|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
| Rate for Payer: NaphCare Correctional Healthcare |
$53,164.02
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1671
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1671
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$19,593.61
|
|
|
Service Code
|
APR-DRG 1672
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$19,593.61 |
| Max. Negotiated Rate |
$19,593.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$19,593.61
|
| Rate for Payer: Mercy Care Medicaid |
$19,593.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$19,593.61
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1672
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$30,500.38
|
|
|
Service Code
|
APR-DRG 1673
|
| Hospital Charge Code |
APRDRG1674
|
| Min. Negotiated Rate |
$30,500.38 |
| Max. Negotiated Rate |
$30,500.38 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,500.38
|
| Rate for Payer: Mercy Care Medicaid |
$30,500.38
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,500.38
|
|
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
Facility
|
IP
|
$53,164.02
|
|
|
Service Code
|
APR-DRG 1674
|
| Hospital Charge Code |
APRDRG1673
|
| Min. Negotiated Rate |
$53,164.02 |
| Max. Negotiated Rate |
$53,164.02 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$53,164.02
|
| Rate for Payer: Mercy Care Medicaid |
$53,164.02
|
| Rate for Payer: NaphCare Correctional Healthcare |
$53,164.02
|
|
|
OTHER CARDIOTHORACIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$63,940.91
|
|
|
Service Code
|
MSDRG 228
|
| Min. Negotiated Rate |
$63,940.91 |
| Max. Negotiated Rate |
$63,940.91 |
| Rate for Payer: Seven Corners Travel Insurance |
$63,940.91
|
|
|
OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$40,704.57
|
|
|
Service Code
|
MSDRG 229
|
| Min. Negotiated Rate |
$40,704.57 |
| Max. Negotiated Rate |
$40,704.57 |
| Rate for Payer: Seven Corners Travel Insurance |
$40,704.57
|
|
|
OTHER CEREBROVASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$13,356.05
|
|
|
Service Code
|
MSDRG 071
|
| Min. Negotiated Rate |
$13,356.05 |
| Max. Negotiated Rate |
$13,356.05 |
| Rate for Payer: Seven Corners Travel Insurance |
$13,356.05
|
|
|
OTHER CEREBROVASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$21,516.12
|
|
|
Service Code
|
MSDRG 070
|
| Min. Negotiated Rate |
$21,516.12 |
| Max. Negotiated Rate |
$21,516.12 |
| Rate for Payer: Seven Corners Travel Insurance |
$21,516.12
|
|
|
OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$9,937.37
|
|
|
Service Code
|
MSDRG 072
|
| Min. Negotiated Rate |
$9,937.37 |
| Max. Negotiated Rate |
$9,937.37 |
| Rate for Payer: Seven Corners Travel Insurance |
$9,937.37
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$25,898.49
|
|
|
Service Code
|
APR-DRG 6964
|
| Hospital Charge Code |
APRDRG6962
|
| Min. Negotiated Rate |
$25,898.49 |
| Max. Negotiated Rate |
$25,898.49 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,898.49
|
| Rate for Payer: Mercy Care Medicaid |
$25,898.49
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,898.49
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6961
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6964
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$5,112.50
|
|
|
Service Code
|
APR-DRG 6961
|
| Hospital Charge Code |
APRDRG6964
|
| Min. Negotiated Rate |
$5,112.50 |
| Max. Negotiated Rate |
$5,112.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,112.50
|
| Rate for Payer: Mercy Care Medicaid |
$5,112.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,112.50
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$5,112.50
|
|
|
Service Code
|
APR-DRG 6961
|
| Hospital Charge Code |
APRDRG6963
|
| Min. Negotiated Rate |
$5,112.50 |
| Max. Negotiated Rate |
$5,112.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,112.50
|
| Rate for Payer: Mercy Care Medicaid |
$5,112.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,112.50
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$11,081.42
|
|
|
Service Code
|
APR-DRG 6963
|
| Hospital Charge Code |
APRDRG6962
|
| Min. Negotiated Rate |
$11,081.42 |
| Max. Negotiated Rate |
$11,081.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,081.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,081.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,081.42
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$6,492.16
|
|
|
Service Code
|
APR-DRG 6962
|
| Hospital Charge Code |
APRDRG6961
|
| Min. Negotiated Rate |
$6,492.16 |
| Max. Negotiated Rate |
$6,492.16 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,492.16
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.16
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,492.16
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$25,898.49
|
|
|
Service Code
|
APR-DRG 6964
|
| Hospital Charge Code |
APRDRG6961
|
| Min. Negotiated Rate |
$25,898.49 |
| Max. Negotiated Rate |
$25,898.49 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,898.49
|
| Rate for Payer: Mercy Care Medicaid |
$25,898.49
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,898.49
|
|
|
Other Chemotherapy
|
Facility
|
IP
|
$6,492.16
|
|
|
Service Code
|
APR-DRG 6962
|
| Hospital Charge Code |
APRDRG6963
|
| Min. Negotiated Rate |
$6,492.16 |
| Max. Negotiated Rate |
$6,492.16 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,492.16
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.16
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,492.16
|
|
