|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$17,915.86
|
|
|
Service Code
|
APR-DRG 3093
|
| Hospital Charge Code |
APRDRG3091
|
| Min. Negotiated Rate |
$17,915.86 |
| Max. Negotiated Rate |
$17,915.86 |
| Rate for Payer: AHCCCS Medicaid |
$17,915.86
|
| Rate for Payer: Allwell Medicaid |
$17,915.86
|
| Rate for Payer: AZCH Complete Medicaid |
$17,915.86
|
| Rate for Payer: Banner UC Health Medicaid |
$17,915.86
|
| Rate for Payer: Mercy Care Medicaid |
$17,915.86
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$12,185.42
|
|
|
Service Code
|
APR-DRG 3092
|
| Hospital Charge Code |
APRDRG3091
|
| Min. Negotiated Rate |
$12,185.42 |
| Max. Negotiated Rate |
$12,185.42 |
| Rate for Payer: AHCCCS Medicaid |
$12,185.42
|
| Rate for Payer: Allwell Medicaid |
$12,185.42
|
| Rate for Payer: AZCH Complete Medicaid |
$12,185.42
|
| Rate for Payer: Banner UC Health Medicaid |
$12,185.42
|
| Rate for Payer: Mercy Care Medicaid |
$12,185.42
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$29,232.95
|
|
|
Service Code
|
APR-DRG 3094
|
| Hospital Charge Code |
APRDRG3092
|
| Min. Negotiated Rate |
$29,232.95 |
| Max. Negotiated Rate |
$29,232.95 |
| Rate for Payer: AHCCCS Medicaid |
$29,232.95
|
| Rate for Payer: Allwell Medicaid |
$29,232.95
|
| Rate for Payer: AZCH Complete Medicaid |
$29,232.95
|
| Rate for Payer: Banner UC Health Medicaid |
$29,232.95
|
| Rate for Payer: Mercy Care Medicaid |
$29,232.95
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$12,185.42
|
|
|
Service Code
|
APR-DRG 3092
|
| Hospital Charge Code |
APRDRG3094
|
| Min. Negotiated Rate |
$12,185.42 |
| Max. Negotiated Rate |
$12,185.42 |
| Rate for Payer: AHCCCS Medicaid |
$12,185.42
|
| Rate for Payer: Allwell Medicaid |
$12,185.42
|
| Rate for Payer: AZCH Complete Medicaid |
$12,185.42
|
| Rate for Payer: Banner UC Health Medicaid |
$12,185.42
|
| Rate for Payer: Mercy Care Medicaid |
$12,185.42
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$29,232.95
|
|
|
Service Code
|
APR-DRG 3094
|
| Hospital Charge Code |
APRDRG3093
|
| Min. Negotiated Rate |
$29,232.95 |
| Max. Negotiated Rate |
$29,232.95 |
| Rate for Payer: AHCCCS Medicaid |
$29,232.95
|
| Rate for Payer: Allwell Medicaid |
$29,232.95
|
| Rate for Payer: AZCH Complete Medicaid |
$29,232.95
|
| Rate for Payer: Banner UC Health Medicaid |
$29,232.95
|
| Rate for Payer: Mercy Care Medicaid |
$29,232.95
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$9,220.60
|
|
|
Service Code
|
APR-DRG 3091
|
| Hospital Charge Code |
APRDRG3092
|
| Min. Negotiated Rate |
$9,220.60 |
| Max. Negotiated Rate |
$9,220.60 |
| Rate for Payer: AHCCCS Medicaid |
$9,220.60
|
| Rate for Payer: Allwell Medicaid |
$9,220.60
|
| Rate for Payer: AZCH Complete Medicaid |
$9,220.60
|
| Rate for Payer: Banner UC Health Medicaid |
$9,220.60
|
| Rate for Payer: Mercy Care Medicaid |
$9,220.60
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$9,220.60
|
|
|
Service Code
|
APR-DRG 3091
|
| Hospital Charge Code |
APRDRG3091
|
| Min. Negotiated Rate |
$9,220.60 |
| Max. Negotiated Rate |
$9,220.60 |
| Rate for Payer: AHCCCS Medicaid |
$9,220.60
|
| Rate for Payer: Allwell Medicaid |
$9,220.60
|
| Rate for Payer: AZCH Complete Medicaid |
$9,220.60
|
| Rate for Payer: Banner UC Health Medicaid |
$9,220.60
|
| Rate for Payer: Mercy Care Medicaid |
$9,220.60
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$29,232.95
|
|
|
Service Code
|
APR-DRG 3094
|
| Hospital Charge Code |
APRDRG3094
|
| Min. Negotiated Rate |
$29,232.95 |
| Max. Negotiated Rate |
$29,232.95 |
| Rate for Payer: AHCCCS Medicaid |
$29,232.95
|
