|
Schizophrenia
|
Facility
IP
|
$4,006.40
|
|
|
Service Code
|
APRDRG 7501
|
| Hospital Charge Code |
APRDRG7501
|
| Min. Negotiated Rate |
$4,006.40 |
| Max. Negotiated Rate |
$4,006.40 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,006.40
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,006.40
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,006.40
|
| Rate for Payer: Mercy Care Medicaid |
$4,006.40
|
|
|
Schizophrenia
|
Facility
IP
|
$4,857.20
|
|
|
Service Code
|
APRDRG 7502
|
| Hospital Charge Code |
APRDRG7502
|
| Min. Negotiated Rate |
$4,857.20 |
| Max. Negotiated Rate |
$4,857.20 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,857.20
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,857.20
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,857.20
|
| Rate for Payer: Mercy Care Medicaid |
$4,857.20
|
|
|
Schizophrenia
|
Facility
IP
|
$8,111.69
|
|
|
Service Code
|
APRDRG 7503
|
| Hospital Charge Code |
APRDRG7503
|
| Min. Negotiated Rate |
$8,111.69 |
| Max. Negotiated Rate |
$8,111.69 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$8,111.69
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$8,111.69
|
| Rate for Payer: Banner University Family Care Medicaid |
$8,111.69
|
| Rate for Payer: Mercy Care Medicaid |
$8,111.69
|
|
|
SCOPE VALET PULL THRU
|
Facility
OP
|
$9.00
|
|
| Hospital Charge Code |
22619551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$6.30
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
SCOPE VALET PULL THRU
|
Facility
IP
|
$9.00
|
|
| Hospital Charge Code |
22619551
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
SEAL PORT BIOPSY ADJUSTABLE
|
Facility
OP
|
$75.00
|
|
| Hospital Charge Code |
22354139
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$67.50
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$12.75
|
| Rate for Payer: Amerigroup Medicare |
$12.75
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$28.01
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$12.75
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$12.75
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$19.50
|
| Rate for Payer: Cigna All Products |
$52.50
|
| Rate for Payer: Copperpoint |
$21.04
|
| Rate for Payer: HealthNet Commercial |
$45.00
|
| Rate for Payer: HealthNet Medicare |
$21.00
|
| Rate for Payer: Humana Medicare |
$12.75
|
| Rate for Payer: SELF PAY |
$60.00
|
| Rate for Payer: Veterans (Triwest) |
$12.75
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$43.72
|
| Rate for Payer: United Healthcare Medicare |
$13.50
|
|
|
SEAL PORT BIOPSY ADJUSTABLE
|
Facility
IP
|
$75.00
|
|
| Hospital Charge Code |
22354139
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$67.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$12.75
|
| Rate for Payer: Amerigroup Medicare |
$12.75
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$12.75
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$12.75
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$19.50
|
| Rate for Payer: Copperpoint |
$21.04
|
| Rate for Payer: Humana Medicare |
$12.75
|
| Rate for Payer: SELF PAY |
$60.00
|
| Rate for Payer: Veterans (Triwest) |
$12.75
|
|
|
Sedimentation Rate
|
Facility
IP
|
$34.00
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
633830
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$30.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$5.78
|
| Rate for Payer: Amerigroup Medicare |
$5.78
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$5.78
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$5.78
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$15.64
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$8.84
|
| Rate for Payer: Copperpoint |
$9.54
|
| Rate for Payer: Humana Medicare |
$5.78
|
| Rate for Payer: SELF PAY |
$27.20
|
| Rate for Payer: Veterans (Triwest) |
$5.78
|
|
|
Sedimentation Rate
|
Facility
OP
|
$34.00
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
633830
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$30.60
|
| Rate for Payer: Aetna Medicare |
$9.52
|
| Rate for Payer: AHCCCS Medicaid |
$2.70
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$2.70
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$5.78
|
| Rate for Payer: Amerigroup Medicare |
$5.78
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$12.70
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$2.70
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$5.78
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$5.78
|
| Rate for Payer: Banner University Family Care Medicaid |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$15.64
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$8.84
|
| Rate for Payer: Cigna All Products |
$22.10
|
| Rate for Payer: Copperpoint |
$9.54
|
| Rate for Payer: HealthNet Commercial |
$20.40
|
| Rate for Payer: HealthNet Medicare |
$9.52
|
| Rate for Payer: Humana Medicare |
$5.78
|
| Rate for Payer: Mercy Care Medicaid |
$2.70
|
| Rate for Payer: SELF PAY |
$27.20
|
