|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0291
|
| Hospital Charge Code |
APRDRG0294
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0291
|
| Hospital Charge Code |
APRDRG0291
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$17,934.10
|
|
|
Service Code
|
APR-DRG 0293
|
| Hospital Charge Code |
APRDRG0291
|
| Min. Negotiated Rate |
$17,934.10 |
| Max. Negotiated Rate |
$17,934.10 |
| Rate for Payer: AHCCCS Medicaid |
$17,934.10
|
| Rate for Payer: Allwell Medicaid |
$17,934.10
|
| Rate for Payer: AZCH Complete Medicaid |
$17,934.10
|
| Rate for Payer: Banner UC Health Medicaid |
$17,934.10
|
| Rate for Payer: Mercy Care Medicaid |
$17,934.10
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0292
|
| Hospital Charge Code |
APRDRG0292
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0292
|
| Hospital Charge Code |
APRDRG0293
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$32,208.99
|
|
|
Service Code
|
APR-DRG 0294
|
| Hospital Charge Code |
APRDRG0293
|
| Min. Negotiated Rate |
$32,208.99 |
| Max. Negotiated Rate |
$32,208.99 |
| Rate for Payer: AHCCCS Medicaid |
$32,208.99
|
| Rate for Payer: Allwell Medicaid |
$32,208.99
|
| Rate for Payer: AZCH Complete Medicaid |
$32,208.99
|
| Rate for Payer: Banner UC Health Medicaid |
$32,208.99
|
| Rate for Payer: Mercy Care Medicaid |
$32,208.99
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0291
|
| Hospital Charge Code |
APRDRG0293
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0291
|
| Hospital Charge Code |
APRDRG0292
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$17,934.10
|
|
|
Service Code
|
APR-DRG 0293
|
| Hospital Charge Code |
APRDRG0293
|
| Min. Negotiated Rate |
$17,934.10 |
| Max. Negotiated Rate |
$17,934.10 |
| Rate for Payer: AHCCCS Medicaid |
$17,934.10
|
| Rate for Payer: Allwell Medicaid |
$17,934.10
|
| Rate for Payer: AZCH Complete Medicaid |
$17,934.10
|
| Rate for Payer: Banner UC Health Medicaid |
$17,934.10
|
| Rate for Payer: Mercy Care Medicaid |
$17,934.10
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$32,208.99
|
|
|
Service Code
|
APR-DRG 0294
|
| Hospital Charge Code |
APRDRG0294
|
| Min. Negotiated Rate |
$32,208.99 |
| Max. Negotiated Rate |
$32,208.99 |
| Rate for Payer: AHCCCS Medicaid |
$32,208.99
|
| Rate for Payer: Allwell Medicaid |
$32,208.99
|
| Rate for Payer: AZCH Complete Medicaid |
$32,208.99
|
| Rate for Payer: Banner UC Health Medicaid |
$32,208.99
|
| Rate for Payer: Mercy Care Medicaid |
$32,208.99
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$17,934.10
|
|
|
Service Code
|
APR-DRG 0293
|
| Hospital Charge Code |
APRDRG0294
|
| Min. Negotiated Rate |
$17,934.10 |
| Max. Negotiated Rate |
$17,934.10 |
| Rate for Payer: AHCCCS Medicaid |
$17,934.10
|
| Rate for Payer: Allwell Medicaid |
$17,934.10
|
| Rate for Payer: AZCH Complete Medicaid |
$17,934.10
|
| Rate for Payer: Banner UC Health Medicaid |
$17,934.10
|
| Rate for Payer: Mercy Care Medicaid |
$17,934.10
|
|
|
Other Percutaneous Intracranial Procedures
|
Facility
|
IP
|
$13,233.31
|
|
|
Service Code
|
APR-DRG 0292
|
| Hospital Charge Code |
APRDRG0294
|
| Min. Negotiated Rate |
$13,233.31 |
| Max. Negotiated Rate |
$13,233.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,233.31
|
| Rate for Payer: Allwell Medicaid |
$13,233.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,233.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,233.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,233.31
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1824
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$14,379.40
|
|
|
Service Code
|
APR-DRG 1822
|
| Hospital Charge Code |
APRDRG1821
|
| Min. Negotiated Rate |
$14,379.40 |
| Max. Negotiated Rate |
$14,379.40 |
| Rate for Payer: AHCCCS Medicaid |
$14,379.40
|
| Rate for Payer: Allwell Medicaid |
$14,379.40
|
| Rate for Payer: AZCH Complete Medicaid |
$14,379.40
|
| Rate for Payer: Banner UC Health Medicaid |
$14,379.40
|
| Rate for Payer: Mercy Care Medicaid |
$14,379.40
