|
Major Bladder Procedures
|
Facility
|
IP
|
$18,918.16
|
|
|
Service Code
|
APR-DRG 4413
|
| Hospital Charge Code |
APRDRG4414
|
| Min. Negotiated Rate |
$18,918.16 |
| Max. Negotiated Rate |
$18,918.16 |
| Rate for Payer: AHCCCS Medicaid |
$18,918.16
|
| Rate for Payer: Allwell Medicaid |
$18,918.16
|
| Rate for Payer: AZCH Complete Medicaid |
$18,918.16
|
| Rate for Payer: Banner UC Health Medicaid |
$18,918.16
|
| Rate for Payer: Mercy Care Medicaid |
$18,918.16
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$9,977.42
|
|
|
Service Code
|
APR-DRG 4411
|
| Hospital Charge Code |
APRDRG4411
|
| Min. Negotiated Rate |
$9,977.42 |
| Max. Negotiated Rate |
$9,977.42 |
| Rate for Payer: AHCCCS Medicaid |
$9,977.42
|
| Rate for Payer: Allwell Medicaid |
$9,977.42
|
| Rate for Payer: AZCH Complete Medicaid |
$9,977.42
|
| Rate for Payer: Banner UC Health Medicaid |
$9,977.42
|
| Rate for Payer: Mercy Care Medicaid |
$9,977.42
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$9,977.42
|
|
|
Service Code
|
APR-DRG 4411
|
| Hospital Charge Code |
APRDRG4412
|
| Min. Negotiated Rate |
$9,977.42 |
| Max. Negotiated Rate |
$9,977.42 |
| Rate for Payer: AHCCCS Medicaid |
$9,977.42
|
| Rate for Payer: Allwell Medicaid |
$9,977.42
|
| Rate for Payer: AZCH Complete Medicaid |
$9,977.42
|
| Rate for Payer: Banner UC Health Medicaid |
$9,977.42
|
| Rate for Payer: Mercy Care Medicaid |
$9,977.42
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$39,319.78
|
|
|
Service Code
|
APR-DRG 4414
|
| Hospital Charge Code |
APRDRG4411
|
| Min. Negotiated Rate |
$39,319.78 |
| Max. Negotiated Rate |
$39,319.78 |
| Rate for Payer: AHCCCS Medicaid |
$39,319.78
|
| Rate for Payer: Allwell Medicaid |
$39,319.78
|
| Rate for Payer: AZCH Complete Medicaid |
$39,319.78
|
| Rate for Payer: Banner UC Health Medicaid |
$39,319.78
|
| Rate for Payer: Mercy Care Medicaid |
$39,319.78
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$14,750.44
|
|
|
Service Code
|
APR-DRG 4412
|
| Hospital Charge Code |
APRDRG4414
|
| Min. Negotiated Rate |
$14,750.44 |
| Max. Negotiated Rate |
$14,750.44 |
| Rate for Payer: AHCCCS Medicaid |
$14,750.44
|
| Rate for Payer: Allwell Medicaid |
$14,750.44
|
| Rate for Payer: AZCH Complete Medicaid |
$14,750.44
|
| Rate for Payer: Banner UC Health Medicaid |
$14,750.44
|
| Rate for Payer: Mercy Care Medicaid |
$14,750.44
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$39,319.78
|
|
|
Service Code
|
APR-DRG 4414
|
| Hospital Charge Code |
APRDRG4414
|
| Min. Negotiated Rate |
$39,319.78 |
| Max. Negotiated Rate |
$39,319.78 |
| Rate for Payer: AHCCCS Medicaid |
$39,319.78
|
| Rate for Payer: Allwell Medicaid |
$39,319.78
|
| Rate for Payer: AZCH Complete Medicaid |
$39,319.78
|
| Rate for Payer: Banner UC Health Medicaid |
$39,319.78
|
| Rate for Payer: Mercy Care Medicaid |
$39,319.78
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$9,977.42
|
|
|
Service Code
|
APR-DRG 4411
|
| Hospital Charge Code |
APRDRG4413
|
