|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3852
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,215.11
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3851
|
| Min. Negotiated Rate |
$3,161.91 |
| Max. Negotiated Rate |
$3,161.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,161.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,161.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,161.91
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$13,174.40
|
|
|
Service Code
|
APR-DRG 3854
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$13,174.40 |
| Max. Negotiated Rate |
$13,174.40 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,174.40
|
| Rate for Payer: Mercy Care Medicaid |
$13,174.40
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,174.40
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$3,161.91
|
|
|
Service Code
|
APR-DRG 3851
|
| Hospital Charge Code |
APRDRG3853
|
| Min. Negotiated Rate |
$3,161.91 |
| Max. Negotiated Rate |
$3,161.91 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,161.91
|
| Rate for Payer: Mercy Care Medicaid |
$3,161.91
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,161.91
|
|
|
Other Skin, Subcutaneous Tissue And Breast Disorders
|
Facility
|
IP
|
$6,215.11
|
|
|
Service Code
|
APR-DRG 3853
|
| Hospital Charge Code |
APRDRG3851
|
| Min. Negotiated Rate |
$6,215.11 |
| Max. Negotiated Rate |
$6,215.11 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,215.11
|
| Rate for Payer: Mercy Care Medicaid |
$6,215.11
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,215.11
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$22,332.91
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$22,332.91 |
| Max. Negotiated Rate |
$22,332.91 |
| Rate for Payer: Seven Corners Travel Insurance |
$22,332.91
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$41,854.84
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$41,854.84 |
| Max. Negotiated Rate |
$41,854.84 |
| Rate for Payer: Seven Corners Travel Insurance |
$41,854.84
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,650.84
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$18,650.84 |
| Max. Negotiated Rate |
$18,650.84 |
| Rate for Payer: Seven Corners Travel Insurance |
$18,650.84
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,167.19
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3642
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$23,238.08
|
|
|
Service Code
|
APR-DRG 3644
|
| Hospital Charge Code |
APRDRG3643
|
| Min. Negotiated Rate |
$23,238.08 |
| Max. Negotiated Rate |
$23,238.08 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$23,238.08
|
| Rate for Payer: Mercy Care Medicaid |
$23,238.08
|
| Rate for Payer: NaphCare Correctional Healthcare |
$23,238.08
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3644
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$5,287.85
|
|
|
Service Code
|
APR-DRG 3641
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$5,287.85 |
| Max. Negotiated Rate |
$5,287.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,287.85
|
| Rate for Payer: Mercy Care Medicaid |
$5,287.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,287.85
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$7,336.64
|
|
|
Service Code
|
APR-DRG 3642
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$7,336.64 |
| Max. Negotiated Rate |
$7,336.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,336.64
|
| Rate for Payer: Mercy Care Medicaid |
$7,336.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,336.64
|
|
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
Facility
|
IP
|
$12,167.19
|
|
|
Service Code
|
APR-DRG 3643
|
| Hospital Charge Code |
APRDRG3641
|
| Min. Negotiated Rate |
$12,167.19 |
| Max. Negotiated Rate |
$12,167.19 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,167.19
|
| Rate for Payer: Mercy Care Medicaid |
$12,167.19
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,167.19
|
|
