|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$9,990.04
|
|
|
Service Code
|
APR-DRG 4472
|
| Hospital Charge Code |
APRDRG4472
|
| Min. Negotiated Rate |
$9,990.04 |
| Max. Negotiated Rate |
$9,990.04 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,990.04
|
| Rate for Payer: Mercy Care Medicaid |
$9,990.04
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,990.04
|
|
|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$9,990.04
|
|
|
Service Code
|
APR-DRG 4472
|
| Hospital Charge Code |
APRDRG4471
|
| Min. Negotiated Rate |
$9,990.04 |
| Max. Negotiated Rate |
$9,990.04 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,990.04
|
| Rate for Payer: Mercy Care Medicaid |
$9,990.04
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,990.04
|
|
|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$14,459.36
|
|
|
Service Code
|
APR-DRG 4473
|
| Hospital Charge Code |
APRDRG4471
|
| Min. Negotiated Rate |
$14,459.36 |
| Max. Negotiated Rate |
$14,459.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,459.36
|
| Rate for Payer: Mercy Care Medicaid |
$14,459.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,459.36
|
|
|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$32,618.61
|
|
|
Service Code
|
APR-DRG 4474
|
| Hospital Charge Code |
APRDRG4474
|
| Min. Negotiated Rate |
$32,618.61 |
| Max. Negotiated Rate |
$32,618.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$32,618.61
|
| Rate for Payer: Mercy Care Medicaid |
$32,618.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$32,618.61
|
|
|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$14,459.36
|
|
|
Service Code
|
APR-DRG 4473
|
| Hospital Charge Code |
APRDRG4474
|
| Min. Negotiated Rate |
$14,459.36 |
| Max. Negotiated Rate |
$14,459.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,459.36
|
| Rate for Payer: Mercy Care Medicaid |
$14,459.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,459.36
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$45,962.11
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$45,962.11 |
| Max. Negotiated Rate |
$45,962.11 |
| Rate for Payer: Seven Corners Travel Insurance |
$45,962.11
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,191.63
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$68,191.63 |
| Max. Negotiated Rate |
$68,191.63 |
| Rate for Payer: Seven Corners Travel Insurance |
$68,191.63
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,995.30
|
|
|
Service Code
|
MSDRG 272
|
| Min. Negotiated Rate |
$32,995.30 |
| Max. Negotiated Rate |
$32,995.30 |
| Rate for Payer: Seven Corners Travel Insurance |
$32,995.30
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$14,516.88
|
|
|
Service Code
|
APR-DRG 0912
|
| Hospital Charge Code |
APRDRG0911
|
| Min. Negotiated Rate |
$14,516.88 |
| Max. Negotiated Rate |
$14,516.88 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,516.88
|
| Rate for Payer: Mercy Care Medicaid |
$14,516.88
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,516.88
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$25,458.01
|
|
|
Service Code
|
APR-DRG 0913
|
| Hospital Charge Code |
APRDRG0912
|
| Min. Negotiated Rate |
$25,458.01 |
| Max. Negotiated Rate |
$25,458.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,458.01
|
| Rate for Payer: Mercy Care Medicaid |
$25,458.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,458.01
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$9,677.92
|
|
|
Service Code
|
APR-DRG 0911
|
| Hospital Charge Code |
APRDRG0912
|
| Min. Negotiated Rate |
$9,677.92 |
| Max. Negotiated Rate |
$9,677.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,677.92
|
| Rate for Payer: Mercy Care Medicaid |
$9,677.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,677.92
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$14,516.88
|
|
|
Service Code
|
APR-DRG 0912
|
| Hospital Charge Code |
APRDRG0913
|
| Min. Negotiated Rate |
$14,516.88 |
| Max. Negotiated Rate |
$14,516.88 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,516.88
|
| Rate for Payer: Mercy Care Medicaid |
$14,516.88
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,516.88
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$14,516.88
|
|
|
Service Code
|
APR-DRG 0912
|
| Hospital Charge Code |
APRDRG0912
|
| Min. Negotiated Rate |
$14,516.88 |
| Max. Negotiated Rate |
$14,516.88 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,516.88
|
| Rate for Payer: Mercy Care Medicaid |
$14,516.88
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,516.88
