|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$26,146.09
|
|
|
Service Code
|
APR-DRG 2274
|
| Hospital Charge Code |
APRDRG2273
|
| Min. Negotiated Rate |
$26,146.09 |
| Max. Negotiated Rate |
$26,146.09 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$26,146.09
|
| Rate for Payer: Mercy Care Medicaid |
$26,146.09
|
| Rate for Payer: NaphCare Correctional Healthcare |
$26,146.09
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$7,520.41
|
|
|
Service Code
|
APR-DRG 2271
|
| Hospital Charge Code |
APRDRG2272
|
| Min. Negotiated Rate |
$7,520.41 |
| Max. Negotiated Rate |
$7,520.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,520.41
|
| Rate for Payer: Mercy Care Medicaid |
$7,520.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,520.41
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$26,146.09
|
|
|
Service Code
|
APR-DRG 2274
|
| Hospital Charge Code |
APRDRG2274
|
| Min. Negotiated Rate |
$26,146.09 |
| Max. Negotiated Rate |
$26,146.09 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$26,146.09
|
| Rate for Payer: Mercy Care Medicaid |
$26,146.09
|
| Rate for Payer: NaphCare Correctional Healthcare |
$26,146.09
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$14,697.84
|
|
|
Service Code
|
APR-DRG 2273
|
| Hospital Charge Code |
APRDRG2272
|
| Min. Negotiated Rate |
$14,697.84 |
| Max. Negotiated Rate |
$14,697.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,697.84
|
| Rate for Payer: Mercy Care Medicaid |
$14,697.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,697.84
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$26,146.09
|
|
|
Service Code
|
APR-DRG 2274
|
| Hospital Charge Code |
APRDRG2271
|
| Min. Negotiated Rate |
$26,146.09 |
| Max. Negotiated Rate |
$26,146.09 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$26,146.09
|
| Rate for Payer: Mercy Care Medicaid |
$26,146.09
|
| Rate for Payer: NaphCare Correctional Healthcare |
$26,146.09
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$14,697.84
|
|
|
Service Code
|
APR-DRG 2273
|
| Hospital Charge Code |
APRDRG2271
|
| Min. Negotiated Rate |
$14,697.84 |
| Max. Negotiated Rate |
$14,697.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,697.84
|
| Rate for Payer: Mercy Care Medicaid |
$14,697.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,697.84
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$14,697.84
|
|
|
Service Code
|
APR-DRG 2273
|
| Hospital Charge Code |
APRDRG2274
|
| Min. Negotiated Rate |
$14,697.84 |
| Max. Negotiated Rate |
$14,697.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,697.84
|
| Rate for Payer: Mercy Care Medicaid |
$14,697.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,697.84
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$26,146.09
|
|
|
Service Code
|
APR-DRG 2274
|
| Hospital Charge Code |
APRDRG2272
|
| Min. Negotiated Rate |
$26,146.09 |
| Max. Negotiated Rate |
$26,146.09 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$26,146.09
|
| Rate for Payer: Mercy Care Medicaid |
$26,146.09
|
| Rate for Payer: NaphCare Correctional Healthcare |
$26,146.09
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$9,499.76
|
|
|
Service Code
|
APR-DRG 2272
|
| Hospital Charge Code |
APRDRG2273
|
| Min. Negotiated Rate |
$9,499.76 |
| Max. Negotiated Rate |
$9,499.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,499.76
|
| Rate for Payer: Mercy Care Medicaid |
$9,499.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,499.76
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$7,520.41
|
|
|
Service Code
|
APR-DRG 2271
|
| Hospital Charge Code |
APRDRG2273
|
| Min. Negotiated Rate |
$7,520.41 |
| Max. Negotiated Rate |
$7,520.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,520.41
|
| Rate for Payer: Mercy Care Medicaid |
$7,520.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,520.41
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$7,520.41
|
|
|
Service Code
|
APR-DRG 2271
|
| Hospital Charge Code |
APRDRG2271
|
| Min. Negotiated Rate |
$7,520.41 |
| Max. Negotiated Rate |
