|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$109,327.92
|
|
|
Service Code
|
APR-DRG 0044
|
| Hospital Charge Code |
APRDRG0042
|
| Min. Negotiated Rate |
$109,327.92 |
| Max. Negotiated Rate |
$109,327.92 |
| Rate for Payer: AHCCCS Medicaid |
$109,327.92
|
| Rate for Payer: Allwell Medicaid |
$109,327.92
|
| Rate for Payer: AZCH Complete Medicaid |
$109,327.92
|
| Rate for Payer: Banner UC Health Medicaid |
$109,327.92
|
| Rate for Payer: Mercy Care Medicaid |
$109,327.92
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$74,757.32
|
|
|
Service Code
|
APR-DRG 0043
|
| Hospital Charge Code |
APRDRG0044
|
| Min. Negotiated Rate |
$74,757.32 |
| Max. Negotiated Rate |
$74,757.32 |
| Rate for Payer: AHCCCS Medicaid |
$74,757.32
|
| Rate for Payer: Allwell Medicaid |
$74,757.32
|
| Rate for Payer: AZCH Complete Medicaid |
$74,757.32
|
| Rate for Payer: Banner UC Health Medicaid |
$74,757.32
|
| Rate for Payer: Mercy Care Medicaid |
$74,757.32
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$109,327.92
|
|
|
Service Code
|
APR-DRG 0044
|
| Hospital Charge Code |
APRDRG0044
|
| Min. Negotiated Rate |
$109,327.92 |
| Max. Negotiated Rate |
$109,327.92 |
| Rate for Payer: AHCCCS Medicaid |
$109,327.92
|
| Rate for Payer: Allwell Medicaid |
$109,327.92
|
| Rate for Payer: AZCH Complete Medicaid |
$109,327.92
|
| Rate for Payer: Banner UC Health Medicaid |
$109,327.92
|
| Rate for Payer: Mercy Care Medicaid |
$109,327.92
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$52,364.42
|
|
|
Service Code
|
APR-DRG 0042
|
| Hospital Charge Code |
APRDRG0043
|
| Min. Negotiated Rate |
$52,364.42 |
| Max. Negotiated Rate |
$52,364.42 |
| Rate for Payer: AHCCCS Medicaid |
$52,364.42
|
| Rate for Payer: Allwell Medicaid |
$52,364.42
|
| Rate for Payer: AZCH Complete Medicaid |
$52,364.42
|
| Rate for Payer: Banner UC Health Medicaid |
$52,364.42
|
| Rate for Payer: Mercy Care Medicaid |
$52,364.42
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$44,109.64
|
|
|
Service Code
|
APR-DRG 0041
|
| Hospital Charge Code |
APRDRG0044
|
| Min. Negotiated Rate |
$44,109.64 |
| Max. Negotiated Rate |
$44,109.64 |
| Rate for Payer: AHCCCS Medicaid |
$44,109.64
|
| Rate for Payer: Allwell Medicaid |
$44,109.64
|
| Rate for Payer: AZCH Complete Medicaid |
$44,109.64
|
| Rate for Payer: Banner UC Health Medicaid |
$44,109.64
|
| Rate for Payer: Mercy Care Medicaid |
$44,109.64
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$109,327.92
|
|
|
Service Code
|
APR-DRG 0044
|
| Hospital Charge Code |
APRDRG0041
|
| Min. Negotiated Rate |
$109,327.92 |
| Max. Negotiated Rate |
$109,327.92 |
| Rate for Payer: AHCCCS Medicaid |
$109,327.92
|
| Rate for Payer: Allwell Medicaid |
$109,327.92
|
| Rate for Payer: AZCH Complete Medicaid |
$109,327.92
|
| Rate for Payer: Banner UC Health Medicaid |
$109,327.92
|
| Rate for Payer: Mercy Care Medicaid |
$109,327.92
|
|
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
Facility
|
IP
|
$44,109.64
|
|
|
Service Code
|
APR-DRG 0041
|
| Hospital Charge Code |
APRDRG0041
|
| Min. Negotiated Rate |
$44,109.64 |
| Max. Negotiated Rate |
