Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$6,980.33
|
|
Service Code
|
APR-DRG 1114
|
Hospital Charge Code |
APRDRG1112
|
Min. Negotiated Rate |
$6,980.33 |
Max. Negotiated Rate |
$6,980.33 |
Rate for Payer: AHCCCS Medicaid |
$6,980.33
|
Rate for Payer: Allwell Medicaid |
$6,980.33
|
Rate for Payer: AZCH Complete Medicaid |
$6,980.33
|
Rate for Payer: Banner UC Health Medicaid |
$6,980.33
|
Rate for Payer: Mercy Care Medicaid |
$6,980.33
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$3,838.06
|
|
Service Code
|
APR-DRG 1111
|
Hospital Charge Code |
APRDRG1111
|
Min. Negotiated Rate |
$3,838.06 |
Max. Negotiated Rate |
$3,838.06 |
Rate for Payer: AHCCCS Medicaid |
$3,838.06
|
Rate for Payer: Allwell Medicaid |
$3,838.06
|
Rate for Payer: AZCH Complete Medicaid |
$3,838.06
|
Rate for Payer: Banner UC Health Medicaid |
$3,838.06
|
Rate for Payer: Mercy Care Medicaid |
$3,838.06
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$4,238.56
|
|
Service Code
|
APR-DRG 1112
|
Hospital Charge Code |
APRDRG1111
|
Min. Negotiated Rate |
$4,238.56 |
Max. Negotiated Rate |
$4,238.56 |
Rate for Payer: AHCCCS Medicaid |
$4,238.56
|
Rate for Payer: Allwell Medicaid |
$4,238.56
|
Rate for Payer: AZCH Complete Medicaid |
$4,238.56
|
Rate for Payer: Banner UC Health Medicaid |
$4,238.56
|
Rate for Payer: Mercy Care Medicaid |
$4,238.56
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$6,980.33
|
|
Service Code
|
APR-DRG 1114
|
Hospital Charge Code |
APRDRG1114
|
Min. Negotiated Rate |
$6,980.33 |
Max. Negotiated Rate |
$6,980.33 |
Rate for Payer: AHCCCS Medicaid |
$6,980.33
|
Rate for Payer: Allwell Medicaid |
$6,980.33
|
Rate for Payer: AZCH Complete Medicaid |
$6,980.33
|
Rate for Payer: Banner UC Health Medicaid |
$6,980.33
|
Rate for Payer: Mercy Care Medicaid |
$6,980.33
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$5,340.46
|
|
Service Code
|
APR-DRG 1113
|
Hospital Charge Code |
APRDRG1113
|
Min. Negotiated Rate |
$5,340.46 |
Max. Negotiated Rate |
$5,340.46 |
Rate for Payer: AHCCCS Medicaid |
$5,340.46
|
Rate for Payer: Allwell Medicaid |
$5,340.46
|
Rate for Payer: AZCH Complete Medicaid |
$5,340.46
|
Rate for Payer: Banner UC Health Medicaid |
$5,340.46
|
Rate for Payer: Mercy Care Medicaid |
$5,340.46
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$5,340.46
|
|
Service Code
|
APR-DRG 1113
|
Hospital Charge Code |
APRDRG1112
|
Min. Negotiated Rate |
$5,340.46 |
Max. Negotiated Rate |
$5,340.46 |
Rate for Payer: AHCCCS Medicaid |
$5,340.46
|
Rate for Payer: Allwell Medicaid |
$5,340.46
|
Rate for Payer: AZCH Complete Medicaid |
$5,340.46
|
Rate for Payer: Banner UC Health Medicaid |
$5,340.46
|
Rate for Payer: Mercy Care Medicaid |
$5,340.46
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$6,980.33
|
|
Service Code
|
