|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,320.32
|
|
|
Service Code
|
APR-DRG 6633
|
| Hospital Charge Code |
APRDRG6633
|
| Min. Negotiated Rate |
$6,320.32 |
| Max. Negotiated Rate |
$6,320.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,320.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,320.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,320.32
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,320.32
|
|
|
Service Code
|
APR-DRG 6633
|
| Hospital Charge Code |
APRDRG6631
|
| Min. Negotiated Rate |
$6,320.32 |
| Max. Negotiated Rate |
$6,320.32 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,320.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,320.32
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,320.32
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$11,114.38
|
|
|
Service Code
|
APR-DRG 6634
|
| Hospital Charge Code |
APRDRG6633
|
| Min. Negotiated Rate |
$11,114.38 |
| Max. Negotiated Rate |
$11,114.38 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,114.38
|
| Rate for Payer: Mercy Care Medicaid |
$11,114.38
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,114.38
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$4,459.50
|
|
|
Service Code
|
APR-DRG 6632
|
| Hospital Charge Code |
APRDRG6632
|
| Min. Negotiated Rate |
$4,459.50 |
| Max. Negotiated Rate |
$4,459.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,459.50
|
| Rate for Payer: Mercy Care Medicaid |
$4,459.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,459.50
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$4,459.50
|
|
|
Service Code
|
APR-DRG 6632
|
| Hospital Charge Code |
APRDRG6633
|
| Min. Negotiated Rate |
$4,459.50 |
| Max. Negotiated Rate |
$4,459.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,459.50
|
| Rate for Payer: Mercy Care Medicaid |
$4,459.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,459.50
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$3,436.86
|
|
|
Service Code
|
APR-DRG 6631
|
| Hospital Charge Code |
APRDRG6633
|
| Min. Negotiated Rate |
$3,436.86 |
| Max. Negotiated Rate |
$3,436.86 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,436.86
|
| Rate for Payer: Mercy Care Medicaid |
$3,436.86
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,436.86
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$4,459.50
|
|
|
Service Code
|
APR-DRG 6632
|
| Hospital Charge Code |
APRDRG6634
|
| Min. Negotiated Rate |
$4,459.50 |
| Max. Negotiated Rate |
$4,459.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,459.50
|
| Rate for Payer: Mercy Care Medicaid |
$4,459.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,459.50
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$15,043.85
|
|
|
Service Code
|
MSDRG 818
|
| Min. Negotiated Rate |
$15,043.85 |
| Max. Negotiated Rate |
$15,043.85 |
| Rate for Payer: Seven Corners Travel Insurance |
$15,043.85
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$29,487.74
|
|
|
Service Code
|
MSDRG 817
|
| Min. Negotiated Rate |
$29,487.74 |
| Max. Negotiated Rate |
$29,487.74 |
| Rate for Payer: Seven Corners Travel Insurance |
$29,487.74
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,251.39
|
|
|
Service Code
|
MSDRG 819
|
| Min. Negotiated Rate |
$11,251.39 |
| Max. Negotiated Rate |
$11,251.39 |
| Rate for Payer: Seven Corners Travel Insurance |
$11,251.39
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$9,498.96
|
|
|
Service Code
|
MSDRG 832
|
| Min. Negotiated Rate |
$9,498.96 |
| Max. Negotiated Rate |
$9,498.96 |
| Rate for Payer: Seven Corners Travel Insurance |
$9,498.96
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$15,592.55
|
|
|
Service Code
|
MSDRG 831
|
| Min. Negotiated Rate |
$15,592.55 |
| Max. Negotiated Rate |
$15,592.55 |
| Rate for Payer: Seven Corners Travel Insurance |
$15,592.55
|
|
|
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$6,981.20
|
|
|
Service Code
|
MSDRG 833
|
| Min. Negotiated Rate |
$6,981.20 |
| Max. Negotiated Rate |
$6,981.20 |
| Rate for Payer: Seven Corners Travel Insurance |
$6,981.20
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,085.54
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,085.54
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,085.54
|
|