| Min. Negotiated Rate |
$9,977.42 |
| Max. Negotiated Rate |
$9,977.42 |
| Rate for Payer: AHCCCS Medicaid |
$9,977.42
|
| Rate for Payer: Allwell Medicaid |
$9,977.42
|
| Rate for Payer: AZCH Complete Medicaid |
$9,977.42
|
| Rate for Payer: Banner UC Health Medicaid |
$9,977.42
|
| Rate for Payer: Mercy Care Medicaid |
$9,977.42
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$18,918.16
|
|
|
Service Code
|
APR-DRG 4413
|
| Hospital Charge Code |
APRDRG4411
|
| Min. Negotiated Rate |
$18,918.16 |
| Max. Negotiated Rate |
$18,918.16 |
| Rate for Payer: AHCCCS Medicaid |
$18,918.16
|
| Rate for Payer: Allwell Medicaid |
$18,918.16
|
| Rate for Payer: AZCH Complete Medicaid |
$18,918.16
|
| Rate for Payer: Banner UC Health Medicaid |
$18,918.16
|
| Rate for Payer: Mercy Care Medicaid |
$18,918.16
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$39,319.78
|
|
|
Service Code
|
APR-DRG 4414
|
| Hospital Charge Code |
APRDRG4412
|
| Min. Negotiated Rate |
$39,319.78 |
| Max. Negotiated Rate |
$39,319.78 |
| Rate for Payer: AHCCCS Medicaid |
$39,319.78
|
| Rate for Payer: Allwell Medicaid |
$39,319.78
|
| Rate for Payer: AZCH Complete Medicaid |
$39,319.78
|
| Rate for Payer: Banner UC Health Medicaid |
$39,319.78
|
| Rate for Payer: Mercy Care Medicaid |
$39,319.78
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$18,918.16
|
|
|
Service Code
|
APR-DRG 4413
|
| Hospital Charge Code |
APRDRG4413
|
| Min. Negotiated Rate |
$18,918.16 |
| Max. Negotiated Rate |
$18,918.16 |
| Rate for Payer: AHCCCS Medicaid |
$18,918.16
|
| Rate for Payer: Allwell Medicaid |
$18,918.16
|
| Rate for Payer: AZCH Complete Medicaid |
$18,918.16
|
| Rate for Payer: Banner UC Health Medicaid |
$18,918.16
|
| Rate for Payer: Mercy Care Medicaid |
$18,918.16
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$9,977.42
|
|
|
Service Code
|
APR-DRG 4411
|
| Hospital Charge Code |
APRDRG4414
|
| Min. Negotiated Rate |
$9,977.42 |
| Max. Negotiated Rate |
$9,977.42 |
| Rate for Payer: AHCCCS Medicaid |
$9,977.42
|
| Rate for Payer: Allwell Medicaid |
$9,977.42
|
| Rate for Payer: AZCH Complete Medicaid |
$9,977.42
|
| Rate for Payer: Banner UC Health Medicaid |
$9,977.42
|
| Rate for Payer: Mercy Care Medicaid |
$9,977.42
|
|
|
Major Bladder Procedures
|
Facility
|
IP
|
$39,319.78
|
|
|
Service Code
|
APR-DRG 4414
|
| Hospital Charge Code |
APRDRG4413
|
| Min. Negotiated Rate |
$39,319.78 |
| Max. Negotiated Rate |
$39,319.78 |
| Rate for Payer: AHCCCS Medicaid |
$39,319.78
|
| Rate for Payer: Allwell Medicaid |
$39,319.78
|
| Rate for Payer: AZCH Complete Medicaid |
$39,319.78
|
| Rate for Payer: Banner UC Health Medicaid |
$39,319.78
|
| Rate for Payer: Mercy Care Medicaid |
$39,319.78
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$75,687.37
|
|
|
Service Code
|
APR-DRG 1604
|
| Hospital Charge Code |
APRDRG1604
|
| Min. Negotiated Rate |
$75,687.37 |
| Max. Negotiated Rate |
$75,687.37 |
| Rate for Payer: AHCCCS Medicaid |
$75,687.37
|
