|
Other Mental Health Disorders
|
Facility
|
IP
|
$3,814.91
|
|
|
Service Code
|
APR-DRG 7601
|
| Hospital Charge Code |
APRDRG7603
|
| Min. Negotiated Rate |
$3,814.91 |
| Max. Negotiated Rate |
$3,814.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,814.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,814.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,814.91
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$4,496.68
|
|
|
Service Code
|
APR-DRG 7602
|
| Hospital Charge Code |
APRDRG7603
|
| 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 |
APRDRG7603
|
| 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
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$8,107.48
|
|
|
Service Code
|
APR-DRG 7604
|
| Hospital Charge Code |
APRDRG7604
|
| 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 |
APRDRG7601
|
| 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
|
$3,814.91
|
|
|
Service Code
|
APR-DRG 7601
|
| Hospital Charge Code |
APRDRG7601
|
| Min. Negotiated Rate |
$3,814.91 |
| Max. Negotiated Rate |
$3,814.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,814.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,814.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,814.91
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$6,403.08
|
|
|
Service Code
|
APR-DRG 7603
|
| Hospital Charge Code |
APRDRG7604
|
| 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
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$6,403.08
|
|
|
Service Code
|
APR-DRG 7603
|
| Hospital Charge Code |
APRDRG7602
|
| 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
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$8,107.48
|
|
|
Service Code
|
APR-DRG 7604
|
| Hospital Charge Code |
APRDRG7601
|
| 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
|
$8,107.48
|
|
|
Service Code
|
APR-DRG 7604
|
| Hospital Charge Code |
APRDRG7603
|
| 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 |
APRDRG7604
|
| 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
|
$3,814.91
|
|
|
Service Code
|
APR-DRG 7601
|
| Hospital Charge Code |
APRDRG7604
|
| Min. Negotiated Rate |
$3,814.91 |
| Max. Negotiated Rate |
$3,814.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,814.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,814.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,814.91
|
|
|
Other Mental Health Disorders
|
Facility
|
IP
|
$3,814.91
|
|
|
Service Code
|
APR-DRG 7601
|
| Hospital Charge Code |
APRDRG7602
|
| Min. Negotiated Rate |
$3,814.91 |
| Max. Negotiated Rate |
$3,814.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,814.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,814.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,814.91
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$19,807.52
|
|
|
Service Code
|
MSDRG 964
|
| Min. Negotiated Rate |
$19,807.52 |
| Max. Negotiated Rate |
$19,807.52 |
| Rate for Payer: Seven Corners Travel Insurance |
$19,807.52
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$35,332.00
|
|
|
Service Code
|
MSDRG 963
|
| Min. Negotiated Rate |
$35,332.00 |
| Max. Negotiated Rate |
$35,332.00 |
| Rate for Payer: Seven Corners Travel Insurance |
$35,332.00
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$12,272.67
|
|
|
Service Code
|
MSDRG 965
|
| Min. Negotiated Rate |
$12,272.67 |
| Max. Negotiated Rate |
$12,272.67 |
| Rate for Payer: Seven Corners Travel Insurance |
$12,272.67
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$12,364.28
|
|
|
Service Code
|
APR-DRG 3514
|
| Hospital Charge Code |
APRDRG3513
|
| Min. Negotiated Rate |
$12,364.28 |
| Max. Negotiated Rate |
$12,364.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,364.28
|
| Rate for Payer: Mercy Care Medicaid |
$12,364.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,364.28
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$4,171.93
|
|
|
Service Code
|
APR-DRG 3512
|
| Hospital Charge Code |
APRDRG3512
|
| Min. Negotiated Rate |
$4,171.93 |
| Max. Negotiated Rate |
$4,171.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,171.93
|
| Rate for Payer: Mercy Care Medicaid |
$4,171.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,171.93
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$6,504.78
|
|
|
Service Code
|
APR-DRG 3513
|
| Hospital Charge Code |
APRDRG3514
|
| Min. Negotiated Rate |
$6,504.78 |
| Max. Negotiated Rate |
$6,504.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,504.78
|
| Rate for Payer: Mercy Care Medicaid |
$6,504.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,504.78
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$3,575.04
|
|
|
Service Code
|
APR-DRG 3511
|
| Hospital Charge Code |
APRDRG3514
|
| Min. Negotiated Rate |
$3,575.04 |
| Max. Negotiated Rate |
$3,575.04 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,575.04
|
| Rate for Payer: Mercy Care Medicaid |
$3,575.04
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,575.04
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$4,171.93
|
|
|
Service Code
|
APR-DRG 3512
|
| Hospital Charge Code |
APRDRG3514
|
| Min. Negotiated Rate |
$4,171.93 |
| Max. Negotiated Rate |
$4,171.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,171.93
|
| Rate for Payer: Mercy Care Medicaid |
$4,171.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,171.93
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$12,364.28
|
|
|
Service Code
|
APR-DRG 3514
|
| Hospital Charge Code |
APRDRG3514
|
| Min. Negotiated Rate |
$12,364.28 |
| Max. Negotiated Rate |
$12,364.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,364.28
|
| Rate for Payer: Mercy Care Medicaid |
$12,364.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,364.28
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$4,171.93
|
|
|
Service Code
|
APR-DRG 3512
|
| Hospital Charge Code |
APRDRG3513
|
| Min. Negotiated Rate |
$4,171.93 |
| Max. Negotiated Rate |
$4,171.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,171.93
|
| Rate for Payer: Mercy Care Medicaid |
$4,171.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,171.93
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$4,171.93
|
|
|
Service Code
|
APR-DRG 3512
|
| Hospital Charge Code |
APRDRG3511
|
| Min. Negotiated Rate |
$4,171.93 |
| Max. Negotiated Rate |
$4,171.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,171.93
|
| Rate for Payer: Mercy Care Medicaid |
$4,171.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,171.93
|
|
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
Facility
|
IP
|
$3,575.04
|
|
|
Service Code
|
APR-DRG 3511
|
| Hospital Charge Code |
APRDRG3512
|
| Min. Negotiated Rate |
$3,575.04 |
| Max. Negotiated Rate |
$3,575.04 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,575.04
|
| Rate for Payer: Mercy Care Medicaid |
$3,575.04
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,575.04
|
|