$44,109.64 |
| Rate for Payer: AHCCCS Medicaid |
$44,109.64
|
| Rate for Payer: Allwell Medicaid |
$44,109.64
|
| Rate for Payer: AZCH Complete Medicaid |
$44,109.64
|
| Rate for Payer: Banner UC Health Medicaid |
$44,109.64
|
| Rate for Payer: Mercy Care Medicaid |
$44,109.64
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$39,671.18
|
|
|
Service Code
|
APR-DRG 0052
|
| Hospital Charge Code |
APRDRG0054
|
| Min. Negotiated Rate |
$39,671.18 |
| Max. Negotiated Rate |
$39,671.18 |
| Rate for Payer: AHCCCS Medicaid |
$39,671.18
|
| Rate for Payer: Allwell Medicaid |
$39,671.18
|
| Rate for Payer: AZCH Complete Medicaid |
$39,671.18
|
| Rate for Payer: Banner UC Health Medicaid |
$39,671.18
|
| Rate for Payer: Mercy Care Medicaid |
$39,671.18
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$29,144.57
|
|
|
Service Code
|
APR-DRG 0051
|
| Hospital Charge Code |
APRDRG0054
|
| Min. Negotiated Rate |
$29,144.57 |
| Max. Negotiated Rate |
$29,144.57 |
| Rate for Payer: AHCCCS Medicaid |
$29,144.57
|
| Rate for Payer: Allwell Medicaid |
$29,144.57
|
| Rate for Payer: AZCH Complete Medicaid |
$29,144.57
|
| Rate for Payer: Banner UC Health Medicaid |
$29,144.57
|
| Rate for Payer: Mercy Care Medicaid |
$29,144.57
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$39,671.18
|
|
|
Service Code
|
APR-DRG 0052
|
| Hospital Charge Code |
APRDRG0052
|
| Min. Negotiated Rate |
$39,671.18 |
| Max. Negotiated Rate |
$39,671.18 |
| Rate for Payer: AHCCCS Medicaid |
$39,671.18
|
| Rate for Payer: Allwell Medicaid |
$39,671.18
|
| Rate for Payer: AZCH Complete Medicaid |
$39,671.18
|
| Rate for Payer: Banner UC Health Medicaid |
$39,671.18
|
| Rate for Payer: Mercy Care Medicaid |
$39,671.18
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$71,753.92
|
|
|
Service Code
|
APR-DRG 0054
|
| Hospital Charge Code |
APRDRG0051
|
| Min. Negotiated Rate |
$71,753.92 |
| Max. Negotiated Rate |
$71,753.92 |
| Rate for Payer: AHCCCS Medicaid |
$71,753.92
|
| Rate for Payer: Allwell Medicaid |
$71,753.92
|
| Rate for Payer: AZCH Complete Medicaid |
$71,753.92
|
| Rate for Payer: Banner UC Health Medicaid |
$71,753.92
|
| Rate for Payer: Mercy Care Medicaid |
$71,753.92
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$50,436.27
|
|
|
Service Code
|
APR-DRG 0053
|
| Hospital Charge Code |
APRDRG0053
|
| Min. Negotiated Rate |
$50,436.27 |
| Max. Negotiated Rate |
$50,436.27 |
| Rate for Payer: AHCCCS Medicaid |
$50,436.27
|
| Rate for Payer: Allwell Medicaid |
$50,436.27
|
| Rate for Payer: AZCH Complete Medicaid |
$50,436.27
|
| Rate for Payer: Banner UC Health Medicaid |
$50,436.27
|
| Rate for Payer: Mercy Care Medicaid |
$50,436.27
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$71,753.92
|
|
|
Service Code
|
APR-DRG 0054
|
| Hospital Charge Code |
APRDRG0054
|
| Min. Negotiated Rate |
$71,753.92 |
| Max. Negotiated Rate |
$71,753.92 |
| Rate for Payer: AHCCCS Medicaid |
$71,753.92
|
| Rate for Payer: Allwell Medicaid |
$71,753.92
|
| Rate for Payer: AZCH Complete Medicaid |
$71,753.92
|
| Rate for Payer: Banner UC Health Medicaid |
$71,753.92
|
