|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$18,408.24
|
|
|
Service Code
|
APR-DRG 1753
|
| Hospital Charge Code |
APRDRG1753
|
| Min. Negotiated Rate |
$18,408.24 |
| Max. Negotiated Rate |
$18,408.24 |
| Rate for Payer: AHCCCS Medicaid |
$18,408.24
|
| Rate for Payer: Allwell Medicaid |
$18,408.24
|
| Rate for Payer: AZCH Complete Medicaid |
$18,408.24
|
| Rate for Payer: Banner UC Health Medicaid |
$18,408.24
|
| Rate for Payer: Mercy Care Medicaid |
$18,408.24
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$18,408.24
|
|
|
Service Code
|
APR-DRG 1753
|
| Hospital Charge Code |
APRDRG1752
|
| Min. Negotiated Rate |
$18,408.24 |
| Max. Negotiated Rate |
$18,408.24 |
| Rate for Payer: AHCCCS Medicaid |
$18,408.24
|
| Rate for Payer: Allwell Medicaid |
$18,408.24
|
| Rate for Payer: AZCH Complete Medicaid |
$18,408.24
|
| Rate for Payer: Banner UC Health Medicaid |
$18,408.24
|
| Rate for Payer: Mercy Care Medicaid |
$18,408.24
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$18,408.24
|
|
|
Service Code
|
APR-DRG 1753
|
| Hospital Charge Code |
APRDRG1751
|
| Min. Negotiated Rate |
$18,408.24 |
| Max. Negotiated Rate |
$18,408.24 |
| Rate for Payer: AHCCCS Medicaid |
$18,408.24
|
| Rate for Payer: Allwell Medicaid |
$18,408.24
|
| Rate for Payer: AZCH Complete Medicaid |
$18,408.24
|
| Rate for Payer: Banner UC Health Medicaid |
$18,408.24
|
| Rate for Payer: Mercy Care Medicaid |
$18,408.24
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$13,243.13
|
|
|
Service Code
|
APR-DRG 1751
|
| Hospital Charge Code |
APRDRG1751
|
| Min. Negotiated Rate |
$13,243.13 |
| Max. Negotiated Rate |
$13,243.13 |
| Rate for Payer: AHCCCS Medicaid |
$13,243.13
|
| Rate for Payer: Allwell Medicaid |
$13,243.13
|
| Rate for Payer: AZCH Complete Medicaid |
$13,243.13
|
| Rate for Payer: Banner UC Health Medicaid |
$13,243.13
|
| Rate for Payer: Mercy Care Medicaid |
$13,243.13
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$14,984.71
|
|
|
Service Code
|
APR-DRG 1752
|
| Hospital Charge Code |
APRDRG1752
|
| Min. Negotiated Rate |
$14,984.71 |
| Max. Negotiated Rate |
$14,984.71 |
| Rate for Payer: AHCCCS Medicaid |
$14,984.71
|
| Rate for Payer: Allwell Medicaid |
$14,984.71
|
| Rate for Payer: AZCH Complete Medicaid |
$14,984.71
|
| Rate for Payer: Banner UC Health Medicaid |
$14,984.71
|
| Rate for Payer: Mercy Care Medicaid |
$14,984.71
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$28,128.95
|
|
|
Service Code
|
APR-DRG 1754
|
| Hospital Charge Code |
APRDRG1753
|
| Min. Negotiated Rate |
$28,128.95 |
| Max. Negotiated Rate |
$28,128.95 |
| Rate for Payer: AHCCCS Medicaid |
$28,128.95
|
| Rate for Payer: Allwell Medicaid |
$28,128.95
|
| Rate for Payer: AZCH Complete Medicaid |
$28,128.95
|
| Rate for Payer: Banner UC Health Medicaid |
$28,128.95
|
| Rate for Payer: Mercy Care Medicaid |
$28,128.95
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$14,984.71
|
|
|
Service Code
|
APR-DRG 1752
|
| Hospital Charge Code |
