Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$7,417.31
|
|
Service Code
|
APR-DRG 3101
|
Hospital Charge Code |
APRDRG3104
|
Min. Negotiated Rate |
$7,417.31 |
Max. Negotiated Rate |
$7,417.31 |
Rate for Payer: AHCCCS Medicaid |
$7,417.31
|
Rate for Payer: Allwell Medicaid |
$7,417.31
|
Rate for Payer: AZCH Complete Medicaid |
$7,417.31
|
Rate for Payer: Banner UC Health Medicaid |
$7,417.31
|
Rate for Payer: Mercy Care Medicaid |
$7,417.31
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$9,515.89
|
|
Service Code
|
APR-DRG 3102
|
Hospital Charge Code |
APRDRG3101
|
Min. Negotiated Rate |
$9,515.89 |
Max. Negotiated Rate |
$9,515.89 |
Rate for Payer: AHCCCS Medicaid |
$9,515.89
|
Rate for Payer: Allwell Medicaid |
$9,515.89
|
Rate for Payer: AZCH Complete Medicaid |
$9,515.89
|
Rate for Payer: Banner UC Health Medicaid |
$9,515.89
|
Rate for Payer: Mercy Care Medicaid |
$9,515.89
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$7,417.31
|
|
Service Code
|
APR-DRG 3101
|
Hospital Charge Code |
APRDRG3102
|
Min. Negotiated Rate |
$7,417.31 |
Max. Negotiated Rate |
$7,417.31 |
Rate for Payer: AHCCCS Medicaid |
$7,417.31
|
Rate for Payer: Allwell Medicaid |
$7,417.31
|
Rate for Payer: AZCH Complete Medicaid |
$7,417.31
|
Rate for Payer: Banner UC Health Medicaid |
$7,417.31
|
Rate for Payer: Mercy Care Medicaid |
$7,417.31
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$13,581.91
|
|
Service Code
|
APR-DRG 3103
|
Hospital Charge Code |
APRDRG3103
|
Min. Negotiated Rate |
$13,581.91 |
Max. Negotiated Rate |
$13,581.91 |
Rate for Payer: AHCCCS Medicaid |
$13,581.91
|
Rate for Payer: Allwell Medicaid |
$13,581.91
|
Rate for Payer: AZCH Complete Medicaid |
$13,581.91
|
Rate for Payer: Banner UC Health Medicaid |
$13,581.91
|
Rate for Payer: Mercy Care Medicaid |
$13,581.91
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$7,417.31
|
|
Service Code
|
APR-DRG 3101
|
Hospital Charge Code |
APRDRG3103
|
Min. Negotiated Rate |
$7,417.31 |
Max. Negotiated Rate |
$7,417.31 |
Rate for Payer: AHCCCS Medicaid |
$7,417.31
|
Rate for Payer: Allwell Medicaid |
$7,417.31
|
Rate for Payer: AZCH Complete Medicaid |
$7,417.31
|
Rate for Payer: Banner UC Health Medicaid |
$7,417.31
|
Rate for Payer: Mercy Care Medicaid |
$7,417.31
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$9,515.89
|
|
Service Code
|
APR-DRG 3102
|
Hospital Charge Code |
APRDRG3103
|
Min. Negotiated Rate |
$9,515.89 |
Max. Negotiated Rate |
$9,515.89 |
Rate for Payer: AHCCCS Medicaid |
$9,515.89
|
Rate for Payer: Allwell Medicaid |
$9,515.89
|
Rate for Payer: AZCH Complete Medicaid |
$9,515.89
|
Rate for Payer: Banner UC Health Medicaid |
$9,515.89
|
Rate for Payer: Mercy Care Medicaid |
$9,515.89
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$9,515.89
|
|
Service Code
|
APR-DRG 3102
|
Hospital Charge Code |