| Rate for Payer: Allwell Medicaid |
$29,232.95
|
| Rate for Payer: AZCH Complete Medicaid |
$29,232.95
|
| Rate for Payer: Banner UC Health Medicaid |
$29,232.95
|
| Rate for Payer: Mercy Care Medicaid |
$29,232.95
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$17,915.86
|
|
|
Service Code
|
APR-DRG 3093
|
| Hospital Charge Code |
APRDRG3094
|
| Min. Negotiated Rate |
$17,915.86 |
| Max. Negotiated Rate |
$17,915.86 |
| Rate for Payer: AHCCCS Medicaid |
$17,915.86
|
| Rate for Payer: Allwell Medicaid |
$17,915.86
|
| Rate for Payer: AZCH Complete Medicaid |
$17,915.86
|
| Rate for Payer: Banner UC Health Medicaid |
$17,915.86
|
| Rate for Payer: Mercy Care Medicaid |
$17,915.86
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$12,185.42
|
|
|
Service Code
|
APR-DRG 3092
|
| Hospital Charge Code |
APRDRG3092
|
| Min. Negotiated Rate |
$12,185.42 |
| Max. Negotiated Rate |
$12,185.42 |
| Rate for Payer: AHCCCS Medicaid |
$12,185.42
|
| Rate for Payer: Allwell Medicaid |
$12,185.42
|
| Rate for Payer: AZCH Complete Medicaid |
$12,185.42
|
| Rate for Payer: Banner UC Health Medicaid |
$12,185.42
|
| Rate for Payer: Mercy Care Medicaid |
$12,185.42
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$9,220.60
|
|
|
Service Code
|
APR-DRG 3091
|
| Hospital Charge Code |
APRDRG3094
|
| Min. Negotiated Rate |
$9,220.60 |
| Max. Negotiated Rate |
$9,220.60 |
| Rate for Payer: AHCCCS Medicaid |
$9,220.60
|
| Rate for Payer: Allwell Medicaid |
$9,220.60
|
| Rate for Payer: AZCH Complete Medicaid |
$9,220.60
|
| Rate for Payer: Banner UC Health Medicaid |
$9,220.60
|
| Rate for Payer: Mercy Care Medicaid |
$9,220.60
|
|
|
Other Significant Hip And Femur Surgery
|
Facility
|
IP
|
$17,915.86
|
|
|
Service Code
|
APR-DRG 3093
|
| Hospital Charge Code |
APRDRG3092
|
| Min. Negotiated Rate |
$17,915.86 |
| Max. Negotiated Rate |
$17,915.86 |
| Rate for Payer: AHCCCS Medicaid |
$17,915.86
|
| Rate for Payer: Allwell Medicaid |
$17,915.86
|
| Rate for Payer: AZCH Complete Medicaid |
$17,915.86
|
| Rate for Payer: Banner UC Health Medicaid |
$17,915.86
|
| Rate for Payer: Mercy Care Medicaid |
$17,915.86
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$4,016.22
|
|
|
Service Code
|
APR-DRG 3852
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$4,016.22 |
| Max. Negotiated Rate |
$4,016.22 |
| Rate for Payer: AHCCCS Medicaid |
$4,016.22
|
| Rate for Payer: Allwell Medicaid |
$4,016.22
|
| Rate for Payer: AZCH Complete Medicaid |
$4,016.22
|
| Rate for Payer: Banner UC Health Medicaid |
$4,016.22
|
| Rate for Payer: Mercy Care Medicaid |
$4,016.22
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$13,174.40
|
|
|
Service Code
|
APR-DRG 3854
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$13,174.40 |
| Max. Negotiated Rate |
$13,174.40 |
| Rate for Payer: AHCCCS Medicaid |
$13,174.40
|
| Rate for Payer: Allwell Medicaid |
$13,174.40
|
| Rate for Payer: AZCH Complete Medicaid |
$13,174.40
|
| Rate for Payer: Banner UC Health Medicaid |
$13,174.40
|
| Rate for Payer: Mercy Care Medicaid |
$13,174.40
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3852
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: AHCCCS Medicaid |
$6,215.11
|
| Rate for Payer: Allwell Medicaid |
$6,215.11
|
| Rate for Payer: AZCH Complete Medicaid |
$6,215.11
|
| Rate for Payer: Banner UC Health Medicaid |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3854
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: AHCCCS Medicaid |
$6,215.11
|
| Rate for Payer: Allwell Medicaid |
$6,215.11
|
| Rate for Payer: AZCH Complete Medicaid |
$6,215.11
|