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$9,677.92
|
|
|
Service Code
|
APR-DRG 0911
|
| Hospital Charge Code |
APRDRG0914
|
| Min. Negotiated Rate |
$9,677.92 |
| Max. Negotiated Rate |
$9,677.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,677.92
|
| Rate for Payer: Mercy Care Medicaid |
$9,677.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,677.92
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$9,677.92
|
|
|
Service Code
|
APR-DRG 0911
|
| Hospital Charge Code |
APRDRG0911
|
| Min. Negotiated Rate |
$9,677.92 |
| Max. Negotiated Rate |
$9,677.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,677.92
|
| Rate for Payer: Mercy Care Medicaid |
$9,677.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,677.92
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$42,771.37
|
|
|
Service Code
|
APR-DRG 0914
|
| Hospital Charge Code |
APRDRG0912
|
| Min. Negotiated Rate |
$42,771.37 |
| Max. Negotiated Rate |
$42,771.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,771.37
|
| Rate for Payer: Mercy Care Medicaid |
$42,771.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,771.37
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$25,458.01
|
|
|
Service Code
|
APR-DRG 0913
|
| Hospital Charge Code |
APRDRG0911
|
| Min. Negotiated Rate |
$25,458.01 |
| Max. Negotiated Rate |
$25,458.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,458.01
|
| Rate for Payer: Mercy Care Medicaid |
$25,458.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,458.01
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$42,771.37
|
|
|
Service Code
|
APR-DRG 0914
|
| Hospital Charge Code |
APRDRG0914
|
| Min. Negotiated Rate |
$42,771.37 |
| Max. Negotiated Rate |
$42,771.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,771.37
|
| Rate for Payer: Mercy Care Medicaid |
$42,771.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,771.37
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$42,771.37
|
|
|
Service Code
|
APR-DRG 0914
|
| Hospital Charge Code |
APRDRG0911
|
| Min. Negotiated Rate |
$42,771.37 |
| Max. Negotiated Rate |
$42,771.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,771.37
|
| Rate for Payer: Mercy Care Medicaid |
$42,771.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,771.37
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$25,458.01
|
|
|
Service Code
|
APR-DRG 0913
|
| Hospital Charge Code |
APRDRG0914
|
| Min. Negotiated Rate |
$25,458.01 |
| Max. Negotiated Rate |
$25,458.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,458.01
|
| Rate for Payer: Mercy Care Medicaid |
$25,458.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,458.01
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$42,771.37
|
|
|
Service Code
|
APR-DRG 0914
|
| Hospital Charge Code |
APRDRG0913
|
| Min. Negotiated Rate |
$42,771.37 |
| Max. Negotiated Rate |
$42,771.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,771.37
|
| Rate for Payer: Mercy Care Medicaid |
$42,771.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,771.37
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$25,458.01
|
|
|
Service Code
|
APR-DRG 0913
|
| Hospital Charge Code |
APRDRG0913
|
| Min. Negotiated Rate |
$25,458.01 |
| Max. Negotiated Rate |
$25,458.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,458.01
|
| Rate for Payer: Mercy Care Medicaid |
$25,458.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,458.01
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$14,516.88
|
|
|
Service Code
|
APR-DRG 0912
|
| Hospital Charge Code |
APRDRG0914
|
| Min. Negotiated Rate |
$14,516.88 |
| Max. Negotiated Rate |
$14,516.88 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,516.88
|
| Rate for Payer: Mercy Care Medicaid |
$14,516.88
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,516.88
|
|
|
Other Major Head And Neck Procedures
|
Facility
|
IP
|
$9,677.92
|
|
|
Service Code
|
APR-DRG 0911
|
| Hospital Charge Code |
APRDRG0913
|
| Min. Negotiated Rate |
$9,677.92 |
| Max. Negotiated Rate |
$9,677.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,677.92
|
| Rate for Payer: Mercy Care Medicaid |
$9,677.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,677.92
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,826.92
|
|
|
Service Code
|
APR-DRG 4841
|
| Hospital Charge Code |
APRDRG4844
|
| Min. Negotiated Rate |
$7,826.92 |
| Max. Negotiated Rate |
$7,826.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,826.92
|
| Rate for Payer: Mercy Care Medicaid |
$7,826.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,826.92
|
|