APR-DRG 1114
|
Hospital Charge Code |
APRDRG1111
|
Min. Negotiated Rate |
$6,980.33 |
Max. Negotiated Rate |
$6,980.33 |
Rate for Payer: AHCCCS Medicaid |
$6,980.33
|
Rate for Payer: Allwell Medicaid |
$6,980.33
|
Rate for Payer: AZCH Complete Medicaid |
$6,980.33
|
Rate for Payer: Banner UC Health Medicaid |
$6,980.33
|
Rate for Payer: Mercy Care Medicaid |
$6,980.33
|
|
Vertigo And Other Labyrinth Disorders
|
Facility
|
IP
|
$4,238.56
|
|
Service Code
|
APR-DRG 1112
|
Hospital Charge Code |
APRDRG1112
|
Min. Negotiated Rate |
$4,238.56 |
Max. Negotiated Rate |
$4,238.56 |
Rate for Payer: AHCCCS Medicaid |
$4,238.56
|
Rate for Payer: Allwell Medicaid |
$4,238.56
|
Rate for Payer: AZCH Complete Medicaid |
$4,238.56
|
Rate for Payer: Banner UC Health Medicaid |
$4,238.56
|
Rate for Payer: Mercy Care Medicaid |
$4,238.56
|
|
Vesicovaginal Fistual abdominal
|
Facility
|
IP
|
$4,452.00
|
|
Service Code
|
CPT 51900
|
Hospital Charge Code |
27267834
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,157.52 |
Max. Negotiated Rate |
$4,006.80 |
Rate for Payer: Aetna of AZ Commercial |
$4,006.80
|
Rate for Payer: Bisbee Police All Plans |
$1,157.52
|
Rate for Payer: Cash Price |
$3,561.60
|
Rate for Payer: Self Pay Self Pay |
$3,561.60
|
|
Vesicovaginal Fistual abdominal
|
Facility
|
OP
|
$4,452.00
|
|
Service Code
|
CPT 51900
|
Hospital Charge Code |
27267834
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$0.13 |
Max. Negotiated Rate |
$4,006.80 |
Rate for Payer: Aetna of AZ Commercial |
$4,006.80
|
Rate for Payer: Aetna of AZ Medicare |
$1,246.56
|
Rate for Payer: AHCCCS Medicaid |
$0.13
|
Rate for Payer: Allwell Medicaid |
$0.13
|
Rate for Payer: Allwell Medicare |
$667.80
|
Rate for Payer: Amerigroup Medicare |
$667.80
|
Rate for Payer: APIPA Medicare/Medicaid |
$1,662.82
|
Rate for Payer: AZCH Complete Medicaid |
$0.13
|
Rate for Payer: AZCH Complete Medicare |
$667.80
|
Rate for Payer: Banner UC Health Medicaid |
$0.13
|
Rate for Payer: Banner UC Health Medicare |
$667.80
|
Rate for Payer: Bisbee Police All Plans |
$1,157.52
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$3,027.36
|
Rate for Payer: Cash Price |
$3,561.60
|
Rate for Payer: Cash Price |
$3,561.60
|
Rate for Payer: Cigna of AZ Commercial |
$2,226.00
|
Rate for Payer: Copperpoint Commercial |
$1,101.87
|
Rate for Payer: Health Net of AZ Commercial |
$2,671.20
|
Rate for Payer: Health Net of AZ Medicare |
$1,246.56
|
Rate for Payer: Humana of AZ Medicare |
$667.80
|
Rate for Payer: Mercy Care Medicaid |
$0.13
|
Rate for Payer: Self Pay Self Pay |
$3,561.60
|
Rate for Payer: TriWest Medicare |
$667.80
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$801.36
|
|
Vesicovaginal Fistual vaginal
|
Facility
|
OP
|
$2,890.00
|
|
Service Code
|
CPT 57320
|
Hospital Charge Code |
27291798