$7,520.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,520.41
|
| Rate for Payer: Mercy Care Medicaid |
$7,520.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,520.41
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$9,499.76
|
|
|
Service Code
|
APR-DRG 2272
|
| Hospital Charge Code |
APRDRG2274
|
| Min. Negotiated Rate |
$9,499.76 |
| Max. Negotiated Rate |
$9,499.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,499.76
|
| Rate for Payer: Mercy Care Medicaid |
$9,499.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,499.76
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$7,520.41
|
|
|
Service Code
|
APR-DRG 2271
|
| Hospital Charge Code |
APRDRG2274
|
| Min. Negotiated Rate |
$7,520.41 |
| Max. Negotiated Rate |
$7,520.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,520.41
|
| Rate for Payer: Mercy Care Medicaid |
$7,520.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,520.41
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$9,499.76
|
|
|
Service Code
|
APR-DRG 2272
|
| Hospital Charge Code |
APRDRG2271
|
| Min. Negotiated Rate |
$9,499.76 |
| Max. Negotiated Rate |
$9,499.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,499.76
|
| Rate for Payer: Mercy Care Medicaid |
$9,499.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,499.76
|
|
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
Facility
|
IP
|
$14,697.84
|
|
|
Service Code
|
APR-DRG 2273
|
| Hospital Charge Code |
APRDRG2273
|
| Min. Negotiated Rate |
$14,697.84 |
| Max. Negotiated Rate |
$14,697.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,697.84
|
| Rate for Payer: Mercy Care Medicaid |
$14,697.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,697.84
|
|
|
Herpes Simplex (HSV) 1 2, NAA
|
Facility
|
IP
|
$573.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
22587723
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$515.70 |
| Max. Negotiated Rate |
$515.70 |
| Rate for Payer: Aetna of AZ Commercial |
$515.70
|
| Rate for Payer: Cash Price |
$458.40
|
|
|
Herpes Simplex (HSV) 1 2, NAA
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
22948345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.88 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Aetna of AZ Commercial |
$542.70
|
| Rate for Payer: Arizona Complete Health Allwell |
$96.48
|
| Rate for Payer: Banner UC Health Medicare |
$96.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$410.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$96.48
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$96.48
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Cigna of AZ Commercial |
$391.95
|
| Rate for Payer: Devoted Health Medicare |
$108.54
|
| Rate for Payer: Humana of AZ Medicare |
$96.48
|
| Rate for Payer: Seven Corners Travel Insurance |
$50.88
|
| Rate for Payer: Southwest Service Administrators UFCW |
$410.04
|
| Rate for Payer: TriWest Medicare |
$96.48
|
| Rate for Payer: United Healthcare Commercial |
$344.92
|
| Rate for Payer: United Healthcare Medicare |
$96.48
|
| Rate for Payer: Veterans Affairs TRICARE |
$95.52
|
|
|
Herpes Simplex (HSV) 1 2, NAA
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
22948345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$542.70 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Aetna of AZ Commercial |
$542.70
|
| Rate for Payer: Cash Price |
$482.40
|
|
|
Herpes Simplex (HSV) 1 2, NAA
|
Facility
|
OP
|
$573.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
22587723
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.88 |
| Max. Negotiated Rate |
$515.70 |
| Rate for Payer: Aetna of AZ Commercial |
$515.70
|
| Rate for Payer: Arizona Complete Health Allwell |
$91.68
|
| Rate for Payer: Banner UC Health Medicare |
$91.68
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$389.64
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$91.68
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$91.68
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cigna of AZ Commercial |
$372.45
|
| Rate for Payer: Devoted Health Medicare |
$103.14
|
| Rate for Payer: Humana of AZ Medicare |
