|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: AHCCCS Medicaid |
$2,896.78
|
| Rate for Payer: Allwell Medicaid |
$2,896.78
|
| Rate for Payer: AZCH Complete Medicaid |
$2,896.78
|
| Rate for Payer: Banner UC Health Medicaid |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: AHCCCS Medicaid |
$5,180.54
|
| Rate for Payer: Allwell Medicaid |
$5,180.54
|
| Rate for Payer: AZCH Complete Medicaid |
$5,180.54
|
| Rate for Payer: Banner UC Health Medicaid |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$13,933.31
|
|
|
Service Code
|
APR-DRG 0272
|
| Hospital Charge Code |
APRDRG0272
|
| Min. Negotiated Rate |
$13,933.31 |
| Max. Negotiated Rate |
$13,933.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,933.31
|
| Rate for Payer: Allwell Medicaid |
$13,933.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,933.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,933.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,933.31
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$11,264.48
|
|
|
Service Code
|
APR-DRG 0271
|
| Hospital Charge Code |
APRDRG0272
|
| Min. Negotiated Rate |
$11,264.48 |
| Max. Negotiated Rate |
$11,264.48 |
| Rate for Payer: AHCCCS Medicaid |
$11,264.48
|
| Rate for Payer: Allwell Medicaid |
$11,264.48
|
| Rate for Payer: AZCH Complete Medicaid |
$11,264.48
|
| Rate for Payer: Banner UC Health Medicaid |
$11,264.48
|
| Rate for Payer: Mercy Care Medicaid |
$11,264.48
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$41,005.25
|
|
|
Service Code
|
APR-DRG 0274
|
| Hospital Charge Code |
APRDRG0271
|
| Min. Negotiated Rate |
$41,005.25 |
| Max. Negotiated Rate |
$41,005.25 |
| Rate for Payer: AHCCCS Medicaid |
$41,005.25
|
| Rate for Payer: Allwell Medicaid |
$41,005.25
|
| Rate for Payer: AZCH Complete Medicaid |
$41,005.25
|
| Rate for Payer: Banner UC Health Medicaid |
$41,005.25
|
| Rate for Payer: Mercy Care Medicaid |
$41,005.25
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$21,839.49
|
|
|
Service Code
|
APR-DRG 0273
|
| Hospital Charge Code |
APRDRG0272
|
| Min. Negotiated Rate |
$21,839.49 |
| Max. Negotiated Rate |
$21,839.49 |
| Rate for Payer: AHCCCS Medicaid |
$21,839.49
|
| Rate for Payer: Allwell Medicaid |
$21,839.49
|
| Rate for Payer: AZCH Complete Medicaid |
$21,839.49
|
| Rate for Payer: Banner UC Health Medicaid |
$21,839.49
|
| Rate for Payer: Mercy Care Medicaid |
$21,839.49
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$21,839.49
|
|
|
Service Code
|
APR-DRG 0273
|
| Hospital Charge Code |
APRDRG0271
|
| Min. Negotiated Rate |
$21,839.49 |
| Max. Negotiated Rate |
$21,839.49 |
| Rate for Payer: AHCCCS Medicaid |
$21,839.49
|
| Rate for Payer: Allwell Medicaid |
$21,839.49
|
| Rate for Payer: AZCH Complete Medicaid |
$21,839.49
|
| Rate for Payer: Banner UC Health Medicaid |
$21,839.49
|
| Rate for Payer: Mercy Care Medicaid |
$21,839.49
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$21,839.49
|
|
|
Service Code
|
APR-DRG 0273
|
| Hospital Charge Code |
APRDRG0273
|
| Min. Negotiated Rate |
$21,839.49 |
| Max. Negotiated Rate |
$21,839.49 |
| Rate for Payer: AHCCCS Medicaid |
$21,839.49
|
| Rate for Payer: Allwell Medicaid |
$21,839.49
|
| Rate for Payer: AZCH Complete Medicaid |
$21,839.49
|
| Rate for Payer: Banner UC Health Medicaid |
$21,839.49
|
| Rate for Payer: Mercy Care Medicaid |
$21,839.49
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$11,264.48
|
|
|
Service Code
|
APR-DRG 0271
|
| Hospital Charge Code |
APRDRG0271
|
| Min. Negotiated Rate |
$11,264.48 |
| Max. Negotiated Rate |
$11,264.48 |
| Rate for Payer: AHCCCS Medicaid |
$11,264.48
|
| Rate for Payer: Allwell Medicaid |
$11,264.48
|
| Rate for Payer: AZCH Complete Medicaid |
$11,264.48
|
| Rate for Payer: Banner UC Health Medicaid |
$11,264.48
|
| Rate for Payer: Mercy Care Medicaid |
$11,264.48
