|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$3,281.15
|
|
|
Service Code
|
APR-DRG 1451
|
| Hospital Charge Code |
APRDRG1452
|
| Min. Negotiated Rate |
$3,281.15 |
| Max. Negotiated Rate |
$3,281.15 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,281.15
|
| Rate for Payer: Mercy Care Medicaid |
$3,281.15
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,281.15
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$8,968.10
|
|
|
Service Code
|
APR-DRG 1454
|
| Hospital Charge Code |
APRDRG1451
|
| Min. Negotiated Rate |
$8,968.10 |
| Max. Negotiated Rate |
$8,968.10 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,968.10
|
| Rate for Payer: Mercy Care Medicaid |
$8,968.10
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,968.10
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$3,281.15
|
|
|
Service Code
|
APR-DRG 1451
|
| Hospital Charge Code |
APRDRG1453
|
| Min. Negotiated Rate |
$3,281.15 |
| Max. Negotiated Rate |
$3,281.15 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,281.15
|
| Rate for Payer: Mercy Care Medicaid |
$3,281.15
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,281.15
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$5,228.24
|
|
|
Service Code
|
APR-DRG 1453
|
| Hospital Charge Code |
APRDRG1451
|
| Min. Negotiated Rate |
$5,228.24 |
| Max. Negotiated Rate |
$5,228.24 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,228.24
|
| Rate for Payer: Mercy Care Medicaid |
$5,228.24
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,228.24
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$8,968.10
|
|
|
Service Code
|
APR-DRG 1454
|
| Hospital Charge Code |
APRDRG1454
|
| Min. Negotiated Rate |
$8,968.10 |
| Max. Negotiated Rate |
$8,968.10 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,968.10
|
| Rate for Payer: Mercy Care Medicaid |
$8,968.10
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,968.10
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$3,928.54
|
|
|
Service Code
|
APR-DRG 1452
|
| Hospital Charge Code |
APRDRG1453
|
| Min. Negotiated Rate |
$3,928.54 |
| Max. Negotiated Rate |
$3,928.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,928.54
|
| Rate for Payer: Mercy Care Medicaid |
$3,928.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,928.54
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$3,928.54
|
|
|
Service Code
|
APR-DRG 1452
|
| Hospital Charge Code |
APRDRG1451
|
| Min. Negotiated Rate |
$3,928.54 |
| Max. Negotiated Rate |
$3,928.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,928.54
|
| Rate for Payer: Mercy Care Medicaid |
$3,928.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,928.54
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$3,928.54
|
|
|
Service Code
|
APR-DRG 1452
|
| Hospital Charge Code |
APRDRG1454
|
| Min. Negotiated Rate |
$3,928.54 |
| Max. Negotiated Rate |
$3,928.54 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,928.54
|
| Rate for Payer: Mercy Care Medicaid |
$3,928.54
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,928.54
|
|
|
Acute Bronchitis And Related Symptoms
|
Facility
|
IP
|
$5,228.24
|
|
|
Service Code
|
APR-DRG 1453
|
| Hospital Charge Code |
APRDRG1452
|
| Min. Negotiated Rate |
$5,228.24 |
| Max. Negotiated Rate |
$5,228.24 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,228.24
|
| Rate for Payer: Mercy Care Medicaid |
$5,228.24
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,228.24
|
|
|
Acute Hepatitis LC
|
Facility
|
OP
|
$1,669.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
26187661
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.06 |
| Max. Negotiated Rate |
$1,502.10 |
| Rate for Payer: Aetna of AZ Commercial |
$1,502.10
|
| Rate for Payer: Arizona Complete Health Allwell |
$267.04
|
| Rate for Payer: Banner UC Health Medicare |
$267.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$1,134.92
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$267.04
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$267.04
|
| Rate for Payer: Cash Price |
$1,335.20
|
| Rate for Payer: Cash Price |
$1,335.20
|
| Rate for Payer: Cigna of AZ Commercial |
$1,084.85
|
| Rate for Payer: Devoted Health Medicare |
$300.42
|
| Rate for Payer: Humana of AZ Medicare |
$267.04
|
| Rate for Payer: Seven Corners Travel Insurance |
$69.06
|
| Rate for Payer: Southwest Service Administrators UFCW |
$1,134.92
|
| Rate for Payer: TriWest Medicare |
$267.04
|
| Rate for Payer: United Healthcare Commercial |
$954.67
|
| Rate for Payer: United Healthcare Medicare |
$267.04
|
| Rate for Payer: Veterans Affairs TRICARE |
$264.37
|
|
|
Acute Hepatitis LC
|
Facility
|
IP
|
$1,669.00
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
26187661
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1,502.10 |
| Max. Negotiated Rate |
$1,502.10 |
| Rate for Payer: Aetna of AZ Commercial |
$1,502.10
|
| Rate for Payer: Cash Price |
$1,335.20
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$4,072.33
|
|
|
Service Code
|
APR-DRG 4692
|
| Hospital Charge Code |
APRDRG4693
|
| Min. Negotiated Rate |
$4,072.33 |
| Max. Negotiated Rate |
