|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$26,638.47
|
|
|
Service Code
|
APR-DRG 2244
|
| Hospital Charge Code |
APRDRG2242
|
| Min. Negotiated Rate |
$26,638.47 |
| Max. Negotiated Rate |
$26,638.47 |
| Rate for Payer: AHCCCS Medicaid |
$26,638.47
|
| Rate for Payer: Allwell Medicaid |
$26,638.47
|
| Rate for Payer: AZCH Complete Medicaid |
$26,638.47
|
| Rate for Payer: Banner UC Health Medicaid |
$26,638.47
|
| Rate for Payer: Mercy Care Medicaid |
$26,638.47
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$10,072.81
|
|
|
Service Code
|
APR-DRG 2242
|
| Hospital Charge Code |
APRDRG2244
|
| Min. Negotiated Rate |
$10,072.81 |
| Max. Negotiated Rate |
$10,072.81 |
| Rate for Payer: AHCCCS Medicaid |
$10,072.81
|
| Rate for Payer: Allwell Medicaid |
$10,072.81
|
| Rate for Payer: AZCH Complete Medicaid |
$10,072.81
|
| Rate for Payer: Banner UC Health Medicaid |
$10,072.81
|
| Rate for Payer: Mercy Care Medicaid |
$10,072.81
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$14,502.85
|
|
|
Service Code
|
APR-DRG 2243
|
| Hospital Charge Code |
APRDRG2244
|
| Min. Negotiated Rate |
$14,502.85 |
| Max. Negotiated Rate |
$14,502.85 |
| Rate for Payer: AHCCCS Medicaid |
$14,502.85
|
| Rate for Payer: Allwell Medicaid |
$14,502.85
|
| Rate for Payer: AZCH Complete Medicaid |
$14,502.85
|
| Rate for Payer: Banner UC Health Medicaid |
$14,502.85
|
| Rate for Payer: Mercy Care Medicaid |
$14,502.85
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$14,502.85
|
|
|
Service Code
|
APR-DRG 2243
|
| Hospital Charge Code |
APRDRG2243
|
| Min. Negotiated Rate |
$14,502.85 |
| Max. Negotiated Rate |
$14,502.85 |
| Rate for Payer: AHCCCS Medicaid |
$14,502.85
|
| Rate for Payer: Allwell Medicaid |
$14,502.85
|
| Rate for Payer: AZCH Complete Medicaid |
$14,502.85
|
| Rate for Payer: Banner UC Health Medicaid |
$14,502.85
|
| Rate for Payer: Mercy Care Medicaid |
$14,502.85
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$26,638.47
|
|
|
Service Code
|
APR-DRG 2244
|
| Hospital Charge Code |
APRDRG2241
|
| Min. Negotiated Rate |
$26,638.47 |
| Max. Negotiated Rate |
$26,638.47 |
| Rate for Payer: AHCCCS Medicaid |
$26,638.47
|
| Rate for Payer: Allwell Medicaid |
$26,638.47
|
| Rate for Payer: AZCH Complete Medicaid |
$26,638.47
|
| Rate for Payer: Banner UC Health Medicaid |
$26,638.47
|
| Rate for Payer: Mercy Care Medicaid |
$26,638.47
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$7,725.92
|
|
|
Service Code
|
APR-DRG 2241
|
| Hospital Charge Code |
APRDRG2242
|
| Min. Negotiated Rate |
$7,725.92 |
| Max. Negotiated Rate |
$7,725.92 |
| Rate for Payer: AHCCCS Medicaid |
$7,725.92
|
| Rate for Payer: Allwell Medicaid |
$7,725.92
|
| Rate for Payer: AZCH Complete Medicaid |
$7,725.92
|
| Rate for Payer: Banner UC Health Medicaid |
$7,725.92
|
| Rate for Payer: Mercy Care Medicaid |
$7,725.92
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$7,725.92
|
|
|
Service Code
|
APR-DRG 2241
|
| Hospital Charge Code |