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$13,933.31
|
|
|
Service Code
|
APR-DRG 0272
|
| Hospital Charge Code |
APRDRG0271
|
| Min. Negotiated Rate |
$13,933.31 |
| Max. Negotiated Rate |
$13,933.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,933.31
|
| Rate for Payer: Allwell Medicaid |
$13,933.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,933.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,933.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,933.31
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$11,264.48
|
|
|
Service Code
|
APR-DRG 0271
|
| Hospital Charge Code |
APRDRG0273
|
| Min. Negotiated Rate |
$11,264.48 |
| Max. Negotiated Rate |
$11,264.48 |
| Rate for Payer: AHCCCS Medicaid |
$11,264.48
|
| Rate for Payer: Allwell Medicaid |
$11,264.48
|
| Rate for Payer: AZCH Complete Medicaid |
$11,264.48
|
| Rate for Payer: Banner UC Health Medicaid |
$11,264.48
|
| Rate for Payer: Mercy Care Medicaid |
$11,264.48
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$13,933.31
|
|
|
Service Code
|
APR-DRG 0272
|
| Hospital Charge Code |
APRDRG0273
|
| Min. Negotiated Rate |
$13,933.31 |
| Max. Negotiated Rate |
$13,933.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,933.31
|
| Rate for Payer: Allwell Medicaid |
$13,933.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,933.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,933.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,933.31
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$13,933.31
|
|
|
Service Code
|
APR-DRG 0272
|
| Hospital Charge Code |
APRDRG0274
|
| Min. Negotiated Rate |
$13,933.31 |
| Max. Negotiated Rate |
$13,933.31 |
| Rate for Payer: AHCCCS Medicaid |
$13,933.31
|
| Rate for Payer: Allwell Medicaid |
$13,933.31
|
| Rate for Payer: AZCH Complete Medicaid |
$13,933.31
|
| Rate for Payer: Banner UC Health Medicaid |
$13,933.31
|
| Rate for Payer: Mercy Care Medicaid |
$13,933.31
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$41,005.25
|
|
|
Service Code
|
APR-DRG 0274
|
| Hospital Charge Code |
APRDRG0274
|
| Min. Negotiated Rate |
$41,005.25 |
| Max. Negotiated Rate |
$41,005.25 |
| Rate for Payer: AHCCCS Medicaid |
$41,005.25
|
| Rate for Payer: Allwell Medicaid |
$41,005.25
|
| Rate for Payer: AZCH Complete Medicaid |
$41,005.25
|
| Rate for Payer: Banner UC Health Medicaid |
$41,005.25
|
| Rate for Payer: Mercy Care Medicaid |
$41,005.25
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$41,005.25
|
|
|
Service Code
|
APR-DRG 0274
|
| Hospital Charge Code |
APRDRG0273
|
| Min. Negotiated Rate |
$41,005.25 |
| Max. Negotiated Rate |
$41,005.25 |
| Rate for Payer: AHCCCS Medicaid |
$41,005.25
|
| Rate for Payer: Allwell Medicaid |
$41,005.25
|
| Rate for Payer: AZCH Complete Medicaid |
$41,005.25
|
| Rate for Payer: Banner UC Health Medicaid |
$41,005.25
|
| Rate for Payer: Mercy Care Medicaid |
$41,005.25
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$21,839.49
|
|
|
Service Code
|
APR-DRG 0273
|
| Hospital Charge Code |
APRDRG0274
|
| Min. Negotiated Rate |
$21,839.49 |
| Max. Negotiated Rate |
$21,839.49 |
| Rate for Payer: AHCCCS Medicaid |
$21,839.49
|
| Rate for Payer: Allwell Medicaid |
$21,839.49
|
| Rate for Payer: AZCH Complete Medicaid |
$21,839.49
|
| Rate for Payer: Banner UC Health Medicaid |
$21,839.49
|
| Rate for Payer: Mercy Care Medicaid |
$21,839.49
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$41,005.25
|
|
|
Service Code
|
APR-DRG 0274
|
| Hospital Charge Code |
APRDRG0272
|
| Min. Negotiated Rate |
$41,005.25 |
| Max. Negotiated Rate |
$41,005.25 |
| Rate for Payer: AHCCCS Medicaid |
$41,005.25
|
| Rate for Payer: Allwell Medicaid |
$41,005.25
|
| Rate for Payer: AZCH Complete Medicaid |
$41,005.25
|
| Rate for Payer: Banner UC Health Medicaid |
$41,005.25
|
| Rate for Payer: Mercy Care Medicaid |
$41,005.25
