|
Asthma
|
Facility
|
IP
|
$9,015.80
|
|
|
Service Code
|
APR-DRG 1414
|
| Hospital Charge Code |
APRDRG1411
|
| Min. Negotiated Rate |
$9,015.80 |
| Max. Negotiated Rate |
$9,015.80 |
| Rate for Payer: AHCCCS Medicaid |
$9,015.80
|
| Rate for Payer: Allwell Medicaid |
$9,015.80
|
| Rate for Payer: AZCH Complete Medicaid |
$9,015.80
|
| Rate for Payer: Banner UC Health Medicaid |
$9,015.80
|
| Rate for Payer: Mercy Care Medicaid |
$9,015.80
|
|
|
atenolol 25 mg Tab [CQCH]
|
Facility
|
OP
|
$0.17
|
|
|
Service Code
|
NDC 51079075920
|
| Hospital Charge Code |
105911831
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Aetna of AZ Commercial |
$0.15
|
| Rate for Payer: Aetna of AZ Medicare |
$0.05
|
| Rate for Payer: Allwell Medicare |
$0.03
|
| Rate for Payer: Amerigroup Medicare |
$0.03
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.06
|
| Rate for Payer: AZCH Complete Medicare |
$0.03
|
| Rate for Payer: Banner UC Health Medicare |
$0.03
|
| Rate for Payer: Bisbee Police All Plans |
$0.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.12
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cigna of AZ Commercial |
$0.11
|
| Rate for Payer: Copperpoint Commercial |
$0.04
|
| Rate for Payer: Health Net of AZ Commercial |
$0.10
|
| Rate for Payer: Health Net of AZ Medicare |
$0.05
|
| Rate for Payer: Humana of AZ Medicare |
$0.03
|
| Rate for Payer: Self Pay Self Pay |
$0.14
|
| Rate for Payer: TriWest Medicare |
$0.03
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.10
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.03
|
|
|
atenolol 25 mg Tab [CQCH]
|
Facility
|
IP
|
$0.17
|
|
|
Service Code
|
NDC 51079075920
|
| Hospital Charge Code |
105911831
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Aetna of AZ Commercial |
$0.15
|
| Rate for Payer: Bisbee Police All Plans |
$0.04
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$0.14
|
|
|
atenolol 50 mg Tab [CQCH]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
NDC 51079068420
|
| Hospital Charge Code |
105911766
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Aetna of AZ Commercial |
$0.07
|
| Rate for Payer: Aetna of AZ Medicare |
$0.02
|
| Rate for Payer: Allwell Medicare |
$0.01
|
| Rate for Payer: Amerigroup Medicare |
$0.01
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.03
|
| Rate for Payer: AZCH Complete Medicare |
$0.01
|
| Rate for Payer: Banner UC Health Medicare |
$0.01
|
| Rate for Payer: Bisbee Police All Plans |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Cigna of AZ Commercial |
$0.05
|
| Rate for Payer: Copperpoint Commercial |
$0.02
|
| Rate for Payer: Health Net of AZ Commercial |
$0.05
|
| Rate for Payer: Health Net of AZ Medicare |
$0.02
|
| Rate for Payer: Humana of AZ Medicare |
$0.01
|
| Rate for Payer: Self Pay Self Pay |
$0.06
|
| Rate for Payer: TriWest Medicare |
$0.01
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.05
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.01
|
|
|
atenolol 50 mg Tab [CQCH]
|
Facility
|
IP
|
$0.08
|
|
|
Service Code
|
NDC 51079068420
|
| Hospital Charge Code |
105911766
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Aetna of AZ Commercial |
$0.07
|
| Rate for Payer: Bisbee Police All Plans |
$0.02
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Self Pay Self Pay |
$0.06
|
|
|
atorvastatin 20 mg Tab [CQCH]
|
Facility
|
IP
|
$0.75
|
|
|
Service Code
|
NDC 904629161
|
| Hospital Charge Code |
105911897
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Aetna of AZ Commercial |
$0.68
|
| Rate for Payer: Bisbee Police All Plans |
$0.20
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Self Pay Self Pay |
$0.60
|
|
|
atorvastatin 20 mg Tab [CQCH]
|
Facility
|
OP
|
$0.75
|
|
|
Service Code
|
NDC 904629161
|
| Hospital Charge Code |
105911897
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Aetna of AZ Commercial |
$0.68
|
| Rate for Payer: Aetna of AZ Medicare |
$0.21
|
| Rate for Payer: Allwell Medicare |
$0.11
|
| Rate for Payer: Amerigroup Medicare |
$0.11
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.28
