|
.HIV GenoSure(R) MG LC
|
Facility
|
OP
|
$1,502.00
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
23173793
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$225.30 |
| Max. Negotiated Rate |
$1,351.80 |
| Rate for Payer: Aetna of AZ Commercial |
$1,351.80
|
| Rate for Payer: Aetna of AZ Medicare |
$420.56
|
| Rate for Payer: AHCCCS Medicaid |
$257.45
|
| Rate for Payer: Allwell Medicaid |
$257.45
|
| Rate for Payer: Allwell Medicare |
$225.30
|
| Rate for Payer: Amerigroup Medicare |
$225.30
|
| Rate for Payer: APIPA Medicare/Medicaid |
$561.00
|
| Rate for Payer: AZCH Complete Medicaid |
$257.45
|
| Rate for Payer: AZCH Complete Medicare |
$225.30
|
| Rate for Payer: Banner UC Health Medicaid |
$257.45
|
| Rate for Payer: Banner UC Health Medicare |
$225.30
|
| Rate for Payer: Bisbee Police All Plans |
$390.52
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,021.36
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cigna of AZ Commercial |
$976.30
|
| Rate for Payer: Copperpoint Commercial |
$371.74
|
| Rate for Payer: Health Net of AZ Commercial |
$901.20
|
| Rate for Payer: Health Net of AZ Medicare |
$420.56
|
| Rate for Payer: Humana of AZ Medicare |
$225.30
|
| Rate for Payer: Mercy Care Medicaid |
$257.45
|
| Rate for Payer: Self Pay Self Pay |
$1,201.60
|
| Rate for Payer: TriWest Medicare |
$225.30
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$875.67
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$270.36
|
|
|
.HIV GenoSure(R) MG LC
|
Facility
|
OP
|
$1,502.00
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
22311150
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$225.30 |
| Max. Negotiated Rate |
$1,351.80 |
| Rate for Payer: Aetna of AZ Commercial |
$1,351.80
|
| Rate for Payer: Aetna of AZ Medicare |
$420.56
|
| Rate for Payer: AHCCCS Medicaid |
$257.45
|
| Rate for Payer: Allwell Medicaid |
$257.45
|
| Rate for Payer: Allwell Medicare |
$225.30
|
| Rate for Payer: Amerigroup Medicare |
$225.30
|
| Rate for Payer: APIPA Medicare/Medicaid |
$561.00
|
| Rate for Payer: AZCH Complete Medicaid |
$257.45
|
| Rate for Payer: AZCH Complete Medicare |
$225.30
|
| Rate for Payer: Banner UC Health Medicaid |
$257.45
|
| Rate for Payer: Banner UC Health Medicare |
$225.30
|
| Rate for Payer: Bisbee Police All Plans |
$390.52
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,021.36
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cigna of AZ Commercial |
$976.30
|
| Rate for Payer: Copperpoint Commercial |
$371.74
|
| Rate for Payer: Health Net of AZ Commercial |
$901.20
|
| Rate for Payer: Health Net of AZ Medicare |
$420.56
|
| Rate for Payer: Humana of AZ Medicare |
$225.30
|
| Rate for Payer: Mercy Care Medicaid |
$257.45
|
| Rate for Payer: Self Pay Self Pay |
$1,201.60
|
| Rate for Payer: TriWest Medicare |
$225.30
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$875.67
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$270.36
|
|
|
.HIV GenoSure(R) MG LC
|
Facility
|
IP
|
$1,502.00
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
23173793
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$390.52 |
| Max. Negotiated Rate |
$1,351.80 |
| Rate for Payer: Aetna of AZ Commercial |
$1,351.80
|
| Rate for Payer: Bisbee Police All Plans |
$390.52
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Self Pay Self Pay |
$1,201.60
|
|
|
HIV Quant, LC
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
2269440
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.10 |
| Max. Negotiated Rate |
$952.20 |
| Rate for Payer: Aetna of AZ Commercial |
$952.20
|
| Rate for Payer: Aetna of AZ Medicare |
$296.24
|
| Rate for Payer: AHCCCS Medicaid |
$85.10
|
| Rate for Payer: Allwell Medicaid |
$85.10
|
| Rate for Payer: Allwell Medicare |
$158.70
|
| Rate for Payer: Amerigroup Medicare |
$158.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$395.16
|
| Rate for Payer: AZCH Complete Medicaid |
$85.10
|
| Rate for Payer: AZCH Complete Medicare |
$158.70
|
| Rate for Payer: Banner UC Health Medicaid |
