Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$20,677.97

Service Code	APR-DRG 9503
Hospital Charge Code	APRDRG9503
Min. Negotiated Rate	$20,677.97
Max. Negotiated Rate	$20,677.97
Rate for Payer: AHCCCS Medicaid	$20,677.97
Rate for Payer: Allwell Medicaid	$20,677.97
Rate for Payer: AZCH Complete Medicaid	$20,677.97
Rate for Payer: Banner UC Health Medicaid	$20,677.97
Rate for Payer: Mercy Care Medicaid	$20,677.97

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$13,793.03

Service Code	APR-DRG 9502
Hospital Charge Code	APRDRG9502
Min. Negotiated Rate	$13,793.03
Max. Negotiated Rate	$13,793.03
Rate for Payer: AHCCCS Medicaid	$13,793.03
Rate for Payer: Allwell Medicaid	$13,793.03
Rate for Payer: AZCH Complete Medicaid	$13,793.03
Rate for Payer: Banner UC Health Medicaid	$13,793.03
Rate for Payer: Mercy Care Medicaid	$13,793.03

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$13,793.03

Service Code	APR-DRG 9502
Hospital Charge Code	APRDRG9503
Min. Negotiated Rate	$13,793.03
Max. Negotiated Rate	$13,793.03
Rate for Payer: AHCCCS Medicaid	$13,793.03
Rate for Payer: Allwell Medicaid	$13,793.03
Rate for Payer: AZCH Complete Medicaid	$13,793.03
Rate for Payer: Banner UC Health Medicaid	$13,793.03
Rate for Payer: Mercy Care Medicaid	$13,793.03

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$20,677.97

Service Code	APR-DRG 9503
Hospital Charge Code	APRDRG9502
Min. Negotiated Rate	$20,677.97
Max. Negotiated Rate	$20,677.97
Rate for Payer: AHCCCS Medicaid	$20,677.97
Rate for Payer: Allwell Medicaid	$20,677.97
Rate for Payer: AZCH Complete Medicaid	$20,677.97
Rate for Payer: Banner UC Health Medicaid	$20,677.97
Rate for Payer: Mercy Care Medicaid	$20,677.97

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$9,564.29

Service Code	APR-DRG 9501
Hospital Charge Code	APRDRG9501
Min. Negotiated Rate	$9,564.29
Max. Negotiated Rate	$9,564.29
Rate for Payer: AHCCCS Medicaid	$9,564.29
Rate for Payer: Allwell Medicaid	$9,564.29
Rate for Payer: AZCH Complete Medicaid	$9,564.29
Rate for Payer: Banner UC Health Medicaid	$9,564.29
Rate for Payer: Mercy Care Medicaid	$9,564.29

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$13,793.03

Service Code	APR-DRG 9502
Hospital Charge Code	APRDRG9501
Min. Negotiated Rate	$13,793.03
Max. Negotiated Rate	$13,793.03
Rate for Payer: AHCCCS Medicaid	$13,793.03
Rate for Payer: Allwell Medicaid	$13,793.03
Rate for Payer: AZCH Complete Medicaid	$13,793.03
Rate for Payer: Banner UC Health Medicaid	$13,793.03
Rate for Payer: Mercy Care Medicaid	$13,793.03

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$39,678.20

Service Code	APR-DRG 9504
Hospital Charge Code	APRDRG9502
Min. Negotiated Rate	$39,678.20
Max. Negotiated Rate	$39,678.20
Rate for Payer: AHCCCS Medicaid	$39,678.20
Rate for Payer: Allwell Medicaid	$39,678.20
Rate for Payer: AZCH Complete Medicaid	$39,678.20
Rate for Payer: Banner UC Health Medicaid	$39,678.20
Rate for Payer: Mercy Care Medicaid	$39,678.20

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$39,678.20

Service Code	APR-DRG 9504
Hospital Charge Code	APRDRG9501
Min. Negotiated Rate	$39,678.20
Max. Negotiated Rate	$39,678.20
Rate for Payer: AHCCCS Medicaid	$39,678.20
Rate for Payer: Allwell Medicaid	$39,678.20
Rate for Payer: AZCH Complete Medicaid	$39,678.20
Rate for Payer: Banner UC Health Medicaid	$39,678.20
Rate for Payer: Mercy Care Medicaid	$39,678.20