APRDRG1753
|
| Min. Negotiated Rate |
$14,984.71 |
| Max. Negotiated Rate |
$14,984.71 |
| Rate for Payer: AHCCCS Medicaid |
$14,984.71
|
| Rate for Payer: Allwell Medicaid |
$14,984.71
|
| Rate for Payer: AZCH Complete Medicaid |
$14,984.71
|
| Rate for Payer: Banner UC Health Medicaid |
$14,984.71
|
| Rate for Payer: Mercy Care Medicaid |
$14,984.71
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$14,984.71
|
|
|
Service Code
|
APR-DRG 1752
|
| Hospital Charge Code |
APRDRG1754
|
| Min. Negotiated Rate |
$14,984.71 |
| Max. Negotiated Rate |
$14,984.71 |
| Rate for Payer: AHCCCS Medicaid |
$14,984.71
|
| Rate for Payer: Allwell Medicaid |
$14,984.71
|
| Rate for Payer: AZCH Complete Medicaid |
$14,984.71
|
| Rate for Payer: Banner UC Health Medicaid |
$14,984.71
|
| Rate for Payer: Mercy Care Medicaid |
$14,984.71
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$28,128.95
|
|
|
Service Code
|
APR-DRG 1754
|
| Hospital Charge Code |
APRDRG1754
|
| Min. Negotiated Rate |
$28,128.95 |
| Max. Negotiated Rate |
$28,128.95 |
| Rate for Payer: AHCCCS Medicaid |
$28,128.95
|
| Rate for Payer: Allwell Medicaid |
$28,128.95
|
| Rate for Payer: AZCH Complete Medicaid |
$28,128.95
|
| Rate for Payer: Banner UC Health Medicaid |
$28,128.95
|
| Rate for Payer: Mercy Care Medicaid |
$28,128.95
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$13,243.13
|
|
|
Service Code
|
APR-DRG 1751
|
| Hospital Charge Code |
APRDRG1754
|
| Min. Negotiated Rate |
$13,243.13 |
| Max. Negotiated Rate |
$13,243.13 |
| Rate for Payer: AHCCCS Medicaid |
$13,243.13
|
| Rate for Payer: Allwell Medicaid |
$13,243.13
|
| Rate for Payer: AZCH Complete Medicaid |
$13,243.13
|
| Rate for Payer: Banner UC Health Medicaid |
$13,243.13
|
| Rate for Payer: Mercy Care Medicaid |
$13,243.13
|
|
|
Percutaneous Cardiac Intervention Without Ami
|
Facility
|
IP
|
$13,243.13
|
|
|
Service Code
|
APR-DRG 1751
|
| Hospital Charge Code |
APRDRG1753
|
| Min. Negotiated Rate |
$13,243.13 |
| Max. Negotiated Rate |
$13,243.13 |
| Rate for Payer: AHCCCS Medicaid |
$13,243.13
|
| Rate for Payer: Allwell Medicaid |
$13,243.13
|
| Rate for Payer: AZCH Complete Medicaid |
$13,243.13
|
| Rate for Payer: Banner UC Health Medicaid |
$13,243.13
|
| Rate for Payer: Mercy Care Medicaid |
$13,243.13
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$13,076.90
|
|
|
Service Code
|
APR-DRG 0301
|
| Hospital Charge Code |
APRDRG0302
|
| Min. Negotiated Rate |
$13,076.90 |
| Max. Negotiated Rate |
$13,076.90 |
| Rate for Payer: AHCCCS Medicaid |
$13,076.90
|
| Rate for Payer: Allwell Medicaid |
$13,076.90
|
| Rate for Payer: AZCH Complete Medicaid |
$13,076.90
|
| Rate for Payer: Banner UC Health Medicaid |
$13,076.90
|
| Rate for Payer: Mercy Care Medicaid |
$13,076.90
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$18,696.52
|
|
|
Service Code
|
APR-DRG 0302
|
| Hospital Charge Code |
APRDRG0301
|
| Min. Negotiated Rate |
$18,696.52 |
| Max. Negotiated Rate |
$18,696.52 |
| Rate for Payer: AHCCCS Medicaid |
