|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$24,992.99
|
|
|
Service Code
|
APR-DRG 3123
|
| Hospital Charge Code |
APRDRG3123
|
| Min. Negotiated Rate |
$24,992.99 |
| Max. Negotiated Rate |
$24,992.99 |
| Rate for Payer: AHCCCS Medicaid |
$24,992.99
|
| Rate for Payer: Allwell Medicaid |
$24,992.99
|
| Rate for Payer: AZCH Complete Medicaid |
$24,992.99
|
| Rate for Payer: Banner UC Health Medicaid |
$24,992.99
|
| Rate for Payer: Mercy Care Medicaid |
$24,992.99
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$47,114.44
|
|
|
Service Code
|
APR-DRG 3124
|
| Hospital Charge Code |
APRDRG3123
|
| Min. Negotiated Rate |
$47,114.44 |
| Max. Negotiated Rate |
$47,114.44 |
| Rate for Payer: AHCCCS Medicaid |
$47,114.44
|
| Rate for Payer: Allwell Medicaid |
$47,114.44
|
| Rate for Payer: AZCH Complete Medicaid |
$47,114.44
|
| Rate for Payer: Banner UC Health Medicaid |
$47,114.44
|
| Rate for Payer: Mercy Care Medicaid |
$47,114.44
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$8,693.15
|
|
|
Service Code
|
APR-DRG 3121
|
| Hospital Charge Code |
APRDRG3121
|
| Min. Negotiated Rate |
$8,693.15 |
| Max. Negotiated Rate |
$8,693.15 |
| Rate for Payer: AHCCCS Medicaid |
$8,693.15
|
| Rate for Payer: Allwell Medicaid |
$8,693.15
|
| Rate for Payer: AZCH Complete Medicaid |
$8,693.15
|
| Rate for Payer: Banner UC Health Medicaid |
$8,693.15
|
| Rate for Payer: Mercy Care Medicaid |
$8,693.15
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$24,992.99
|
|
|
Service Code
|
APR-DRG 3123
|
| Hospital Charge Code |
APRDRG3124
|
| Min. Negotiated Rate |
$24,992.99 |
| Max. Negotiated Rate |
$24,992.99 |
| Rate for Payer: AHCCCS Medicaid |
$24,992.99
|
| Rate for Payer: Allwell Medicaid |
$24,992.99
|
| Rate for Payer: AZCH Complete Medicaid |
$24,992.99
|
| Rate for Payer: Banner UC Health Medicaid |
$24,992.99
|
| Rate for Payer: Mercy Care Medicaid |
$24,992.99
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$14,706.25
|
|
|
Service Code
|
APR-DRG 3122
|
| Hospital Charge Code |
APRDRG3124
|
| Min. Negotiated Rate |
$14,706.25 |
| Max. Negotiated Rate |
$14,706.25 |
| Rate for Payer: AHCCCS Medicaid |
$14,706.25
|
| Rate for Payer: Allwell Medicaid |
$14,706.25
|
| Rate for Payer: AZCH Complete Medicaid |
$14,706.25
|
| Rate for Payer: Banner UC Health Medicaid |
$14,706.25
|
| Rate for Payer: Mercy Care Medicaid |
$14,706.25
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$8,693.15
|
|
|
Service Code
|
APR-DRG 3121
|
| Hospital Charge Code |
APRDRG3124
|
| Min. Negotiated Rate |
$8,693.15 |
| Max. Negotiated Rate |
$8,693.15 |
| Rate for Payer: AHCCCS Medicaid |
$8,693.15
|
| Rate for Payer: Allwell Medicaid |
$8,693.15
|
| Rate for Payer: AZCH Complete Medicaid |
$8,693.15
|
| Rate for Payer: Banner UC Health Medicaid |
$8,693.15
|
| Rate for Payer: Mercy Care Medicaid |
$8,693.15
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$14,706.25
|
|
|
Service Code
|
APR-DRG 3122
|
| Hospital Charge Code |
APRDRG3123
|
