|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6511
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,262.16
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,262.16
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,262.16
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$8,496.06
|
|
|
Service Code
|
APR-DRG 1211
|
| Hospital Charge Code |
APRDRG1214
|
| Min. Negotiated Rate |
$8,496.06 |
| Max. Negotiated Rate |
$8,496.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,496.06
|
| Rate for Payer: Mercy Care Medicaid |
$8,496.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,496.06
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$31,089.56
|
|
|
Service Code
|
APR-DRG 1214
|
| Hospital Charge Code |
APRDRG1213
|
| Min. Negotiated Rate |
$31,089.56 |
| Max. Negotiated Rate |
$31,089.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$31,089.56
|
| Rate for Payer: Mercy Care Medicaid |
$31,089.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$31,089.56
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$31,089.56
|
|
|
Service Code
|
APR-DRG 1214
|
| Hospital Charge Code |
APRDRG1212
|
| Min. Negotiated Rate |
$31,089.56 |
| Max. Negotiated Rate |
$31,089.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$31,089.56
|
| Rate for Payer: Mercy Care Medicaid |
$31,089.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$31,089.56
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,552.06
|
|
|
Service Code
|
APR-DRG 1212
|
| Hospital Charge Code |
APRDRG1213
|
| Min. Negotiated Rate |
$11,552.06 |
| Max. Negotiated Rate |
$11,552.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,552.06
|
| Rate for Payer: Mercy Care Medicaid |
$11,552.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,552.06
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$31,089.56
|
|
|
Service Code
|
APR-DRG 1214
|
| Hospital Charge Code |
APRDRG1214
|
| Min. Negotiated Rate |
$31,089.56 |
| Max. Negotiated Rate |
$31,089.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$31,089.56
|
| Rate for Payer: Mercy Care Medicaid |
$31,089.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$31,089.56
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$17,983.90
|
|
|
Service Code
|
APR-DRG 1213
|
| Hospital Charge Code |
APRDRG1211
|
| Min. Negotiated Rate |
$17,983.90 |
| Max. Negotiated Rate |
$17,983.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,983.90
|
| Rate for Payer: Mercy Care Medicaid |
$17,983.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,983.90
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$17,983.90
|
|
|
Service Code
|
APR-DRG 1213
|
| Hospital Charge Code |
APRDRG1212
|
| Min. Negotiated Rate |
$17,983.90 |
| Max. Negotiated Rate |
$17,983.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,983.90
|
| Rate for Payer: Mercy Care Medicaid |
$17,983.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,983.90
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$17,983.90
|
|
|
Service Code
|
APR-DRG 1213
|
| Hospital Charge Code |
APRDRG1214
|
| Min. Negotiated Rate |
$17,983.90 |
| Max. Negotiated Rate |
$17,983.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,983.90
|
| Rate for Payer: Mercy Care Medicaid |
$17,983.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,983.90
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,552.06
|
|
|
Service Code
|
APR-DRG 1212
|
| Hospital Charge Code |
APRDRG1212
|
| Min. Negotiated Rate |
$11,552.06 |
| Max. Negotiated Rate |
$11,552.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,552.06
|
| Rate for Payer: Mercy Care Medicaid |
$11,552.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,552.06
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,552.06
|
|
|
Service Code
|
APR-DRG 1212
|
| Hospital Charge Code |
APRDRG1214
|
| Min. Negotiated Rate |
$11,552.06 |
| Max. Negotiated Rate |
$11,552.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,552.06
|
| Rate for Payer: Mercy Care Medicaid |
$11,552.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,552.06
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$8,496.06
|
|
|
Service Code
|
APR-DRG 1211
|
| Hospital Charge Code |
APRDRG1213
|
| Min. Negotiated Rate |
$8,496.06 |
| Max. Negotiated Rate |
$8,496.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,496.06
|
| Rate for Payer: Mercy Care Medicaid |
$8,496.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,496.06
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$17,983.90
|
|
|
Service Code
|
APR-DRG 1213
|
| Hospital Charge Code |
APRDRG1213
|
| Min. Negotiated Rate |
$17,983.90 |
| Max. Negotiated Rate |
$17,983.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,983.90
|
| Rate for Payer: Mercy Care Medicaid |
$17,983.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,983.90
|
|
|
Other Respiratory And Chest Procedures
|
Facility
|
IP
|
$31,089.56
|
|
|
Service Code
|
APR-DRG 1214
|
| Hospital Charge Code |
APRDRG1211
|
| Min. Negotiated Rate |
$31,089.56 |
| Max. Negotiated Rate |
$31,089.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$31,089.56
|
| Rate for Payer: Mercy Care Medicaid |
$31,089.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$31,089.56
|
|