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$433.50 |
Max. Negotiated Rate |
$6,393.84 |
Rate for Payer: Aetna of AZ Commercial |
$2,601.00
|
Rate for Payer: Aetna of AZ Medicare |
$809.20
|
Rate for Payer: AHCCCS Medicaid |
$6,393.84
|
Rate for Payer: Allwell Medicaid |
$6,393.84
|
Rate for Payer: Allwell Medicare |
$433.50
|
Rate for Payer: Amerigroup Medicare |
$433.50
|
Rate for Payer: APIPA Medicare/Medicaid |
$1,079.42
|
Rate for Payer: AZCH Complete Medicaid |
$6,393.84
|
Rate for Payer: AZCH Complete Medicare |
$433.50
|
Rate for Payer: Banner UC Health Medicaid |
$6,393.84
|
Rate for Payer: Banner UC Health Medicare |
$433.50
|
Rate for Payer: Bisbee Police All Plans |
$751.40
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,965.20
|
Rate for Payer: Cash Price |
$2,312.00
|
Rate for Payer: Cash Price |
$2,312.00
|
Rate for Payer: Cigna of AZ Commercial |
$1,445.00
|
Rate for Payer: Copperpoint Commercial |
$715.28
|
Rate for Payer: Health Net of AZ Commercial |
$1,734.00
|
Rate for Payer: Health Net of AZ Medicare |
$809.20
|
Rate for Payer: Humana of AZ Medicare |
$433.50
|
Rate for Payer: Mercy Care Medicaid |
$6,393.84
|
Rate for Payer: Self Pay Self Pay |
$2,312.00
|
Rate for Payer: TriWest Medicare |
$433.50
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$520.20
|
|
Vesicovaginal Fistual vaginal
|
Facility
|
IP
|
$2,890.00
|
|
Service Code
|
CPT 57320
|
Hospital Charge Code |
27291798
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$751.40 |
Max. Negotiated Rate |
$2,601.00 |
Rate for Payer: Aetna of AZ Commercial |
$2,601.00
|
Rate for Payer: Bisbee Police All Plans |
$751.40
|
Rate for Payer: Cash Price |
$2,312.00
|
Rate for Payer: Self Pay Self Pay |
$2,312.00
|
|
Viral Culture, General LC
|
Facility
|
IP
|
$447.00
|
|
Service Code
|
CPT 87252
|
Hospital Charge Code |
2029221
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$116.22 |
Max. Negotiated Rate |
$402.30 |
Rate for Payer: Aetna of AZ Commercial |
$402.30
|
Rate for Payer: Bisbee Police All Plans |
$116.22
|
Rate for Payer: Cash Price |
$357.60
|
Rate for Payer: Self Pay Self Pay |
$357.60
|
|
Viral Culture, General LC
|
Facility
|
OP
|
$447.00
|
|
Service Code
|
CPT 87252
|
Hospital Charge Code |
2029221
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$26.07 |
Max. Negotiated Rate |
$402.30 |
Rate for Payer: Aetna of AZ Commercial |
$402.30
|
Rate for Payer: Aetna of AZ Medicare |
$125.16
|
Rate for Payer: AHCCCS Medicaid |
$26.07
|
Rate for Payer: Allwell Medicaid |
$26.07
|
Rate for Payer: Allwell Medicare |
$67.05
|
Rate for Payer: Amerigroup Medicare |
$67.05
|
Rate for Payer: APIPA Medicare/Medicaid |
$166.95
|
Rate for Payer: AZCH Complete Medicaid |
$26.07
|
Rate for Payer: AZCH Complete Medicare |
$67.05
|
Rate for Payer: Banner UC Health Medicaid |