APRDRG3104
|
Min. Negotiated Rate |
$9,515.89 |
Max. Negotiated Rate |
$9,515.89 |
Rate for Payer: AHCCCS Medicaid |
$9,515.89
|
Rate for Payer: Allwell Medicaid |
$9,515.89
|
Rate for Payer: AZCH Complete Medicaid |
$9,515.89
|
Rate for Payer: Banner UC Health Medicaid |
$9,515.89
|
Rate for Payer: Mercy Care Medicaid |
$9,515.89
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$26,829.25
|
|
Service Code
|
APR-DRG 3104
|
Hospital Charge Code |
APRDRG3104
|
Min. Negotiated Rate |
$26,829.25 |
Max. Negotiated Rate |
$26,829.25 |
Rate for Payer: AHCCCS Medicaid |
$26,829.25
|
Rate for Payer: Allwell Medicaid |
$26,829.25
|
Rate for Payer: AZCH Complete Medicaid |
$26,829.25
|
Rate for Payer: Banner UC Health Medicaid |
$26,829.25
|
Rate for Payer: Mercy Care Medicaid |
$26,829.25
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$13,581.91
|
|
Service Code
|
APR-DRG 3103
|
Hospital Charge Code |
APRDRG3101
|
Min. Negotiated Rate |
$13,581.91 |
Max. Negotiated Rate |
$13,581.91 |
Rate for Payer: AHCCCS Medicaid |
$13,581.91
|
Rate for Payer: Allwell Medicaid |
$13,581.91
|
Rate for Payer: AZCH Complete Medicaid |
$13,581.91
|
Rate for Payer: Banner UC Health Medicaid |
$13,581.91
|
Rate for Payer: Mercy Care Medicaid |
$13,581.91
|
|
Intervertebral Disc Excision And Decompression
|
Facility
|
IP
|
$26,829.25
|
|
Service Code
|
APR-DRG 3104
|
Hospital Charge Code |
APRDRG3101
|
Min. Negotiated Rate |
$26,829.25 |
Max. Negotiated Rate |
$26,829.25 |
Rate for Payer: AHCCCS Medicaid |
$26,829.25
|
Rate for Payer: Allwell Medicaid |
$26,829.25
|
Rate for Payer: AZCH Complete Medicaid |
$26,829.25
|
Rate for Payer: Banner UC Health Medicaid |
$26,829.25
|
Rate for Payer: Mercy Care Medicaid |
$26,829.25
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$12,767.58
|
|
Service Code
|
APR-DRG 2474
|
Hospital Charge Code |
APRDRG2471
|
Min. Negotiated Rate |
$12,767.58 |
Max. Negotiated Rate |
$12,767.58 |
Rate for Payer: AHCCCS Medicaid |
$12,767.58
|
Rate for Payer: Allwell Medicaid |
$12,767.58
|
Rate for Payer: AZCH Complete Medicaid |
$12,767.58
|
Rate for Payer: Banner UC Health Medicaid |
$12,767.58
|
Rate for Payer: Mercy Care Medicaid |
$12,767.58
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$12,767.58
|
|
Service Code
|
APR-DRG 2474
|
Hospital Charge Code |
APRDRG2472
|
Min. Negotiated Rate |
$12,767.58 |
Max. Negotiated Rate |
$12,767.58 |
Rate for Payer: AHCCCS Medicaid |
$12,767.58
|
Rate for Payer: Allwell Medicaid |
$12,767.58
|
Rate for Payer: AZCH Complete Medicaid |
$12,767.58
|
Rate for Payer: Banner UC Health Medicaid |
$12,767.58
|
Rate for Payer: Mercy Care Medicaid |
$12,767.58
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$3,100.19
|
|
Service Code
|
APR-DRG 2471
|
Hospital Charge Code |
APRDRG2473
|
Min. Negotiated Rate |
$3,100.19 |
Max. Negotiated Rate |
