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Charge Type Setting Price  
Service Code APR-DRG 9112
Hospital Charge Code APRDRG9114
Min. Negotiated Rate $14,627.00
Max. Negotiated Rate $14,627.00
Rate for Payer: AHCCCS Medicaid $14,627.00
Rate for Payer: Allwell Medicaid $14,627.00
Rate for Payer: AZCH Complete Medicaid $14,627.00
Rate for Payer: Banner UC Health Medicaid $14,627.00
Rate for Payer: Mercy Care Medicaid $14,627.00
Service Code APR-DRG 9112
Hospital Charge Code APRDRG9111
Min. Negotiated Rate $14,627.00
Max. Negotiated Rate $14,627.00
Rate for Payer: AHCCCS Medicaid $14,627.00
Rate for Payer: Allwell Medicaid $14,627.00
Rate for Payer: AZCH Complete Medicaid $14,627.00
Rate for Payer: Banner UC Health Medicaid $14,627.00
Rate for Payer: Mercy Care Medicaid $14,627.00
Service Code APR-DRG 9111
Hospital Charge Code APRDRG9114
Min. Negotiated Rate $13,096.54
Max. Negotiated Rate $13,096.54
Rate for Payer: AHCCCS Medicaid $13,096.54
Rate for Payer: Allwell Medicaid $13,096.54
Rate for Payer: AZCH Complete Medicaid $13,096.54
Rate for Payer: Banner UC Health Medicaid $13,096.54
Rate for Payer: Mercy Care Medicaid $13,096.54
Service Code APR-DRG 9111
Hospital Charge Code APRDRG9112
Min. Negotiated Rate $13,096.54
Max. Negotiated Rate $13,096.54
Rate for Payer: AHCCCS Medicaid $13,096.54
Rate for Payer: Allwell Medicaid $13,096.54
Rate for Payer: AZCH Complete Medicaid $13,096.54
Rate for Payer: Banner UC Health Medicaid $13,096.54
Rate for Payer: Mercy Care Medicaid $13,096.54
Service Code APR-DRG 9114
Hospital Charge Code APRDRG9112
Min. Negotiated Rate $49,192.69
Max. Negotiated Rate $49,192.69
Rate for Payer: AHCCCS Medicaid $49,192.69
Rate for Payer: Allwell Medicaid $49,192.69
Rate for Payer: AZCH Complete Medicaid $49,192.69
Rate for Payer: Banner UC Health Medicaid $49,192.69
Rate for Payer: Mercy Care Medicaid $49,192.69
Service Code APR-DRG 9113
Hospital Charge Code APRDRG9111
Min. Negotiated Rate $20,800.72
Max. Negotiated Rate $20,800.72
Rate for Payer: AHCCCS Medicaid $20,800.72
Rate for Payer: Allwell Medicaid $20,800.72
Rate for Payer: AZCH Complete Medicaid $20,800.72
Rate for Payer: Banner UC Health Medicaid $20,800.72
Rate for Payer: Mercy Care Medicaid $20,800.72
Service Code APR-DRG 9113
Hospital Charge Code APRDRG9112
Min. Negotiated Rate $20,800.72
Max. Negotiated Rate $20,800.72
Rate for Payer: AHCCCS Medicaid $20,800.72
Rate for Payer: Allwell Medicaid $20,800.72
Rate for Payer: AZCH Complete Medicaid $20,800.72
Rate for Payer: Banner UC Health Medicaid $20,800.72
Rate for Payer: Mercy Care Medicaid $20,800.72
Service Code APR-DRG 9111
Hospital Charge Code APRDRG9113
Min. Negotiated Rate $13,096.54
Max. Negotiated Rate $13,096.54
Rate for Payer: AHCCCS Medicaid $13,096.54
Rate for Payer: Allwell Medicaid $13,096.54
Rate for Payer: AZCH Complete Medicaid $13,096.54
Rate for Payer: Banner UC Health Medicaid $13,096.54
Rate for Payer: Mercy Care Medicaid $13,096.54
Service Code APR-DRG 9112
Hospital Charge Code APRDRG9113
