|
Other Musculoskeletal System And Connective Tissue Procedures
|
Facility
|
IP
|
$15,453.95
|
|
|
Service Code
|
APR-DRG 3203
|
| Hospital Charge Code |
APRDRG3202
|
| Min. Negotiated Rate |
$15,453.95 |
| Max. Negotiated Rate |
$15,453.95 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,453.95
|
| Rate for Payer: Mercy Care Medicaid |
$15,453.95
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,453.95
|
|
|
Other Musculoskeletal System And Connective Tissue Procedures
|
Facility
|
IP
|
$6,873.72
|
|
|
Service Code
|
APR-DRG 3201
|
| Hospital Charge Code |
APRDRG3202
|
| Min. Negotiated Rate |
$6,873.72 |
| Max. Negotiated Rate |
$6,873.72 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,873.72
|
| Rate for Payer: Mercy Care Medicaid |
$6,873.72
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,873.72
|
|
|
Other Musculoskeletal System And Connective Tissue Procedures
|
Facility
|
IP
|
$15,453.95
|
|
|
Service Code
|
APR-DRG 3203
|
| Hospital Charge Code |
APRDRG3204
|
| Min. Negotiated Rate |
$15,453.95 |
| Max. Negotiated Rate |
$15,453.95 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,453.95
|
| Rate for Payer: Mercy Care Medicaid |
$15,453.95
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,453.95
|
|
|
Other Musculoskeletal System And Connective Tissue Procedures
|
Facility
|
IP
|
$25,580.76
|
|
|
Service Code
|
APR-DRG 3204
|
| Hospital Charge Code |
APRDRG3201
|
| Min. Negotiated Rate |
$25,580.76 |
| Max. Negotiated Rate |
$25,580.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,580.76
|
| Rate for Payer: Mercy Care Medicaid |
$25,580.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,580.76
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC
|
Facility
|
IP
|
$15,781.35
|
|
|
Service Code
|
MSDRG 844
|
| Min. Negotiated Rate |
$15,781.35 |
| Max. Negotiated Rate |
$15,781.35 |
| Rate for Payer: Seven Corners Travel Insurance |
$15,781.35
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC
|
Facility
|
IP
|
$25,781.09
|
|
|
Service Code
|
MSDRG 843
|
| Min. Negotiated Rate |
$25,781.09 |
| Max. Negotiated Rate |
$25,781.09 |
| Rate for Payer: Seven Corners Travel Insurance |
$25,781.09
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,146.21
|
|
|
Service Code
|
MSDRG 845
|
| Min. Negotiated Rate |
$11,146.21 |
| Max. Negotiated Rate |
$11,146.21 |
| Rate for Payer: Seven Corners Travel Insurance |
$11,146.21
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,330.42
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,330.42
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,330.42
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,330.42
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4254
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,180.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4254
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,896.78
|
|
