|
OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$7,400.63
|
|
|
Service Code
|
MSDRG 951
|
| Min. Negotiated Rate |
$7,400.63 |
| Max. Negotiated Rate |
$7,400.63 |
| Rate for Payer: Seven Corners Travel Insurance |
$7,400.63
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5181
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5181
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5183
|
| Min. Negotiated Rate |
$7,829.03 |
| Max. Negotiated Rate |
$7,829.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,829.03
|
| Rate for Payer: Mercy Care Medicaid |
$7,829.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,829.03
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$5,804.79
|
|
|
Service Code
|
APR-DRG 5181
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$5,804.79 |
| Max. Negotiated Rate |
$5,804.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,804.79
|
| Rate for Payer: Mercy Care Medicaid |
$5,804.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,804.79
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$7,829.03 |
| Max. Negotiated Rate |
$7,829.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,829.03
|
| Rate for Payer: Mercy Care Medicaid |
$7,829.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,829.03
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$21,533.68
|
|
|
Service Code
|
APR-DRG 5184
|
| Hospital Charge Code |
APRDRG5181
|
| Min. Negotiated Rate |
$21,533.68 |
| Max. Negotiated Rate |
$21,533.68 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,533.68
|
| Rate for Payer: Mercy Care Medicaid |
$21,533.68
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,533.68
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5182
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,416.77
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5181
|
| Min. Negotiated Rate |
$7,829.03 |
| Max. Negotiated Rate |
$7,829.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,829.03
|
| Rate for Payer: Mercy Care Medicaid |
$7,829.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,829.03
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,829.03
|
|
|
Service Code
|
APR-DRG 5182
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$7,829.03 |
| Max. Negotiated Rate |
$7,829.03 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,829.03
|
| Rate for Payer: Mercy Care Medicaid |
$7,829.03
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,829.03
|
|
|
Other Female Reproductive System And Related Procedures
|
Facility
|
IP
|
$15,416.77
|
|
|
Service Code
|
APR-DRG 5183
|
| Hospital Charge Code |
APRDRG5184
|
| Min. Negotiated Rate |
$15,416.77 |
| Max. Negotiated Rate |
$15,416.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,416.77
|
| Rate for Payer: Mercy Care Medicaid |
$15,416.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,416.77
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$33,184.02
|
|
|
Service Code
|
MSDRG 749
|
| Min. Negotiated Rate |
$33,184.02 |
| Max. Negotiated Rate |
$33,184.02 |
| Rate for Payer: Seven Corners Travel Insurance |
$33,184.02
|
|
|
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,073.43
|
|
|
Service Code
|
MSDRG 750
|
| Min. Negotiated Rate |
$19,073.43 |
| Max. Negotiated Rate |
$19,073.43 |
| Rate for Payer: Seven Corners Travel Insurance |
$19,073.43
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,726.54
|
|
|
Service Code
|
APR-DRG 2492
|
| Hospital Charge Code |
APRDRG2493
|
| Min. Negotiated Rate |
$3,726.54 |
| Max. Negotiated Rate |
$3,726.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,726.54
|
| Rate for Payer: Mercy Care Medicaid |
$3,726.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,726.54
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$11,184.52
|
|
|
Service Code
|
APR-DRG 2494
|
| Hospital Charge Code |
APRDRG2493
|
| Min. Negotiated Rate |
$11,184.52 |
| Max. Negotiated Rate |
$11,184.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,184.52
|
| Rate for Payer: Mercy Care Medicaid |
$11,184.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,184.52
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$11,184.52
|
|
|
Service Code
|
APR-DRG 2494
|
| Hospital Charge Code |
APRDRG2494
|
| Min. Negotiated Rate |
$11,184.52 |
| Max. Negotiated Rate |
$11,184.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,184.52
|
| Rate for Payer: Mercy Care Medicaid |
$11,184.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,184.52
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$11,184.52
|
|
|
Service Code
|
APR-DRG 2494
|
| Hospital Charge Code |
APRDRG2491
|
| Min. Negotiated Rate |
$11,184.52 |
| Max. Negotiated Rate |
$11,184.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,184.52
|
| Rate for Payer: Mercy Care Medicaid |
$11,184.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,184.52
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2494
|
| Min. Negotiated Rate |
$3,125.44 |
| Max. Negotiated Rate |
$3,125.44 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,125.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,125.44
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,125.44
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$5,482.14
|
|
|
Service Code
|
APR-DRG 2493
|
| Hospital Charge Code |
APRDRG2493
|
| Min. Negotiated Rate |
$5,482.14 |
| Max. Negotiated Rate |
$5,482.14 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,482.14
|
| Rate for Payer: Mercy Care Medicaid |
$5,482.14
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,482.14
|
|
