|
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$22,093.82
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$22,093.82 |
| Max. Negotiated Rate |
$22,093.82 |
| Rate for Payer: Seven Corners Travel Insurance |
$22,093.82
|
|
|
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$12,010.41
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$12,010.41 |
| Max. Negotiated Rate |
$12,010.41 |
| Rate for Payer: Seven Corners Travel Insurance |
$12,010.41
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$12,183.32
|
|
|
Service Code
|
APR-DRG 0433
|
| Hospital Charge Code |
APRDRG0433
|
| Min. Negotiated Rate |
$12,183.32 |
| Max. Negotiated Rate |
$12,183.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,183.32
|
| Rate for Payer: Mercy Care Medicaid |
$12,183.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,183.32
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$12,183.32
|
|
|
Service Code
|
APR-DRG 0433
|
| Hospital Charge Code |
APRDRG0431
|
| Min. Negotiated Rate |
$12,183.32 |
| Max. Negotiated Rate |
$12,183.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,183.32
|
| Rate for Payer: Mercy Care Medicaid |
$12,183.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,183.32
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$5,729.74
|
|
|
Service Code
|
APR-DRG 0431
|
| Hospital Charge Code |
APRDRG0433
|
| Min. Negotiated Rate |
$5,729.74 |
| Max. Negotiated Rate |
$5,729.74 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,729.74
|
| Rate for Payer: Mercy Care Medicaid |
$5,729.74
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,729.74
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$23,520.05
|
|
|
Service Code
|
APR-DRG 0434
|
| Hospital Charge Code |
APRDRG0431
|
| Min. Negotiated Rate |
$23,520.05 |
| Max. Negotiated Rate |
$23,520.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,520.05
|
| Rate for Payer: Mercy Care Medicaid |
$23,520.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,520.05
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$7,869.71
|
|
|
Service Code
|
APR-DRG 0432
|
| Hospital Charge Code |
APRDRG0432
|
| Min. Negotiated Rate |
$7,869.71 |
| Max. Negotiated Rate |
$7,869.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,869.71
|
| Rate for Payer: Mercy Care Medicaid |
$7,869.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,869.71
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$7,869.71
|
|
|
Service Code
|
APR-DRG 0432
|
| Hospital Charge Code |
APRDRG0433
|
| Min. Negotiated Rate |
$7,869.71 |
| Max. Negotiated Rate |
$7,869.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,869.71
|
| Rate for Payer: Mercy Care Medicaid |
$7,869.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,869.71
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$23,520.05
|
|
|
Service Code
|
APR-DRG 0434
|
| Hospital Charge Code |
APRDRG0432
|
| Min. Negotiated Rate |
$23,520.05 |
| Max. Negotiated Rate |
$23,520.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,520.05
|
| Rate for Payer: Mercy Care Medicaid |
$23,520.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,520.05
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$12,183.32
|
|
|
Service Code
|
APR-DRG 0433
|
| Hospital Charge Code |
APRDRG0434
|
| Min. Negotiated Rate |
$12,183.32 |
| Max. Negotiated Rate |
$12,183.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,183.32
|
| Rate for Payer: Mercy Care Medicaid |
$12,183.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,183.32
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$12,183.32
|
|
|
Service Code
|
APR-DRG 0433
|
| Hospital Charge Code |
APRDRG0432
|
| Min. Negotiated Rate |
$12,183.32 |
| Max. Negotiated Rate |
$12,183.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,183.32
|
| Rate for Payer: Mercy Care Medicaid |
$12,183.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,183.32
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$23,520.05
|
|
|
Service Code
|
APR-DRG 0434
|
| Hospital Charge Code |
APRDRG0433
|
| Min. Negotiated Rate |
$23,520.05 |
| Max. Negotiated Rate |
$23,520.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,520.05
|
| Rate for Payer: Mercy Care Medicaid |
$23,520.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,520.05
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$5,729.74
|
|
|
Service Code
|
APR-DRG 0431
|
| Hospital Charge Code |
APRDRG0434
|
| Min. Negotiated Rate |
$5,729.74 |
| Max. Negotiated Rate |
$5,729.74 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,729.74
|
| Rate for Payer: Mercy Care Medicaid |
$5,729.74
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,729.74