$18,696.52
|
| Rate for Payer: Allwell Medicaid |
$18,696.52
|
| Rate for Payer: AZCH Complete Medicaid |
$18,696.52
|
| Rate for Payer: Banner UC Health Medicaid |
$18,696.52
|
| Rate for Payer: Mercy Care Medicaid |
$18,696.52
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$36,903.46
|
|
|
Service Code
|
APR-DRG 0304
|
| Hospital Charge Code |
APRDRG0301
|
| Min. Negotiated Rate |
$36,903.46 |
| Max. Negotiated Rate |
$36,903.46 |
| Rate for Payer: AHCCCS Medicaid |
$36,903.46
|
| Rate for Payer: Allwell Medicaid |
$36,903.46
|
| Rate for Payer: AZCH Complete Medicaid |
$36,903.46
|
| Rate for Payer: Banner UC Health Medicaid |
$36,903.46
|
| Rate for Payer: Mercy Care Medicaid |
$36,903.46
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$18,696.52
|
|
|
Service Code
|
APR-DRG 0302
|
| Hospital Charge Code |
APRDRG0304
|
| Min. Negotiated Rate |
$18,696.52 |
| Max. Negotiated Rate |
$18,696.52 |
| Rate for Payer: AHCCCS Medicaid |
$18,696.52
|
| Rate for Payer: Allwell Medicaid |
$18,696.52
|
| Rate for Payer: AZCH Complete Medicaid |
$18,696.52
|
| Rate for Payer: Banner UC Health Medicaid |
$18,696.52
|
| Rate for Payer: Mercy Care Medicaid |
$18,696.52
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$26,175.55
|
|
|
Service Code
|
APR-DRG 0303
|
| Hospital Charge Code |
APRDRG0304
|
| Min. Negotiated Rate |
$26,175.55 |
| Max. Negotiated Rate |
$26,175.55 |
| Rate for Payer: AHCCCS Medicaid |
$26,175.55
|
| Rate for Payer: Allwell Medicaid |
$26,175.55
|
| Rate for Payer: AZCH Complete Medicaid |
$26,175.55
|
| Rate for Payer: Banner UC Health Medicaid |
$26,175.55
|
| Rate for Payer: Mercy Care Medicaid |
$26,175.55
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$26,175.55
|
|
|
Service Code
|
APR-DRG 0303
|
| Hospital Charge Code |
APRDRG0303
|
| Min. Negotiated Rate |
$26,175.55 |
| Max. Negotiated Rate |
$26,175.55 |
| Rate for Payer: AHCCCS Medicaid |
$26,175.55
|
| Rate for Payer: Allwell Medicaid |
$26,175.55
|
| Rate for Payer: AZCH Complete Medicaid |
$26,175.55
|
| Rate for Payer: Banner UC Health Medicaid |
$26,175.55
|
| Rate for Payer: Mercy Care Medicaid |
$26,175.55
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$13,076.90
|
|
|
Service Code
|
APR-DRG 0301
|
| Hospital Charge Code |
APRDRG0303
|
| Min. Negotiated Rate |
$13,076.90 |
| Max. Negotiated Rate |
$13,076.90 |
| Rate for Payer: AHCCCS Medicaid |
$13,076.90
|
| Rate for Payer: Allwell Medicaid |
$13,076.90
|
| Rate for Payer: AZCH Complete Medicaid |
$13,076.90
|
| Rate for Payer: Banner UC Health Medicaid |
$13,076.90
|
| Rate for Payer: Mercy Care Medicaid |
$13,076.90
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$36,903.46
|
|
|
Service Code
|
APR-DRG 0304
|
| Hospital Charge Code |
APRDRG0302
|
| Min. Negotiated Rate |
$36,903.46 |
| Max. Negotiated Rate |
$36,903.46 |
| Rate for Payer: AHCCCS Medicaid |
$36,903.46
|
| Rate for Payer: Allwell Medicaid |
$36,903.46
|
| Rate for Payer: AZCH Complete Medicaid |
$36,903.46