APRDRG2241
|
| Min. Negotiated Rate |
$7,725.92 |
| Max. Negotiated Rate |
$7,725.92 |
| Rate for Payer: AHCCCS Medicaid |
$7,725.92
|
| Rate for Payer: Allwell Medicaid |
$7,725.92
|
| Rate for Payer: AZCH Complete Medicaid |
$7,725.92
|
| Rate for Payer: Banner UC Health Medicaid |
$7,725.92
|
| Rate for Payer: Mercy Care Medicaid |
$7,725.92
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$7,725.92
|
|
|
Service Code
|
APR-DRG 2241
|
| Hospital Charge Code |
APRDRG2244
|
| Min. Negotiated Rate |
$7,725.92 |
| Max. Negotiated Rate |
$7,725.92 |
| Rate for Payer: AHCCCS Medicaid |
$7,725.92
|
| Rate for Payer: Allwell Medicaid |
$7,725.92
|
| Rate for Payer: AZCH Complete Medicaid |
$7,725.92
|
| Rate for Payer: Banner UC Health Medicaid |
$7,725.92
|
| Rate for Payer: Mercy Care Medicaid |
$7,725.92
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$10,072.81
|
|
|
Service Code
|
APR-DRG 2242
|
| Hospital Charge Code |
APRDRG2241
|
| Min. Negotiated Rate |
$10,072.81 |
| Max. Negotiated Rate |
$10,072.81 |
| Rate for Payer: AHCCCS Medicaid |
$10,072.81
|
| Rate for Payer: Allwell Medicaid |
$10,072.81
|
| Rate for Payer: AZCH Complete Medicaid |
$10,072.81
|
| Rate for Payer: Banner UC Health Medicaid |
$10,072.81
|
| Rate for Payer: Mercy Care Medicaid |
$10,072.81
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$7,725.92
|
|
|
Service Code
|
APR-DRG 2241
|
| Hospital Charge Code |
APRDRG2243
|
| Min. Negotiated Rate |
$7,725.92 |
| Max. Negotiated Rate |
$7,725.92 |
| Rate for Payer: AHCCCS Medicaid |
$7,725.92
|
| Rate for Payer: Allwell Medicaid |
$7,725.92
|
| Rate for Payer: AZCH Complete Medicaid |
$7,725.92
|
| Rate for Payer: Banner UC Health Medicaid |
$7,725.92
|
| Rate for Payer: Mercy Care Medicaid |
$7,725.92
|
|
|
Peritoneal Adhesiolysis
|
Facility
|
IP
|
$26,638.47
|
|
|
Service Code
|
APR-DRG 2244
|
| Hospital Charge Code |
APRDRG2243
|
| Min. Negotiated Rate |
$26,638.47 |
| Max. Negotiated Rate |
$26,638.47 |
| Rate for Payer: AHCCCS Medicaid |
$26,638.47
|
| Rate for Payer: Allwell Medicaid |
$26,638.47
|
| Rate for Payer: AZCH Complete Medicaid |
$26,638.47
|
| Rate for Payer: Banner UC Health Medicaid |
$26,638.47
|
| Rate for Payer: Mercy Care Medicaid |
$26,638.47
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$18,338.80
|
|
|
Service Code
|
APR-DRG 1703
|
| Hospital Charge Code |
APRDRG1703
|
| Min. Negotiated Rate |
$18,338.80 |
| Max. Negotiated Rate |
$18,338.80 |
| Rate for Payer: AHCCCS Medicaid |
$18,338.80
|
| Rate for Payer: Allwell Medicaid |
$18,338.80
|
| Rate for Payer: AZCH Complete Medicaid |
$18,338.80
|
| Rate for Payer: Banner UC Health Medicaid |
$18,338.80
|
| Rate for Payer: Mercy Care Medicaid |
$18,338.80
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$13,306.26
|
|
|
Service Code
|
APR-DRG 1701
|
| Hospital Charge Code |
APRDRG1702
|
| Min. Negotiated Rate |
$13,306.26 |
| Max. Negotiated Rate |
$13,306.26 |
| Rate for Payer: AHCCCS Medicaid |
$13,306.26
|