$3,100.19 |
Rate for Payer: AHCCCS Medicaid |
$3,100.19
|
Rate for Payer: Allwell Medicaid |
$3,100.19
|
Rate for Payer: AZCH Complete Medicaid |
$3,100.19
|
Rate for Payer: Banner UC Health Medicaid |
$3,100.19
|
Rate for Payer: Mercy Care Medicaid |
$3,100.19
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$12,767.58
|
|
Service Code
|
APR-DRG 2474
|
Hospital Charge Code |
APRDRG2474
|
Min. Negotiated Rate |
$12,767.58 |
Max. Negotiated Rate |
$12,767.58 |
Rate for Payer: AHCCCS Medicaid |
$12,767.58
|
Rate for Payer: Allwell Medicaid |
$12,767.58
|
Rate for Payer: AZCH Complete Medicaid |
$12,767.58
|
Rate for Payer: Banner UC Health Medicaid |
$12,767.58
|
Rate for Payer: Mercy Care Medicaid |
$12,767.58
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$3,100.19
|
|
Service Code
|
APR-DRG 2471
|
Hospital Charge Code |
APRDRG2471
|
Min. Negotiated Rate |
$3,100.19 |
Max. Negotiated Rate |
$3,100.19 |
Rate for Payer: AHCCCS Medicaid |
$3,100.19
|
Rate for Payer: Allwell Medicaid |
$3,100.19
|
Rate for Payer: AZCH Complete Medicaid |
$3,100.19
|
Rate for Payer: Banner UC Health Medicaid |
$3,100.19
|
Rate for Payer: Mercy Care Medicaid |
$3,100.19
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$6,678.73
|
|
Service Code
|
APR-DRG 2473
|
Hospital Charge Code |
APRDRG2473
|
Min. Negotiated Rate |
$6,678.73 |
Max. Negotiated Rate |
$6,678.73 |
Rate for Payer: AHCCCS Medicaid |
$6,678.73
|
Rate for Payer: Allwell Medicaid |
$6,678.73
|
Rate for Payer: AZCH Complete Medicaid |
$6,678.73
|
Rate for Payer: Banner UC Health Medicaid |
$6,678.73
|
Rate for Payer: Mercy Care Medicaid |
$6,678.73
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$6,678.73
|
|
Service Code
|
APR-DRG 2473
|
Hospital Charge Code |
APRDRG2474
|
Min. Negotiated Rate |
$6,678.73 |
Max. Negotiated Rate |
$6,678.73 |
Rate for Payer: AHCCCS Medicaid |
$6,678.73
|
Rate for Payer: Allwell Medicaid |
$6,678.73
|
Rate for Payer: AZCH Complete Medicaid |
$6,678.73
|
Rate for Payer: Banner UC Health Medicaid |
$6,678.73
|
Rate for Payer: Mercy Care Medicaid |
$6,678.73
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$3,100.19
|
|
Service Code
|
APR-DRG 2471
|
Hospital Charge Code |
APRDRG2474
|
Min. Negotiated Rate |
$3,100.19 |
Max. Negotiated Rate |
$3,100.19 |
Rate for Payer: AHCCCS Medicaid |
$3,100.19
|
Rate for Payer: Allwell Medicaid |
$3,100.19
|
Rate for Payer: AZCH Complete Medicaid |
$3,100.19
|
Rate for Payer: Banner UC Health Medicaid |
$3,100.19
|
Rate for Payer: Mercy Care Medicaid |
$3,100.19
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$4,125.63
|
|
Service Code
|
APR-DRG 2472
|
Hospital Charge Code |
APRDRG2474
|
Min. Negotiated Rate |
$4,125.63 |
Max. Negotiated Rate |
$4,125.63 |
Rate for Payer: AHCCCS Medicaid |
$4,125.63
|
Rate for Payer: Allwell Medicaid |
$4,125.63
|
Rate for Payer: AZCH Complete Medicaid |
