|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$9,703.87
|
|
|
Service Code
|
APR-DRG 7921
|
| Hospital Charge Code |
APRDRG7923
|
| Min. Negotiated Rate |
$9,703.87 |
| Max. Negotiated Rate |
$9,703.87 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,703.87
|
| Rate for Payer: Mercy Care Medicaid |
$9,703.87
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,703.87
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$9,703.87
|
|
|
Service Code
|
APR-DRG 7921
|
| Hospital Charge Code |
APRDRG7921
|
| Min. Negotiated Rate |
$9,703.87 |
| Max. Negotiated Rate |
$9,703.87 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,703.87
|
| Rate for Payer: Mercy Care Medicaid |
$9,703.87
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,703.87
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$35,671.10
|
|
|
Service Code
|
APR-DRG 7924
|
| Hospital Charge Code |
APRDRG7924
|
| Min. Negotiated Rate |
$35,671.10 |
| Max. Negotiated Rate |
$35,671.10 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$35,671.10
|
| Rate for Payer: Mercy Care Medicaid |
$35,671.10
|
| Rate for Payer: NaphCare Correctional Healthcare |
$35,671.10
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$9,703.87
|
|
|
Service Code
|
APR-DRG 7921
|
| Hospital Charge Code |
APRDRG7924
|
| Min. Negotiated Rate |
$9,703.87 |
| Max. Negotiated Rate |
$9,703.87 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,703.87
|
| Rate for Payer: Mercy Care Medicaid |
$9,703.87
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,703.87
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$12,044.44
|
|
|
Service Code
|
APR-DRG 7922
|
| Hospital Charge Code |
APRDRG7921
|
| Min. Negotiated Rate |
$12,044.44 |
| Max. Negotiated Rate |
$12,044.44 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,044.44
|
| Rate for Payer: Mercy Care Medicaid |
$12,044.44
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,044.44
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$17,711.75
|
|
|
Service Code
|
APR-DRG 7923
|
| Hospital Charge Code |
APRDRG7924
|
| Min. Negotiated Rate |
$17,711.75 |
| Max. Negotiated Rate |
$17,711.75 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,711.75
|
| Rate for Payer: Mercy Care Medicaid |
$17,711.75
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,711.75
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$35,671.10
|
|
|
Service Code
|
APR-DRG 7924
|
| Hospital Charge Code |
APRDRG7923
|
| Min. Negotiated Rate |
$35,671.10 |
| Max. Negotiated Rate |
$35,671.10 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$35,671.10
|
| Rate for Payer: Mercy Care Medicaid |
$35,671.10
|
| Rate for Payer: NaphCare Correctional Healthcare |
$35,671.10
|
|
|
Extensive O.R. Procedures For Other Complications Of Treatment
|
Facility
|
IP
|
$12,044.44
|
|
|
Service Code
|
APR-DRG 7922
|
| Hospital Charge Code |
APRDRG7924
|
| Min. Negotiated Rate |
$12,044.44 |
| Max. Negotiated Rate |
$12,044.44 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,044.44
|
| Rate for Payer: Mercy Care Medicaid |
$12,044.44
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,044.44
|
|
|
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$31,774.01
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$31,774.01 |
| Max. Negotiated Rate |
$31,774.01 |
| Rate for Payer: Seven Corners Travel Insurance |
$31,774.01
|
|
|
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$60,637.49
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$60,637.49 |
| Max. Negotiated Rate |
$60,637.49 |
| Rate for Payer: Seven Corners Travel Insurance |
$60,637.49
|
|
|
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$22,152.00
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$22,152.00 |
| Max. Negotiated Rate |
$22,152.00 |
| Rate for Payer: Seven Corners Travel Insurance |
$22,152.00
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$20,677.97
|
|
|
Service Code
|
APR-DRG 9503
|
| Hospital Charge Code |
APRDRG9503
|
| Min. Negotiated Rate |
$20,677.97 |
| Max. Negotiated Rate |
$20,677.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$20,677.97
|
| Rate for Payer: Mercy Care Medicaid |
$20,677.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$20,677.97
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$9,564.29
|
|
|
Service Code
|
APR-DRG 9501
|
| Hospital Charge Code |
APRDRG9502
|
| Min. Negotiated Rate |
$9,564.29 |
| Max. Negotiated Rate |
$9,564.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,564.29
|
| Rate for Payer: Mercy Care Medicaid |
$9,564.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,564.29