|
| Rate for Payer: Banner UC Health Medicaid |
$36,903.46
|
| Rate for Payer: Mercy Care Medicaid |
$36,903.46
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$18,696.52
|
|
|
Service Code
|
APR-DRG 0302
|
| Hospital Charge Code |
APRDRG0303
|
| Min. Negotiated Rate |
$18,696.52 |
| Max. Negotiated Rate |
$18,696.52 |
| Rate for Payer: AHCCCS Medicaid |
$18,696.52
|
| Rate for Payer: Allwell Medicaid |
$18,696.52
|
| Rate for Payer: AZCH Complete Medicaid |
$18,696.52
|
| Rate for Payer: Banner UC Health Medicaid |
$18,696.52
|
| Rate for Payer: Mercy Care Medicaid |
$18,696.52
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$36,903.46
|
|
|
Service Code
|
APR-DRG 0304
|
| Hospital Charge Code |
APRDRG0303
|
| Min. Negotiated Rate |
$36,903.46 |
| Max. Negotiated Rate |
$36,903.46 |
| Rate for Payer: AHCCCS Medicaid |
$36,903.46
|
| Rate for Payer: Allwell Medicaid |
$36,903.46
|
| Rate for Payer: AZCH Complete Medicaid |
$36,903.46
|
| Rate for Payer: Banner UC Health Medicaid |
$36,903.46
|
| Rate for Payer: Mercy Care Medicaid |
$36,903.46
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$13,076.90
|
|
|
Service Code
|
APR-DRG 0301
|
| Hospital Charge Code |
APRDRG0304
|
| Min. Negotiated Rate |
$13,076.90 |
| Max. Negotiated Rate |
$13,076.90 |
| Rate for Payer: AHCCCS Medicaid |
$13,076.90
|
| Rate for Payer: Allwell Medicaid |
$13,076.90
|
| Rate for Payer: AZCH Complete Medicaid |
$13,076.90
|
| Rate for Payer: Banner UC Health Medicaid |
$13,076.90
|
| Rate for Payer: Mercy Care Medicaid |
$13,076.90
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$36,903.46
|
|
|
Service Code
|
APR-DRG 0304
|
| Hospital Charge Code |
APRDRG0304
|
| Min. Negotiated Rate |
$36,903.46 |
| Max. Negotiated Rate |
$36,903.46 |
| Rate for Payer: AHCCCS Medicaid |
$36,903.46
|
| Rate for Payer: Allwell Medicaid |
$36,903.46
|
| Rate for Payer: AZCH Complete Medicaid |
$36,903.46
|
| Rate for Payer: Banner UC Health Medicaid |
$36,903.46
|
| Rate for Payer: Mercy Care Medicaid |
$36,903.46
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$18,696.52
|
|
|
Service Code
|
APR-DRG 0302
|
| Hospital Charge Code |
APRDRG0302
|
| Min. Negotiated Rate |
$18,696.52 |
| Max. Negotiated Rate |
$18,696.52 |
| Rate for Payer: AHCCCS Medicaid |
$18,696.52
|
| Rate for Payer: Allwell Medicaid |
$18,696.52
|
| Rate for Payer: AZCH Complete Medicaid |
$18,696.52
|
| Rate for Payer: Banner UC Health Medicaid |
$18,696.52
|
| Rate for Payer: Mercy Care Medicaid |
$18,696.52
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
IP
|
$26,175.55
|
|
|
Service Code
|
APR-DRG 0303
|
| Hospital Charge Code |
APRDRG0302
|
| Min. Negotiated Rate |
$26,175.55 |
| Max. Negotiated Rate |
$26,175.55 |
| Rate for Payer: AHCCCS Medicaid |
$26,175.55
|
| Rate for Payer: Allwell Medicaid |
$26,175.55
|
| Rate for Payer: AZCH Complete Medicaid |
$26,175.55
|
| Rate for Payer: Banner UC Health Medicaid |
$26,175.55
|
| Rate for Payer: Mercy Care Medicaid |
$26,175.55
|
|
