|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$3,568.72
|
|
|
Service Code
|
APR-DRG 1971
|
| Hospital Charge Code |
APRDRG1974
|
| Min. Negotiated Rate |
$3,568.72 |
| Max. Negotiated Rate |
$3,568.72 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,568.72
|
| Rate for Payer: Mercy Care Medicaid |
$3,568.72
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,568.72
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$3,568.72
|
|
|
Service Code
|
APR-DRG 1971
|
| Hospital Charge Code |
APRDRG1971
|
| Min. Negotiated Rate |
$3,568.72 |
| Max. Negotiated Rate |
$3,568.72 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,568.72
|
| Rate for Payer: Mercy Care Medicaid |
$3,568.72
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,568.72
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$4,634.85
|
|
|
Service Code
|
APR-DRG 1972
|
| Hospital Charge Code |
APRDRG1972
|
| Min. Negotiated Rate |
$4,634.85 |
| Max. Negotiated Rate |
$4,634.85 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,634.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,634.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,634.85
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,945.57
|
|
|
PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
|
IP
|
$28,416.32
|
|
|
Service Code
|
MSDRG 041
|
| Min. Negotiated Rate |
$28,416.32 |
| Max. Negotiated Rate |
$28,416.32 |
| Rate for Payer: Seven Corners Travel Insurance |
$28,416.32
|
|
|
PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
|
IP
|
$49,902.69
|
|
|
Service Code
|
MSDRG 040
|
| Min. Negotiated Rate |
$49,902.69 |
| Max. Negotiated Rate |
$49,902.69 |
| Rate for Payer: Seven Corners Travel Insurance |
$49,902.69
|
|
|
PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,329.06
|
|
|
Service Code
|
MSDRG 042
|
| Min. Negotiated Rate |
$22,329.06 |
| Max. Negotiated Rate |
$22,329.06 |
| Rate for Payer: Seven Corners Travel Insurance |
$22,329.06
|
|
|
PERIPHERAL VASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$13,881.92
|
|
|
Service Code
|
MSDRG 300
|
| Min. Negotiated Rate |
$13,881.92 |
| Max. Negotiated Rate |
$13,881.92 |
| Rate for Payer: Seven Corners Travel Insurance |
$13,881.92
|
|
|
PERIPHERAL VASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$21,101.26
|
|
|
Service Code
|
MSDRG 299
|
| Min. Negotiated Rate |
$21,101.26 |
| Max. Negotiated Rate |
$21,101.26 |
| Rate for Payer: Seven Corners Travel Insurance |
$21,101.26
|
|
|
PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$9,474.89
|
|
|
Service Code
|
MSDRG 301
|
| Min. Negotiated Rate |
$9,474.89 |
| Max. Negotiated Rate |
$9,474.89 |
| Rate for Payer: Seven Corners Travel Insurance |
$9,474.89
|
|