| Rate for Payer: Allwell Medicaid |
$13,306.26
|
| Rate for Payer: AZCH Complete Medicaid |
$13,306.26
|
| Rate for Payer: Banner UC Health Medicaid |
$13,306.26
|
| Rate for Payer: Mercy Care Medicaid |
$13,306.26
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$30,224.73
|
|
|
Service Code
|
APR-DRG 1704
|
| Hospital Charge Code |
APRDRG1703
|
| Min. Negotiated Rate |
$30,224.73 |
| Max. Negotiated Rate |
$30,224.73 |
| Rate for Payer: AHCCCS Medicaid |
$30,224.73
|
| Rate for Payer: Allwell Medicaid |
$30,224.73
|
| Rate for Payer: AZCH Complete Medicaid |
$30,224.73
|
| Rate for Payer: Banner UC Health Medicaid |
$30,224.73
|
| Rate for Payer: Mercy Care Medicaid |
$30,224.73
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$30,224.73
|
|
|
Service Code
|
APR-DRG 1704
|
| Hospital Charge Code |
APRDRG1704
|
| Min. Negotiated Rate |
$30,224.73 |
| Max. Negotiated Rate |
$30,224.73 |
| Rate for Payer: AHCCCS Medicaid |
$30,224.73
|
| Rate for Payer: Allwell Medicaid |
$30,224.73
|
| Rate for Payer: AZCH Complete Medicaid |
$30,224.73
|
| Rate for Payer: Banner UC Health Medicaid |
$30,224.73
|
| Rate for Payer: Mercy Care Medicaid |
$30,224.73
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$18,338.80
|
|
|
Service Code
|
APR-DRG 1703
|
| Hospital Charge Code |
APRDRG1702
|
| Min. Negotiated Rate |
$18,338.80 |
| Max. Negotiated Rate |
$18,338.80 |
| Rate for Payer: AHCCCS Medicaid |
$18,338.80
|
| Rate for Payer: Allwell Medicaid |
$18,338.80
|
| Rate for Payer: AZCH Complete Medicaid |
$18,338.80
|
| Rate for Payer: Banner UC Health Medicaid |
$18,338.80
|
| Rate for Payer: Mercy Care Medicaid |
$18,338.80
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$15,691.72
|
|
|
Service Code
|
APR-DRG 1702
|
| Hospital Charge Code |
APRDRG1703
|
| Min. Negotiated Rate |
$15,691.72 |
| Max. Negotiated Rate |
$15,691.72 |
| Rate for Payer: AHCCCS Medicaid |
$15,691.72
|
| Rate for Payer: Allwell Medicaid |
$15,691.72
|
| Rate for Payer: AZCH Complete Medicaid |
$15,691.72
|
| Rate for Payer: Banner UC Health Medicaid |
$15,691.72
|
| Rate for Payer: Mercy Care Medicaid |
$15,691.72
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$15,691.72
|
|
|
Service Code
|
APR-DRG 1702
|
| Hospital Charge Code |
APRDRG1704
|
| Min. Negotiated Rate |
$15,691.72 |
| Max. Negotiated Rate |
$15,691.72 |
| Rate for Payer: AHCCCS Medicaid |
$15,691.72
|
| Rate for Payer: Allwell Medicaid |
$15,691.72
|
| Rate for Payer: AZCH Complete Medicaid |
$15,691.72
|
| Rate for Payer: Banner UC Health Medicaid |
$15,691.72
|
| Rate for Payer: Mercy Care Medicaid |
$15,691.72
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$15,691.72
|
|
|
Service Code
|
APR-DRG 1702
|
| Hospital Charge Code |
APRDRG1701
|
| Min. Negotiated Rate |
$15,691.72 |
| Max. Negotiated Rate |
$15,691.72 |
| Rate for Payer: AHCCCS Medicaid |
$15,691.72
|
| Rate for Payer: Allwell Medicaid |
$15,691.72
|
| Rate for Payer: AZCH Complete Medicaid |
$15,691.72
|