| Min. Negotiated Rate |
$14,706.25 |
| Max. Negotiated Rate |
$14,706.25 |
| Rate for Payer: AHCCCS Medicaid |
$14,706.25
|
| Rate for Payer: Allwell Medicaid |
$14,706.25
|
| Rate for Payer: AZCH Complete Medicaid |
$14,706.25
|
| Rate for Payer: Banner UC Health Medicaid |
$14,706.25
|
| Rate for Payer: Mercy Care Medicaid |
$14,706.25
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$8,693.15
|
|
|
Service Code
|
APR-DRG 3121
|
| Hospital Charge Code |
APRDRG3122
|
| Min. Negotiated Rate |
$8,693.15 |
| Max. Negotiated Rate |
$8,693.15 |
| Rate for Payer: AHCCCS Medicaid |
$8,693.15
|
| Rate for Payer: Allwell Medicaid |
$8,693.15
|
| Rate for Payer: AZCH Complete Medicaid |
$8,693.15
|
| Rate for Payer: Banner UC Health Medicaid |
$8,693.15
|
| Rate for Payer: Mercy Care Medicaid |
$8,693.15
|
|
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
Facility
|
IP
|
$24,992.99
|
|
|
Service Code
|
APR-DRG 3123
|
| Hospital Charge Code |
APRDRG3122
|
| Min. Negotiated Rate |
$24,992.99 |
| Max. Negotiated Rate |
$24,992.99 |
| Rate for Payer: AHCCCS Medicaid |
$24,992.99
|
| Rate for Payer: Allwell Medicaid |
$24,992.99
|
| Rate for Payer: AZCH Complete Medicaid |
$24,992.99
|
| Rate for Payer: Banner UC Health Medicaid |
$24,992.99
|
| Rate for Payer: Mercy Care Medicaid |
$24,992.99
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$39,763.07
|
|
|
Service Code
|
APR-DRG 3614
|
| Hospital Charge Code |
APRDRG3612
|
| Min. Negotiated Rate |
$39,763.07 |
| Max. Negotiated Rate |
$39,763.07 |
| Rate for Payer: AHCCCS Medicaid |
$39,763.07
|
| Rate for Payer: Allwell Medicaid |
$39,763.07
|
| Rate for Payer: AZCH Complete Medicaid |
$39,763.07
|
| Rate for Payer: Banner UC Health Medicaid |
$39,763.07
|
| Rate for Payer: Mercy Care Medicaid |
$39,763.07
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$20,628.17
|
|
|
Service Code
|
APR-DRG 3613
|
| Hospital Charge Code |
APRDRG3613
|
| Min. Negotiated Rate |
$20,628.17 |
| Max. Negotiated Rate |
$20,628.17 |
| Rate for Payer: AHCCCS Medicaid |
$20,628.17
|
| Rate for Payer: Allwell Medicaid |
$20,628.17
|
| Rate for Payer: AZCH Complete Medicaid |
$20,628.17
|
| Rate for Payer: Banner UC Health Medicaid |
$20,628.17
|
| Rate for Payer: Mercy Care Medicaid |
$20,628.17
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$10,155.57
|
|
|
Service Code
|
APR-DRG 3611
|
| Hospital Charge Code |
APRDRG3611
|
| Min. Negotiated Rate |
$10,155.57 |
| Max. Negotiated Rate |
$10,155.57 |
| Rate for Payer: AHCCCS Medicaid |
$10,155.57
|
| Rate for Payer: Allwell Medicaid |
$10,155.57
|
| Rate for Payer: AZCH Complete Medicaid |
$10,155.57
|
| Rate for Payer: Banner UC Health Medicaid |
$10,155.57
|
| Rate for Payer: Mercy Care Medicaid |
$10,155.57
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$20,628.17
|
|
|
Service Code
|
APR-DRG 3613
|
| Hospital Charge Code |
APRDRG3611
|
| Min. Negotiated Rate |
$20,628.17 |
| Max. Negotiated Rate |
$20,628.17 |
| Rate for Payer: AHCCCS Medicaid |