| Rate for Payer: Veterans (Triwest) |
$5.78
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$19.82
|
| Rate for Payer: United Healthcare Medicare |
$6.12
|
|
|
Seizure
|
Facility
IP
|
$5,959.80
|
|
|
Service Code
|
APRDRG 533
|
| Hospital Charge Code |
APRDRG533
|
| Min. Negotiated Rate |
$5,959.80 |
| Max. Negotiated Rate |
$5,959.80 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$5,959.80
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$5,959.80
|
| Rate for Payer: Banner University Family Care Medicaid |
$5,959.80
|
| Rate for Payer: Mercy Care Medicaid |
$5,959.80
|
|
|
Seizure
|
Facility
IP
|
$14,885.11
|
|
|
Service Code
|
APRDRG 534
|
| Hospital Charge Code |
APRDRG534
|
| Min. Negotiated Rate |
$14,885.11 |
| Max. Negotiated Rate |
$14,885.11 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14,885.11
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14,885.11
|
| Rate for Payer: Banner University Family Care Medicaid |
$14,885.11
|
| Rate for Payer: Mercy Care Medicaid |
$14,885.11
|
|
|
Seizure
|
Facility
IP
|
$4,510.70
|
|
|
Service Code
|
APRDRG 532
|
| Hospital Charge Code |
APRDRG532
|
| Min. Negotiated Rate |
$4,510.70 |
| Max. Negotiated Rate |
$4,510.70 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,510.70
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,510.70
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,510.70
|
| Rate for Payer: Mercy Care Medicaid |
$4,510.70
|
|
|
Seizure
|
Facility
IP
|
$3,695.68
|
|
|
Service Code
|
APRDRG 531
|
| Hospital Charge Code |
APRDRG531
|
| Min. Negotiated Rate |
$3,695.68 |
| Max. Negotiated Rate |
$3,695.68 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$3,695.68
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$3,695.68
|
| Rate for Payer: Banner University Family Care Medicaid |
$3,695.68
|
| Rate for Payer: Mercy Care Medicaid |
$3,695.68
|
|
|
SENSATION SHORT THROW 13MM
|
Facility
OP
|
$44.50
|
|
| Hospital Charge Code |
27497394
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Humana Medicare |
$7.57
|
| Rate for Payer: SELF PAY |
$35.60
|
| Rate for Payer: Aetna POS, PPO, HMO |
$40.05
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.57
|
| Rate for Payer: Amerigroup Medicare |
$7.57
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.62
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.57
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.57
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.57
|
| Rate for Payer: Cigna All Products |
$31.15
|
| Rate for Payer: Copperpoint |
$12.48
|
| Rate for Payer: HealthNet Commercial |
$26.70
|
| Rate for Payer: HealthNet Medicare |
$12.46
|
| Rate for Payer: Veterans (Triwest) |
$7.57
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$25.94
|
| Rate for Payer: United Healthcare Medicare |
$8.01
|
|
|
SENSATION SHORT THROW 13MM
|
Facility
IP
|
$44.50
|
|
| Hospital Charge Code |
27497394
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.05
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.57
|
| Rate for Payer: Amerigroup Medicare |
$7.57
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.57
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.57
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.57
|
| Rate for Payer: Copperpoint |
$12.48
|
| Rate for Payer: Humana Medicare |
$7.57
|
| Rate for Payer: SELF PAY |
$35.60
|
| Rate for Payer: Veterans (Triwest) |
$7.57
|
|
|
SENSOR, NEONATAL/ADLT,OXIMAX
|
Facility
OP
|
$111.00
|
|
| Hospital Charge Code |
23290390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$99.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$99.90
|
| Rate for Payer: Aetna Medicare |
$31.08
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$18.87
|
| Rate for Payer: Amerigroup Medicare |
$18.87
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$41.46
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$18.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$18.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$28.86
|
| Rate for Payer: Cigna All Products |
$77.70
|
| Rate for Payer: Copperpoint |
$31.14
|
| Rate for Payer: HealthNet Commercial |
$66.60
|
| Rate for Payer: HealthNet Medicare |
$31.08
|
| Rate for Payer: Humana Medicare |
$18.87
|
| Rate for Payer: SELF PAY |
$88.80
|
| Rate for Payer: Veterans (Triwest) |
$18.87
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$64.71
|
| Rate for Payer: United Healthcare Medicare |
$19.98
|
|
|
SENSOR, NEONATAL/ADLT,OXIMAX
|
Facility
IP
|
$111.00
|
|
| Hospital Charge Code |
23290390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$99.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$99.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$18.87
|
| Rate for Payer: Amerigroup Medicare |
$18.87
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$18.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$18.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$28.86
|
| Rate for Payer: Copperpoint |
$31.14
|
| Rate for Payer: Humana Medicare |
