rate |
$3,953.09 |
| Rate for Payer: AHCCCS Medicaid |
$3,953.09
|
| Rate for Payer: Allwell Medicaid |
$3,953.09
|
| Rate for Payer: AZCH Complete Medicaid |
$3,953.09
|
| Rate for Payer: Banner UC Health Medicaid |
$3,953.09
|
| Rate for Payer: Mercy Care Medicaid |
$3,953.09
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$5,346.07
|
|
|
Service Code
|
APR-DRG 7223
|
| Hospital Charge Code |
APRDRG7222
|
| Min. Negotiated Rate |
$5,346.07 |
| Max. Negotiated Rate |
$5,346.07 |
| Rate for Payer: AHCCCS Medicaid |
$5,346.07
|
| Rate for Payer: Allwell Medicaid |
$5,346.07
|
| Rate for Payer: AZCH Complete Medicaid |
$5,346.07
|
| Rate for Payer: Banner UC Health Medicaid |
$5,346.07
|
| Rate for Payer: Mercy Care Medicaid |
$5,346.07
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$3,953.09
|
|
|
Service Code
|
APR-DRG 7222
|
| Hospital Charge Code |
APRDRG7223
|
| Min. Negotiated Rate |
$3,953.09 |
| Max. Negotiated Rate |
$3,953.09 |
| Rate for Payer: AHCCCS Medicaid |
$3,953.09
|
| Rate for Payer: Allwell Medicaid |
$3,953.09
|
| Rate for Payer: AZCH Complete Medicaid |
$3,953.09
|
| Rate for Payer: Banner UC Health Medicaid |
$3,953.09
|
| Rate for Payer: Mercy Care Medicaid |
$3,953.09
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$2,771.93
|
|
|
Service Code
|
APR-DRG 7221
|
| Hospital Charge Code |
APRDRG7223
|
| Min. Negotiated Rate |
$2,771.93 |
| Max. Negotiated Rate |
$2,771.93 |
| Rate for Payer: AHCCCS Medicaid |
$2,771.93
|
| Rate for Payer: Allwell Medicaid |
$2,771.93
|
| Rate for Payer: AZCH Complete Medicaid |
$2,771.93
|
| Rate for Payer: Banner UC Health Medicaid |
$2,771.93
|
| Rate for Payer: Mercy Care Medicaid |
$2,771.93
|
|
|
Fever And Inflammatory Conditions
|
Facility
|
IP
|
$2,771.93
|
|
|
Service Code
|
APR-DRG 7221
|
| Hospital Charge Code |
APRDRG7224
|
| Min. Negotiated Rate |
$2,771.93 |
| Max. Negotiated Rate |
$2,771.93 |
| Rate for Payer: AHCCCS Medicaid |
$2,771.93
|
| Rate for Payer: Allwell Medicaid |
$2,771.93
|
| Rate for Payer: AZCH Complete Medicaid |
$2,771.93
|
| Rate for Payer: Banner UC Health Medicaid |
$2,771.93
|
| Rate for Payer: Mercy Care Medicaid |
$2,771.93
|
|