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$5,729.74
|
|
|
Service Code
|
APR-DRG 0431
|
| Hospital Charge Code |
APRDRG0431
|
| Min. Negotiated Rate |
$5,729.74 |
| Max. Negotiated Rate |
$5,729.74 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,729.74
|
| Rate for Payer: Mercy Care Medicaid |
$5,729.74
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,729.74
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$5,729.74
|
|
|
Service Code
|
APR-DRG 0431
|
| Hospital Charge Code |
APRDRG0432
|
| Min. Negotiated Rate |
$5,729.74 |
| Max. Negotiated Rate |
$5,729.74 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,729.74
|
| Rate for Payer: Mercy Care Medicaid |
$5,729.74
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,729.74
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$7,869.71
|
|
|
Service Code
|
APR-DRG 0432
|
| Hospital Charge Code |
APRDRG0431
|
| Min. Negotiated Rate |
$7,869.71 |
| Max. Negotiated Rate |
$7,869.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,869.71
|
| Rate for Payer: Mercy Care Medicaid |
$7,869.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,869.71
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$23,520.05
|
|
|
Service Code
|
APR-DRG 0434
|
| Hospital Charge Code |
APRDRG0434
|
| Min. Negotiated Rate |
$23,520.05 |
| Max. Negotiated Rate |
$23,520.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,520.05
|
| Rate for Payer: Mercy Care Medicaid |
$23,520.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,520.05
|
|
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
Facility
|
IP
|
$7,869.71
|
|
|
Service Code
|
APR-DRG 0432
|
| Hospital Charge Code |
APRDRG0434
|
| Min. Negotiated Rate |
$7,869.71 |
| Max. Negotiated Rate |
$7,869.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,869.71
|
| Rate for Payer: Mercy Care Medicaid |
$7,869.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,869.71
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$5,101.98
|
|
|
Service Code
|
APR-DRG 9301
|
| Hospital Charge Code |
APRDRG9302
|
| Min. Negotiated Rate |
$5,101.98 |
| Max. Negotiated Rate |
$5,101.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,101.98
|
| Rate for Payer: Mercy Care Medicaid |
$5,101.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,101.98
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$21,711.14
|
|
|
Service Code
|
APR-DRG 9304
|
| Hospital Charge Code |
APRDRG9303
|
| Min. Negotiated Rate |
$21,711.14 |
| Max. Negotiated Rate |
$21,711.14 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,711.14
|
| Rate for Payer: Mercy Care Medicaid |
$21,711.14
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,711.14
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$21,711.14
|
|
|
Service Code
|
APR-DRG 9304
|
| Hospital Charge Code |
APRDRG9304
|
| Min. Negotiated Rate |
$21,711.14 |
| Max. Negotiated Rate |
$21,711.14 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,711.14
|
| Rate for Payer: Mercy Care Medicaid |
$21,711.14
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,711.14
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$10,476.11
|
|
|
Service Code
|
APR-DRG 9303
|
| Hospital Charge Code |
APRDRG9303
|
| Min. Negotiated Rate |
$10,476.11 |
| Max. Negotiated Rate |
$10,476.11 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,476.11
|
| Rate for Payer: Mercy Care Medicaid |
$10,476.11
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,476.11
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$6,601.58
|
|
|
Service Code
|
APR-DRG 9302
|
| Hospital Charge Code |
APRDRG9301
|
| Min. Negotiated Rate |
$6,601.58 |
| Max. Negotiated Rate |
$6,601.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,601.58
|
| Rate for Payer: Mercy Care Medicaid |
$6,601.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,601.58
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$6,601.58
|
|
|
Service Code
|
APR-DRG 9302
|
| Hospital Charge Code |
APRDRG9303
|
| Min. Negotiated Rate |
$6,601.58 |
| Max. Negotiated Rate |
$6,601.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,601.58
|
| Rate for Payer: Mercy Care Medicaid |
$6,601.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,601.58
|
|
|
Multiple Significant Trauma Without O.R. Procedure
|
Facility
|
IP
|
$5,101.98
|
|
|
Service Code
|
APR-DRG 9301
|
| Hospital Charge Code |
APRDRG9304
|
| Min. Negotiated Rate |
$5,101.98 |
| Max. Negotiated Rate |
$5,101.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,101.98
|
| Rate for Payer: Mercy Care Medicaid |
$5,101.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,101.98
|
|
