|
Other Esophageal Disorders
|
Facility
|
IP
|
$6,661.20
|
|
|
Service Code
|
APR-DRG 2433
|
| Hospital Charge Code |
APRDRG2433
|
| Min. Negotiated Rate |
$6,661.20 |
| Max. Negotiated Rate |
$6,661.20 |
| Rate for Payer: AHCCCS Medicaid |
$6,661.20
|
| Rate for Payer: Allwell Medicaid |
$6,661.20
|
| Rate for Payer: AZCH Complete Medicaid |
$6,661.20
|
| Rate for Payer: Banner UC Health Medicaid |
$6,661.20
|
| Rate for Payer: Mercy Care Medicaid |
$6,661.20
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$4,561.91
|
|
|
Service Code
|
APR-DRG 2432
|
| Hospital Charge Code |
APRDRG2434
|
| Min. Negotiated Rate |
$4,561.91 |
| Max. Negotiated Rate |
$4,561.91 |
| Rate for Payer: AHCCCS Medicaid |
$4,561.91
|
| Rate for Payer: Allwell Medicaid |
$4,561.91
|
| Rate for Payer: AZCH Complete Medicaid |
$4,561.91
|
| Rate for Payer: Banner UC Health Medicaid |
$4,561.91
|
| Rate for Payer: Mercy Care Medicaid |
$4,561.91
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$13,180.71
|
|
|
Service Code
|
APR-DRG 2434
|
| Hospital Charge Code |
APRDRG2433
|
| Min. Negotiated Rate |
$13,180.71 |
| Max. Negotiated Rate |
$13,180.71 |
| Rate for Payer: AHCCCS Medicaid |
$13,180.71
|
| Rate for Payer: Allwell Medicaid |
$13,180.71
|
| Rate for Payer: AZCH Complete Medicaid |
$13,180.71
|
| Rate for Payer: Banner UC Health Medicaid |
$13,180.71
|
| Rate for Payer: Mercy Care Medicaid |
$13,180.71
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$13,180.71
|
|
|
Service Code
|
APR-DRG 2434
|
| Hospital Charge Code |
APRDRG2434
|
| Min. Negotiated Rate |
$13,180.71 |
| Max. Negotiated Rate |
$13,180.71 |
| Rate for Payer: AHCCCS Medicaid |
$13,180.71
|
| Rate for Payer: Allwell Medicaid |
$13,180.71
|
| Rate for Payer: AZCH Complete Medicaid |
$13,180.71
|
| Rate for Payer: Banner UC Health Medicaid |
$13,180.71
|
| Rate for Payer: Mercy Care Medicaid |
$13,180.71
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$4,561.91
|
|
|
Service Code
|
APR-DRG 2432
|
| Hospital Charge Code |
APRDRG2432
|
| Min. Negotiated Rate |
$4,561.91 |
| Max. Negotiated Rate |
$4,561.91 |
| Rate for Payer: AHCCCS Medicaid |
$4,561.91
|
| Rate for Payer: Allwell Medicaid |
$4,561.91
|
| Rate for Payer: AZCH Complete Medicaid |
$4,561.91
|
| Rate for Payer: Banner UC Health Medicaid |
$4,561.91
|
| Rate for Payer: Mercy Care Medicaid |
$4,561.91
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$3,798.08
|
|
|
Service Code
|
APR-DRG 2431
|
| Hospital Charge Code |
APRDRG2431
|
| Min. Negotiated Rate |
$3,798.08 |
| Max. Negotiated Rate |
$3,798.08 |
| Rate for Payer: AHCCCS Medicaid |
$3,798.08
|
| Rate for Payer: Allwell Medicaid |
$3,798.08
|
| Rate for Payer: AZCH Complete Medicaid |
$3,798.08
|
| Rate for Payer: Banner UC Health Medicaid |
$3,798.08
|
| Rate for Payer: Mercy Care Medicaid |
$3,798.08
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$3,798.08
|
|
|
Service Code
|
APR-DRG 2431
|
| Hospital Charge Code |
APRDRG2434
|
| Min. Negotiated Rate |
$3,798.08 |
| Max. Negotiated Rate |
$3,798.08 |
| Rate for Payer: AHCCCS Medicaid |
$3,798.08
|
| Rate for Payer: Allwell Medicaid |
$3,798.08
|
| Rate for Payer: AZCH Complete Medicaid |
$3,798.08
|
| Rate for Payer: Banner UC Health Medicaid |
