|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$13,174.40
|
|
|
Service Code
|
APR-DRG 3854
|
| Hospital Charge Code |
APRDRG3852
|
| 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
|
$13,174.40
|
|
|
Service Code
|
APR-DRG 3854
|
| Hospital Charge Code |
APRDRG3851
|
| 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
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3851
|
| 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 Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: AHCCCS Medicaid |
$12,167.19
|
| Rate for Payer: Allwell Medicaid |
$12,167.19
|
| Rate for Payer: AZCH Complete Medicaid |
$12,167.19
|
| Rate for Payer: Banner UC Health Medicaid |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: AHCCCS Medicaid |
$5,287.85
|
| Rate for Payer: Allwell Medicaid |
$5,287.85
|
| Rate for Payer: AZCH Complete Medicaid |
$5,287.85
|
| Rate for Payer: Banner UC Health Medicaid |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: AHCCCS Medicaid |
$12,167.19
|
| Rate for Payer: Allwell Medicaid |
$12,167.19
|
| Rate for Payer: AZCH Complete Medicaid |
$12,167.19
|
| Rate for Payer: Banner UC Health Medicaid |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: AHCCCS Medicaid |
$12,167.19
|
| Rate for Payer: Allwell Medicaid |
$12,167.19
|
| Rate for Payer: AZCH Complete Medicaid |
$12,167.19
|
| Rate for Payer: Banner UC Health Medicaid |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: AHCCCS Medicaid |
$23,238.08
|
| Rate for Payer: Allwell Medicaid |
$23,238.08
|
| Rate for Payer: AZCH Complete Medicaid |
$23,238.08
|
| Rate for Payer: Banner UC Health Medicaid |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: AHCCCS Medicaid |
$7,336.64
|
| Rate for Payer: Allwell Medicaid |
$7,336.64
|
| Rate for Payer: AZCH Complete Medicaid |
$7,336.64
|
| Rate for Payer: Banner UC Health Medicaid |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: AHCCCS Medicaid |
$7,336.64
|
| Rate for Payer: Allwell Medicaid |
$7,336.64
|
| Rate for Payer: AZCH Complete Medicaid |
$7,336.64
|
| Rate for Payer: Banner UC Health Medicaid |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: AHCCCS Medicaid |
$12,167.19
|
| Rate for Payer: Allwell Medicaid |
$12,167.19
|
| Rate for Payer: AZCH Complete Medicaid |
$12,167.19
|
| Rate for Payer: Banner UC Health Medicaid |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: AHCCCS Medicaid |
$5,287.85
|
| Rate for Payer: Allwell Medicaid |
$5,287.85
|
| Rate for Payer: AZCH Complete Medicaid |
$5,287.85
|
| Rate for Payer: Banner UC Health Medicaid |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: AHCCCS Medicaid |
$23,238.08
|
| Rate for Payer: Allwell Medicaid |
$23,238.08
|
| Rate for Payer: AZCH Complete Medicaid |
$23,238.08
|
| Rate for Payer: Banner UC Health Medicaid |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: AHCCCS Medicaid |
$23,238.08
|
| Rate for Payer: Allwell Medicaid |
$23,238.08
|
| Rate for Payer: AZCH Complete Medicaid |
$23,238.08
|
| Rate for Payer: Banner UC Health Medicaid |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: AHCCCS Medicaid |
$7,336.64
|
| Rate for Payer: Allwell Medicaid |
$7,336.64
|
| Rate for Payer: AZCH Complete Medicaid |
$7,336.64
|
| Rate for Payer: Banner UC Health Medicaid |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: AHCCCS Medicaid |
$23,238.08
|
| Rate for Payer: Allwell Medicaid |
$23,238.08
|
| Rate for Payer: AZCH Complete Medicaid |
$23,238.08
|
| Rate for Payer: Banner UC Health Medicaid |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: AHCCCS Medicaid |