$85.10
|
| Rate for Payer: Banner UC Health Medicare |
$158.70
|
| Rate for Payer: Bisbee Police All Plans |
$275.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$719.44
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cigna of AZ Commercial |
$687.70
|
| Rate for Payer: Copperpoint Commercial |
$261.86
|
| Rate for Payer: Health Net of AZ Commercial |
$634.80
|
| Rate for Payer: Health Net of AZ Medicare |
$296.24
|
| Rate for Payer: Humana of AZ Medicare |
$158.70
|
| Rate for Payer: Mercy Care Medicaid |
$85.10
|
| Rate for Payer: Self Pay Self Pay |
$846.40
|
| Rate for Payer: TriWest Medicare |
$158.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$616.81
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$190.44
|
|
|
HIV Quant, LC
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
2269440
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$275.08 |
| Max. Negotiated Rate |
$952.20 |
| Rate for Payer: Aetna of AZ Commercial |
$952.20
|
| Rate for Payer: Bisbee Police All Plans |
$275.08
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Self Pay Self Pay |
$846.40
|
|
|
HIV RNA, PCR (Graph) rfx/Geno LC
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
22240940
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$275.08 |
| Max. Negotiated Rate |
$952.20 |
| Rate for Payer: Aetna of AZ Commercial |
$952.20
|
| Rate for Payer: Bisbee Police All Plans |
$275.08
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Self Pay Self Pay |
$846.40
|
|
|
HIV RNA, PCR (Graph) rfx/Geno LC
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
22240940
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.10 |
| Max. Negotiated Rate |
$952.20 |
| Rate for Payer: Aetna of AZ Commercial |
$952.20
|
| Rate for Payer: Aetna of AZ Medicare |
$296.24
|
| Rate for Payer: AHCCCS Medicaid |
$85.10
|
| Rate for Payer: Allwell Medicaid |
$85.10
|
| Rate for Payer: Allwell Medicare |
$158.70
|
| Rate for Payer: Amerigroup Medicare |
$158.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$395.16
|
| Rate for Payer: AZCH Complete Medicaid |
$85.10
|
| Rate for Payer: AZCH Complete Medicare |
$158.70
|
| Rate for Payer: Banner UC Health Medicaid |
$85.10
|
| Rate for Payer: Banner UC Health Medicare |
$158.70
|
| Rate for Payer: Bisbee Police All Plans |
$275.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$719.44
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cigna of AZ Commercial |
$687.70
|
| Rate for Payer: Copperpoint Commercial |
$261.86
|
| Rate for Payer: Health Net of AZ Commercial |
$634.80
|
| Rate for Payer: Health Net of AZ Medicare |
$296.24
|
| Rate for Payer: Humana of AZ Medicare |
$158.70
|
| Rate for Payer: Mercy Care Medicaid |
$85.10
|
| Rate for Payer: Self Pay Self Pay |
$846.40
|
| Rate for Payer: TriWest Medicare |
$158.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$616.81
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$190.44
|
|
|
.HIV RNA Ql LC
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
22530964
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$479.70 |
| Rate for Payer: Aetna of AZ Commercial |
$479.70
|
| Rate for Payer: Aetna of AZ Medicare |
$149.24
|
| Rate for Payer: AHCCCS Medicaid |
$35.09
|
| Rate for Payer: Allwell Medicaid |
$35.09
|
| Rate for Payer: Allwell Medicare |
$79.95
|
| Rate for Payer: Amerigroup Medicare |
$79.95
|
| Rate for Payer: APIPA Medicare/Medicaid |
$199.08
|
| Rate for Payer: AZCH Complete Medicaid |
$35.09
|
| Rate for Payer: AZCH Complete Medicare |
$79.95
|
| Rate for Payer: Banner UC Health Medicaid |
$35.09
|
| Rate for Payer: Banner UC Health Medicare |
$79.95
|
| Rate for Payer: Bisbee Police All Plans |
$138.58
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$362.44
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cigna of AZ Commercial |
$346.45
|
| Rate for Payer: Copperpoint Commercial |
$131.92
|
| Rate for Payer: Health Net of AZ Commercial |
$319.80
|
| Rate for Payer: Health Net of AZ Medicare |
$149.24
|
