|
Other Bladder Procedures
|
Facility
|
IP
|
$8,323.51
|
|
|
Service Code
|
APR-DRG 4452
|
| Hospital Charge Code |
APRDRG4453
|
| Min. Negotiated Rate |
$8,323.51 |
| Max. Negotiated Rate |
$8,323.51 |
| Rate for Payer: AHCCCS Medicaid |
$8,323.51
|
| Rate for Payer: Allwell Medicaid |
$8,323.51
|
| Rate for Payer: AZCH Complete Medicaid |
$8,323.51
|
| Rate for Payer: Banner UC Health Medicaid |
$8,323.51
|
| Rate for Payer: Mercy Care Medicaid |
$8,323.51
|
|
|
Other Bladder Procedures
|
Facility
|
IP
|
$6,412.90
|
|
|
Service Code
|
APR-DRG 4451
|
| Hospital Charge Code |
APRDRG4452
|
| Min. Negotiated Rate |
$6,412.90 |
| Max. Negotiated Rate |
$6,412.90 |
| Rate for Payer: AHCCCS Medicaid |
$6,412.90
|
| Rate for Payer: Allwell Medicaid |
$6,412.90
|
| Rate for Payer: AZCH Complete Medicaid |
$6,412.90
|
| Rate for Payer: Banner UC Health Medicaid |
$6,412.90
|
| Rate for Payer: Mercy Care Medicaid |
$6,412.90
|
|
|
Other Bladder Procedures
|
Facility
|
IP
|
$11,951.86
|
|
|
Service Code
|
APR-DRG 4453
|
| Hospital Charge Code |
APRDRG4451
|
| Min. Negotiated Rate |
$11,951.86 |
| Max. Negotiated Rate |
$11,951.86 |
| Rate for Payer: AHCCCS Medicaid |
$11,951.86
|
| Rate for Payer: Allwell Medicaid |
$11,951.86
|
| Rate for Payer: AZCH Complete Medicaid |
$11,951.86
|
| Rate for Payer: Banner UC Health Medicaid |
$11,951.86
|
| Rate for Payer: Mercy Care Medicaid |
$11,951.86
|
|
|
Other Bladder Procedures
|
Facility
|
IP
|
$24,267.74
|
|
|
Service Code
|
APR-DRG 4454
|
| Hospital Charge Code |
APRDRG4452
|
| Min. Negotiated Rate |
$24,267.74 |
| Max. Negotiated Rate |
$24,267.74 |
| Rate for Payer: AHCCCS Medicaid |
$24,267.74
|
| Rate for Payer: Allwell Medicaid |
$24,267.74
|
| Rate for Payer: AZCH Complete Medicaid |
$24,267.74
|
| Rate for Payer: Banner UC Health Medicaid |
$24,267.74
|
| Rate for Payer: Mercy Care Medicaid |
$24,267.74
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: AHCCCS Medicaid |
$30,500.38
|
| Rate for Payer: Allwell Medicaid |
$30,500.38
|
| Rate for Payer: AZCH Complete Medicaid |
$30,500.38
|
| Rate for Payer: Banner UC Health Medicaid |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1672
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: AHCCCS Medicaid |
$30,500.38
|
| Rate for Payer: Allwell Medicaid |
$30,500.38
|
| Rate for Payer: AZCH Complete Medicaid |
$30,500.38
|
| Rate for Payer: Banner UC Health Medicaid |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: AHCCCS Medicaid |
$53,164.02
|
| Rate for Payer: Allwell Medicaid |
$53,164.02
|
| Rate for Payer: AZCH Complete Medicaid |
$53,164.02
|
| Rate for Payer: Banner UC Health Medicaid |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: AHCCCS Medicaid |
$30,500.38
|
| Rate for Payer: Allwell Medicaid |
$30,500.38
|
| Rate for Payer: AZCH Complete Medicaid |
$30,500.38
|
| Rate for Payer: Banner UC Health Medicaid |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1672
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: AHCCCS Medicaid |
$53,164.02
|
| Rate for Payer: Allwell Medicaid |
$53,164.02
|
| Rate for Payer: AZCH Complete Medicaid |
$53,164.02
|
| Rate for Payer: Banner UC Health Medicaid |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1672
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1672
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: AHCCCS Medicaid |
$30,500.38
|
| Rate for Payer: Allwell Medicaid |
$30,500.38
|
| Rate for Payer: AZCH Complete Medicaid |
$30,500.38
|
| Rate for Payer: Banner UC Health Medicaid |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: AHCCCS Medicaid |
$19,593.61
|
| Rate for Payer: Allwell Medicaid |
$19,593.61
|
| Rate for Payer: AZCH Complete Medicaid |
$19,593.61
|
| Rate for Payer: Banner UC Health Medicaid |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: AHCCCS Medicaid |
$53,164.02
|
| Rate for Payer: Allwell Medicaid |
$53,164.02
|
| Rate for Payer: AZCH Complete Medicaid |
$53,164.02
|
| Rate for Payer: Banner UC Health Medicaid |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: AHCCCS Medicaid |
$53,164.02
|
| Rate for Payer: Allwell Medicaid |
$53,164.02
|
| Rate for Payer: AZCH Complete Medicaid |
$53,164.02
|
| Rate for Payer: Banner UC Health Medicaid |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$6,492.16
|
|
|
Service Code
|
APR-DRG 6962
|
| Hospital Charge Code |
APRDRG6961
|
| Min. Negotiated Rate |
$6,492.16 |
| Max. Negotiated Rate |
$6,492.16 |
| Rate for Payer: AHCCCS Medicaid |
$6,492.16
|
| Rate for Payer: Allwell Medicaid |
$6,492.16
|
| Rate for Payer: AZCH Complete Medicaid |
$6,492.16
|
| Rate for Payer: Banner UC Health Medicaid |
$6,492.16
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.16
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6961
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: AHCCCS Medicaid |
$11,081.42
|
| Rate for Payer: Allwell Medicaid |
$11,081.42
|
| Rate for Payer: AZCH Complete Medicaid |
$11,081.42
|
| Rate for Payer: Banner UC Health Medicaid |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6964
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: AHCCCS Medicaid |
$11,081.42
|
| Rate for Payer: Allwell Medicaid |
$11,081.42
|
| Rate for Payer: AZCH Complete Medicaid |
$11,081.42
|
| Rate for Payer: Banner UC Health Medicaid |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6962
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: AHCCCS Medicaid |
$11,081.42
|
| Rate for Payer: Allwell Medicaid |
$11,081.42
|
| Rate for Payer: AZCH Complete Medicaid |
$11,081.42
|
| Rate for Payer: Banner UC Health Medicaid |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$6,492.16
|
|
|
Service Code
|
APR-DRG 6962
|
| Hospital Charge Code |
APRDRG6963
|
| Min. Negotiated Rate |
$6,492.16 |
| Max. Negotiated Rate |
$6,492.16 |
| Rate for Payer: AHCCCS Medicaid |
$6,492.16
|
| Rate for Payer: Allwell Medicaid |
$6,492.16
|
| Rate for Payer: AZCH Complete Medicaid |
$6,492.16
|
| Rate for Payer: Banner UC Health Medicaid |
$6,492.16
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.16
|
|