$26.07
|
Rate for Payer: Banner UC Health Medicare |
$67.05
|
Rate for Payer: Bisbee Police All Plans |
$116.22
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$303.96
|
Rate for Payer: Cash Price |
$357.60
|
Rate for Payer: Cash Price |
$357.60
|
Rate for Payer: Cigna of AZ Commercial |
$290.55
|
Rate for Payer: Copperpoint Commercial |
$110.63
|
Rate for Payer: Health Net of AZ Commercial |
$268.20
|
Rate for Payer: Health Net of AZ Medicare |
$125.16
|
Rate for Payer: Humana of AZ Medicare |
$67.05
|
Rate for Payer: Mercy Care Medicaid |
$26.07
|
Rate for Payer: Self Pay Self Pay |
$357.60
|
Rate for Payer: TriWest Medicare |
$67.05
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$260.60
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$80.46
|
|
Viral Illness
|
Facility
|
IP
|
$13,657.66
|
|
Service Code
|
APR-DRG 7234
|
Hospital Charge Code |
APRDRG7232
|
Min. Negotiated Rate |
$13,657.66 |
Max. Negotiated Rate |
$13,657.66 |
Rate for Payer: AHCCCS Medicaid |
$13,657.66
|
Rate for Payer: Allwell Medicaid |
$13,657.66
|
Rate for Payer: AZCH Complete Medicaid |
$13,657.66
|
Rate for Payer: Banner UC Health Medicaid |
$13,657.66
|
Rate for Payer: Mercy Care Medicaid |
$13,657.66
|
|
Viral Illness
|
Facility
|
IP
|
$3,679.54
|
|
Service Code
|
APR-DRG 7232
|
Hospital Charge Code |
APRDRG7233
|
Min. Negotiated Rate |
$3,679.54 |
Max. Negotiated Rate |
$3,679.54 |
Rate for Payer: AHCCCS Medicaid |
$3,679.54
|
Rate for Payer: Allwell Medicaid |
$3,679.54
|
Rate for Payer: AZCH Complete Medicaid |
$3,679.54
|
Rate for Payer: Banner UC Health Medicaid |
$3,679.54
|
Rate for Payer: Mercy Care Medicaid |
$3,679.54
|
|
Viral Illness
|
Facility
|
IP
|
$3,679.54
|
|
Service Code
|
APR-DRG 7232
|
Hospital Charge Code |
APRDRG7231
|
Min. Negotiated Rate |
$3,679.54 |
Max. Negotiated Rate |
$3,679.54 |
Rate for Payer: AHCCCS Medicaid |
$3,679.54
|
Rate for Payer: Allwell Medicaid |
$3,679.54
|
Rate for Payer: AZCH Complete Medicaid |
$3,679.54
|
Rate for Payer: Banner UC Health Medicaid |
$3,679.54
|
Rate for Payer: Mercy Care Medicaid |
$3,679.54
|
|
Viral Illness
|
Facility
|
IP
|
$5,933.14
|
|
Service Code
|
APR-DRG 7233
|
Hospital Charge Code |
APRDRG7231
|
Min. Negotiated Rate |
$5,933.14 |
Max. Negotiated Rate |
$5,933.14 |
Rate for Payer: AHCCCS Medicaid |
$5,933.14
|
Rate for Payer: Allwell Medicaid |
$5,933.14
|
Rate for Payer: AZCH Complete Medicaid |
$5,933.14
|
Rate for Payer: Banner UC Health Medicaid |
$5,933.14
|
Rate for Payer: Mercy Care Medicaid |
$5,933.14
|
|
Viral Illness
|
Facility
|
IP
|
$13,657.66
|
|
Service Code
|
APR-DRG 7234
|
Hospital Charge Code |
APRDRG7233
|
Min. Negotiated Rate |
$13,657.66 |
Max. Negotiated Rate |
$13,657.66 |
Rate for Payer: AHCCCS Medicaid |
$13,657.66
|
Rate for Payer: Allwell Medicaid |