$3,798.08
|
| Rate for Payer: Mercy Care Medicaid |
$3,798.08
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$13,180.71
|
|
|
Service Code
|
APR-DRG 2434
|
| Hospital Charge Code |
APRDRG2431
|
| Min. Negotiated Rate |
$13,180.71 |
| Max. Negotiated Rate |
$13,180.71 |
| Rate for Payer: AHCCCS Medicaid |
$13,180.71
|
| Rate for Payer: Allwell Medicaid |
$13,180.71
|
| Rate for Payer: AZCH Complete Medicaid |
$13,180.71
|
| Rate for Payer: Banner UC Health Medicaid |
$13,180.71
|
| Rate for Payer: Mercy Care Medicaid |
$13,180.71
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$6,661.20
|
|
|
Service Code
|
APR-DRG 2433
|
| Hospital Charge Code |
APRDRG2431
|
| Min. Negotiated Rate |
$6,661.20 |
| Max. Negotiated Rate |
$6,661.20 |
| Rate for Payer: AHCCCS Medicaid |
$6,661.20
|
| Rate for Payer: Allwell Medicaid |
$6,661.20
|
| Rate for Payer: AZCH Complete Medicaid |
$6,661.20
|
| Rate for Payer: Banner UC Health Medicaid |
$6,661.20
|
| Rate for Payer: Mercy Care Medicaid |
$6,661.20
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$4,561.91
|
|
|
Service Code
|
APR-DRG 2432
|
| Hospital Charge Code |
APRDRG2431
|
| Min. Negotiated Rate |
$4,561.91 |
| Max. Negotiated Rate |
$4,561.91 |
| Rate for Payer: AHCCCS Medicaid |
$4,561.91
|
| Rate for Payer: Allwell Medicaid |
$4,561.91
|
| Rate for Payer: AZCH Complete Medicaid |
$4,561.91
|
| Rate for Payer: Banner UC Health Medicaid |
$4,561.91
|
| Rate for Payer: Mercy Care Medicaid |
$4,561.91
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$4,561.91
|
|
|
Service Code
|
APR-DRG 2432
|
| Hospital Charge Code |
APRDRG2433
|
| Min. Negotiated Rate |
$4,561.91 |
| Max. Negotiated Rate |
$4,561.91 |
| Rate for Payer: AHCCCS Medicaid |
$4,561.91
|
| Rate for Payer: Allwell Medicaid |
$4,561.91
|
| Rate for Payer: AZCH Complete Medicaid |
$4,561.91
|
| Rate for Payer: Banner UC Health Medicaid |
$4,561.91
|
| Rate for Payer: Mercy Care Medicaid |
$4,561.91
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$6,661.20
|
|
|
Service Code
|
APR-DRG 2433
|
| Hospital Charge Code |
APRDRG2432
|
| Min. Negotiated Rate |
$6,661.20 |
| Max. Negotiated Rate |
$6,661.20 |
| Rate for Payer: AHCCCS Medicaid |
$6,661.20
|
| Rate for Payer: Allwell Medicaid |
$6,661.20
|
| Rate for Payer: AZCH Complete Medicaid |
$6,661.20
|
| Rate for Payer: Banner UC Health Medicaid |
$6,661.20
|
| Rate for Payer: Mercy Care Medicaid |
$6,661.20
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$3,798.08
|
|
|
Service Code
|
APR-DRG 2431
|
| Hospital Charge Code |
APRDRG2432
|
| Min. Negotiated Rate |
$3,798.08 |
| Max. Negotiated Rate |
$3,798.08 |
| Rate for Payer: AHCCCS Medicaid |
$3,798.08
|
| Rate for Payer: Allwell Medicaid |
$3,798.08
|
| Rate for Payer: AZCH Complete Medicaid |
$3,798.08
|
| Rate for Payer: Banner UC Health Medicaid |
$3,798.08
|
| Rate for Payer: Mercy Care Medicaid |
$3,798.08
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$6,661.20
|
|
|
Service Code
|
APR-DRG 2433
|
| Hospital Charge Code |
APRDRG2434
|
| Min. Negotiated Rate |
$6,661.20 |
| Max. Negotiated Rate |
$6,661.20 |
| Rate for Payer: AHCCCS Medicaid |
$6,661.20
|
| Rate for Payer: Allwell Medicaid |
$6,661.20
|