Min. Negotiated Rate $14,627.00
Max. Negotiated Rate $14,627.00
Rate for Payer: AHCCCS Medicaid $14,627.00
Rate for Payer: Allwell Medicaid $14,627.00
Rate for Payer: AZCH Complete Medicaid $14,627.00
Rate for Payer: Banner UC Health Medicaid $14,627.00
Rate for Payer: Mercy Care Medicaid $14,627.00
Service Code APR-DRG 9113
Hospital Charge Code APRDRG9114
Min. Negotiated Rate $20,800.72
Max. Negotiated Rate $20,800.72
Rate for Payer: AHCCCS Medicaid $20,800.72
Rate for Payer: Allwell Medicaid $20,800.72
Rate for Payer: AZCH Complete Medicaid $20,800.72
Rate for Payer: Banner UC Health Medicaid $20,800.72
Rate for Payer: Mercy Care Medicaid $20,800.72
Service Code APR-DRG 9113
Hospital Charge Code APRDRG9113
Min. Negotiated Rate $20,800.72
Max. Negotiated Rate $20,800.72
Rate for Payer: AHCCCS Medicaid $20,800.72
Rate for Payer: Allwell Medicaid $20,800.72
Rate for Payer: AZCH Complete Medicaid $20,800.72
Rate for Payer: Banner UC Health Medicaid $20,800.72
Rate for Payer: Mercy Care Medicaid $20,800.72
Service Code APR-DRG 9114
Hospital Charge Code APRDRG9113
Min. Negotiated Rate $49,192.69
Max. Negotiated Rate $49,192.69
Rate for Payer: AHCCCS Medicaid $49,192.69
Rate for Payer: Allwell Medicaid $49,192.69
Rate for Payer: AZCH Complete Medicaid $49,192.69
Rate for Payer: Banner UC Health Medicaid $49,192.69
Rate for Payer: Mercy Care Medicaid $49,192.69
Service Code APR-DRG 9114
Hospital Charge Code APRDRG9111
Min. Negotiated Rate $49,192.69
Max. Negotiated Rate $49,192.69
Rate for Payer: AHCCCS Medicaid $49,192.69
Rate for Payer: Allwell Medicaid $49,192.69
Rate for Payer: AZCH Complete Medicaid $49,192.69
Rate for Payer: Banner UC Health Medicaid $49,192.69
Rate for Payer: Mercy Care Medicaid $49,192.69
Service Code APR-DRG 7923
Hospital Charge Code APRDRG7922
Min. Negotiated Rate $17,711.75
Max. Negotiated Rate $17,711.75
Rate for Payer: AHCCCS Medicaid $17,711.75
Rate for Payer: Allwell Medicaid $17,711.75
Rate for Payer: AZCH Complete Medicaid $17,711.75
Rate for Payer: Banner UC Health Medicaid $17,711.75
Rate for Payer: Mercy Care Medicaid $17,711.75
Service Code APR-DRG 7924
Hospital Charge Code APRDRG7924
Min. Negotiated Rate $35,671.10
Max. Negotiated Rate $35,671.10
Rate for Payer: AHCCCS Medicaid $35,671.10
Rate for Payer: Allwell Medicaid $35,671.10
Rate for Payer: AZCH Complete Medicaid $35,671.10
Rate for Payer: Banner UC Health Medicaid $35,671.10
Rate for Payer: Mercy Care Medicaid $35,671.10
Service Code APR-DRG 7921
Hospital Charge Code APRDRG7923
Min. Negotiated Rate $9,703.87
Max. Negotiated Rate $9,703.87
Rate for Payer: AHCCCS Medicaid $9,703.87
Rate for Payer: Allwell Medicaid $9,703.87
Rate for Payer: AZCH Complete Medicaid $9,703.87
Rate for Payer: Banner UC Health Medicaid $9,703.87
Rate for Payer: Mercy Care Medicaid $9,703.87
Service Code APR-DRG 7921
Hospital Charge Code APRDRG7922
Min. Negotiated Rate $9,703.87
Max. Negotiated Rate $9,703.87
Rate for Payer: AHCCCS Medicaid $9,703.87
Rate for Payer: Allwell Medicaid $9,703.87
