|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$4,914.71
|
|
|
Service Code
|
APR-DRG 1133
|
| Hospital Charge Code |
APRDRG1131
|
| Min. Negotiated Rate |
$4,914.71 |
| Max. Negotiated Rate |
$4,914.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,914.71
|
| Rate for Payer: Mercy Care Medicaid |
$4,914.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,914.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$9,409.98
|
|
|
Service Code
|
APR-DRG 1134
|
| Hospital Charge Code |
APRDRG1133
|
| Min. Negotiated Rate |
$9,409.98 |
| Max. Negotiated Rate |
$9,409.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,409.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,409.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,409.98
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$3,359.71
|
|
|
Service Code
|
APR-DRG 1132
|
| Hospital Charge Code |
APRDRG1133
|
| Min. Negotiated Rate |
$3,359.71 |
| Max. Negotiated Rate |
$3,359.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,359.71
|
| Rate for Payer: Mercy Care Medicaid |
$3,359.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,359.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$9,409.98
|
|
|
Service Code
|
APR-DRG 1134
|
| Hospital Charge Code |
APRDRG1134
|
| Min. Negotiated Rate |
$9,409.98 |
| Max. Negotiated Rate |
$9,409.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,409.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,409.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,409.98
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$3,359.71
|
|
|
Service Code
|
APR-DRG 1132
|
| Hospital Charge Code |
APRDRG1134
|
| Min. Negotiated Rate |
$3,359.71 |
| Max. Negotiated Rate |
$3,359.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,359.71
|
| Rate for Payer: Mercy Care Medicaid |
$3,359.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,359.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$3,359.71
|
|
|
Service Code
|
APR-DRG 1132
|
| Hospital Charge Code |
APRDRG1131
|
| Min. Negotiated Rate |
$3,359.71 |
| Max. Negotiated Rate |
$3,359.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,359.71
|
| Rate for Payer: Mercy Care Medicaid |
$3,359.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,359.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$3,359.71
|
|
|
Service Code
|
APR-DRG 1132
|
| Hospital Charge Code |
APRDRG1132
|
| Min. Negotiated Rate |
$3,359.71 |
| Max. Negotiated Rate |
$3,359.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,359.71
|
| Rate for Payer: Mercy Care Medicaid |
$3,359.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,359.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$2,419.13
|
|
|
Service Code
|
APR-DRG 1131
|
| Hospital Charge Code |
APRDRG1134
|
| Min. Negotiated Rate |
$2,419.13 |
| Max. Negotiated Rate |
$2,419.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,419.13
|
| Rate for Payer: Mercy Care Medicaid |
$2,419.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,419.13
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$9,409.98
|
|
|
Service Code
|
APR-DRG 1134
|
| Hospital Charge Code |
APRDRG1131
|
| Min. Negotiated Rate |
$9,409.98 |
| Max. Negotiated Rate |
$9,409.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,409.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,409.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,409.98
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$2,419.13
|
|
|
Service Code
|
APR-DRG 1131
|
| Hospital Charge Code |
APRDRG1131
|
| Min. Negotiated Rate |
$2,419.13 |
| Max. Negotiated Rate |
$2,419.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,419.13
|
| Rate for Payer: Mercy Care Medicaid |
$2,419.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,419.13
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$4,914.71
|
|
|
Service Code
|
APR-DRG 1133
|
| Hospital Charge Code |
APRDRG1134
|
| Min. Negotiated Rate |
$4,914.71 |
| Max. Negotiated Rate |
$4,914.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,914.71
|
| Rate for Payer: Mercy Care Medicaid |
$4,914.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,914.71
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$2,419.13
|
|
|
Service Code
|
APR-DRG 1131
|
| Hospital Charge Code |
APRDRG1133
|
| Min. Negotiated Rate |
$2,419.13 |
| Max. Negotiated Rate |
$2,419.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,419.13
|
| Rate for Payer: Mercy Care Medicaid |
$2,419.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,419.13
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$9,409.98
|
|
|
Service Code
|
APR-DRG 1134
|
| Hospital Charge Code |
APRDRG1132
|
| Min. Negotiated Rate |
$9,409.98 |
| Max. Negotiated Rate |
$9,409.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,409.98
|
| Rate for Payer: Mercy Care Medicaid |
$9,409.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,409.98
|
|
|
Infections Of Upper Respiratory Tract
|
Facility
|