$91.68
|
| Rate for Payer: Seven Corners Travel Insurance |
$50.88
|
| Rate for Payer: Southwest Service Administrators UFCW |
$389.64
|
| Rate for Payer: TriWest Medicare |
$91.68
|
| Rate for Payer: United Healthcare Commercial |
$327.76
|
| Rate for Payer: United Healthcare Medicare |
$91.68
|
| Rate for Payer: Veterans Affairs TRICARE |
$90.76
|
|
|
Hgb Frac. w/o Solubility LC
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
2087611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.19 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Aetna of AZ Commercial |
$191.70
|
| Rate for Payer: Arizona Complete Health Allwell |
$34.08
|
| Rate for Payer: Banner UC Health Medicare |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$144.84
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$34.08
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$34.08
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cigna of AZ Commercial |
$138.45
|
| Rate for Payer: Devoted Health Medicare |
$38.34
|
| Rate for Payer: Humana of AZ Medicare |
$34.08
|
| Rate for Payer: Seven Corners Travel Insurance |
$26.19
|
| Rate for Payer: Southwest Service Administrators UFCW |
$144.84
|
| Rate for Payer: TriWest Medicare |
$34.08
|
| Rate for Payer: United Healthcare Commercial |
$121.84
|
| Rate for Payer: United Healthcare Medicare |
$34.08
|
| Rate for Payer: Veterans Affairs TRICARE |
$33.74
|
|
|
Hgb Frac. w/o Solubility LC
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
2087611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Aetna of AZ Commercial |
$191.70
|
| Rate for Payer: Cash Price |
$170.40
|
|
|
HIFLO BUBBLE HUMIDIFIER EMPTY
|
Facility
|
OP
|
$148.00
|
|
| Hospital Charge Code |
24180129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.44 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna of AZ Commercial |
$133.20
|
| Rate for Payer: Arizona Complete Health Allwell |
$23.68
|
| Rate for Payer: Banner UC Health Medicare |
$23.68
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$100.64
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$23.68
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$23.68
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cigna of AZ Commercial |
$103.60
|
| Rate for Payer: Devoted Health Medicare |
$26.64
|
| Rate for Payer: Humana of AZ Medicare |
$23.68
|
| Rate for Payer: Southwest Service Administrators UFCW |
$100.64
|
| Rate for Payer: TriWest Medicare |
$23.68
|
| Rate for Payer: United Healthcare Commercial |
$84.66
|
| Rate for Payer: United Healthcare Medicare |
$23.68
|
| Rate for Payer: Veterans Affairs TRICARE |
$23.44
|
|
|
HIFLO BUBBLE HUMIDIFIER EMPTY
|
Facility
|
IP
|
$148.00
|
|
| Hospital Charge Code |
24180129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$133.20 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna of AZ Commercial |
$133.20
|
| Rate for Payer: Cash Price |
$118.40
|
|
|
HIGHFLOW NASAL CANNULA
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
24153385
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna of AZ Commercial |
$14.40
|
| Rate for Payer: Arizona Complete Health Allwell |
$2.56
|
| Rate for Payer: Banner UC Health Medicare |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$10.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$2.56
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$2.56
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cigna of AZ Commercial |
$11.20
|
| Rate for Payer: Devoted Health Medicare |
$2.88
|
| Rate for Payer: Humana of AZ Medicare |
$2.56
|
| Rate for Payer: Southwest Service Administrators UFCW |
$10.88
|
| Rate for Payer: TriWest Medicare |
$2.56
|
| Rate for Payer: United Healthcare Commercial |
$9.15
|
| Rate for Payer: United Healthcare Medicare |
$2.56
|
| Rate for Payer: Veterans Affairs TRICARE |
$2.53
|
|
|
HIGHFLOW NASAL CANNULA
|
Facility
|
IP
|
$16.00
|
|
| Hospital Charge Code |
24153385
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna of AZ Commercial |
$14.40
|
| Rate for Payer: Cash Price |
$12.80
|
|
