|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$9,472.41
|
|
|
Service Code
|
APR-DRG 5122
|
| Hospital Charge Code |
APRDRG5122
|
| Min. Negotiated Rate |
$9,472.41 |
| Max. Negotiated Rate |
$9,472.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,472.41
|
| Rate for Payer: Mercy Care Medicaid |
$9,472.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,472.41
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$15,999.64
|
|
|
Service Code
|
APR-DRG 5123
|
| Hospital Charge Code |
APRDRG5123
|
| Min. Negotiated Rate |
$15,999.64 |
| Max. Negotiated Rate |
$15,999.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,999.64
|
| Rate for Payer: Mercy Care Medicaid |
$15,999.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,999.64
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$8,163.59
|
|
|
Service Code
|
APR-DRG 5121
|
| Hospital Charge Code |
APRDRG5124
|
| Min. Negotiated Rate |
$8,163.59 |
| Max. Negotiated Rate |
$8,163.59 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,163.59
|
| Rate for Payer: Mercy Care Medicaid |
$8,163.59
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,163.59
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$27,193.98
|
|
|
Service Code
|
APR-DRG 5124
|
| Hospital Charge Code |
APRDRG5123
|
| Min. Negotiated Rate |
$27,193.98 |
| Max. Negotiated Rate |
$27,193.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,193.98
|
| Rate for Payer: Mercy Care Medicaid |
$27,193.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,193.98
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$8,163.59
|
|
|
Service Code
|
APR-DRG 5121
|
| Hospital Charge Code |
APRDRG5121
|
| Min. Negotiated Rate |
$8,163.59 |
| Max. Negotiated Rate |
$8,163.59 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,163.59
|
| Rate for Payer: Mercy Care Medicaid |
$8,163.59
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,163.59
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$9,472.41
|
|
|
Service Code
|
APR-DRG 5122
|
| Hospital Charge Code |
APRDRG5121
|
| Min. Negotiated Rate |
$9,472.41 |
| Max. Negotiated Rate |
$9,472.41 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$9,472.41
|
| Rate for Payer: Mercy Care Medicaid |
$9,472.41
|
| Rate for Payer: NaphCare Correctional Healthcare |
$9,472.41
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$27,193.98
|
|
|
Service Code
|
APR-DRG 5124
|
| Hospital Charge Code |
APRDRG5122
|
| Min. Negotiated Rate |
$27,193.98 |
| Max. Negotiated Rate |
$27,193.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,193.98
|
| Rate for Payer: Mercy Care Medicaid |
$27,193.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,193.98
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$15,999.64
|
|
|
Service Code
|
APR-DRG 5123
|
| Hospital Charge Code |
APRDRG5121
|
| Min. Negotiated Rate |
$15,999.64 |
| Max. Negotiated Rate |
$15,999.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,999.64
|
| Rate for Payer: Mercy Care Medicaid |
$15,999.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,999.64
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$27,193.98
|
|
|
Service Code
|
APR-DRG 5124
|
| Hospital Charge Code |
APRDRG5124
|
| Min. Negotiated Rate |
$27,193.98 |
| Max. Negotiated Rate |
$27,193.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,193.98
|
| Rate for Payer: Mercy Care Medicaid |
$27,193.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,193.98
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$15,999.64
|
|
|
Service Code
|
APR-DRG 5123
|
| Hospital Charge Code |
APRDRG5122
|
| Min. Negotiated Rate |
$15,999.64 |
| Max. Negotiated Rate |
$15,999.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,999.64
|
| Rate for Payer: Mercy Care Medicaid |
$15,999.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,999.64
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$27,193.98
|
|
|
Service Code
|
APR-DRG 5124
|
| Hospital Charge Code |
APRDRG5121
|
| Min. Negotiated Rate |
$27,193.98 |
| Max. Negotiated Rate |
$27,193.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,193.98
|
| Rate for Payer: Mercy Care Medicaid |
$27,193.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,193.98
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$8,163.59
|
|
|
Service Code
|
APR-DRG 5121
|
| Hospital Charge Code |
APRDRG5122
|
| Min. Negotiated Rate |
$8,163.59 |
| Max. Negotiated Rate |
$8,163.59 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,163.59
|
| Rate for Payer: Mercy Care Medicaid |
$8,163.59
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,163.59
