|
Abdominal Pain
|
Facility
|
IP
|
$3,504.19
|
|
|
Service Code
|
APR-DRG 2511
|
| Hospital Charge Code |
APRDRG2512
|
| Min. Negotiated Rate |
$3,504.19 |
| Max. Negotiated Rate |
$3,504.19 |
| Rate for Payer: AHCCCS Medicaid |
$3,504.19
|
| Rate for Payer: Allwell Medicaid |
$3,504.19
|
| Rate for Payer: AZCH Complete Medicaid |
$3,504.19
|
| Rate for Payer: Banner UC Health Medicaid |
$3,504.19
|
| Rate for Payer: Mercy Care Medicaid |
$3,504.19
|
|
|
ABG STICK
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
2280035
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$48.88 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna of AZ Commercial |
$169.20
|
| Rate for Payer: Bisbee Police All Plans |
$48.88
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Self Pay Self Pay |
$150.40
|
|
|
ABG STICK
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
2280035
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$2,161.00 |
| Rate for Payer: Aetna of AZ Commercial |
$169.20
|
| Rate for Payer: Aetna of AZ Medicare |
$52.64
|
| Rate for Payer: AHCCCS Medicaid |
$162.32
|
| Rate for Payer: Allwell Medicaid |
$162.32
|
| Rate for Payer: Allwell Medicare |
$28.20
|
| Rate for Payer: Amerigroup Medicare |
$28.20
|
| Rate for Payer: APIPA Medicare/Medicaid |
$70.22
|
| Rate for Payer: AZCH Complete Medicaid |
$162.32
|
| Rate for Payer: AZCH Complete Medicare |
$28.20
|
| Rate for Payer: Banner UC Health Medicaid |
$162.32
|
| Rate for Payer: Banner UC Health Medicare |
$28.20
|
| Rate for Payer: Bisbee Police All Plans |
$48.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$127.84
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cigna of AZ Commercial |
$131.60
|
| Rate for Payer: Copperpoint Commercial |
$46.53
|
| Rate for Payer: Health Net of AZ Commercial |
$112.80
|
| Rate for Payer: Health Net of AZ Medicare |
$52.64
|
| Rate for Payer: Humana of AZ Medicare |
$28.20
|
| Rate for Payer: Mercy Care Medicaid |
$162.32
|
| Rate for Payer: Self Pay Self Pay |
$150.40
|
| Rate for Payer: TriWest Medicare |
$28.20
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$2,161.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$33.84
|
|
|
ABORh
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
1481849
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.14 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna of AZ Commercial |
$80.10
|
| Rate for Payer: Bisbee Police All Plans |
$23.14
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Self Pay Self Pay |
$71.20
|
|
|
ABORh
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
1481849
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna of AZ Commercial |
$80.10
|
| Rate for Payer: Aetna of AZ Medicare |
$24.92
|
| Rate for Payer: AHCCCS Medicaid |
$2.99
|
| Rate for Payer: Allwell Medicaid |
$2.99
|
| Rate for Payer: Allwell Medicare |
$13.35
|
| Rate for Payer: Amerigroup Medicare |
$13.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$33.24
|
| Rate for Payer: AZCH Complete Medicaid |
$2.99
|
| Rate for Payer: AZCH Complete Medicare |
$13.35
|
| Rate for Payer: Banner UC Health Medicaid |
$2.99
|
| Rate for Payer: Banner UC Health Medicare |
$13.35
|
| Rate for Payer: Bisbee Police All Plans |
$23.14
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$60.52
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cigna of AZ Commercial |
