|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC
|
Facility
|
IP
|
$11,968.58
|
|
|
Service Code
|
MSDRG 155
|
| Min. Negotiated Rate |
$11,968.58 |
| Max. Negotiated Rate |
$11,968.58 |
| Rate for Payer: Seven Corners Travel Insurance |
$11,968.58
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$20,206.88
|
|
|
Service Code
|
MSDRG 154
|
| Min. Negotiated Rate |
$20,206.88 |
| Max. Negotiated Rate |
$20,206.88 |
| Rate for Payer: Seven Corners Travel Insurance |
$20,206.88
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$9,112.48
|
|
|
Service Code
|
MSDRG 156
|
| Min. Negotiated Rate |
$9,112.48 |
| Max. Negotiated Rate |
$9,112.48 |
| Rate for Payer: Seven Corners Travel Insurance |
$9,112.48
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$22,396.25
|
|
|
Service Code
|
MSDRG 144
|
| Min. Negotiated Rate |
$22,396.25 |
| Max. Negotiated Rate |
$22,396.25 |
| Rate for Payer: Seven Corners Travel Insurance |
$22,396.25
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$48,421.59
|
|
|
Service Code
|
MSDRG 143
|
| Min. Negotiated Rate |
$48,421.59 |
| Max. Negotiated Rate |
$48,421.59 |
| Rate for Payer: Seven Corners Travel Insurance |
$48,421.59
|
|
|
OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$15,589.98
|
|
|
Service Code
|
MSDRG 145
|
| Min. Negotiated Rate |
$15,589.98 |
| Max. Negotiated Rate |
$15,589.98 |
| Rate for Payer: Seven Corners Travel Insurance |
$15,589.98
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$8,771.01
|
|
|
Service Code
|
APR-DRG 0982
|
| Hospital Charge Code |
APRDRG0982
|
| Min. Negotiated Rate |
$8,771.01 |
| Max. Negotiated Rate |
$8,771.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,771.01
|
| Rate for Payer: Mercy Care Medicaid |
$8,771.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,771.01
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$27,722.13
|
|
|
Service Code
|
APR-DRG 0984
|
| Hospital Charge Code |
APRDRG0983
|
| Min. Negotiated Rate |
$27,722.13 |
| Max. Negotiated Rate |
$27,722.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,722.13
|
| Rate for Payer: Mercy Care Medicaid |
$27,722.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,722.13
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$8,771.01
|
|
|
Service Code
|
APR-DRG 0982
|
| Hospital Charge Code |
APRDRG0984
|
| Min. Negotiated Rate |
$8,771.01 |
| Max. Negotiated Rate |
$8,771.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,771.01
|
| Rate for Payer: Mercy Care Medicaid |
$8,771.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,771.01
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$15,063.97
|
|
|
Service Code
|
APR-DRG 0983
|
| Hospital Charge Code |
APRDRG0984
|
| Min. Negotiated Rate |
$15,063.97 |
| Max. Negotiated Rate |
$15,063.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,063.97
|
| Rate for Payer: Mercy Care Medicaid |
$15,063.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,063.97
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$6,205.29
|
|
|
Service Code
|
APR-DRG 0981
|
| Hospital Charge Code |
APRDRG0984
|
| Min. Negotiated Rate |
$6,205.29 |
| Max. Negotiated Rate |
$6,205.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,205.29
|
| Rate for Payer: Mercy Care Medicaid |
$6,205.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,205.29
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$6,205.29
|
|
|
Service Code
|
APR-DRG 0981
|
| Hospital Charge Code |
APRDRG0982
|
| Min. Negotiated Rate |
$6,205.29 |
| Max. Negotiated Rate |
$6,205.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,205.29
|
| Rate for Payer: Mercy Care Medicaid |
$6,205.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,205.29
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$15,063.97
|
|
|
Service Code
|
APR-DRG 0983
|
| Hospital Charge Code |
APRDRG0983
|
| Min. Negotiated Rate |
$15,063.97 |
| Max. Negotiated Rate |
$15,063.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,063.97
|
| Rate for Payer: Mercy Care Medicaid |
$15,063.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,063.97
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$27,722.13
|
|
|
Service Code
|
APR-DRG 0984
|
| Hospital Charge Code |
APRDRG0981
|
| Min. Negotiated Rate |
$27,722.13 |
| Max. Negotiated Rate |
$27,722.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,722.13
|
| Rate for Payer: Mercy Care Medicaid |
