|
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
|
$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
|
$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 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
|
$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
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5181
|
| 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 |
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
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5184
|
| 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
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5183
|
| 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 |
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 |
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
|
$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
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5181
|
| 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 |
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
|
$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
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5183
|
| 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 |
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
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5181
|
| 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
|
$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 Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$11,184.52
|
|
|
Service Code
|
APR-DRG 2494
|
| Hospital Charge Code |
APRDRG2494
|
| Min. Negotiated Rate |
$11,184.52 |
| Max. Negotiated Rate |
$11,184.52 |
| Rate for Payer: AHCCCS Medicaid |
$11,184.52
|
| Rate for Payer: Allwell Medicaid |
$11,184.52
|
| Rate for Payer: AZCH Complete Medicaid |
$11,184.52
|
| Rate for Payer: Banner UC Health Medicaid |
$11,184.52
|
| Rate for Payer: Mercy Care Medicaid |
$11,184.52
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$11,184.52
|
|
|
Service Code
|
APR-DRG 2494
|
| Hospital Charge Code |
APRDRG2493
|
| Min. Negotiated Rate |
$11,184.52 |
| Max. Negotiated Rate |
$11,184.52 |
| Rate for Payer: AHCCCS Medicaid |
$11,184.52
|
| Rate for Payer: Allwell Medicaid |
$11,184.52
|
| Rate for Payer: AZCH Complete Medicaid |
$11,184.52
|
| Rate for Payer: Banner UC Health Medicaid |
$11,184.52
|
| Rate for Payer: Mercy Care Medicaid |
$11,184.52
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$5,482.14
|
|
|
Service Code
|
APR-DRG 2493
|
| Hospital Charge Code |
APRDRG2492
|
| Min. Negotiated Rate |
$5,482.14 |
| Max. Negotiated Rate |
$5,482.14 |
| Rate for Payer: AHCCCS Medicaid |
$5,482.14
|
| Rate for Payer: Allwell Medicaid |
$5,482.14
|
| Rate for Payer: AZCH Complete Medicaid |
$5,482.14
|
| Rate for Payer: Banner UC Health Medicaid |
$5,482.14
|
| Rate for Payer: Mercy Care Medicaid |
$5,482.14
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2492
|
| Min. Negotiated Rate |
$3,125.44 |
| Max. Negotiated Rate |
$3,125.44 |
| Rate for Payer: AHCCCS Medicaid |
$3,125.44
|
| Rate for Payer: Allwell Medicaid |
$3,125.44
|
| Rate for Payer: AZCH Complete Medicaid |
$3,125.44
|
| Rate for Payer: Banner UC Health Medicaid |
$3,125.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,125.44
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,726.54
|
|
|
Service Code
|
APR-DRG 2492
|
| Hospital Charge Code |
APRDRG2493
|
| Min. Negotiated Rate |
$3,726.54 |
| Max. Negotiated Rate |
$3,726.54 |
| Rate for Payer: AHCCCS Medicaid |
$3,726.54
|
| Rate for Payer: Allwell Medicaid |
$3,726.54
|
| Rate for Payer: AZCH Complete Medicaid |
$3,726.54
|
| Rate for Payer: Banner UC Health Medicaid |
$3,726.54
|
| Rate for Payer: Mercy Care Medicaid |
$3,726.54
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2491
|
| Min. Negotiated Rate |
$3,125.44 |
| Max. Negotiated Rate |
$3,125.44 |
| Rate for Payer: AHCCCS Medicaid |
$3,125.44
|
| Rate for Payer: Allwell Medicaid |
$3,125.44
|
| Rate for Payer: AZCH Complete Medicaid |
$3,125.44
|
| Rate for Payer: Banner UC Health Medicaid |
$3,125.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,125.44
|
|