$57.85
|
| Rate for Payer: Copperpoint Commercial |
$22.03
|
| Rate for Payer: Health Net of AZ Commercial |
$53.40
|
| Rate for Payer: Health Net of AZ Medicare |
$24.92
|
| Rate for Payer: Humana of AZ Medicare |
$13.35
|
| Rate for Payer: Mercy Care Medicaid |
$2.99
|
| Rate for Payer: Self Pay Self Pay |
$71.20
|
| Rate for Payer: TriWest Medicare |
$13.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$51.89
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$16.02
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$3,385.66
|
|
|
Service Code
|
APR-DRG 5431
|
| Hospital Charge Code |
APRDRG5434
|
| Min. Negotiated Rate |
$3,385.66 |
| Max. Negotiated Rate |
$3,385.66 |
| Rate for Payer: AHCCCS Medicaid |
$3,385.66
|
| Rate for Payer: Allwell Medicaid |
$3,385.66
|
| Rate for Payer: AZCH Complete Medicaid |
$3,385.66
|
| Rate for Payer: Banner UC Health Medicaid |
$3,385.66
|
| Rate for Payer: Mercy Care Medicaid |
$3,385.66
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$13,229.11
|
|
|
Service Code
|
APR-DRG 5434
|
| Hospital Charge Code |
APRDRG5431
|
| Min. Negotiated Rate |
$13,229.11 |
| Max. Negotiated Rate |
$13,229.11 |
| Rate for Payer: AHCCCS Medicaid |
$13,229.11
|
| Rate for Payer: Allwell Medicaid |
$13,229.11
|
| Rate for Payer: AZCH Complete Medicaid |
$13,229.11
|
| Rate for Payer: Banner UC Health Medicaid |
$13,229.11
|
| Rate for Payer: Mercy Care Medicaid |
$13,229.11
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$13,229.11
|
|
|
Service Code
|
APR-DRG 5434
|
| Hospital Charge Code |
APRDRG5433
|
| Min. Negotiated Rate |
$13,229.11 |
| Max. Negotiated Rate |
$13,229.11 |
| Rate for Payer: AHCCCS Medicaid |
$13,229.11
|
| Rate for Payer: Allwell Medicaid |
$13,229.11
|
| Rate for Payer: AZCH Complete Medicaid |
$13,229.11
|
| Rate for Payer: Banner UC Health Medicaid |
$13,229.11
|
| Rate for Payer: Mercy Care Medicaid |
$13,229.11
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$13,229.11
|
|
|
Service Code
|
APR-DRG 5434
|
| Hospital Charge Code |
APRDRG5434
|
| Min. Negotiated Rate |
$13,229.11 |
| Max. Negotiated Rate |
$13,229.11 |
| Rate for Payer: AHCCCS Medicaid |
$13,229.11
|
| Rate for Payer: Allwell Medicaid |
$13,229.11
|
| Rate for Payer: AZCH Complete Medicaid |
$13,229.11
|
| Rate for Payer: Banner UC Health Medicaid |
$13,229.11
|
| Rate for Payer: Mercy Care Medicaid |
$13,229.11
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$5,752.18
|
|
|
Service Code
|
APR-DRG 5433
|
| Hospital Charge Code |
APRDRG5432
|
| Min. Negotiated Rate |
$5,752.18 |
| Max. Negotiated Rate |
$5,752.18 |
| Rate for Payer: AHCCCS Medicaid |
$5,752.18
|
| Rate for Payer: Allwell Medicaid |
$5,752.18
|
| Rate for Payer: AZCH Complete Medicaid |
$5,752.18
|
| Rate for Payer: Banner UC Health Medicaid |
$5,752.18
|
| Rate for Payer: Mercy Care Medicaid |
$5,752.18
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$5,752.18
|
|
|
Service Code
|
APR-DRG 5433
|
| Hospital Charge Code |
APRDRG5431
|
| Min. Negotiated Rate |
$5,752.18 |
| Max. Negotiated Rate |
$5,752.18 |
| Rate for Payer: AHCCCS Medicaid |
$5,752.18
|
| Rate for Payer: Allwell Medicaid |
$5,752.18
|
| Rate for Payer: AZCH Complete Medicaid |
$5,752.18
|
| Rate for Payer: Banner UC Health Medicaid |
$5,752.18
|
| Rate for Payer: Mercy Care Medicaid |
$5,752.18