| Rate for Payer: Banner UC Health Medicaid |
$15,691.72
|
| Rate for Payer: Mercy Care Medicaid |
$15,691.72
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$18,338.80
|
|
|
Service Code
|
APR-DRG 1703
|
| Hospital Charge Code |
APRDRG1701
|
| Min. Negotiated Rate |
$18,338.80 |
| Max. Negotiated Rate |
$18,338.80 |
| Rate for Payer: AHCCCS Medicaid |
$18,338.80
|
| Rate for Payer: Allwell Medicaid |
$18,338.80
|
| Rate for Payer: AZCH Complete Medicaid |
$18,338.80
|
| Rate for Payer: Banner UC Health Medicaid |
$18,338.80
|
| Rate for Payer: Mercy Care Medicaid |
$18,338.80
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$15,691.72
|
|
|
Service Code
|
APR-DRG 1702
|
| Hospital Charge Code |
APRDRG1702
|
| Min. Negotiated Rate |
$15,691.72 |
| Max. Negotiated Rate |
$15,691.72 |
| Rate for Payer: AHCCCS Medicaid |
$15,691.72
|
| Rate for Payer: Allwell Medicaid |
$15,691.72
|
| Rate for Payer: AZCH Complete Medicaid |
$15,691.72
|
| Rate for Payer: Banner UC Health Medicaid |
$15,691.72
|
| Rate for Payer: Mercy Care Medicaid |
$15,691.72
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$13,306.26
|
|
|
Service Code
|
APR-DRG 1701
|
| Hospital Charge Code |
APRDRG1703
|
| Min. Negotiated Rate |
$13,306.26 |
| Max. Negotiated Rate |
$13,306.26 |
| Rate for Payer: AHCCCS Medicaid |
$13,306.26
|
| Rate for Payer: Allwell Medicaid |
$13,306.26
|
| Rate for Payer: AZCH Complete Medicaid |
$13,306.26
|
| Rate for Payer: Banner UC Health Medicaid |
$13,306.26
|
| Rate for Payer: Mercy Care Medicaid |
$13,306.26
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$30,224.73
|
|
|
Service Code
|
APR-DRG 1704
|
| Hospital Charge Code |
APRDRG1701
|
| Min. Negotiated Rate |
$30,224.73 |
| Max. Negotiated Rate |
$30,224.73 |
| Rate for Payer: AHCCCS Medicaid |
$30,224.73
|
| Rate for Payer: Allwell Medicaid |
$30,224.73
|
| Rate for Payer: AZCH Complete Medicaid |
$30,224.73
|
| Rate for Payer: Banner UC Health Medicaid |
$30,224.73
|
| Rate for Payer: Mercy Care Medicaid |
$30,224.73
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$13,306.26
|
|
|
Service Code
|
APR-DRG 1701
|
| Hospital Charge Code |
APRDRG1704
|
| Min. Negotiated Rate |
$13,306.26 |
| Max. Negotiated Rate |
$13,306.26 |
| Rate for Payer: AHCCCS Medicaid |
$13,306.26
|
| Rate for Payer: Allwell Medicaid |
$13,306.26
|
| Rate for Payer: AZCH Complete Medicaid |
$13,306.26
|
| Rate for Payer: Banner UC Health Medicaid |
$13,306.26
|
| Rate for Payer: Mercy Care Medicaid |
$13,306.26
|
|
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
Facility
|
IP
|
$18,338.80
|
|
|
Service Code
|
APR-DRG 1703
|
| Hospital Charge Code |
APRDRG1704
|
| Min. Negotiated Rate |
$18,338.80 |
| Max. Negotiated Rate |
$18,338.80 |
| Rate for Payer: AHCCCS Medicaid |
$18,338.80
|
| Rate for Payer: Allwell Medicaid |
$18,338.80
|
| Rate for Payer: AZCH Complete Medicaid |
$18,338.80
|
| Rate for Payer: Banner UC Health Medicaid |
$18,338.80
|
| Rate for Payer: Mercy Care Medicaid |
$18,338.80
|
|
