|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$10,704.77
|
|
|
Service Code
|
APR-DRG 4843
|
| Hospital Charge Code |
APRDRG4841
|
| Min. Negotiated Rate |
$10,704.77 |
| Max. Negotiated Rate |
$10,704.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,704.77
|
| Rate for Payer: Mercy Care Medicaid |
$10,704.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,704.77
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$8,821.51
|
|
|
Service Code
|
APR-DRG 4842
|
| Hospital Charge Code |
APRDRG4842
|
| Min. Negotiated Rate |
$8,821.51 |
| Max. Negotiated Rate |
$8,821.51 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,821.51
|
| Rate for Payer: Mercy Care Medicaid |
$8,821.51
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,821.51
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,826.92
|
|
|
Service Code
|
APR-DRG 4841
|
| Hospital Charge Code |
APRDRG4841
|
| 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
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$10,704.77
|
|
|
Service Code
|
APR-DRG 4843
|
| Hospital Charge Code |
APRDRG4842
|
| Min. Negotiated Rate |
$10,704.77 |
| Max. Negotiated Rate |
$10,704.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,704.77
|
| Rate for Payer: Mercy Care Medicaid |
$10,704.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,704.77
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$10,704.77
|
|
|
Service Code
|
APR-DRG 4843
|
| Hospital Charge Code |
APRDRG4844
|
| Min. Negotiated Rate |
$10,704.77 |
| Max. Negotiated Rate |
$10,704.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,704.77
|
| Rate for Payer: Mercy Care Medicaid |
$10,704.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,704.77
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$8,821.51
|
|
|
Service Code
|
APR-DRG 4842
|
| Hospital Charge Code |
APRDRG4841
|
| Min. Negotiated Rate |
$8,821.51 |
| Max. Negotiated Rate |
$8,821.51 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,821.51
|
| Rate for Payer: Mercy Care Medicaid |
$8,821.51
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,821.51
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$27,039.67
|
|
|
Service Code
|
APR-DRG 4844
|
| Hospital Charge Code |
APRDRG4843
|
| Min. Negotiated Rate |
$27,039.67 |
| Max. Negotiated Rate |
$27,039.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,039.67
|
| Rate for Payer: Mercy Care Medicaid |
$27,039.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,039.67
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,826.92
|
|
|
Service Code
|
APR-DRG 4841
|
| Hospital Charge Code |
APRDRG4842
|
| 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
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$8,821.51
|
|
|
Service Code
|
APR-DRG 4842
|
| Hospital Charge Code |
APRDRG4844
|
| Min. Negotiated Rate |
$8,821.51 |
| Max. Negotiated Rate |
$8,821.51 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,821.51
|
| Rate for Payer: Mercy Care Medicaid |
$8,821.51
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,821.51
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$8,821.51
|
|
|
Service Code
|
APR-DRG 4842
|
| Hospital Charge Code |
APRDRG4843
|
| Min. Negotiated Rate |
$8,821.51 |
| Max. Negotiated Rate |
$8,821.51 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,821.51
|
| Rate for Payer: Mercy Care Medicaid |
$8,821.51
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,821.51
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$27,039.67
|
|
|
Service Code
|
APR-DRG 4844
|
| Hospital Charge Code |
APRDRG4841
|
| Min. Negotiated Rate |
$27,039.67 |
| Max. Negotiated Rate |
$27,039.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,039.67
|
| Rate for Payer: Mercy Care Medicaid |
$27,039.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,039.67
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$27,039.67
|
|
|
Service Code
|
APR-DRG 4844
|
| Hospital Charge Code |
APRDRG4842
|
| Min. Negotiated Rate |
$27,039.67 |
| Max. Negotiated Rate |
$27,039.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,039.67
|
| Rate for Payer: Mercy Care Medicaid |
$27,039.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,039.67
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$27,039.67
|
|
|
Service Code
|
APR-DRG 4844
|
| Hospital Charge Code |
APRDRG4844
|
| Min. Negotiated Rate |
$27,039.67 |
| Max. Negotiated Rate |
$27,039.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,039.67
|
| Rate for Payer: Mercy Care Medicaid |
$27,039.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,039.67
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$10,704.77
|
|
|
Service Code
|
APR-DRG 4843
|
| Hospital Charge Code |
APRDRG4843
|
| Min. Negotiated Rate |
$10,704.77 |
| Max. Negotiated Rate |
$10,704.77 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,704.77
|
| Rate for Payer: Mercy Care Medicaid |
$10,704.77
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,704.77
|
|
|
Other Male Reproductive System And Related Procedures
|
Facility
|
IP
|
$7,826.92
|
|
|
Service Code
|
APR-DRG 4841
|
| Hospital Charge Code |
APRDRG4843
|
| 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
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$13,770.42
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$13,770.42 |
| Max. Negotiated Rate |
$13,770.42 |
| Rate for Payer: Seven Corners Travel Insurance |
$13,770.42
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$8,870.46
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$8,870.46 |
| Max. Negotiated Rate |
$8,870.46 |
| Rate for Payer: Seven Corners Travel Insurance |
$8,870.46
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$24,433.07
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$24,433.07 |
| Max. Negotiated Rate |
$24,433.07 |
| Rate for Payer: Seven Corners Travel Insurance |
$24,433.07
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$17,374.10
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$17,374.10 |
| Max. Negotiated Rate |
$17,374.10 |
| Rate for Payer: Seven Corners Travel Insurance |
$17,374.10
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$28,915.17
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$28,915.17 |
| Max. Negotiated Rate |
$28,915.17 |
| Rate for Payer: Seven Corners Travel Insurance |
$28,915.17
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$19,011.43
|
|
|
Service Code
|
MSDRG 716
|
| Min. Negotiated Rate |
$19,011.43 |
| Max. Negotiated Rate |
$19,011.43 |
| Rate for Payer: Seven Corners Travel Insurance |
$19,011.43
|
|
|
OTHER MENTAL DISORDER DIAGNOSES
|
Facility
|
IP
|
$13,925.00
|
|
|
Service Code
|
MSDRG 887
|
| Min. Negotiated Rate |
$13,925.00 |
| Max. Negotiated Rate |
$13,925.00 |
| Rate for Payer: Seven Corners Travel Insurance |
$13,925.00
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$8,107.48
|
|
|
Service Code
|
APR-DRG 7604
|
| Hospital Charge Code |
APRDRG7602
|
| Min. Negotiated Rate |
$8,107.48 |
| Max. Negotiated Rate |
$8,107.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,107.48
|
| Rate for Payer: Mercy Care Medicaid |
$8,107.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,107.48
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$4,496.68
|
|
|
Service Code
|
APR-DRG 7602
|
| Hospital Charge Code |
APRDRG7602
|
| Min. Negotiated Rate |
$4,496.68 |
| Max. Negotiated Rate |
$4,496.68 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,496.68
|
| Rate for Payer: Mercy Care Medicaid |
$4,496.68
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,496.68
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$6,403.08
|
|
|
Service Code
|
APR-DRG 7603
|
| Hospital Charge Code |
APRDRG7601
|
| Min. Negotiated Rate |
$6,403.08 |
| Max. Negotiated Rate |
$6,403.08 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,403.08
|
| Rate for Payer: Mercy Care Medicaid |
$6,403.08
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,403.08
|
|