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$3,385.66
|
|
|
Service Code
|
APR-DRG 5431
|
| Hospital Charge Code |
APRDRG5431
|
| Min. Negotiated Rate |
$3,385.66 |
| Max. Negotiated Rate |
$3,385.66 |
| Rate for Payer: AHCCCS Medicaid |
$3,385.66
|
| Rate for Payer: Allwell Medicaid |
$3,385.66
|
| Rate for Payer: AZCH Complete Medicaid |
$3,385.66
|
| Rate for Payer: Banner UC Health Medicaid |
$3,385.66
|
| Rate for Payer: Mercy Care Medicaid |
$3,385.66
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$3,385.66
|
|
|
Service Code
|
APR-DRG 5431
|
| Hospital Charge Code |
APRDRG5433
|
| Min. Negotiated Rate |
$3,385.66 |
| Max. Negotiated Rate |
$3,385.66 |
| Rate for Payer: AHCCCS Medicaid |
$3,385.66
|
| Rate for Payer: Allwell Medicaid |
$3,385.66
|
| Rate for Payer: AZCH Complete Medicaid |
$3,385.66
|
| Rate for Payer: Banner UC Health Medicaid |
$3,385.66
|
| Rate for Payer: Mercy Care Medicaid |
$3,385.66
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$4,146.68
|
|
|
Service Code
|
APR-DRG 5432
|
| Hospital Charge Code |
APRDRG5432
|
| Min. Negotiated Rate |
$4,146.68 |
| Max. Negotiated Rate |
$4,146.68 |
| Rate for Payer: AHCCCS Medicaid |
$4,146.68
|
| Rate for Payer: Allwell Medicaid |
$4,146.68
|
| Rate for Payer: AZCH Complete Medicaid |
$4,146.68
|
| Rate for Payer: Banner UC Health Medicaid |
$4,146.68
|
| Rate for Payer: Mercy Care Medicaid |
$4,146.68
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$4,146.68
|
|
|
Service Code
|
APR-DRG 5432
|
| Hospital Charge Code |
APRDRG5434
|
| Min. Negotiated Rate |
$4,146.68 |
| Max. Negotiated Rate |
$4,146.68 |
| Rate for Payer: AHCCCS Medicaid |
$4,146.68
|
| Rate for Payer: Allwell Medicaid |
$4,146.68
|
| Rate for Payer: AZCH Complete Medicaid |
$4,146.68
|
| Rate for Payer: Banner UC Health Medicaid |
$4,146.68
|
| Rate for Payer: Mercy Care Medicaid |
$4,146.68
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$13,229.11
|
|
|
Service Code
|
APR-DRG 5434
|
| Hospital Charge Code |
APRDRG5432
|
| Min. Negotiated Rate |
$13,229.11 |
| Max. Negotiated Rate |
$13,229.11 |
| Rate for Payer: AHCCCS Medicaid |
$13,229.11
|
| Rate for Payer: Allwell Medicaid |
$13,229.11
|
| Rate for Payer: AZCH Complete Medicaid |
$13,229.11
|
| Rate for Payer: Banner UC Health Medicaid |
$13,229.11
|
| Rate for Payer: Mercy Care Medicaid |
$13,229.11
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$5,752.18
|
|
|
Service Code
|
APR-DRG 5433
|
| Hospital Charge Code |
APRDRG5433
|
| Min. Negotiated Rate |
$5,752.18 |
| Max. Negotiated Rate |
$5,752.18 |
| Rate for Payer: AHCCCS Medicaid |
$5,752.18
|
| Rate for Payer: Allwell Medicaid |
$5,752.18
|
| Rate for Payer: AZCH Complete Medicaid |
$5,752.18
|
| Rate for Payer: Banner UC Health Medicaid |
$5,752.18
|
| Rate for Payer: Mercy Care Medicaid |
$5,752.18
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$4,146.68
|
|
|
Service Code
|
APR-DRG 5432
|
| Hospital Charge Code |
APRDRG5433
|
| Min. Negotiated Rate |
$4,146.68 |
| Max. Negotiated Rate |
$4,146.68 |
| Rate for Payer: AHCCCS Medicaid |
$4,146.68
|
| Rate for Payer: Allwell Medicaid |
$4,146.68
|
| Rate for Payer: AZCH Complete Medicaid |
$4,146.68
|
| Rate for Payer: Banner UC Health Medicaid |
$4,146.68
|
| Rate for Payer: Mercy Care Medicaid |
$4,146.68
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$3,385.66
|
|
|