|
|
|
Other Open Craniotomy
|
Facility
|
IP
|
$11,264.48
|
|
|
Service Code
|
APR-DRG 0271
|
| Hospital Charge Code |
APRDRG0274
|
| Min. Negotiated Rate |
$11,264.48 |
| Max. Negotiated Rate |
$11,264.48 |
| Rate for Payer: AHCCCS Medicaid |
$11,264.48
|
| Rate for Payer: Allwell Medicaid |
$11,264.48
|
| Rate for Payer: AZCH Complete Medicaid |
$11,264.48
|
| Rate for Payer: Banner UC Health Medicaid |
$11,264.48
|
| Rate for Payer: Mercy Care Medicaid |
$11,264.48
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$7,842.35
|
|
|
Service Code
|
APR-DRG 6811
|
| Hospital Charge Code |
APRDRG6814
|
| Min. Negotiated Rate |
$7,842.35 |
| Max. Negotiated Rate |
$7,842.35 |
| Rate for Payer: AHCCCS Medicaid |
$7,842.35
|
| Rate for Payer: Allwell Medicaid |
$7,842.35
|
| Rate for Payer: AZCH Complete Medicaid |
$7,842.35
|
| Rate for Payer: Banner UC Health Medicaid |
$7,842.35
|
| Rate for Payer: Mercy Care Medicaid |
$7,842.35
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$11,098.25
|
|
|
Service Code
|
APR-DRG 6812
|
| Hospital Charge Code |
APRDRG6812
|
| Min. Negotiated Rate |
$11,098.25 |
| Max. Negotiated Rate |
$11,098.25 |
| Rate for Payer: AHCCCS Medicaid |
$11,098.25
|
| Rate for Payer: Allwell Medicaid |
$11,098.25
|
| Rate for Payer: AZCH Complete Medicaid |
$11,098.25
|
| Rate for Payer: Banner UC Health Medicaid |
$11,098.25
|
| Rate for Payer: Mercy Care Medicaid |
$11,098.25
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$7,842.35
|
|
|
Service Code
|
APR-DRG 6811
|
| Hospital Charge Code |
APRDRG6812
|
| Min. Negotiated Rate |
$7,842.35 |
| Max. Negotiated Rate |
$7,842.35 |
| Rate for Payer: AHCCCS Medicaid |
$7,842.35
|
| Rate for Payer: Allwell Medicaid |
$7,842.35
|
| Rate for Payer: AZCH Complete Medicaid |
$7,842.35
|
| Rate for Payer: Banner UC Health Medicaid |
$7,842.35
|
| Rate for Payer: Mercy Care Medicaid |
$7,842.35
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$45,273.97
|
|
|
Service Code
|
APR-DRG 6814
|
| Hospital Charge Code |
APRDRG6811
|
| Min. Negotiated Rate |
$45,273.97 |
| Max. Negotiated Rate |
$45,273.97 |
| Rate for Payer: AHCCCS Medicaid |
$45,273.97
|
| Rate for Payer: Allwell Medicaid |
$45,273.97
|
| Rate for Payer: AZCH Complete Medicaid |
$45,273.97
|
| Rate for Payer: Banner UC Health Medicaid |
$45,273.97
|
| Rate for Payer: Mercy Care Medicaid |
$45,273.97
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$45,273.97
|
|
|
Service Code
|
APR-DRG 6814
|
| Hospital Charge Code |
APRDRG6814
|
| Min. Negotiated Rate |
$45,273.97 |
| Max. Negotiated Rate |
$45,273.97 |
| Rate for Payer: AHCCCS Medicaid |
$45,273.97
|
| Rate for Payer: Allwell Medicaid |
$45,273.97
|
| Rate for Payer: AZCH Complete Medicaid |
$45,273.97
|
| Rate for Payer: Banner UC Health Medicaid |
$45,273.97
|
| Rate for Payer: Mercy Care Medicaid |
$45,273.97
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$45,273.97
|
|
|
Service Code
|
APR-DRG 6814
|
| Hospital Charge Code |
APRDRG6812
|
| Min. Negotiated Rate |
$45,273.97 |
| Max. Negotiated Rate |
$45,273.97 |
| Rate for Payer: AHCCCS Medicaid |
$45,273.97
|
| Rate for Payer: Allwell Medicaid |
$45,273.97
|
| Rate for Payer: AZCH Complete Medicaid |
$45,273.97
|
| Rate for Payer: Banner UC Health Medicaid |
$45,273.97
|
| Rate for Payer: Mercy Care Medicaid |
$45,273.97
|
|
|
Other O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
Facility
|
IP
|
$11,098.25
|
|
|
Service Code
|
APR-DRG 6812
|
| Hospital Charge Code |
APRDRG6811
|
| Min. Negotiated Rate |
$11,098.25 |
| Max. Negotiated Rate |
$11,098.25 |
| Rate for Payer: AHCCCS Medicaid |
$11,098.25
|
| Rate for Payer: Allwell Medicaid |
$11,098.25
|
| Rate for Payer: AZCH Complete Medicaid |
$11,098.25
|
| Rate for Payer: Banner UC Health Medicaid |
$11,098.25
|
| Rate for Payer: Mercy Care Medicaid |
$11,098.25
|
|