IP
|
$4,914.71
|
|
|
Service Code
|
APR-DRG 1133
|
| Hospital Charge Code |
APRDRG1132
|
| Min. Negotiated Rate |
$4,914.71 |
| Max. Negotiated Rate |
$4,914.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,914.71
|
| Rate for Payer: Mercy Care Medicaid |
$4,914.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,914.71
|
|
|
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
23934513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna of AZ Commercial |
$93.60
|
| Rate for Payer: Cash Price |
$83.20
|
|
|
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
23934513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna of AZ Commercial |
$93.60
|
| Rate for Payer: Arizona Complete Health Allwell |
$16.64
|
| Rate for Payer: Banner UC Health Medicare |
$16.64
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$70.72
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$16.64
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$16.64
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cigna of AZ Commercial |
$67.60
|
| Rate for Payer: Devoted Health Medicare |
$18.72
|
| Rate for Payer: Humana of AZ Medicare |
$16.64
|
| Rate for Payer: Seven Corners Travel Insurance |
$74.40
|
| Rate for Payer: Southwest Service Administrators UFCW |
$70.72
|
| Rate for Payer: TriWest Medicare |
$16.64
|
| Rate for Payer: United Healthcare Commercial |
$59.49
|
| Rate for Payer: United Healthcare Medicare |
$16.64
|
| Rate for Payer: Veterans Affairs TRICARE |
$16.47
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$33,463.79
|
|
|
Service Code
|
APR-DRG 7104
|
| Hospital Charge Code |
APRDRG7102
|
| Min. Negotiated Rate |
$33,463.79 |
| Max. Negotiated Rate |
$33,463.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,463.79
|
| Rate for Payer: Mercy Care Medicaid |
$33,463.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,463.79
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$17,367.37
|
|
|
Service Code
|
APR-DRG 7103
|
| Hospital Charge Code |
APRDRG7102
|
| Min. Negotiated Rate |
$17,367.37 |
| Max. Negotiated Rate |
$17,367.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,367.37
|
| Rate for Payer: Mercy Care Medicaid |
$17,367.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,367.37
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$17,367.37
|
|
|
Service Code
|
APR-DRG 7103
|
| Hospital Charge Code |
APRDRG7103
|
| Min. Negotiated Rate |
$17,367.37 |
| Max. Negotiated Rate |
$17,367.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,367.37
|
| Rate for Payer: Mercy Care Medicaid |
$17,367.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,367.37
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$33,463.79
|
|
|
Service Code
|
APR-DRG 7104
|
| Hospital Charge Code |
APRDRG7103
|
| Min. Negotiated Rate |
$33,463.79 |
| Max. Negotiated Rate |
$33,463.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,463.79
|
| Rate for Payer: Mercy Care Medicaid |
$33,463.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,463.79
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$7,378.73
|
|
|
Service Code
|
APR-DRG 7101
|
| Hospital Charge Code |
APRDRG7104
|
| Min. Negotiated Rate |
$7,378.73 |
| Max. Negotiated Rate |
$7,378.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,378.73
|
| Rate for Payer: Mercy Care Medicaid |
$7,378.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,378.73
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$33,463.79
|
|
|
Service Code
|
APR-DRG 7104
|
| Hospital Charge Code |
APRDRG7104
|
| Min. Negotiated Rate |
$33,463.79 |
| Max. Negotiated Rate |
$33,463.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,463.79
|
| Rate for Payer: Mercy Care Medicaid |
$33,463.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,463.79
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$7,378.73
|
|
|
Service Code
|
APR-DRG 7101
|
| Hospital Charge Code |
APRDRG7101
|
| Min. Negotiated Rate |
$7,378.73 |
| Max. Negotiated Rate |
$7,378.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,378.73
|
| Rate for Payer: Mercy Care Medicaid |
$7,378.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,378.73
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$10,647.95
|
|
|
Service Code
|
APR-DRG 7102
|
| Hospital Charge Code |
APRDRG7104
|
| Min. Negotiated Rate |
$10,647.95 |
| Max. Negotiated Rate |
$10,647.95 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,647.95
|
| Rate for Payer: Mercy Care Medicaid |
$10,647.95
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,647.95
|
|
|
Infectious And Parasitic Diseases Including Hiv With O.R. Procedure
|
Facility
|
IP
|
$33,463.79
|
|
|
Service Code
|
APR-DRG 7104
|
| Hospital Charge Code |
APRDRG7101
|
| Min. Negotiated Rate |
$33,463.79 |
| Max. Negotiated Rate |
$33,463.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,463.79
|
| Rate for Payer: Mercy Care Medicaid |
$33,463.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,463.79
|
|