Service Code
|
APR-DRG 5431
|
| Hospital Charge Code |
APRDRG5432
|
| Min. Negotiated Rate |
$3,385.66 |
| Max. Negotiated Rate |
$3,385.66 |
| Rate for Payer: AHCCCS Medicaid |
$3,385.66
|
| Rate for Payer: Allwell Medicaid |
$3,385.66
|
| Rate for Payer: AZCH Complete Medicaid |
$3,385.66
|
| Rate for Payer: Banner UC Health Medicaid |
$3,385.66
|
| Rate for Payer: Mercy Care Medicaid |
$3,385.66
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$4,146.68
|
|
|
Service Code
|
APR-DRG 5432
|
| Hospital Charge Code |
APRDRG5431
|
| Min. Negotiated Rate |
$4,146.68 |
| Max. Negotiated Rate |
$4,146.68 |
| Rate for Payer: AHCCCS Medicaid |
$4,146.68
|
| Rate for Payer: Allwell Medicaid |
$4,146.68
|
| Rate for Payer: AZCH Complete Medicaid |
$4,146.68
|
| Rate for Payer: Banner UC Health Medicaid |
$4,146.68
|
| Rate for Payer: Mercy Care Medicaid |
$4,146.68
|
|
|
Abortion With D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$5,752.18
|
|
|
Service Code
|
APR-DRG 5433
|
| Hospital Charge Code |
APRDRG5434
|
| Min. Negotiated Rate |
$5,752.18 |
| Max. Negotiated Rate |
$5,752.18 |
| Rate for Payer: AHCCCS Medicaid |
$5,752.18
|
| Rate for Payer: Allwell Medicaid |
$5,752.18
|
| Rate for Payer: AZCH Complete Medicaid |
$5,752.18
|
| Rate for Payer: Banner UC Health Medicaid |
$5,752.18
|
| Rate for Payer: Mercy Care Medicaid |
$5,752.18
|
|
|
Abortion Without D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$4,204.19
|
|
|
Service Code
|
APR-DRG 5643
|
| Hospital Charge Code |
APRDRG5641
|
| Min. Negotiated Rate |
$4,204.19 |
| Max. Negotiated Rate |
$4,204.19 |
| Rate for Payer: AHCCCS Medicaid |
$4,204.19
|
| Rate for Payer: Allwell Medicaid |
$4,204.19
|
| Rate for Payer: AZCH Complete Medicaid |
$4,204.19
|
| Rate for Payer: Banner UC Health Medicaid |
$4,204.19
|
| Rate for Payer: Mercy Care Medicaid |
$4,204.19
|
|
|
Abortion Without D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$2,687.76
|
|
|
Service Code
|
APR-DRG 5642
|
| Hospital Charge Code |
APRDRG5643
|
| Min. Negotiated Rate |
$2,687.76 |
| Max. Negotiated Rate |
$2,687.76 |
| Rate for Payer: AHCCCS Medicaid |
$2,687.76
|
| Rate for Payer: Allwell Medicaid |
$2,687.76
|
| Rate for Payer: AZCH Complete Medicaid |
$2,687.76
|
| Rate for Payer: Banner UC Health Medicaid |
$2,687.76
|
| Rate for Payer: Mercy Care Medicaid |
$2,687.76
|
|
|
Abortion Without D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$10,044.05
|
|
|
Service Code
|
APR-DRG 5644
|
| Hospital Charge Code |
APRDRG5643
|
| Min. Negotiated Rate |
$10,044.05 |
| Max. Negotiated Rate |
$10,044.05 |
| Rate for Payer: AHCCCS Medicaid |
$10,044.05
|
| Rate for Payer: Allwell Medicaid |
$10,044.05
|
| Rate for Payer: AZCH Complete Medicaid |
$10,044.05
|
| Rate for Payer: Banner UC Health Medicaid |
$10,044.05
|
| Rate for Payer: Mercy Care Medicaid |
$10,044.05
|
|
|
Abortion Without D&C, Aspiration Curettage Or Hysterotomy
|
Facility
|
IP
|
$10,044.05
|
|
|
Service Code
|
APR-DRG 5644
|
| Hospital Charge Code |
APRDRG5644
|
| Min. Negotiated Rate |
$10,044.05 |
| Max. Negotiated Rate |
$10,044.05 |
| Rate for Payer: AHCCCS Medicaid |
$10,044.05
|
| Rate for Payer: Allwell Medicaid |
$10,044.05
|
| Rate for Payer: AZCH Complete Medicaid |
$10,044.05
|
| Rate for Payer: Banner UC Health Medicaid |
$10,044.05
|
| Rate for Payer: Mercy Care Medicaid |
$10,044.05
|
|