| Rate for Payer: Mercy Care Medicaid |
$71,753.92
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$39,671.18
|
|
|
Service Code
|
APR-DRG 0052
|
| Hospital Charge Code |
APRDRG0051
|
| Min. Negotiated Rate |
$39,671.18 |
| Max. Negotiated Rate |
$39,671.18 |
| Rate for Payer: AHCCCS Medicaid |
$39,671.18
|
| Rate for Payer: Allwell Medicaid |
$39,671.18
|
| Rate for Payer: AZCH Complete Medicaid |
$39,671.18
|
| Rate for Payer: Banner UC Health Medicaid |
$39,671.18
|
| Rate for Payer: Mercy Care Medicaid |
$39,671.18
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$39,671.18
|
|
|
Service Code
|
APR-DRG 0052
|
| Hospital Charge Code |
APRDRG0053
|
| Min. Negotiated Rate |
$39,671.18 |
| Max. Negotiated Rate |
$39,671.18 |
| Rate for Payer: AHCCCS Medicaid |
$39,671.18
|
| Rate for Payer: Allwell Medicaid |
$39,671.18
|
| Rate for Payer: AZCH Complete Medicaid |
$39,671.18
|
| Rate for Payer: Banner UC Health Medicaid |
$39,671.18
|
| Rate for Payer: Mercy Care Medicaid |
$39,671.18
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$71,753.92
|
|
|
Service Code
|
APR-DRG 0054
|
| Hospital Charge Code |
APRDRG0053
|
| Min. Negotiated Rate |
$71,753.92 |
| Max. Negotiated Rate |
$71,753.92 |
| Rate for Payer: AHCCCS Medicaid |
$71,753.92
|
| Rate for Payer: Allwell Medicaid |
$71,753.92
|
| Rate for Payer: AZCH Complete Medicaid |
$71,753.92
|
| Rate for Payer: Banner UC Health Medicaid |
$71,753.92
|
| Rate for Payer: Mercy Care Medicaid |
$71,753.92
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$71,753.92
|
|
|
Service Code
|
APR-DRG 0054
|
| Hospital Charge Code |
APRDRG0052
|
| Min. Negotiated Rate |
$71,753.92 |
| Max. Negotiated Rate |
$71,753.92 |
| Rate for Payer: AHCCCS Medicaid |
$71,753.92
|
| Rate for Payer: Allwell Medicaid |
$71,753.92
|
| Rate for Payer: AZCH Complete Medicaid |
$71,753.92
|
| Rate for Payer: Banner UC Health Medicaid |
$71,753.92
|
| Rate for Payer: Mercy Care Medicaid |
$71,753.92
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$29,144.57
|
|
|
Service Code
|
APR-DRG 0051
|
| Hospital Charge Code |
APRDRG0053
|
| Min. Negotiated Rate |
$29,144.57 |
| Max. Negotiated Rate |
$29,144.57 |
| Rate for Payer: AHCCCS Medicaid |
$29,144.57
|
| Rate for Payer: Allwell Medicaid |
$29,144.57
|
| Rate for Payer: AZCH Complete Medicaid |
$29,144.57
|
| Rate for Payer: Banner UC Health Medicaid |
$29,144.57
|
| Rate for Payer: Mercy Care Medicaid |
$29,144.57
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$29,144.57
|
|
|
Service Code
|
APR-DRG 0051
|
| Hospital Charge Code |
APRDRG0052
|
| Min. Negotiated Rate |
$29,144.57 |
| Max. Negotiated Rate |
$29,144.57 |
| Rate for Payer: AHCCCS Medicaid |
$29,144.57
|
| Rate for Payer: Allwell Medicaid |
$29,144.57
|
| Rate for Payer: AZCH Complete Medicaid |
$29,144.57
|
| Rate for Payer: Banner UC Health Medicaid |
$29,144.57
|
| Rate for Payer: Mercy Care Medicaid |
$29,144.57
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$50,436.27
|
|
|
Service Code
|
APR-DRG 0053
|
| Hospital Charge Code |
APRDRG0054
|
| Min. Negotiated Rate |
$50,436.27 |
| Max. Negotiated Rate |