$20,628.17
|
| Rate for Payer: Allwell Medicaid |
$20,628.17
|
| Rate for Payer: AZCH Complete Medicaid |
$20,628.17
|
| Rate for Payer: Banner UC Health Medicaid |
$20,628.17
|
| Rate for Payer: Mercy Care Medicaid |
$20,628.17
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$39,763.07
|
|
|
Service Code
|
APR-DRG 3614
|
| Hospital Charge Code |
APRDRG3613
|
| Min. Negotiated Rate |
$39,763.07 |
| Max. Negotiated Rate |
$39,763.07 |
| Rate for Payer: AHCCCS Medicaid |
$39,763.07
|
| Rate for Payer: Allwell Medicaid |
$39,763.07
|
| Rate for Payer: AZCH Complete Medicaid |
$39,763.07
|
| Rate for Payer: Banner UC Health Medicaid |
$39,763.07
|
| Rate for Payer: Mercy Care Medicaid |
$39,763.07
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$12,534.72
|
|
|
Service Code
|
APR-DRG 3612
|
| Hospital Charge Code |
APRDRG3612
|
| Min. Negotiated Rate |
$12,534.72 |
| Max. Negotiated Rate |
$12,534.72 |
| Rate for Payer: AHCCCS Medicaid |
$12,534.72
|
| Rate for Payer: Allwell Medicaid |
$12,534.72
|
| Rate for Payer: AZCH Complete Medicaid |
$12,534.72
|
| Rate for Payer: Banner UC Health Medicaid |
$12,534.72
|
| Rate for Payer: Mercy Care Medicaid |
$12,534.72
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$39,763.07
|
|
|
Service Code
|
APR-DRG 3614
|
| Hospital Charge Code |
APRDRG3611
|
| Min. Negotiated Rate |
$39,763.07 |
| Max. Negotiated Rate |
$39,763.07 |
| Rate for Payer: AHCCCS Medicaid |
$39,763.07
|
| Rate for Payer: Allwell Medicaid |
$39,763.07
|
| Rate for Payer: AZCH Complete Medicaid |
$39,763.07
|
| Rate for Payer: Banner UC Health Medicaid |
$39,763.07
|
| Rate for Payer: Mercy Care Medicaid |
$39,763.07
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$20,628.17
|
|
|
Service Code
|
APR-DRG 3613
|
| Hospital Charge Code |
APRDRG3612
|
| Min. Negotiated Rate |
$20,628.17 |
| Max. Negotiated Rate |
$20,628.17 |
| Rate for Payer: AHCCCS Medicaid |
$20,628.17
|
| Rate for Payer: Allwell Medicaid |
$20,628.17
|
| Rate for Payer: AZCH Complete Medicaid |
$20,628.17
|
| Rate for Payer: Banner UC Health Medicaid |
$20,628.17
|
| Rate for Payer: Mercy Care Medicaid |
$20,628.17
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$10,155.57
|
|
|
Service Code
|
APR-DRG 3611
|
| Hospital Charge Code |
APRDRG3614
|
| Min. Negotiated Rate |
$10,155.57 |
| Max. Negotiated Rate |
$10,155.57 |
| Rate for Payer: AHCCCS Medicaid |
$10,155.57
|
| Rate for Payer: Allwell Medicaid |
$10,155.57
|
| Rate for Payer: AZCH Complete Medicaid |
$10,155.57
|
| Rate for Payer: Banner UC Health Medicaid |
$10,155.57
|
| Rate for Payer: Mercy Care Medicaid |
$10,155.57
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$20,628.17
|
|
|
Service Code
|
APR-DRG 3613
|
| Hospital Charge Code |
APRDRG3614
|
| Min. Negotiated Rate |
$20,628.17 |
| Max. Negotiated Rate |
$20,628.17 |
| Rate for Payer: AHCCCS Medicaid |
$20,628.17
|
| Rate for Payer: Allwell Medicaid |
$20,628.17
|
| Rate for Payer: AZCH Complete Medicaid |
$20,628.17
|