$18.87
|
| Rate for Payer: SELF PAY |
$88.80
|
| Rate for Payer: Veterans (Triwest) |
$18.87
|
|
|
SENSOR SPO2 INFANT NELLCOR
|
Facility
OP
|
$51.00
|
|
| Hospital Charge Code |
22546699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$45.90
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$8.67
|
| Rate for Payer: Amerigroup Medicare |
$8.67
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$19.05
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$8.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$8.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$13.26
|
| Rate for Payer: Cigna All Products |
$35.70
|
| Rate for Payer: Copperpoint |
$14.31
|
| Rate for Payer: HealthNet Commercial |
$30.60
|
| Rate for Payer: HealthNet Medicare |
$14.28
|
| Rate for Payer: Humana Medicare |
$8.67
|
| Rate for Payer: SELF PAY |
$40.80
|
| Rate for Payer: Veterans (Triwest) |
$8.67
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$29.73
|
| Rate for Payer: United Healthcare Medicare |
$9.18
|
|
|
SENSOR SPO2 INFANT NELLCOR
|
Facility
IP
|
$51.00
|
|
| Hospital Charge Code |
22546699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$45.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$8.67
|
| Rate for Payer: Amerigroup Medicare |
$8.67
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$8.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$8.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$13.26
|
| Rate for Payer: Copperpoint |
$14.31
|
| Rate for Payer: Humana Medicare |
$8.67
|
| Rate for Payer: SELF PAY |
$40.80
|
| Rate for Payer: Veterans (Triwest) |
$8.67
|
|
|
SENSOR SPO2 PEDIATRIC NELLCOR
|
Facility
IP
|
$44.00
|
|
| Hospital Charge Code |
22546697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$39.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.48
|
| Rate for Payer: Amerigroup Medicare |
$7.48
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.48
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.48
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.44
|
| Rate for Payer: Copperpoint |
$12.34
|
| Rate for Payer: Humana Medicare |
$7.48
|
| Rate for Payer: SELF PAY |
$35.20
|
| Rate for Payer: Veterans (Triwest) |
$7.48
|
|
|
SENSOR SPO2 PEDIATRIC NELLCOR
|
Facility
OP
|
$44.00
|
|
| Hospital Charge Code |
22546697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$39.60
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.48
|
| Rate for Payer: Amerigroup Medicare |
$7.48
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.43
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.48
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.48
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.44
|
| Rate for Payer: Cigna All Products |
$30.80
|
| Rate for Payer: Copperpoint |
$12.34
|
| Rate for Payer: HealthNet Commercial |
$26.40
|
| Rate for Payer: HealthNet Medicare |
$12.32
|
| Rate for Payer: Humana Medicare |
$7.48
|
| Rate for Payer: SELF PAY |
$35.20
|
| Rate for Payer: Veterans (Triwest) |
$7.48
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$25.65
|
| Rate for Payer: United Healthcare Medicare |
$7.92
|
|
|
Septicemia And Disseminated Infections
|
Facility
IP
|
$4,966.61
|
|
|
Service Code
|
APRDRG 7202
|
| Hospital Charge Code |
APRDRG7202
|
| Min. Negotiated Rate |
$4,966.61 |
| Max. Negotiated Rate |
$4,966.61 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,966.61
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,966.61
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,966.61
|
| Rate for Payer: Mercy Care Medicaid |
$4,966.61
|
|
|
Septicemia And Disseminated Infections
|
Facility
IP
|
$7,570.91
|
|
|
Service Code
|
APRDRG 7203
|
| Hospital Charge Code |
APRDRG7203
|
| Min. Negotiated Rate |
$7,570.91 |
| Max. Negotiated Rate |
$7,570.91 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$7,570.91
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$7,570.91
|
| Rate for Payer: Banner University Family Care Medicaid |
$7,570.91
|
| Rate for Payer: Mercy Care Medicaid |
$7,570.91
|
|
|
Septicemia And Disseminated Infections
|
Facility
IP
|
$3,873.13
|
|
|
Service Code
|
APRDRG 7201
|
| Hospital Charge Code |
APRDRG7201
|
| Min. Negotiated Rate |
$3,873.13 |
| Max. Negotiated Rate |
$3,873.13 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$3,873.13
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$3,873.13
|
| Rate for Payer: Banner University Family Care Medicaid |
$3,873.13
|
| Rate for Payer: Mercy Care Medicaid |
$3,873.13
|
|
|
Septicemia And Disseminated Infections
|
Facility
IP
|
$14,811.46
|
|
|
Service Code
|
APRDRG 7204
|
| Hospital Charge Code |
APRDRG7204
|
| Min. Negotiated Rate |
$14,811.46 |
| Max. Negotiated Rate |
$14,811.46 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14,811.46
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14,811.46
|
| Rate for Payer: Banner University Family Care Medicaid |
$14,811.46
|
| Rate for Payer: Mercy Care Medicaid |
$14,811.46
|
|