| Rate for Payer: Allwell Medicaid |
$75,687.37
|
| Rate for Payer: AZCH Complete Medicaid |
$75,687.37
|
| Rate for Payer: Banner UC Health Medicaid |
$75,687.37
|
| Rate for Payer: Mercy Care Medicaid |
$75,687.37
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$35,903.96
|
|
|
Service Code
|
APR-DRG 1603
|
| Hospital Charge Code |
APRDRG1602
|
| Min. Negotiated Rate |
$35,903.96 |
| Max. Negotiated Rate |
$35,903.96 |
| Rate for Payer: AHCCCS Medicaid |
$35,903.96
|
| Rate for Payer: Allwell Medicaid |
$35,903.96
|
| Rate for Payer: AZCH Complete Medicaid |
$35,903.96
|
| Rate for Payer: Banner UC Health Medicaid |
$35,903.96
|
| Rate for Payer: Mercy Care Medicaid |
$35,903.96
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$75,687.37
|
|
|
Service Code
|
APR-DRG 1604
|
| Hospital Charge Code |
APRDRG1602
|
| Min. Negotiated Rate |
$75,687.37 |
| Max. Negotiated Rate |
$75,687.37 |
| Rate for Payer: AHCCCS Medicaid |
$75,687.37
|
| Rate for Payer: Allwell Medicaid |
$75,687.37
|
| Rate for Payer: AZCH Complete Medicaid |
$75,687.37
|
| Rate for Payer: Banner UC Health Medicaid |
$75,687.37
|
| Rate for Payer: Mercy Care Medicaid |
$75,687.37
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$35,903.96
|
|
|
Service Code
|
APR-DRG 1603
|
| Hospital Charge Code |
APRDRG1604
|
| Min. Negotiated Rate |
$35,903.96 |
| Max. Negotiated Rate |
$35,903.96 |
| Rate for Payer: AHCCCS Medicaid |
$35,903.96
|
| Rate for Payer: Allwell Medicaid |
$35,903.96
|
| Rate for Payer: AZCH Complete Medicaid |
$35,903.96
|
| Rate for Payer: Banner UC Health Medicaid |
$35,903.96
|
| Rate for Payer: Mercy Care Medicaid |
$35,903.96
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$26,470.84
|
|
|
Service Code
|
APR-DRG 1602
|
| Hospital Charge Code |
APRDRG1603
|
| Min. Negotiated Rate |
$26,470.84 |
| Max. Negotiated Rate |
$26,470.84 |
| Rate for Payer: AHCCCS Medicaid |
$26,470.84
|
| Rate for Payer: Allwell Medicaid |
$26,470.84
|
| Rate for Payer: AZCH Complete Medicaid |
$26,470.84
|
| Rate for Payer: Banner UC Health Medicaid |
$26,470.84
|
| Rate for Payer: Mercy Care Medicaid |
$26,470.84
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$35,903.96
|
|
|
Service Code
|
APR-DRG 1603
|
| Hospital Charge Code |
APRDRG1601
|
| Min. Negotiated Rate |
$35,903.96 |
| Max. Negotiated Rate |
$35,903.96 |
| Rate for Payer: AHCCCS Medicaid |
$35,903.96
|
| Rate for Payer: Allwell Medicaid |
$35,903.96
|
| Rate for Payer: AZCH Complete Medicaid |
$35,903.96
|
| Rate for Payer: Banner UC Health Medicaid |
$35,903.96
|
| Rate for Payer: Mercy Care Medicaid |
$35,903.96
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$75,687.37
|
|
|
Service Code
|
APR-DRG 1604
|
| Hospital Charge Code |
APRDRG1603
|
| Min. Negotiated Rate |
$75,687.37 |
| Max. Negotiated Rate |
$75,687.37 |
| Rate for Payer: AHCCCS Medicaid |
$75,687.37
|
| Rate for Payer: Allwell Medicaid |
$75,687.37
|
| Rate for Payer: AZCH Complete Medicaid |
$75,687.37
|