$13,657.66
|
Rate for Payer: AZCH Complete Medicaid |
$13,657.66
|
Rate for Payer: Banner UC Health Medicaid |
$13,657.66
|
Rate for Payer: Mercy Care Medicaid |
$13,657.66
|
|
Viral Illness
|
Facility
|
IP
|
$2,594.48
|
|
Service Code
|
APR-DRG 7231
|
Hospital Charge Code |
APRDRG7234
|
Min. Negotiated Rate |
$2,594.48 |
Max. Negotiated Rate |
$2,594.48 |
Rate for Payer: AHCCCS Medicaid |
$2,594.48
|
Rate for Payer: Allwell Medicaid |
$2,594.48
|
Rate for Payer: AZCH Complete Medicaid |
$2,594.48
|
Rate for Payer: Banner UC Health Medicaid |
$2,594.48
|
Rate for Payer: Mercy Care Medicaid |
$2,594.48
|
|
Viral Illness
|
Facility
|
IP
|
$3,679.54
|
|
Service Code
|
APR-DRG 7232
|
Hospital Charge Code |
APRDRG7234
|
Min. Negotiated Rate |
$3,679.54 |
Max. Negotiated Rate |
$3,679.54 |
Rate for Payer: AHCCCS Medicaid |
$3,679.54
|
Rate for Payer: Allwell Medicaid |
$3,679.54
|
Rate for Payer: AZCH Complete Medicaid |
$3,679.54
|
Rate for Payer: Banner UC Health Medicaid |
$3,679.54
|
Rate for Payer: Mercy Care Medicaid |
$3,679.54
|
|
Viral Illness
|
Facility
|
IP
|
$2,594.48
|
|
Service Code
|
APR-DRG 7231
|
Hospital Charge Code |
APRDRG7232
|
Min. Negotiated Rate |
$2,594.48 |
Max. Negotiated Rate |
$2,594.48 |
Rate for Payer: AHCCCS Medicaid |
$2,594.48
|
Rate for Payer: Allwell Medicaid |
$2,594.48
|
Rate for Payer: AZCH Complete Medicaid |
$2,594.48
|
Rate for Payer: Banner UC Health Medicaid |
$2,594.48
|
Rate for Payer: Mercy Care Medicaid |
$2,594.48
|
|
Viral Illness
|
Facility
|
IP
|
$5,933.14
|
|
Service Code
|
APR-DRG 7233
|
Hospital Charge Code |
APRDRG7234
|
Min. Negotiated Rate |
$5,933.14 |
Max. Negotiated Rate |
$5,933.14 |
Rate for Payer: AHCCCS Medicaid |
$5,933.14
|
Rate for Payer: Allwell Medicaid |
$5,933.14
|
Rate for Payer: AZCH Complete Medicaid |
$5,933.14
|
Rate for Payer: Banner UC Health Medicaid |
$5,933.14
|
Rate for Payer: Mercy Care Medicaid |
$5,933.14
|
|
Viral Illness
|
Facility
|
IP
|
$5,933.14
|
|
Service Code
|
APR-DRG 7233
|
Hospital Charge Code |
APRDRG7232
|
Min. Negotiated Rate |
$5,933.14 |
Max. Negotiated Rate |
$5,933.14 |
Rate for Payer: AHCCCS Medicaid |
$5,933.14
|
Rate for Payer: Allwell Medicaid |
$5,933.14
|
Rate for Payer: AZCH Complete Medicaid |
$5,933.14
|
Rate for Payer: Banner UC Health Medicaid |
$5,933.14
|
Rate for Payer: Mercy Care Medicaid |
$5,933.14
|
|
Viral Illness
|
Facility
|
IP
|
$13,657.66
|
|
Service Code
|
APR-DRG 7234
|
Hospital Charge Code |
APRDRG7231
|
Min. Negotiated Rate |
$13,657.66 |
Max. Negotiated Rate |
$13,657.66 |
Rate for Payer: AHCCCS Medicaid |
$13,657.66
|
Rate for Payer: Allwell Medicaid |
$13,657.66
|
Rate for Payer: AZCH Complete Medicaid |
$13,657.66
|
Rate for Payer: Banner UC Health Medicaid |
$13,657.66
|
Rate for Payer: Mercy Care Medicaid |
$13,657.66
|
|