| Rate for Payer: Humana of AZ Medicare |
$79.95
|
| Rate for Payer: Mercy Care Medicaid |
$35.09
|
| Rate for Payer: Self Pay Self Pay |
$426.40
|
| Rate for Payer: TriWest Medicare |
$79.95
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$310.74
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$95.94
|
|
|
.HIV RNA Ql LC
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
22530964
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$138.58 |
| Max. Negotiated Rate |
$479.70 |
| Rate for Payer: Aetna of AZ Commercial |
$479.70
|
| Rate for Payer: Bisbee Police All Plans |
$138.58
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Self Pay Self Pay |
$426.40
|
|
|
.HIV RNA Qual LC
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
22305598
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$479.70 |
| Rate for Payer: Aetna of AZ Commercial |
$479.70
|
| Rate for Payer: Aetna of AZ Medicare |
$149.24
|
| Rate for Payer: AHCCCS Medicaid |
$35.09
|
| Rate for Payer: Allwell Medicaid |
$35.09
|
| Rate for Payer: Allwell Medicare |
$79.95
|
| Rate for Payer: Amerigroup Medicare |
$79.95
|
| Rate for Payer: APIPA Medicare/Medicaid |
$199.08
|
| Rate for Payer: AZCH Complete Medicaid |
$35.09
|
| Rate for Payer: AZCH Complete Medicare |
$79.95
|
| Rate for Payer: Banner UC Health Medicaid |
$35.09
|
| Rate for Payer: Banner UC Health Medicare |
$79.95
|
| Rate for Payer: Bisbee Police All Plans |
$138.58
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$362.44
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cigna of AZ Commercial |
$346.45
|
| Rate for Payer: Copperpoint Commercial |
$131.92
|
| Rate for Payer: Health Net of AZ Commercial |
$319.80
|
| Rate for Payer: Health Net of AZ Medicare |
$149.24
|
| Rate for Payer: Humana of AZ Medicare |
$79.95
|
| Rate for Payer: Mercy Care Medicaid |
$35.09
|
| Rate for Payer: Self Pay Self Pay |
$426.40
|
| Rate for Payer: TriWest Medicare |
$79.95
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$310.74
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$95.94
|
|
|
.HIV RNA Qual LC
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
22305598
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$138.58 |
| Max. Negotiated Rate |
$479.70 |
| Rate for Payer: Aetna of AZ Commercial |
$479.70
|
| Rate for Payer: Bisbee Police All Plans |
$138.58
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Self Pay Self Pay |
$426.40
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$8,022.61
|
|
|
Service Code
|
APR-DRG 8923
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$8,022.61 |
| Max. Negotiated Rate |
$8,022.61 |
| Rate for Payer: AHCCCS Medicaid |
$8,022.61
|
| Rate for Payer: Allwell Medicaid |
$8,022.61
|
| Rate for Payer: AZCH Complete Medicaid |
$8,022.61
|
| Rate for Payer: Banner UC Health Medicaid |
$8,022.61
|
| Rate for Payer: Mercy Care Medicaid |
$8,022.61
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$5,410.60
|
|
|
Service Code
|
APR-DRG 8922
|
| Hospital Charge Code |
APRDRG8923
|
| Min. Negotiated Rate |
$5,410.60 |
| Max. Negotiated Rate |
$5,410.60 |
| Rate for Payer: AHCCCS Medicaid |
$5,410.60
|
| Rate for Payer: Allwell Medicaid |
$5,410.60
|
| Rate for Payer: AZCH Complete Medicaid |
$5,410.60
|
| Rate for Payer: Banner UC Health Medicaid |
$5,410.60
|
| Rate for Payer: Mercy Care Medicaid |
$5,410.60
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: AHCCCS Medicaid |
$4,266.62
|
| Rate for Payer: Allwell Medicaid |
$4,266.62
|
| Rate for Payer: AZCH Complete Medicaid |
$4,266.62
|
| Rate for Payer: Banner UC Health Medicaid |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$13,882.81
|
|
|
Service Code
|
APR-DRG 8924
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$13,882.81 |
| Max. Negotiated Rate |
$13,882.81 |
| Rate for Payer: AHCCCS Medicaid |
$13,882.81
|
| Rate for Payer: Allwell Medicaid |
$13,882.81
|
| Rate for Payer: AZCH Complete Medicaid |
$13,882.81
|
| Rate for Payer: Banner UC Health Medicaid |
$13,882.81
|
| Rate for Payer: Mercy Care Medicaid |