$4,072.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,072.33
|
| Rate for Payer: Mercy Care Medicaid |
$4,072.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,072.33
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$6,575.63
|
|
|
Service Code
|
APR-DRG 4693
|
| Hospital Charge Code |
APRDRG4693
|
| Min. Negotiated Rate |
$6,575.63 |
| Max. Negotiated Rate |
$6,575.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,575.63
|
| Rate for Payer: Mercy Care Medicaid |
$6,575.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,575.63
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$3,009.01
|
|
|
Service Code
|
APR-DRG 4691
|
| Hospital Charge Code |
APRDRG4693
|
| Min. Negotiated Rate |
$3,009.01 |
| Max. Negotiated Rate |
$3,009.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,009.01
|
| Rate for Payer: Mercy Care Medicaid |
$3,009.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,009.01
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$6,575.63
|
|
|
Service Code
|
APR-DRG 4693
|
| Hospital Charge Code |
APRDRG4692
|
| Min. Negotiated Rate |
$6,575.63 |
| Max. Negotiated Rate |
$6,575.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,575.63
|
| Rate for Payer: Mercy Care Medicaid |
$6,575.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,575.63
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$12,796.34
|
|
|
Service Code
|
APR-DRG 4694
|
| Hospital Charge Code |
APRDRG4693
|
| Min. Negotiated Rate |
$12,796.34 |
| Max. Negotiated Rate |
$12,796.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,796.34
|
| Rate for Payer: Mercy Care Medicaid |
$12,796.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,796.34
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$4,072.33
|
|
|
Service Code
|
APR-DRG 4692
|
| Hospital Charge Code |
APRDRG4691
|
| Min. Negotiated Rate |
$4,072.33 |
| Max. Negotiated Rate |
$4,072.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,072.33
|
| Rate for Payer: Mercy Care Medicaid |
$4,072.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,072.33
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$4,072.33
|
|
|
Service Code
|
APR-DRG 4692
|
| Hospital Charge Code |
APRDRG4692
|
| Min. Negotiated Rate |
$4,072.33 |
| Max. Negotiated Rate |
$4,072.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,072.33
|
| Rate for Payer: Mercy Care Medicaid |
$4,072.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,072.33
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$6,575.63
|
|
|
Service Code
|
APR-DRG 4693
|
| Hospital Charge Code |
APRDRG4694
|
| Min. Negotiated Rate |
$6,575.63 |
| Max. Negotiated Rate |
$6,575.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,575.63
|
| Rate for Payer: Mercy Care Medicaid |
$6,575.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,575.63
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$4,072.33
|
|
|
Service Code
|
APR-DRG 4692
|
| Hospital Charge Code |
APRDRG4694
|
| Min. Negotiated Rate |
$4,072.33 |
| Max. Negotiated Rate |
$4,072.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,072.33
|
| Rate for Payer: Mercy Care Medicaid |
$4,072.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,072.33
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$3,009.01
|
|
|
Service Code
|
APR-DRG 4691
|
| Hospital Charge Code |
APRDRG4694
|
| Min. Negotiated Rate |
$3,009.01 |
| Max. Negotiated Rate |
$3,009.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,009.01
|
| Rate for Payer: Mercy Care Medicaid |
$3,009.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,009.01
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$12,796.34
|
|
|
Service Code
|
APR-DRG 4694
|
| Hospital Charge Code |
APRDRG4691
|
| Min. Negotiated Rate |
$12,796.34 |
| Max. Negotiated Rate |
$12,796.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,796.34
|
| Rate for Payer: Mercy Care Medicaid |
$12,796.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,796.34
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$3,009.01
|
|
|
Service Code
|
APR-DRG 4691
|
| Hospital Charge Code |
APRDRG4692
|
| Min. Negotiated Rate |
$3,009.01 |
| Max. Negotiated Rate |
$3,009.01 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$3,009.01
|
| Rate for Payer: Mercy Care Medicaid |
$3,009.01
|
| Rate for Payer: NaphCare Correctional Healthcare |
$3,009.01
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$6,575.63
|
|
|
Service Code
|
APR-DRG 4693
|
| Hospital Charge Code |
APRDRG4691
|
| Min. Negotiated Rate |
$6,575.63 |
| Max. Negotiated Rate |
$6,575.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,575.63
|
| Rate for Payer: Mercy Care Medicaid |
$6,575.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,575.63
|
|
|
Acute Kidney Injury
|
Facility
|
IP
|
$12,796.34
|
|
|
Service Code
|
APR-DRG 4694
|
| Hospital Charge Code |
APRDRG4692
|
| Min. Negotiated Rate |
$12,796.34 |
| Max. Negotiated Rate |
$12,796.34 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$12,796.34
|
| Rate for Payer: Mercy Care Medicaid |
$12,796.34
|
| Rate for Payer: NaphCare Correctional Healthcare |
$12,796.34
|
|