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$39,678.20

Service Code	APR-DRG 9504
Hospital Charge Code	APRDRG9504
Min. Negotiated Rate	$39,678.20
Max. Negotiated Rate	$39,678.20
Rate for Payer: AHCCCS Medicaid	$39,678.20
Rate for Payer: Allwell Medicaid	$39,678.20
Rate for Payer: AZCH Complete Medicaid	$39,678.20
Rate for Payer: Banner UC Health Medicaid	$39,678.20
Rate for Payer: Mercy Care Medicaid	$39,678.20

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$20,677.97

Service Code	APR-DRG 9503
Hospital Charge Code	APRDRG9504
Min. Negotiated Rate	$20,677.97
Max. Negotiated Rate	$20,677.97
Rate for Payer: AHCCCS Medicaid	$20,677.97
Rate for Payer: Allwell Medicaid	$20,677.97
Rate for Payer: AZCH Complete Medicaid	$20,677.97
Rate for Payer: Banner UC Health Medicaid	$20,677.97
Rate for Payer: Mercy Care Medicaid	$20,677.97

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$9,564.29

Service Code	APR-DRG 9501
Hospital Charge Code	APRDRG9503
Min. Negotiated Rate	$9,564.29
Max. Negotiated Rate	$9,564.29
Rate for Payer: AHCCCS Medicaid	$9,564.29
Rate for Payer: Allwell Medicaid	$9,564.29
Rate for Payer: AZCH Complete Medicaid	$9,564.29
Rate for Payer: Banner UC Health Medicaid	$9,564.29
Rate for Payer: Mercy Care Medicaid	$9,564.29

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$9,564.29

Service Code	APR-DRG 9501
Hospital Charge Code	APRDRG9504
Min. Negotiated Rate	$9,564.29
Max. Negotiated Rate	$9,564.29
Rate for Payer: AHCCCS Medicaid	$9,564.29
Rate for Payer: Allwell Medicaid	$9,564.29
Rate for Payer: AZCH Complete Medicaid	$9,564.29
Rate for Payer: Banner UC Health Medicaid	$9,564.29
Rate for Payer: Mercy Care Medicaid	$9,564.29

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$20,677.97

Service Code	APR-DRG 9503
Hospital Charge Code	APRDRG9501
Min. Negotiated Rate	$20,677.97
Max. Negotiated Rate	$20,677.97
Rate for Payer: AHCCCS Medicaid	$20,677.97
Rate for Payer: Allwell Medicaid	$20,677.97
Rate for Payer: AZCH Complete Medicaid	$20,677.97
Rate for Payer: Banner UC Health Medicaid	$20,677.97
Rate for Payer: Mercy Care Medicaid	$20,677.97

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$9,564.29

Service Code	APR-DRG 9501
Hospital Charge Code	APRDRG9502
Min. Negotiated Rate	$9,564.29
Max. Negotiated Rate	$9,564.29
Rate for Payer: AHCCCS Medicaid	$9,564.29
Rate for Payer: Allwell Medicaid	$9,564.29
Rate for Payer: AZCH Complete Medicaid	$9,564.29
Rate for Payer: Banner UC Health Medicaid	$9,564.29
Rate for Payer: Mercy Care Medicaid	$9,564.29

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$13,793.03

Service Code	APR-DRG 9502
Hospital Charge Code	APRDRG9504
Min. Negotiated Rate	$13,793.03
Max. Negotiated Rate	$13,793.03
Rate for Payer: AHCCCS Medicaid	$13,793.03
Rate for Payer: Allwell Medicaid	$13,793.03
Rate for Payer: AZCH Complete Medicaid	$13,793.03
Rate for Payer: Banner UC Health Medicaid	$13,793.03
Rate for Payer: Mercy Care Medicaid	$13,793.03

Extensive O.R. Procedure Unrelated To Principal Diagnosis

Facility

IP

$39,678.20

Service Code	APR-DRG 9504
Hospital Charge Code	APRDRG9503
Min. Negotiated Rate	$39,678.20
Max. Negotiated Rate	$39,678.20
Rate for Payer: AHCCCS Medicaid	$39,678.20
Rate for Payer: Allwell Medicaid	$39,678.20
Rate for Payer: AZCH Complete Medicaid	$39,678.20
Rate for Payer: Banner UC Health Medicaid	$39,678.20
Rate for Payer: Mercy Care Medicaid	$39,678.20

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$6,902.48

Service Code	APR-DRG 8432
Hospital Charge Code	APRDRG8431
Min. Negotiated Rate	$6,902.48
Max. Negotiated Rate	$6,902.48
Rate for Payer: AHCCCS Medicaid	$6,902.48
Rate for Payer: Allwell Medicaid	$6,902.48
Rate for Payer: AZCH Complete Medicaid	$6,902.48
Rate for Payer: Banner UC Health Medicaid	$6,902.48
Rate for Payer: Mercy Care Medicaid	$6,902.48