Rate for Payer: AZCH Complete Medicaid $9,703.87
Rate for Payer: Banner UC Health Medicaid $9,703.87
Rate for Payer: Mercy Care Medicaid $9,703.87
Service Code APR-DRG 7923
Hospital Charge Code APRDRG7921
Min. Negotiated Rate $17,711.75
Max. Negotiated Rate $17,711.75
Rate for Payer: AHCCCS Medicaid $17,711.75
Rate for Payer: Allwell Medicaid $17,711.75
Rate for Payer: AZCH Complete Medicaid $17,711.75
Rate for Payer: Banner UC Health Medicaid $17,711.75
Rate for Payer: Mercy Care Medicaid $17,711.75
Service Code APR-DRG 7924
Hospital Charge Code APRDRG7922
Min. Negotiated Rate $35,671.10
Max. Negotiated Rate $35,671.10
Rate for Payer: AHCCCS Medicaid $35,671.10
Rate for Payer: Allwell Medicaid $35,671.10
Rate for Payer: AZCH Complete Medicaid $35,671.10
Rate for Payer: Banner UC Health Medicaid $35,671.10
Rate for Payer: Mercy Care Medicaid $35,671.10
Service Code APR-DRG 7924
Hospital Charge Code APRDRG7923
Min. Negotiated Rate $35,671.10
Max. Negotiated Rate $35,671.10
Rate for Payer: AHCCCS Medicaid $35,671.10
Rate for Payer: Allwell Medicaid $35,671.10
Rate for Payer: AZCH Complete Medicaid $35,671.10
Rate for Payer: Banner UC Health Medicaid $35,671.10
Rate for Payer: Mercy Care Medicaid $35,671.10
Service Code APR-DRG 7922
Hospital Charge Code APRDRG7922
Min. Negotiated Rate $12,044.44
Max. Negotiated Rate $12,044.44
Rate for Payer: AHCCCS Medicaid $12,044.44
Rate for Payer: Allwell Medicaid $12,044.44
Rate for Payer: AZCH Complete Medicaid $12,044.44
Rate for Payer: Banner UC Health Medicaid $12,044.44
Rate for Payer: Mercy Care Medicaid $12,044.44
Service Code APR-DRG 7923
Hospital Charge Code APRDRG7923
Min. Negotiated Rate $17,711.75
Max. Negotiated Rate $17,711.75
Rate for Payer: AHCCCS Medicaid $17,711.75
Rate for Payer: Allwell Medicaid $17,711.75
Rate for Payer: AZCH Complete Medicaid $17,711.75
Rate for Payer: Banner UC Health Medicaid $17,711.75
Rate for Payer: Mercy Care Medicaid $17,711.75
Service Code APR-DRG 7921
Hospital Charge Code APRDRG7921
Min. Negotiated Rate $9,703.87
Max. Negotiated Rate $9,703.87
Rate for Payer: AHCCCS Medicaid $9,703.87
Rate for Payer: Allwell Medicaid $9,703.87
Rate for Payer: AZCH Complete Medicaid $9,703.87
Rate for Payer: Banner UC Health Medicaid $9,703.87
Rate for Payer: Mercy Care Medicaid $9,703.87
Service Code APR-DRG 7921
Hospital Charge Code APRDRG7924
Min. Negotiated Rate $9,703.87
Max. Negotiated Rate $9,703.87
Rate for Payer: AHCCCS Medicaid $9,703.87
Rate for Payer: Allwell Medicaid $9,703.87
Rate for Payer: AZCH Complete Medicaid $9,703.87
Rate for Payer: Banner UC Health Medicaid $9,703.87
Rate for Payer: Mercy Care Medicaid $9,703.87
Service Code APR-DRG 7923
Hospital Charge Code APRDRG7924
Min. Negotiated Rate $17,711.75
Max. Negotiated Rate $17,711.75
Rate for Payer: AHCCCS Medicaid $17,711.75
Rate for Payer: Allwell Medicaid $17,711.75
Rate for Payer: AZCH Complete Medicaid $17,711.75
Rate for Payer: Banner UC Health Medicaid $17,711.75
Rate for Payer: Mercy Care Medicaid $17,711.75