$50,436.27 |
| Rate for Payer: AHCCCS Medicaid |
$50,436.27
|
| Rate for Payer: Allwell Medicaid |
$50,436.27
|
| Rate for Payer: AZCH Complete Medicaid |
$50,436.27
|
| Rate for Payer: Banner UC Health Medicaid |
$50,436.27
|
| Rate for Payer: Mercy Care Medicaid |
$50,436.27
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$29,144.57
|
|
|
Service Code
|
APR-DRG 0051
|
| Hospital Charge Code |
APRDRG0051
|
| Min. Negotiated Rate |
$29,144.57 |
| Max. Negotiated Rate |
$29,144.57 |
| Rate for Payer: AHCCCS Medicaid |
$29,144.57
|
| Rate for Payer: Allwell Medicaid |
$29,144.57
|
| Rate for Payer: AZCH Complete Medicaid |
$29,144.57
|
| Rate for Payer: Banner UC Health Medicaid |
$29,144.57
|
| Rate for Payer: Mercy Care Medicaid |
$29,144.57
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$50,436.27
|
|
|
Service Code
|
APR-DRG 0053
|
| Hospital Charge Code |
APRDRG0051
|
| Min. Negotiated Rate |
$50,436.27 |
| Max. Negotiated Rate |
$50,436.27 |
| Rate for Payer: AHCCCS Medicaid |
$50,436.27
|
| Rate for Payer: Allwell Medicaid |
$50,436.27
|
| Rate for Payer: AZCH Complete Medicaid |
$50,436.27
|
| Rate for Payer: Banner UC Health Medicaid |
$50,436.27
|
| Rate for Payer: Mercy Care Medicaid |
$50,436.27
|
|
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
Facility
|
IP
|
$50,436.27
|
|
|
Service Code
|
APR-DRG 0053
|
| Hospital Charge Code |
APRDRG0052
|
| Min. Negotiated Rate |
$50,436.27 |
| Max. Negotiated Rate |
$50,436.27 |
| Rate for Payer: AHCCCS Medicaid |
$50,436.27
|
| Rate for Payer: Allwell Medicaid |
$50,436.27
|
| Rate for Payer: AZCH Complete Medicaid |
$50,436.27
|
| Rate for Payer: Banner UC Health Medicaid |
$50,436.27
|
| Rate for Payer: Mercy Care Medicaid |
$50,436.27
|
|
|
TRACH MASK
|
Facility
|
IP
|
$14.00
|
|
| Hospital Charge Code |
22355568
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna of AZ Commercial |
$12.60
|
| Rate for Payer: Bisbee Police All Plans |
$3.64
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Self Pay Self Pay |
$11.20
|
|
|
TRACH MASK
|
Facility
|
OP
|
$14.00
|
|
| Hospital Charge Code |
22355568
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna of AZ Commercial |
$12.60
|
| Rate for Payer: Aetna of AZ Medicare |
$3.92
|
| Rate for Payer: Allwell Medicare |
$2.24
|
| Rate for Payer: Amerigroup Medicare |
$2.24
|
| Rate for Payer: APIPA Medicare/Medicaid |
$5.23
|
| Rate for Payer: AZCH Complete Medicare |
$2.24
|
| Rate for Payer: Banner UC Health Medicare |
$2.24
|
| Rate for Payer: Bisbee Police All Plans |
$3.64
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$9.52
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cigna of AZ Commercial |
$9.80
|
| Rate for Payer: Copperpoint Commercial |
$3.46
|
| Rate for Payer: Health Net of AZ Commercial |
$8.40
|
| Rate for Payer: Health Net of AZ Medicare |
$3.92
|
| Rate for Payer: Humana of AZ Medicare |
$2.24
|
| Rate for Payer: Self Pay Self Pay |
$11.20
|
| Rate for Payer: TriWest Medicare |
$2.24
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$8.16
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$2.52
|
|