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$39,678.20
|
|
|
Service Code
|
APR-DRG 9504
|
| Hospital Charge Code |
APRDRG9501
|
| Min. Negotiated Rate |
$39,678.20 |
| Max. Negotiated Rate |
$39,678.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,678.20
|
| Rate for Payer: Mercy Care Medicaid |
$39,678.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,678.20
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$13,793.03
|
|
|
Service Code
|
APR-DRG 9502
|
| Hospital Charge Code |
APRDRG9501
|
| Min. Negotiated Rate |
$13,793.03 |
| Max. Negotiated Rate |
$13,793.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,793.03
|
| Rate for Payer: Mercy Care Medicaid |
$13,793.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,793.03
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$20,677.97
|
|
|
Service Code
|
APR-DRG 9503
|
| Hospital Charge Code |
APRDRG9501
|
| Min. Negotiated Rate |
$20,677.97 |
| Max. Negotiated Rate |
$20,677.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$20,677.97
|
| Rate for Payer: Mercy Care Medicaid |
$20,677.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$20,677.97
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$20,677.97
|
|
|
Service Code
|
APR-DRG 9503
|
| Hospital Charge Code |
APRDRG9502
|
| Min. Negotiated Rate |
$20,677.97 |
| Max. Negotiated Rate |
$20,677.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$20,677.97
|
| Rate for Payer: Mercy Care Medicaid |
$20,677.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$20,677.97
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$13,793.03
|
|
|
Service Code
|
APR-DRG 9502
|
| Hospital Charge Code |
APRDRG9502
|
| Min. Negotiated Rate |
$13,793.03 |
| Max. Negotiated Rate |
$13,793.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,793.03
|
| Rate for Payer: Mercy Care Medicaid |
$13,793.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,793.03
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$39,678.20
|
|
|
Service Code
|
APR-DRG 9504
|
| Hospital Charge Code |
APRDRG9502
|
| Min. Negotiated Rate |
$39,678.20 |
| Max. Negotiated Rate |
$39,678.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,678.20
|
| Rate for Payer: Mercy Care Medicaid |
$39,678.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,678.20
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$9,564.29
|
|
|
Service Code
|
APR-DRG 9501
|
| Hospital Charge Code |
APRDRG9503
|
| Min. Negotiated Rate |
$9,564.29 |
| Max. Negotiated Rate |
$9,564.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,564.29
|
| Rate for Payer: Mercy Care Medicaid |
$9,564.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,564.29
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$13,793.03
|
|
|
Service Code
|
APR-DRG 9502
|
| Hospital Charge Code |
APRDRG9504
|
| Min. Negotiated Rate |
$13,793.03 |
| Max. Negotiated Rate |
$13,793.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,793.03
|
| Rate for Payer: Mercy Care Medicaid |
$13,793.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,793.03
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$39,678.20
|
|
|
Service Code
|
APR-DRG 9504
|
| Hospital Charge Code |
APRDRG9503
|
| Min. Negotiated Rate |
$39,678.20 |
| Max. Negotiated Rate |
$39,678.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,678.20
|
| Rate for Payer: Mercy Care Medicaid |
$39,678.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,678.20
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$39,678.20
|
|
|
Service Code
|
APR-DRG 9504
|
| Hospital Charge Code |
APRDRG9504
|
| Min. Negotiated Rate |
$39,678.20 |
| Max. Negotiated Rate |
$39,678.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,678.20
|
| Rate for Payer: Mercy Care Medicaid |
$39,678.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,678.20
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$13,793.03
|
|
|
Service Code
|
APR-DRG 9502
|
| Hospital Charge Code |
APRDRG9503
|
| Min. Negotiated Rate |
$13,793.03 |
| Max. Negotiated Rate |
$13,793.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,793.03
|
| Rate for Payer: Mercy Care Medicaid |
$13,793.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,793.03
|
|
|
Extensive O.R. Procedure Unrelated To Principal Diagnosis
|
Facility
|
IP
|
$20,677.97
|
|
|
Service Code
|
APR-DRG 9503
|
| Hospital Charge Code |
APRDRG9504
|
| Min. Negotiated Rate |
$20,677.97 |
| Max. Negotiated Rate |
$20,677.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$20,677.97
|
| Rate for Payer: Mercy Care Medicaid |
$20,677.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$20,677.97
|
|