|
| Rate for Payer: AZCH Complete Medicare |
$0.11
|
| Rate for Payer: Banner UC Health Medicare |
$0.11
|
| Rate for Payer: Bisbee Police All Plans |
$0.20
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.51
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Cigna of AZ Commercial |
$0.49
|
| Rate for Payer: Copperpoint Commercial |
$0.19
|
| Rate for Payer: Health Net of AZ Commercial |
$0.45
|
| Rate for Payer: Health Net of AZ Medicare |
$0.21
|
| Rate for Payer: Humana of AZ Medicare |
$0.11
|
| Rate for Payer: Self Pay Self Pay |
$0.60
|
| Rate for Payer: TriWest Medicare |
$0.11
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.44
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.14
|
|
|
atropine 0.1 mg/mL Inj PFS [CQCH]
|
Facility
|
OP
|
$0.81
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
105912104
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Aetna of AZ Commercial |
$0.73
|
| Rate for Payer: Aetna of AZ Medicare |
$0.23
|
| Rate for Payer: AHCCCS Medicaid |
$0.12
|
| Rate for Payer: Allwell Medicaid |
$0.12
|
| Rate for Payer: Allwell Medicare |
$0.12
|
| Rate for Payer: Amerigroup Medicare |
$0.12
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.12
|
| Rate for Payer: AZCH Complete Medicare |
$0.12
|
| Rate for Payer: Banner UC Health Medicaid |
$0.12
|
| Rate for Payer: Banner UC Health Medicare |
$0.12
|
| Rate for Payer: Bisbee Police All Plans |
$0.21
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.55
|
| Rate for Payer: Cash Price |
$0.64
|
| Rate for Payer: Cash Price |
$0.64
|
| Rate for Payer: Cigna of AZ Commercial |
$0.53
|
| Rate for Payer: Copperpoint Commercial |
$0.20
|
| Rate for Payer: Health Net of AZ Commercial |
$0.49
|
| Rate for Payer: Health Net of AZ Medicare |
$0.23
|
| Rate for Payer: Humana of AZ Medicare |
$0.12
|
| Rate for Payer: Mercy Care Medicaid |
$0.12
|
| Rate for Payer: Self Pay Self Pay |
$0.65
|
| Rate for Payer: TriWest Medicare |
$0.12
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.47
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.15
|
|
|
atropine 0.1 mg/mL Inj PFS [CQCH]
|
Facility
|
IP
|
$0.81
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
105912104
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Aetna of AZ Commercial |
$0.73
|
| Rate for Payer: Bisbee Police All Plans |
$0.21
|
| Rate for Payer: Cash Price |
$0.64
|
| Rate for Payer: Self Pay Self Pay |
$0.65
|
|
|
atropine 1 mg/mL Inj Sol [CQCH]
|
Facility
|
IP
|
$5.97
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
105912035
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.55 |
| Max. Negotiated Rate |
$5.37 |
| Rate for Payer: Aetna of AZ Commercial |
$5.37
|
| Rate for Payer: Bisbee Police All Plans |
$1.55
|
| Rate for Payer: Cash Price |
$4.78
|
| Rate for Payer: Self Pay Self Pay |
$4.78
|
|
|
atropine 1 mg/mL Inj Sol [CQCH]
|
Facility
|
OP
|
$5.97
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
105912035
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$5.37 |
| Rate for Payer: Aetna of AZ Commercial |
$5.37
|
| Rate for Payer: Aetna of AZ Medicare |
$1.67
|
| Rate for Payer: AHCCCS Medicaid |
$0.12
|
| Rate for Payer: Allwell Medicaid |
$0.12
|
| Rate for Payer: Allwell Medicare |
$0.90
|
| Rate for Payer: Amerigroup Medicare |
$0.90
|
| Rate for Payer: APIPA Medicare/Medicaid |
$2.23
|
| Rate for Payer: AZCH Complete Medicaid |
$0.12
|
| Rate for Payer: AZCH Complete Medicare |
$0.90
|
| Rate for Payer: Banner UC Health Medicaid |
$0.12
|
| Rate for Payer: Banner UC Health Medicare |
$0.90
|
| Rate for Payer: Bisbee Police All Plans |
$1.55
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$4.06
|
| Rate for Payer: Cash Price |
$4.78
|
| Rate for Payer: Cash Price |
$4.78
|
| Rate for Payer: Cigna of AZ Commercial |
$3.88
|
| Rate for Payer: Copperpoint Commercial |
$1.48
|
| Rate for Payer: Health Net of AZ Commercial |
$3.58
|
| Rate for Payer: Health Net of AZ Medicare |
$1.67
|
| Rate for Payer: Humana of AZ Medicare |
$0.90
|
| Rate for Payer: Mercy Care Medicaid |