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$4,065.31

Service Code	APR-DRG 8431
Hospital Charge Code	APRDRG8433
Min. Negotiated Rate	$4,065.31
Max. Negotiated Rate	$4,065.31
Rate for Payer: AHCCCS Medicaid	$4,065.31
Rate for Payer: Allwell Medicaid	$4,065.31
Rate for Payer: AZCH Complete Medicaid	$4,065.31
Rate for Payer: Banner UC Health Medicaid	$4,065.31
Rate for Payer: Mercy Care Medicaid	$4,065.31

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$9,698.96

Service Code	APR-DRG 8433
Hospital Charge Code	APRDRG8431
Min. Negotiated Rate	$9,698.96
Max. Negotiated Rate	$9,698.96
Rate for Payer: AHCCCS Medicaid	$9,698.96
Rate for Payer: Allwell Medicaid	$9,698.96
Rate for Payer: AZCH Complete Medicaid	$9,698.96
Rate for Payer: Banner UC Health Medicaid	$9,698.96
Rate for Payer: Mercy Care Medicaid	$9,698.96

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$35,683.02

Service Code	APR-DRG 8434
Hospital Charge Code	APRDRG8433
Min. Negotiated Rate	$35,683.02
Max. Negotiated Rate	$35,683.02
Rate for Payer: AHCCCS Medicaid	$35,683.02
Rate for Payer: Allwell Medicaid	$35,683.02
Rate for Payer: AZCH Complete Medicaid	$35,683.02
Rate for Payer: Banner UC Health Medicaid	$35,683.02
Rate for Payer: Mercy Care Medicaid	$35,683.02

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$6,902.48

Service Code	APR-DRG 8432
Hospital Charge Code	APRDRG8434
Min. Negotiated Rate	$6,902.48
Max. Negotiated Rate	$6,902.48
Rate for Payer: AHCCCS Medicaid	$6,902.48
Rate for Payer: Allwell Medicaid	$6,902.48
Rate for Payer: AZCH Complete Medicaid	$6,902.48
Rate for Payer: Banner UC Health Medicaid	$6,902.48
Rate for Payer: Mercy Care Medicaid	$6,902.48

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$9,698.96

Service Code	APR-DRG 8433
Hospital Charge Code	APRDRG8434
Min. Negotiated Rate	$9,698.96
Max. Negotiated Rate	$9,698.96
Rate for Payer: AHCCCS Medicaid	$9,698.96
Rate for Payer: Allwell Medicaid	$9,698.96
Rate for Payer: AZCH Complete Medicaid	$9,698.96
Rate for Payer: Banner UC Health Medicaid	$9,698.96
Rate for Payer: Mercy Care Medicaid	$9,698.96

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$4,065.31

Service Code	APR-DRG 8431
Hospital Charge Code	APRDRG8432
Min. Negotiated Rate	$4,065.31
Max. Negotiated Rate	$4,065.31
Rate for Payer: AHCCCS Medicaid	$4,065.31
Rate for Payer: Allwell Medicaid	$4,065.31
Rate for Payer: AZCH Complete Medicaid	$4,065.31
Rate for Payer: Banner UC Health Medicaid	$4,065.31
Rate for Payer: Mercy Care Medicaid	$4,065.31

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$6,902.48

Service Code	APR-DRG 8432
Hospital Charge Code	APRDRG8432
Min. Negotiated Rate	$6,902.48
Max. Negotiated Rate	$6,902.48
Rate for Payer: AHCCCS Medicaid	$6,902.48
Rate for Payer: Allwell Medicaid	$6,902.48
Rate for Payer: AZCH Complete Medicaid	$6,902.48
Rate for Payer: Banner UC Health Medicaid	$6,902.48
Rate for Payer: Mercy Care Medicaid	$6,902.48

Extensive Third Degree Burns Without Skin Graft

Facility

IP

$4,065.31

Service Code	APR-DRG 8431
Hospital Charge Code	APRDRG8431
Min. Negotiated Rate	$4,065.31
Max. Negotiated Rate	$4,065.31
Rate for Payer: AHCCCS Medicaid	$4,065.31
Rate for Payer: Allwell Medicaid	$4,065.31
Rate for Payer: AZCH Complete Medicaid	$4,065.31
Rate for Payer: Banner UC Health Medicaid	$4,065.31
Rate for Payer: Mercy Care Medicaid	$4,065.31

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