|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,726.54
|
|
|
Service Code
|
APR-DRG 2492
|
| Hospital Charge Code |
APRDRG2492
|
| 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 |
APRDRG2492
|
| 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
|
$5,482.14
|
|
|
Service Code
|
APR-DRG 2493
|
| Hospital Charge Code |
APRDRG2491
|
| 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
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,726.54
|
|
|
Service Code
|
APR-DRG 2492
|
| Hospital Charge Code |
APRDRG2491
|
| 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
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2491
|
| 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
|
$3,726.54
|
|
|
Service Code
|
APR-DRG 2492
|
| Hospital Charge Code |
APRDRG2494
|
| 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
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2492
|
| 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 |
APRDRG2494
|
| 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
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$5,482.14
|
|
|
Service Code
|
APR-DRG 2493
|
| Hospital Charge Code |
APRDRG2492
|
| 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
|
|
|
Other Gastroenteritis, Nausea And Vomiting
|
Facility
|
IP
|
$3,125.44
|
|
|
Service Code
|
APR-DRG 2491
|
| Hospital Charge Code |
APRDRG2493
|
| 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 HEART ASSIST SYSTEM IMPLANT
|
Facility
|
IP
|
$128,685.67
|
|
|
Service Code
|
MSDRG 215
|
| Min. Negotiated Rate |
$128,685.67 |
| Max. Negotiated Rate |
$128,685.67 |
| Rate for Payer: Seven Corners Travel Insurance |
$128,685.67
|
|
|
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$28,276.71
|
|
|
Service Code
|
MSDRG 424
|
| Min. Negotiated Rate |
$28,276.71 |
| Max. Negotiated Rate |
$28,276.71 |
| Rate for Payer: Seven Corners Travel Insurance |
$28,276.71
|
|
|
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$53,673.95
|
|
|
Service Code
|
MSDRG 423
|
| Min. Negotiated Rate |
$53,673.95 |
| Max. Negotiated Rate |
$53,673.95 |
| Rate for Payer: Seven Corners Travel Insurance |
$53,673.95
|
|
|
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,390.10
|
|
|
Service Code
|
MSDRG 425
|
| Min. Negotiated Rate |
$19,390.10 |
| Max. Negotiated Rate |
$19,390.10 |
| Rate for Payer: Seven Corners Travel Insurance |
$19,390.10
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,034.73
|
|
|
Service Code
|
APR-DRG 2641
|
| Hospital Charge Code |
APRDRG2642
|
| Min. Negotiated Rate |
$9,034.73 |
| Max. Negotiated Rate |
$9,034.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,034.73
|
| Rate for Payer: Mercy Care Medicaid |
$9,034.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,034.73
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,034.73
|
|
|
Service Code
|
APR-DRG 2641
|
| Hospital Charge Code |
APRDRG2641
|
| Min. Negotiated Rate |
$9,034.73 |
| Max. Negotiated Rate |
$9,034.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,034.73
|
| Rate for Payer: Mercy Care Medicaid |
$9,034.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,034.73
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,094.35
|
|
|
Service Code
|
APR-DRG 2642
|
| Hospital Charge Code |
APRDRG2642
|
| Min. Negotiated Rate |
$9,094.35 |
| Max. Negotiated Rate |
$9,094.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,094.35
|
| Rate for Payer: Mercy Care Medicaid |
$9,094.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,094.35
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,094.35
|
|
|
Service Code
|
APR-DRG 2642
|
| Hospital Charge Code |
APRDRG2641
|
| Min. Negotiated Rate |
$9,094.35 |
| Max. Negotiated Rate |
$9,094.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,094.35
|
| Rate for Payer: Mercy Care Medicaid |
$9,094.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,094.35
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,034.73
|
|
|
Service Code
|
APR-DRG 2641
|
| Hospital Charge Code |
APRDRG2644
|
| Min. Negotiated Rate |
$9,034.73 |
| Max. Negotiated Rate |
$9,034.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,034.73
|
| Rate for Payer: Mercy Care Medicaid |
$9,034.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,034.73
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$10,384.23
|
|
|
Service Code
|
APR-DRG 2643
|
| Hospital Charge Code |
APRDRG2644
|
| Min. Negotiated Rate |
$10,384.23 |
| Max. Negotiated Rate |
$10,384.23 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,384.23
|
| Rate for Payer: Mercy Care Medicaid |
$10,384.23
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,384.23
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,094.35
|
|
|
Service Code
|
APR-DRG 2642
|
| Hospital Charge Code |
APRDRG2644
|
| Min. Negotiated Rate |
$9,094.35 |
| Max. Negotiated Rate |
$9,094.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,094.35
|
| Rate for Payer: Mercy Care Medicaid |
$9,094.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,094.35
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$9,034.73
|
|
|
Service Code
|
APR-DRG 2641
|
| Hospital Charge Code |
APRDRG2643
|
| Min. Negotiated Rate |
$9,034.73 |
| Max. Negotiated Rate |
$9,034.73 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,034.73
|
| Rate for Payer: Mercy Care Medicaid |
$9,034.73
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,034.73
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$27,123.14
|
|
|
Service Code
|
APR-DRG 2644
|
| Hospital Charge Code |
APRDRG2642
|
| Min. Negotiated Rate |
$27,123.14 |
| Max. Negotiated Rate |
$27,123.14 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,123.14
|
| Rate for Payer: Mercy Care Medicaid |
$27,123.14
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,123.14
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$10,384.23
|
|
|
Service Code
|
APR-DRG 2643
|
| Hospital Charge Code |
APRDRG2642
|
| Min. Negotiated Rate |
$10,384.23 |
| Max. Negotiated Rate |
$10,384.23 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,384.23
|
| Rate for Payer: Mercy Care Medicaid |
$10,384.23
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,384.23
|
|
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
Facility
|
IP
|
$27,123.14
|
|
|
Service Code
|
APR-DRG 2644
|
| Hospital Charge Code |
APRDRG2641
|
| Min. Negotiated Rate |
$27,123.14 |
| Max. Negotiated Rate |
$27,123.14 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,123.14
|
| Rate for Payer: Mercy Care Medicaid |
$27,123.14
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,123.14
|
|