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$15,999.64
|
|
|
Service Code
|
APR-DRG 5123
|
| Hospital Charge Code |
APRDRG5124
|
| Min. Negotiated Rate |
$15,999.64 |
| Max. Negotiated Rate |
$15,999.64 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,999.64
|
| Rate for Payer: Mercy Care Medicaid |
$15,999.64
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,999.64
|
|
|
Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy
|
Facility
|
IP
|
$8,163.59
|
|
|
Service Code
|
APR-DRG 5121
|
| Hospital Charge Code |
APRDRG5123
|
| Min. Negotiated Rate |
$8,163.59 |
| Max. Negotiated Rate |
$8,163.59 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,163.59
|
| Rate for Payer: Mercy Care Medicaid |
$8,163.59
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,163.59
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$23,387.53
|
|
|
Service Code
|
MSDRG 740
|
| Min. Negotiated Rate |
$23,387.53 |
| Max. Negotiated Rate |
$23,387.53 |
| Rate for Payer: Seven Corners Travel Insurance |
$23,387.53
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$46,304.63
|
|
|
Service Code
|
MSDRG 739
|
| Min. Negotiated Rate |
$46,304.63 |
| Max. Negotiated Rate |
$46,304.63 |
| Rate for Payer: Seven Corners Travel Insurance |
$46,304.63
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$18,431.12
|
|
|
Service Code
|
MSDRG 741
|
| Min. Negotiated Rate |
$18,431.12 |
| Max. Negotiated Rate |
$18,431.12 |
| Rate for Payer: Seven Corners Travel Insurance |
$18,431.12
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$30,793.56
|
|
|
Service Code
|
APR-DRG 5114
|
| Hospital Charge Code |
APRDRG5114
|
| Min. Negotiated Rate |
$30,793.56 |
| Max. Negotiated Rate |
$30,793.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,793.56
|
| Rate for Payer: Mercy Care Medicaid |
$30,793.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,793.56
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$16,776.79
|
|
|
Service Code
|
APR-DRG 5113
|
| Hospital Charge Code |
APRDRG5112
|
| Min. Negotiated Rate |
$16,776.79 |
| Max. Negotiated Rate |
$16,776.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,776.79
|
| Rate for Payer: Mercy Care Medicaid |
$16,776.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,776.79
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$30,793.56
|
|
|
Service Code
|
APR-DRG 5114
|
| Hospital Charge Code |
APRDRG5113
|
| Min. Negotiated Rate |
$30,793.56 |
| Max. Negotiated Rate |
$30,793.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$30,793.56
|
| Rate for Payer: Mercy Care Medicaid |
$30,793.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$30,793.56
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$16,776.79
|
|
|
Service Code
|
APR-DRG 5113
|
| Hospital Charge Code |
APRDRG5113
|
| Min. Negotiated Rate |
$16,776.79 |
| Max. Negotiated Rate |
$16,776.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,776.79
|
| Rate for Payer: Mercy Care Medicaid |
$16,776.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,776.79
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$8,883.93
|
|
|
Service Code
|
APR-DRG 5111
|
| Hospital Charge Code |
APRDRG5111
|
| Min. Negotiated Rate |
$8,883.93 |
| Max. Negotiated Rate |
$8,883.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,883.93
|
| Rate for Payer: Mercy Care Medicaid |
$8,883.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,883.93
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$16,776.79
|
|
|
Service Code
|
APR-DRG 5113
|
| Hospital Charge Code |
APRDRG5111
|
| Min. Negotiated Rate |
$16,776.79 |
| Max. Negotiated Rate |
$16,776.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,776.79
|
| Rate for Payer: Mercy Care Medicaid |
$16,776.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,776.79
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$10,628.31
|
|
|
Service Code
|
APR-DRG 5112
|
| Hospital Charge Code |
APRDRG5111
|
| Min. Negotiated Rate |
$10,628.31 |
| Max. Negotiated Rate |
$10,628.31 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,628.31
|
| Rate for Payer: Mercy Care Medicaid |
$10,628.31
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,628.31
|
|
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
Facility
|
IP
|
$8,883.93
|
|
|
Service Code
|
APR-DRG 5111
|
| Hospital Charge Code |
APRDRG5114
|
| Min. Negotiated Rate |
$8,883.93 |
| Max. Negotiated Rate |
$8,883.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,883.93
|
| Rate for Payer: Mercy Care Medicaid |
$8,883.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,883.93
|
|