| Rate for Payer: Banner UC Health Medicaid |
$75,687.37
|
| Rate for Payer: Mercy Care Medicaid |
$75,687.37
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$75,687.37
|
|
|
Service Code
|
APR-DRG 1604
|
| Hospital Charge Code |
APRDRG1601
|
| Min. Negotiated Rate |
$75,687.37 |
| Max. Negotiated Rate |
$75,687.37 |
| Rate for Payer: AHCCCS Medicaid |
$75,687.37
|
| Rate for Payer: Allwell Medicaid |
$75,687.37
|
| Rate for Payer: AZCH Complete Medicaid |
$75,687.37
|
| Rate for Payer: Banner UC Health Medicaid |
$75,687.37
|
| Rate for Payer: Mercy Care Medicaid |
$75,687.37
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$22,453.92
|
|
|
Service Code
|
APR-DRG 1601
|
| Hospital Charge Code |
APRDRG1602
|
| Min. Negotiated Rate |
$22,453.92 |
| Max. Negotiated Rate |
$22,453.92 |
| Rate for Payer: AHCCCS Medicaid |
$22,453.92
|
| Rate for Payer: Allwell Medicaid |
$22,453.92
|
| Rate for Payer: AZCH Complete Medicaid |
$22,453.92
|
| Rate for Payer: Banner UC Health Medicaid |
$22,453.92
|
| Rate for Payer: Mercy Care Medicaid |
$22,453.92
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$35,903.96
|
|
|
Service Code
|
APR-DRG 1603
|
| Hospital Charge Code |
APRDRG1603
|
| Min. Negotiated Rate |
$35,903.96 |
| Max. Negotiated Rate |
$35,903.96 |
| Rate for Payer: AHCCCS Medicaid |
$35,903.96
|
| Rate for Payer: Allwell Medicaid |
$35,903.96
|
| Rate for Payer: AZCH Complete Medicaid |
$35,903.96
|
| Rate for Payer: Banner UC Health Medicaid |
$35,903.96
|
| Rate for Payer: Mercy Care Medicaid |
$35,903.96
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$22,453.92
|
|
|
Service Code
|
APR-DRG 1601
|
| Hospital Charge Code |
APRDRG1604
|
| Min. Negotiated Rate |
$22,453.92 |
| Max. Negotiated Rate |
$22,453.92 |
| Rate for Payer: AHCCCS Medicaid |
$22,453.92
|
| Rate for Payer: Allwell Medicaid |
$22,453.92
|
| Rate for Payer: AZCH Complete Medicaid |
$22,453.92
|
| Rate for Payer: Banner UC Health Medicaid |
$22,453.92
|
| Rate for Payer: Mercy Care Medicaid |
$22,453.92
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$26,470.84
|
|
|
Service Code
|
APR-DRG 1602
|
| Hospital Charge Code |
APRDRG1601
|
| Min. Negotiated Rate |
$26,470.84 |
| Max. Negotiated Rate |
$26,470.84 |
| Rate for Payer: AHCCCS Medicaid |
$26,470.84
|
| Rate for Payer: Allwell Medicaid |
$26,470.84
|
| Rate for Payer: AZCH Complete Medicaid |
$26,470.84
|
| Rate for Payer: Banner UC Health Medicaid |
$26,470.84
|
| Rate for Payer: Mercy Care Medicaid |
$26,470.84
|
|
|
Major Cardiothoracic Repair Of Heart Anomaly
|
Facility
|
IP
|
$22,453.92
|
|
|
Service Code
|
APR-DRG 1601
|
| Hospital Charge Code |
APRDRG1601
|
| Min. Negotiated Rate |
$22,453.92 |
| Max. Negotiated Rate |
$22,453.92 |
| Rate for Payer: AHCCCS Medicaid |
$22,453.92
|
| Rate for Payer: Allwell Medicaid |
$22,453.92
|
| Rate for Payer: AZCH Complete Medicaid |
$22,453.92
|
| Rate for Payer: Banner UC Health Medicaid |
$22,453.92
|
| Rate for Payer: Mercy Care Medicaid |
$22,453.92
|
|