$5,287.85
|
| Rate for Payer: Allwell Medicaid |
$5,287.85
|
| Rate for Payer: AZCH Complete Medicaid |
$5,287.85
|
| Rate for Payer: Banner UC Health Medicaid |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: AHCCCS Medicaid |
$5,287.85
|
| Rate for Payer: Allwell Medicaid |
$5,287.85
|
| Rate for Payer: AZCH Complete Medicaid |
$5,287.85
|
| Rate for Payer: Banner UC Health Medicaid |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: AHCCCS Medicaid |
$7,336.64
|
| Rate for Payer: Allwell Medicaid |
$7,336.64
|
| Rate for Payer: AZCH Complete Medicaid |
$7,336.64
|
| Rate for Payer: Banner UC Health Medicaid |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$27,320.93
|
|
|
Service Code
|
APR-DRG 2234
|
| Hospital Charge Code |
APRDRG2234
|
| Min. Negotiated Rate |
$27,320.93 |
| Max. Negotiated Rate |
$27,320.93 |
| Rate for Payer: AHCCCS Medicaid |
$27,320.93
|
| Rate for Payer: Allwell Medicaid |
$27,320.93
|
| Rate for Payer: AZCH Complete Medicaid |
$27,320.93
|
| Rate for Payer: Banner UC Health Medicaid |
$27,320.93
|
| Rate for Payer: Mercy Care Medicaid |
$27,320.93
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$9,722.81
|
|
|
Service Code
|
APR-DRG 2232
|
| Hospital Charge Code |
APRDRG2232
|
| Min. Negotiated Rate |
$9,722.81 |
| Max. Negotiated Rate |
$9,722.81 |
| Rate for Payer: AHCCCS Medicaid |
$9,722.81
|
| Rate for Payer: Allwell Medicaid |
$9,722.81
|
| Rate for Payer: AZCH Complete Medicaid |
$9,722.81
|
| Rate for Payer: Banner UC Health Medicaid |
$9,722.81
|
| Rate for Payer: Mercy Care Medicaid |
$9,722.81
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$6,718.71
|
|
|
Service Code
|
APR-DRG 2231
|
| Hospital Charge Code |
APRDRG2232
|
| Min. Negotiated Rate |
$6,718.71 |
| Max. Negotiated Rate |
$6,718.71 |
| Rate for Payer: AHCCCS Medicaid |
$6,718.71
|
| Rate for Payer: Allwell Medicaid |
$6,718.71
|
| Rate for Payer: AZCH Complete Medicaid |
$6,718.71
|
| Rate for Payer: Banner UC Health Medicaid |
$6,718.71
|
| Rate for Payer: Mercy Care Medicaid |
$6,718.71
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$27,320.93
|
|
|
Service Code
|
APR-DRG 2234
|
| Hospital Charge Code |
APRDRG2231
|
| Min. Negotiated Rate |
$27,320.93 |
| Max. Negotiated Rate |
$27,320.93 |
| Rate for Payer: AHCCCS Medicaid |
$27,320.93
|
| Rate for Payer: Allwell Medicaid |
$27,320.93
|
| Rate for Payer: AZCH Complete Medicaid |
$27,320.93
|
| Rate for Payer: Banner UC Health Medicaid |
$27,320.93
|
| Rate for Payer: Mercy Care Medicaid |
$27,320.93
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$9,722.81
|
|
|
Service Code
|
APR-DRG 2232
|
| Hospital Charge Code |
APRDRG2233
|
| Min. Negotiated Rate |
$9,722.81 |
| Max. Negotiated Rate |
$9,722.81 |
| Rate for Payer: AHCCCS Medicaid |
$9,722.81
|
| Rate for Payer: Allwell Medicaid |
$9,722.81
|
| Rate for Payer: AZCH Complete Medicaid |
$9,722.81
|
| Rate for Payer: Banner UC Health Medicaid |
$9,722.81
|
| Rate for Payer: Mercy Care Medicaid |
$9,722.81
|
|
|
Other Small And Large Bowel Procedures
|
Facility
|
IP
|
$9,722.81
|
|
|
Service Code
|
APR-DRG 2232
|
| Hospital Charge Code |
APRDRG2231
|
| Min. Negotiated Rate |
$9,722.81 |
| Max. Negotiated Rate |
$9,722.81 |
| Rate for Payer: AHCCCS Medicaid |
$9,722.81
|
| Rate for Payer: Allwell Medicaid |
$9,722.81
|
| Rate for Payer: AZCH Complete Medicaid |
$9,722.81
|
| Rate for Payer: Banner UC Health Medicaid |
$9,722.81
|
| Rate for Payer: Mercy Care Medicaid |
$9,722.81
|
|