| Rate for Payer: AZCH Complete Medicaid |
$6,661.20
|
| Rate for Payer: Banner UC Health Medicaid |
$6,661.20
|
| Rate for Payer: Mercy Care Medicaid |
$6,661.20
|
|
|
Other Esophageal Disorders
|
Facility
|
IP
|
$3,798.08
|
|
|
Service Code
|
APR-DRG 2431
|
| Hospital Charge Code |
APRDRG2433
|
| Min. Negotiated Rate |
$3,798.08 |
| Max. Negotiated Rate |
$3,798.08 |
| Rate for Payer: AHCCCS Medicaid |
$3,798.08
|
| Rate for Payer: Allwell Medicaid |
$3,798.08
|
| Rate for Payer: AZCH Complete Medicaid |
$3,798.08
|
| Rate for Payer: Banner UC Health Medicaid |
$3,798.08
|
| Rate for Payer: Mercy Care Medicaid |
$3,798.08
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$7,829.03 |
| Max. Negotiated Rate |
$7,829.03 |
| Rate for Payer: AHCCCS Medicaid |
$7,829.03
|
| Rate for Payer: Allwell Medicaid |
$7,829.03
|
| Rate for Payer: AZCH Complete Medicaid |
$7,829.03
|
| Rate for Payer: Banner UC Health Medicaid |
$7,829.03
|
| Rate for Payer: Mercy Care Medicaid |
$7,829.03
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: AHCCCS Medicaid |
$15,416.77
|
| Rate for Payer: Allwell Medicaid |
$15,416.77
|
| Rate for Payer: AZCH Complete Medicaid |
$15,416.77
|
| Rate for Payer: Banner UC Health Medicaid |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: AHCCCS Medicaid |
$5,804.79
|
| Rate for Payer: Allwell Medicaid |
$5,804.79
|
| Rate for Payer: AZCH Complete Medicaid |
$5,804.79
|
| Rate for Payer: Banner UC Health Medicaid |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: AHCCCS Medicaid |
$21,533.68
|
| Rate for Payer: Allwell Medicaid |
$21,533.68
|
| Rate for Payer: AZCH Complete Medicaid |
$21,533.68
|
| Rate for Payer: Banner UC Health Medicaid |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: AHCCCS Medicaid |
$21,533.68
|
| Rate for Payer: Allwell Medicaid |
$21,533.68
|
| Rate for Payer: AZCH Complete Medicaid |
$21,533.68
|
| Rate for Payer: Banner UC Health Medicaid |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5181
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: AHCCCS Medicaid |
$5,804.79
|
| Rate for Payer: Allwell Medicaid |
$5,804.79
|
| Rate for Payer: AZCH Complete Medicaid |
$5,804.79
|
| Rate for Payer: Banner UC Health Medicaid |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: AHCCCS Medicaid |
$21,533.68
|
| Rate for Payer: Allwell Medicaid |
$21,533.68
|
| Rate for Payer: AZCH Complete Medicaid |
$21,533.68
|
| Rate for Payer: Banner UC Health Medicaid |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: AHCCCS Medicaid |
$15,416.77
|
| Rate for Payer: Allwell Medicaid |
$15,416.77
|
| Rate for Payer: AZCH Complete Medicaid |
$15,416.77
|
| Rate for Payer: Banner UC Health Medicaid |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: AHCCCS Medicaid |
$15,416.77
|
| Rate for Payer: Allwell Medicaid |
$15,416.77
|
| Rate for Payer: AZCH Complete Medicaid |
$15,416.77
|
| Rate for Payer: Banner UC Health Medicaid |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: AHCCCS Medicaid |
$5,804.79
|
| Rate for Payer: Allwell Medicaid |
$5,804.79
|
| Rate for Payer: AZCH Complete Medicaid |
$5,804.79
|
| Rate for Payer: Banner UC Health Medicaid |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
|