$13,882.81
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: AHCCCS Medicaid |
$4,266.62
|
| Rate for Payer: Allwell Medicaid |
$4,266.62
|
| Rate for Payer: AZCH Complete Medicaid |
$4,266.62
|
| Rate for Payer: Banner UC Health Medicaid |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$5,410.60
|
|
|
Service Code
|
APR-DRG 8922
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$5,410.60 |
| Max. Negotiated Rate |
$5,410.60 |
| Rate for Payer: AHCCCS Medicaid |
$5,410.60
|
| Rate for Payer: Allwell Medicaid |
$5,410.60
|
| Rate for Payer: AZCH Complete Medicaid |
$5,410.60
|
| Rate for Payer: Banner UC Health Medicaid |
$5,410.60
|
| Rate for Payer: Mercy Care Medicaid |
$5,410.60
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8923
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: AHCCCS Medicaid |
$4,266.62
|
| Rate for Payer: Allwell Medicaid |
$4,266.62
|
| Rate for Payer: AZCH Complete Medicaid |
$4,266.62
|
| Rate for Payer: Banner UC Health Medicaid |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: AHCCCS Medicaid |
$4,266.62
|
| Rate for Payer: Allwell Medicaid |
$4,266.62
|
| Rate for Payer: AZCH Complete Medicaid |
$4,266.62
|
| Rate for Payer: Banner UC Health Medicaid |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$8,022.61
|
|
|
Service Code
|
APR-DRG 8923
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$8,022.61 |
| Max. Negotiated Rate |
$8,022.61 |
| Rate for Payer: AHCCCS Medicaid |
$8,022.61
|
| Rate for Payer: Allwell Medicaid |
$8,022.61
|
| Rate for Payer: AZCH Complete Medicaid |
$8,022.61
|
| Rate for Payer: Banner UC Health Medicaid |
$8,022.61
|
| Rate for Payer: Mercy Care Medicaid |
$8,022.61
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$8,022.61
|
|
|
Service Code
|
APR-DRG 8923
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$8,022.61 |
| Max. Negotiated Rate |
$8,022.61 |
| Rate for Payer: AHCCCS Medicaid |
$8,022.61
|
| Rate for Payer: Allwell Medicaid |
$8,022.61
|
| Rate for Payer: AZCH Complete Medicaid |
$8,022.61
|
| Rate for Payer: Banner UC Health Medicaid |
$8,022.61
|
| Rate for Payer: Mercy Care Medicaid |
$8,022.61
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$13,882.81
|
|
|
Service Code
|
APR-DRG 8924
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$13,882.81 |
| Max. Negotiated Rate |
$13,882.81 |
| Rate for Payer: AHCCCS Medicaid |
$13,882.81
|
| Rate for Payer: Allwell Medicaid |
$13,882.81
|
| Rate for Payer: AZCH Complete Medicaid |
$13,882.81
|
| Rate for Payer: Banner UC Health Medicaid |
$13,882.81
|
| Rate for Payer: Mercy Care Medicaid |
$13,882.81
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$5,410.60
|
|
|
Service Code
|
APR-DRG 8922
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$5,410.60 |
| Max. Negotiated Rate |
$5,410.60 |
| Rate for Payer: AHCCCS Medicaid |
$5,410.60
|
| Rate for Payer: Allwell Medicaid |
$5,410.60
|
| Rate for Payer: AZCH Complete Medicaid |
$5,410.60
|
| Rate for Payer: Banner UC Health Medicaid |
$5,410.60
|
| Rate for Payer: Mercy Care Medicaid |
$5,410.60
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$13,882.81
|
|
|
Service Code
|
APR-DRG 8924
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$13,882.81 |
| Max. Negotiated Rate |
$13,882.81 |
| Rate for Payer: AHCCCS Medicaid |
$13,882.81
|
| Rate for Payer: Allwell Medicaid |
$13,882.81
|
| Rate for Payer: AZCH Complete Medicaid |
$13,882.81
|
| Rate for Payer: Banner UC Health Medicaid |
$13,882.81
|
| Rate for Payer: Mercy Care Medicaid |
$13,882.81
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$13,882.81
|
|
|
Service Code
|
APR-DRG 8924
|
| Hospital Charge Code |
APRDRG8923
|
| Min. Negotiated Rate |
$13,882.81 |
| Max. Negotiated Rate |
$13,882.81 |
| Rate for Payer: AHCCCS Medicaid |
$13,882.81
|
| Rate for Payer: Allwell Medicaid |
$13,882.81
|
| Rate for Payer: AZCH Complete Medicaid |
$13,882.81
|
| Rate for Payer: Banner UC Health Medicaid |
$13,882.81
|
| Rate for Payer: Mercy Care Medicaid |
$13,882.81
|
|