$4,125.63
|
Rate for Payer: Banner UC Health Medicaid |
$4,125.63
|
Rate for Payer: Mercy Care Medicaid |
$4,125.63
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$6,678.73
|
|
Service Code
|
APR-DRG 2473
|
Hospital Charge Code |
APRDRG2472
|
Min. Negotiated Rate |
$6,678.73 |
Max. Negotiated Rate |
$6,678.73 |
Rate for Payer: AHCCCS Medicaid |
$6,678.73
|
Rate for Payer: Allwell Medicaid |
$6,678.73
|
Rate for Payer: AZCH Complete Medicaid |
$6,678.73
|
Rate for Payer: Banner UC Health Medicaid |
$6,678.73
|
Rate for Payer: Mercy Care Medicaid |
$6,678.73
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$6,678.73
|
|
Service Code
|
APR-DRG 2473
|
Hospital Charge Code |
APRDRG2471
|
Min. Negotiated Rate |
$6,678.73 |
Max. Negotiated Rate |
$6,678.73 |
Rate for Payer: AHCCCS Medicaid |
$6,678.73
|
Rate for Payer: Allwell Medicaid |
$6,678.73
|
Rate for Payer: AZCH Complete Medicaid |
$6,678.73
|
Rate for Payer: Banner UC Health Medicaid |
$6,678.73
|
Rate for Payer: Mercy Care Medicaid |
$6,678.73
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$4,125.63
|
|
Service Code
|
APR-DRG 2472
|
Hospital Charge Code |
APRDRG2473
|
Min. Negotiated Rate |
$4,125.63 |
Max. Negotiated Rate |
$4,125.63 |
Rate for Payer: AHCCCS Medicaid |
$4,125.63
|
Rate for Payer: Allwell Medicaid |
$4,125.63
|
Rate for Payer: AZCH Complete Medicaid |
$4,125.63
|
Rate for Payer: Banner UC Health Medicaid |
$4,125.63
|
Rate for Payer: Mercy Care Medicaid |
$4,125.63
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$4,125.63
|
|
Service Code
|
APR-DRG 2472
|
Hospital Charge Code |
APRDRG2472
|
Min. Negotiated Rate |
$4,125.63 |
Max. Negotiated Rate |
$4,125.63 |
Rate for Payer: AHCCCS Medicaid |
$4,125.63
|
Rate for Payer: Allwell Medicaid |
$4,125.63
|
Rate for Payer: AZCH Complete Medicaid |
$4,125.63
|
Rate for Payer: Banner UC Health Medicaid |
$4,125.63
|
Rate for Payer: Mercy Care Medicaid |
$4,125.63
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$4,125.63
|
|
Service Code
|
APR-DRG 2472
|
Hospital Charge Code |
APRDRG2471
|
Min. Negotiated Rate |
$4,125.63 |
Max. Negotiated Rate |
$4,125.63 |
Rate for Payer: AHCCCS Medicaid |
$4,125.63
|
Rate for Payer: Allwell Medicaid |
$4,125.63
|
Rate for Payer: AZCH Complete Medicaid |
$4,125.63
|
Rate for Payer: Banner UC Health Medicaid |
$4,125.63
|
Rate for Payer: Mercy Care Medicaid |
$4,125.63
|
|
Intestinal Obstruction
|
Facility
|
IP
|
$3,100.19
|
|
Service Code
|
APR-DRG 2471
|
Hospital Charge Code |
APRDRG2472
|
Min. Negotiated Rate |
$3,100.19 |
Max. Negotiated Rate |
$3,100.19 |
Rate for Payer: AHCCCS Medicaid |
$3,100.19
|
Rate for Payer: Allwell Medicaid |
$3,100.19
|
Rate for Payer: AZCH Complete Medicaid |
$3,100.19
|
Rate for Payer: Banner UC Health Medicaid |
$3,100.19
|
Rate for Payer: Mercy Care Medicaid |
$3,100.19
|
|