$0.12
|
| Rate for Payer: Self Pay Self Pay |
$4.78
|
| Rate for Payer: TriWest Medicare |
$0.90
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3.48
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.07
|
|
|
atropine-diphenoxylate 0.025 mg-2.5 mg Tab [CQCH]
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
NDC 71205090960
|
| Hospital Charge Code |
105912306
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna of AZ Commercial |
$0.14
|
| Rate for Payer: Bisbee Police All Plans |
$0.04
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$0.13
|
|
|
atropine-diphenoxylate 0.025 mg-2.5 mg Tab [CQCH]
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
NDC 71205090960
|
| Hospital Charge Code |
105912306
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna of AZ Commercial |
$0.14
|
| Rate for Payer: Aetna of AZ Medicare |
$0.04
|
| Rate for Payer: Allwell Medicare |
$0.02
|
| Rate for Payer: Amerigroup Medicare |
$0.02
|
| Rate for Payer: APIPA Medicare/Medicaid |
$0.06
|
| Rate for Payer: AZCH Complete Medicare |
$0.02
|
| Rate for Payer: Banner UC Health Medicare |
$0.02
|
| Rate for Payer: Bisbee Police All Plans |
$0.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$0.11
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cigna of AZ Commercial |
$0.10
|
| Rate for Payer: Copperpoint Commercial |
$0.04
|
| Rate for Payer: Health Net of AZ Commercial |
$0.10
|
| Rate for Payer: Health Net of AZ Medicare |
$0.04
|
| Rate for Payer: Humana of AZ Medicare |
$0.02
|
| Rate for Payer: Self Pay Self Pay |
$0.13
|
| Rate for Payer: TriWest Medicare |
$0.02
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$0.09
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$0.03
|
|
|
atropine Ophth 1% Sol [CQCH]
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
NDC 65030355
|
| Hospital Charge Code |
105912175
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$6.71 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna of AZ Commercial |
$40.27
|
| Rate for Payer: Aetna of AZ Medicare |
$12.53
|
| Rate for Payer: Allwell Medicare |
$6.71
|
| Rate for Payer: Amerigroup Medicare |
$6.71
|
| Rate for Payer: APIPA Medicare/Medicaid |
$16.71
|
| Rate for Payer: AZCH Complete Medicare |
$6.71
|
| Rate for Payer: Banner UC Health Medicare |
$6.71
|
| Rate for Payer: Bisbee Police All Plans |
$11.63
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$30.42
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cigna of AZ Commercial |
$29.08
|
| Rate for Payer: Copperpoint Commercial |
$11.07
|
| Rate for Payer: Health Net of AZ Commercial |
$26.84
|
| Rate for Payer: Health Net of AZ Medicare |
$12.53
|
| Rate for Payer: Humana of AZ Medicare |
$6.71
|
| Rate for Payer: Self Pay Self Pay |
$35.79
|
| Rate for Payer: TriWest Medicare |
$6.71
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$26.08
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$8.05
|
|
|
atropine Ophth 1% Sol [CQCH]
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
NDC 65030355
|
| Hospital Charge Code |
105912175
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna of AZ Commercial |
$40.27
|
| Rate for Payer: Bisbee Police All Plans |
$11.63
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Self Pay Self Pay |
$35.79
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$33,226.72
|
|
|
Service Code
|
APR-DRG 0082
|
| Hospital Charge Code |
APRDRG0082
|
| Min. Negotiated Rate |
$33,226.72 |
| Max. Negotiated Rate |
$33,226.72 |
| Rate for Payer: AHCCCS Medicaid |
$33,226.72
|
| Rate for Payer: Allwell Medicaid |
$33,226.72
|
| Rate for Payer: AZCH Complete Medicaid |
$33,226.72
|
| Rate for Payer: Banner UC Health Medicaid |
$33,226.72
|
| Rate for Payer: Mercy Care Medicaid |
$33,226.72
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$27,684.26
|
|
|
Service Code
|
APR-DRG 0081
|
| Hospital Charge Code |
APRDRG0083
|
| Min. Negotiated Rate |
$27,684.26 |
| Max. Negotiated Rate |
$27,684.26 |
| Rate for Payer: AHCCCS Medicaid |
$27,684.26
|
| Rate for Payer: Allwell Medicaid |