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1823
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$31,432.54
|
|
|
Service Code
|
APR-DRG 1824
|
| Hospital Charge Code |
APRDRG1823
|
| Min. Negotiated Rate |
$31,432.54 |
| Max. Negotiated Rate |
$31,432.54 |
| Rate for Payer: AHCCCS Medicaid |
$31,432.54
|
| Rate for Payer: Allwell Medicaid |
$31,432.54
|
| Rate for Payer: AZCH Complete Medicaid |
$31,432.54
|
| Rate for Payer: Banner UC Health Medicaid |
$31,432.54
|
| Rate for Payer: Mercy Care Medicaid |
$31,432.54
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$17,569.37
|
|
|
Service Code
|
APR-DRG 1823
|
| Hospital Charge Code |
APRDRG1823
|
| Min. Negotiated Rate |
$17,569.37 |
| Max. Negotiated Rate |
$17,569.37 |
| Rate for Payer: AHCCCS Medicaid |
$17,569.37
|
| Rate for Payer: Allwell Medicaid |
$17,569.37
|
| Rate for Payer: AZCH Complete Medicaid |
$17,569.37
|
| Rate for Payer: Banner UC Health Medicaid |
$17,569.37
|
| Rate for Payer: Mercy Care Medicaid |
$17,569.37
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$17,569.37
|
|
|
Service Code
|
APR-DRG 1823
|
| Hospital Charge Code |
APRDRG1822
|
| Min. Negotiated Rate |
$17,569.37 |
| Max. Negotiated Rate |
$17,569.37 |
| Rate for Payer: AHCCCS Medicaid |
$17,569.37
|
| Rate for Payer: Allwell Medicaid |
$17,569.37
|
| Rate for Payer: AZCH Complete Medicaid |
$17,569.37
|
| Rate for Payer: Banner UC Health Medicaid |
$17,569.37
|
| Rate for Payer: Mercy Care Medicaid |
$17,569.37
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$14,379.40
|
|
|
Service Code
|
APR-DRG 1822
|
| Hospital Charge Code |
APRDRG1822
|
| Min. Negotiated Rate |
$14,379.40 |
| Max. Negotiated Rate |
$14,379.40 |
| Rate for Payer: AHCCCS Medicaid |
$14,379.40
|
| Rate for Payer: Allwell Medicaid |
$14,379.40
|
| Rate for Payer: AZCH Complete Medicaid |
$14,379.40
|
| Rate for Payer: Banner UC Health Medicaid |
$14,379.40
|
| Rate for Payer: Mercy Care Medicaid |
$14,379.40
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$31,432.54
|
|
|
Service Code
|
APR-DRG 1824
|
| Hospital Charge Code |
APRDRG1821
|
| Min. Negotiated Rate |
$31,432.54 |
| Max. Negotiated Rate |
$31,432.54 |
| Rate for Payer: AHCCCS Medicaid |
$31,432.54
|
| Rate for Payer: Allwell Medicaid |
$31,432.54
|
| Rate for Payer: AZCH Complete Medicaid |
$31,432.54
|
| Rate for Payer: Banner UC Health Medicaid |
$31,432.54
|
| Rate for Payer: Mercy Care Medicaid |
$31,432.54
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1822
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$31,432.54
|
|
|
Service Code
|
APR-DRG 1824
|
| Hospital Charge Code |
APRDRG1822
|
| Min. Negotiated Rate |
$31,432.54 |
| Max. Negotiated Rate |
$31,432.54 |
| Rate for Payer: AHCCCS Medicaid |
$31,432.54
|
| Rate for Payer: Allwell Medicaid |
$31,432.54
|
| Rate for Payer: AZCH Complete Medicaid |
$31,432.54
|
| Rate for Payer: Banner UC Health Medicaid |
$31,432.54
|
| Rate for Payer: Mercy Care Medicaid |
$31,432.54
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$14,379.40
|
|
|
Service Code
|
APR-DRG 1822
|
| Hospital Charge Code |
APRDRG1824
|
| Min. Negotiated Rate |
$14,379.40 |
| Max. Negotiated Rate |
$14,379.40 |
| Rate for Payer: AHCCCS Medicaid |
$14,379.40
|
| Rate for Payer: Allwell Medicaid |
$14,379.40
|
| Rate for Payer: AZCH Complete Medicaid |
$14,379.40
|
| Rate for Payer: Banner UC Health Medicaid |
$14,379.40
|
| Rate for Payer: Mercy Care Medicaid |
$14,379.40
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1821
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$17,569.37
|
|
|
Service Code
|
APR-DRG 1823
|
| Hospital Charge Code |
APRDRG1821
|
| Min. Negotiated Rate |
$17,569.37 |
| Max. Negotiated Rate |
$17,569.37 |
| Rate for Payer: AHCCCS Medicaid |
$17,569.37
|
| Rate for Payer: Allwell Medicaid |
$17,569.37
|
| Rate for Payer: AZCH Complete Medicaid |
$17,569.37
|
| Rate for Payer: Banner UC Health Medicaid |
$17,569.37
|
| Rate for Payer: Mercy Care Medicaid |
$17,569.37
|
|