| Rate for Payer: Banner UC Health Medicaid |
$20,628.17
|
| Rate for Payer: Mercy Care Medicaid |
$20,628.17
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$12,534.72
|
|
|
Service Code
|
APR-DRG 3612
|
| Hospital Charge Code |
APRDRG3611
|
| Min. Negotiated Rate |
$12,534.72 |
| Max. Negotiated Rate |
$12,534.72 |
| Rate for Payer: AHCCCS Medicaid |
$12,534.72
|
| Rate for Payer: Allwell Medicaid |
$12,534.72
|
| Rate for Payer: AZCH Complete Medicaid |
$12,534.72
|
| Rate for Payer: Banner UC Health Medicaid |
$12,534.72
|
| Rate for Payer: Mercy Care Medicaid |
$12,534.72
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$12,534.72
|
|
|
Service Code
|
APR-DRG 3612
|
| Hospital Charge Code |
APRDRG3613
|
| Min. Negotiated Rate |
$12,534.72 |
| Max. Negotiated Rate |
$12,534.72 |
| Rate for Payer: AHCCCS Medicaid |
$12,534.72
|
| Rate for Payer: Allwell Medicaid |
$12,534.72
|
| Rate for Payer: AZCH Complete Medicaid |
$12,534.72
|
| Rate for Payer: Banner UC Health Medicaid |
$12,534.72
|
| Rate for Payer: Mercy Care Medicaid |
$12,534.72
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$10,155.57
|
|
|
Service Code
|
APR-DRG 3611
|
| Hospital Charge Code |
APRDRG3612
|
| Min. Negotiated Rate |
$10,155.57 |
| Max. Negotiated Rate |
$10,155.57 |
| Rate for Payer: AHCCCS Medicaid |
$10,155.57
|
| Rate for Payer: Allwell Medicaid |
$10,155.57
|
| Rate for Payer: AZCH Complete Medicaid |
$10,155.57
|
| Rate for Payer: Banner UC Health Medicaid |
$10,155.57
|
| Rate for Payer: Mercy Care Medicaid |
$10,155.57
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$10,155.57
|
|
|
Service Code
|
APR-DRG 3611
|
| Hospital Charge Code |
APRDRG3613
|
| Min. Negotiated Rate |
$10,155.57 |
| Max. Negotiated Rate |
$10,155.57 |
| Rate for Payer: AHCCCS Medicaid |
$10,155.57
|
| Rate for Payer: Allwell Medicaid |
$10,155.57
|
| Rate for Payer: AZCH Complete Medicaid |
$10,155.57
|
| Rate for Payer: Banner UC Health Medicaid |
$10,155.57
|
| Rate for Payer: Mercy Care Medicaid |
$10,155.57
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$39,763.07
|
|
|
Service Code
|
APR-DRG 3614
|
| Hospital Charge Code |
APRDRG3614
|
| Min. Negotiated Rate |
$39,763.07 |
| Max. Negotiated Rate |
$39,763.07 |
| Rate for Payer: AHCCCS Medicaid |
$39,763.07
|
| Rate for Payer: Allwell Medicaid |
$39,763.07
|
| Rate for Payer: AZCH Complete Medicaid |
$39,763.07
|
| Rate for Payer: Banner UC Health Medicaid |
$39,763.07
|
| Rate for Payer: Mercy Care Medicaid |
$39,763.07
|
|
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
Facility
|
IP
|
$12,534.72
|
|
|
Service Code
|
APR-DRG 3612
|
| Hospital Charge Code |
APRDRG3614
|
| Min. Negotiated Rate |
$12,534.72 |
| Max. Negotiated Rate |
$12,534.72 |
| Rate for Payer: AHCCCS Medicaid |
$12,534.72
|
| Rate for Payer: Allwell Medicaid |
$12,534.72
|
| Rate for Payer: AZCH Complete Medicaid |
$12,534.72
|
| Rate for Payer: Banner UC Health Medicaid |
$12,534.72
|
| Rate for Payer: Mercy Care Medicaid |
$12,534.72
|
|