$27,722.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,722.13
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$6,205.29
|
|
|
Service Code
|
APR-DRG 0981
|
| Hospital Charge Code |
APRDRG0983
|
| Min. Negotiated Rate |
$6,205.29 |
| Max. Negotiated Rate |
$6,205.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,205.29
|
| Rate for Payer: Mercy Care Medicaid |
$6,205.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,205.29
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$8,771.01
|
|
|
Service Code
|
APR-DRG 0982
|
| Hospital Charge Code |
APRDRG0983
|
| Min. Negotiated Rate |
$8,771.01 |
| Max. Negotiated Rate |
$8,771.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,771.01
|
| Rate for Payer: Mercy Care Medicaid |
$8,771.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,771.01
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$6,205.29
|
|
|
Service Code
|
APR-DRG 0981
|
| Hospital Charge Code |
APRDRG0981
|
| Min. Negotiated Rate |
$6,205.29 |
| Max. Negotiated Rate |
$6,205.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,205.29
|
| Rate for Payer: Mercy Care Medicaid |
$6,205.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,205.29
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$27,722.13
|
|
|
Service Code
|
APR-DRG 0984
|
| Hospital Charge Code |
APRDRG0984
|
| Min. Negotiated Rate |
$27,722.13 |
| Max. Negotiated Rate |
$27,722.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,722.13
|
| Rate for Payer: Mercy Care Medicaid |
$27,722.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,722.13
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$8,771.01
|
|
|
Service Code
|
APR-DRG 0982
|
| Hospital Charge Code |
APRDRG0981
|
| Min. Negotiated Rate |
$8,771.01 |
| Max. Negotiated Rate |
$8,771.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,771.01
|
| Rate for Payer: Mercy Care Medicaid |
$8,771.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,771.01
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$27,722.13
|
|
|
Service Code
|
APR-DRG 0984
|
| Hospital Charge Code |
APRDRG0982
|
| Min. Negotiated Rate |
$27,722.13 |
| Max. Negotiated Rate |
$27,722.13 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,722.13
|
| Rate for Payer: Mercy Care Medicaid |
$27,722.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,722.13
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$15,063.97
|
|
|
Service Code
|
APR-DRG 0983
|
| Hospital Charge Code |
APRDRG0982
|
| Min. Negotiated Rate |
$15,063.97 |
| Max. Negotiated Rate |
$15,063.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,063.97
|
| Rate for Payer: Mercy Care Medicaid |
$15,063.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,063.97
|
|
|
Other Ear, Nose, Mouth And Throat Procedures
|
Facility
|
IP
|
$15,063.97
|
|
|
Service Code
|
APR-DRG 0983
|
| Hospital Charge Code |
APRDRG0981
|
| Min. Negotiated Rate |
$15,063.97 |
| Max. Negotiated Rate |
$15,063.97 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,063.97
|
| Rate for Payer: Mercy Care Medicaid |
$15,063.97
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,063.97
|
|
|
Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses
|
Facility
|
IP
|
$13,565.78
|
|
|
Service Code
|
APR-DRG 1154
|
| Hospital Charge Code |
APRDRG1152
|
| Min. Negotiated Rate |
$13,565.78 |
| Max. Negotiated Rate |
$13,565.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,565.78
|
| Rate for Payer: Mercy Care Medicaid |
$13,565.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,565.78
|
|
|
Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses
|
Facility
|
IP
|
$13,565.78
|
|
|
Service Code
|
APR-DRG 1154
|
| Hospital Charge Code |
APRDRG1151
|
| Min. Negotiated Rate |
$13,565.78 |
| Max. Negotiated Rate |
$13,565.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,565.78
|
| Rate for Payer: Mercy Care Medicaid |
$13,565.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,565.78
|
|
|
Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses
|
Facility
|
IP
|
$3,431.25
|
|
|
Service Code
|
APR-DRG 1151
|
| Hospital Charge Code |
APRDRG1154
|
| Min. Negotiated Rate |
$3,431.25 |
| Max. Negotiated Rate |
$3,431.25 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,431.25
|
| Rate for Payer: Mercy Care Medicaid |
$3,431.25
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,431.25
|
|