$27,684.26
|
| Rate for Payer: AZCH Complete Medicaid |
$27,684.26
|
| Rate for Payer: Banner UC Health Medicaid |
$27,684.26
|
| Rate for Payer: Mercy Care Medicaid |
$27,684.26
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$33,226.72
|
|
|
Service Code
|
APR-DRG 0082
|
| Hospital Charge Code |
APRDRG0083
|
| Min. Negotiated Rate |
$33,226.72 |
| Max. Negotiated Rate |
$33,226.72 |
| Rate for Payer: AHCCCS Medicaid |
$33,226.72
|
| Rate for Payer: Allwell Medicaid |
$33,226.72
|
| Rate for Payer: AZCH Complete Medicaid |
$33,226.72
|
| Rate for Payer: Banner UC Health Medicaid |
$33,226.72
|
| Rate for Payer: Mercy Care Medicaid |
$33,226.72
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$62,166.48
|
|
|
Service Code
|
APR-DRG 0084
|
| Hospital Charge Code |
APRDRG0084
|
| Min. Negotiated Rate |
$62,166.48 |
| Max. Negotiated Rate |
$62,166.48 |
| Rate for Payer: AHCCCS Medicaid |
$62,166.48
|
| Rate for Payer: Allwell Medicaid |
$62,166.48
|
| Rate for Payer: AZCH Complete Medicaid |
$62,166.48
|
| Rate for Payer: Banner UC Health Medicaid |
$62,166.48
|
| Rate for Payer: Mercy Care Medicaid |
$62,166.48
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$62,166.48
|
|
|
Service Code
|
APR-DRG 0084
|
| Hospital Charge Code |
APRDRG0083
|
| Min. Negotiated Rate |
$62,166.48 |
| Max. Negotiated Rate |
$62,166.48 |
| Rate for Payer: AHCCCS Medicaid |
$62,166.48
|
| Rate for Payer: Allwell Medicaid |
$62,166.48
|
| Rate for Payer: AZCH Complete Medicaid |
$62,166.48
|
| Rate for Payer: Banner UC Health Medicaid |
$62,166.48
|
| Rate for Payer: Mercy Care Medicaid |
$62,166.48
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$27,684.26
|
|
|
Service Code
|
APR-DRG 0081
|
| Hospital Charge Code |
APRDRG0081
|
| Min. Negotiated Rate |
$27,684.26 |
| Max. Negotiated Rate |
$27,684.26 |
| Rate for Payer: AHCCCS Medicaid |
$27,684.26
|
| Rate for Payer: Allwell Medicaid |
$27,684.26
|
| Rate for Payer: AZCH Complete Medicaid |
$27,684.26
|
| Rate for Payer: Banner UC Health Medicaid |
$27,684.26
|
| Rate for Payer: Mercy Care Medicaid |
$27,684.26
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$62,166.48
|
|
|
Service Code
|
APR-DRG 0084
|
| Hospital Charge Code |
APRDRG0081
|
| Min. Negotiated Rate |
$62,166.48 |
| Max. Negotiated Rate |
$62,166.48 |
| Rate for Payer: AHCCCS Medicaid |
$62,166.48
|
| Rate for Payer: Allwell Medicaid |
$62,166.48
|
| Rate for Payer: AZCH Complete Medicaid |
$62,166.48
|
| Rate for Payer: Banner UC Health Medicaid |
$62,166.48
|
| Rate for Payer: Mercy Care Medicaid |
$62,166.48
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$33,226.72
|
|
|
Service Code
|
APR-DRG 0082
|
| Hospital Charge Code |
APRDRG0081
|
| Min. Negotiated Rate |
$33,226.72 |
| Max. Negotiated Rate |
$33,226.72 |
| Rate for Payer: AHCCCS Medicaid |
$33,226.72
|
| Rate for Payer: Allwell Medicaid |
$33,226.72
|
| Rate for Payer: AZCH Complete Medicaid |
$33,226.72
|
| Rate for Payer: Banner UC Health Medicaid |
$33,226.72
|
| Rate for Payer: Mercy Care Medicaid |
$33,226.72
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$38,943.83
|
|
|
Service Code
|
APR-DRG 0083
|
| Hospital Charge Code |
APRDRG0082
|
| Min. Negotiated Rate |
$38,943.83 |
| Max. Negotiated Rate |
$38,943.83 |
| Rate for Payer: AHCCCS Medicaid |
$38,943.83
|
| Rate for Payer: Allwell Medicaid |
$38,943.83
|
| Rate for Payer: AZCH Complete Medicaid |
$38,943.83
|
| Rate for Payer: Banner UC Health Medicaid |
$38,943.83
|
| Rate for Payer: Mercy Care Medicaid |
$38,943.83
|
|
|
Autologous Bone Marrow Transplant Or T-Cell Immunotherapy
|
Facility
|
IP
|
$38,943.83
|
|
|
Service Code
|
APR-DRG 0083
|
| Hospital Charge Code |
APRDRG0083
|
| Min. Negotiated Rate |
$38,943.83 |
| Max. Negotiated Rate |
$38,943.83 |
| Rate for Payer: AHCCCS Medicaid |
$38,943.83
|
| Rate for Payer: Allwell Medicaid |
$38,943.83
|
| Rate for Payer: AZCH Complete Medicaid |
$38,943.83
|
| Rate for Payer: Banner UC Health Medicaid |
$38,943.83
|
| Rate for Payer: Mercy Care Medicaid |
$38,943.83
|
|