| Rate for Payer: Banner UC Health Medicaid |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: AHCCCS Medicaid |
$6,215.11
|
| Rate for Payer: Allwell Medicaid |
$6,215.11
|
| Rate for Payer: AZCH Complete Medicaid |
$6,215.11
|
| Rate for Payer: Banner UC Health Medicaid |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3851
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: AHCCCS Medicaid |
$6,215.11
|
| Rate for Payer: Allwell Medicaid |
$6,215.11
|
| Rate for Payer: AZCH Complete Medicaid |
$6,215.11
|
| Rate for Payer: Banner UC Health Medicaid |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$4,016.22
|
|
|
Service Code
|
APR-DRG 3852
|
| Hospital Charge Code |
APRDRG3852
|
| Min. Negotiated Rate |
$4,016.22 |
| Max. Negotiated Rate |
$4,016.22 |
| Rate for Payer: AHCCCS Medicaid |
$4,016.22
|
| Rate for Payer: Allwell Medicaid |
$4,016.22
|
| Rate for Payer: AZCH Complete Medicaid |
$4,016.22
|
| Rate for Payer: Banner UC Health Medicaid |
$4,016.22
|
| Rate for Payer: Mercy Care Medicaid |
$4,016.22
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$3,161.91 |
| Max. Negotiated Rate |
$3,161.91 |
| Rate for Payer: AHCCCS Medicaid |
$3,161.91
|
| Rate for Payer: Allwell Medicaid |
$3,161.91
|
| Rate for Payer: AZCH Complete Medicaid |
$3,161.91
|
| Rate for Payer: Banner UC Health Medicaid |
$3,161.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,161.91
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$13,174.40
|
|
|
Service Code
|
APR-DRG 3854
|
| Hospital Charge Code |
APRDRG3854
|
| Min. Negotiated Rate |
$13,174.40 |
| Max. Negotiated Rate |
$13,174.40 |
| Rate for Payer: AHCCCS Medicaid |
$13,174.40
|
| Rate for Payer: Allwell Medicaid |
$13,174.40
|
| Rate for Payer: AZCH Complete Medicaid |
$13,174.40
|
| Rate for Payer: Banner UC Health Medicaid |
$13,174.40
|
| Rate for Payer: Mercy Care Medicaid |
$13,174.40
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$4,016.22
|
|
|
Service Code
|
APR-DRG 3852
|
| Hospital Charge Code |
APRDRG3854
|
| Min. Negotiated Rate |
$4,016.22 |
| Max. Negotiated Rate |
$4,016.22 |
| Rate for Payer: AHCCCS Medicaid |
$4,016.22
|
| Rate for Payer: Allwell Medicaid |
$4,016.22
|
| Rate for Payer: AZCH Complete Medicaid |
$4,016.22
|
| Rate for Payer: Banner UC Health Medicaid |
$4,016.22
|
| Rate for Payer: Mercy Care Medicaid |
$4,016.22
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3854
|
| Min. Negotiated Rate |
$3,161.91 |
| Max. Negotiated Rate |
$3,161.91 |
| Rate for Payer: AHCCCS Medicaid |
$3,161.91
|
| Rate for Payer: Allwell Medicaid |
$3,161.91
|
| Rate for Payer: AZCH Complete Medicaid |
$3,161.91
|
| Rate for Payer: Banner UC Health Medicaid |
$3,161.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,161.91
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$4,016.22
|
|
|
Service Code
|
APR-DRG 3852
|
| Hospital Charge Code |
APRDRG3851
|
| Min. Negotiated Rate |
$4,016.22 |
| Max. Negotiated Rate |
$4,016.22 |
| Rate for Payer: AHCCCS Medicaid |
$4,016.22
|
| Rate for Payer: Allwell Medicaid |
$4,016.22
|
| Rate for Payer: AZCH Complete Medicaid |
$4,016.22
|
| Rate for Payer: Banner UC Health Medicaid |
$4,016.22
|
| Rate for Payer: Mercy Care Medicaid |
$4,016.22
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3852
|
| Min. Negotiated Rate |
$3,161.91 |
| Max. Negotiated Rate |
$3,161.91 |
| Rate for Payer: AHCCCS Medicaid |
$3,161.91
|
| Rate for Payer: Allwell Medicaid |
$3,161.91
|
| Rate for Payer: AZCH Complete Medicaid |
$3,161.91
|
| Rate for Payer: Banner UC Health Medicaid |
$3,161.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,161.91
|
|
