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Charge Type Setting Price  
Service Code APR-DRG 3414
Hospital Charge Code APRDRG3414
Min. Negotiated Rate $10,958.67
Max. Negotiated Rate $10,958.67
Rate for Payer: AHCCCS Medicaid $10,958.67
Rate for Payer: Allwell Medicaid $10,958.67
Rate for Payer: AZCH Complete Medicaid $10,958.67
Rate for Payer: Banner UC Health Medicaid $10,958.67
Rate for Payer: Mercy Care Medicaid $10,958.67
Service Code APR-DRG 3413
Hospital Charge Code APRDRG3412
Min. Negotiated Rate $5,232.44
Max. Negotiated Rate $5,232.44
Rate for Payer: AHCCCS Medicaid $5,232.44
Rate for Payer: Allwell Medicaid $5,232.44
Rate for Payer: AZCH Complete Medicaid $5,232.44
Rate for Payer: Banner UC Health Medicaid $5,232.44
Rate for Payer: Mercy Care Medicaid $5,232.44
Service Code APR-DRG 3411
Hospital Charge Code APRDRG3411
Min. Negotiated Rate $3,255.90
Max. Negotiated Rate $3,255.90
Rate for Payer: AHCCCS Medicaid $3,255.90
Rate for Payer: Allwell Medicaid $3,255.90
Rate for Payer: AZCH Complete Medicaid $3,255.90
Rate for Payer: Banner UC Health Medicaid $3,255.90
Rate for Payer: Mercy Care Medicaid $3,255.90
Service Code APR-DRG 3412
Hospital Charge Code APRDRG3412
Min. Negotiated Rate $3,893.47
Max. Negotiated Rate $3,893.47
Rate for Payer: AHCCCS Medicaid $3,893.47
Rate for Payer: Allwell Medicaid $3,893.47
Rate for Payer: AZCH Complete Medicaid $3,893.47
Rate for Payer: Banner UC Health Medicaid $3,893.47
Rate for Payer: Mercy Care Medicaid $3,893.47
Service Code APR-DRG 3414
Hospital Charge Code APRDRG3413
Min. Negotiated Rate $10,958.67
Max. Negotiated Rate $10,958.67
Rate for Payer: AHCCCS Medicaid $10,958.67
Rate for Payer: Allwell Medicaid $10,958.67
Rate for Payer: AZCH Complete Medicaid $10,958.67
Rate for Payer: Banner UC Health Medicaid $10,958.67
Rate for Payer: Mercy Care Medicaid $10,958.67
Service Code APR-DRG 3411
Hospital Charge Code APRDRG3412
Min. Negotiated Rate $3,255.90
Max. Negotiated Rate $3,255.90
Rate for Payer: AHCCCS Medicaid $3,255.90
Rate for Payer: Allwell Medicaid $3,255.90
Rate for Payer: AZCH Complete Medicaid $3,255.90
Rate for Payer: Banner UC Health Medicaid $3,255.90
Rate for Payer: Mercy Care Medicaid $3,255.90
Service Code APR-DRG 3411
Hospital Charge Code APRDRG3414
Min. Negotiated Rate $3,255.90
Max. Negotiated Rate $3,255.90
Rate for Payer: AHCCCS Medicaid $3,255.90
Rate for Payer: Allwell Medicaid $3,255.90
Rate for Payer: AZCH Complete Medicaid $3,255.90
Rate for Payer: Banner UC Health Medicaid $3,255.90
Rate for Payer: Mercy Care Medicaid $3,255.90
Service Code APR-DRG 3412
Hospital Charge Code APRDRG3414
Min. Negotiated Rate $3,893.47
Max. Negotiated Rate $3,893.47
Rate for Payer: AHCCCS Medicaid $3,893.47
Rate for Payer: Allwell Medicaid $3,893.47
Rate for Payer: AZCH Complete Medicaid $3,893.47
Rate for Payer: Banner UC Health Medicaid $3,893.47
Rate for Payer: Mercy Care Medicaid $3,893.47
Service Code APR-DRG 3413
Hospital Charge Code APRDRG3414
Min. Negotiated Rate $5,232.44
Max. Negotiated Rate $5,232.44
Rate for Payer: AHCCCS Medicaid $5,232.44
Rate for Payer: Allwell Medicaid $5,232.44
Rate for Payer: AZCH Complete Medicaid $5,232.44
Rate for Payer: Banner UC Health Medicaid $5,232.44
Rate for Payer: Mercy Care Medicaid $5,232.44
Service Code APR-DRG 3411
Hospital Charge Code APRDRG3413
Min. Negotiated Rate $3,255.90
Max. Negotiated Rate $3,255.90
Rate for Payer: AHCCCS Medicaid $3,255.90
Rate for Payer: Allwell Medicaid $3,255.90
Rate for Payer: AZCH Complete Medicaid $3,255.90
Rate for Payer: Banner UC Health Medicaid $3,255.90
Rate for Payer: Mercy Care Medicaid $3,255.90
Service Code APR-DRG 3414
Hospital Charge Code APRDRG3411
Min. Negotiated Rate $10,958.67
Max. Negotiated Rate $10,958.67
Rate for Payer: AHCCCS Medicaid $10,958.67
Rate for Payer: Allwell Medicaid $10,958.67
Rate for Payer: AZCH Complete Medicaid $10,958.67
Rate for Payer: Banner UC Health Medicaid $10,958.67
Rate for Payer: Mercy Care Medicaid $10,958.67
Service Code APR-DRG 3413
Hospital Charge Code APRDRG3411
Min. Negotiated Rate $5,232.44
Max. Negotiated Rate $5,232.44
Rate for Payer: AHCCCS Medicaid $5,232.44
Rate for Payer: Allwell Medicaid $5,232.44
Rate for Payer: AZCH Complete Medicaid $5,232.44
Rate for Payer: Banner UC Health Medicaid $5,232.44
Rate for Payer: Mercy Care Medicaid $5,232.44
Service Code APR-DRG 3412
Hospital Charge Code APRDRG3413
Min. Negotiated Rate $3,893.47
Max. Negotiated Rate $3,893.47
Rate for Payer: AHCCCS Medicaid $3,893.47
Rate for Payer: Allwell Medicaid $3,893.47
Rate for Payer: AZCH Complete Medicaid $3,893.47
Rate for Payer: Banner UC Health Medicaid $3,893.47
Rate for Payer: Mercy Care Medicaid $3,893.47
Service Code APR-DRG 3414
Hospital Charge Code APRDRG3412
Min. Negotiated Rate $10,958.67
Max. Negotiated Rate $10,958.67
Rate for Payer: AHCCCS Medicaid $10,958.67
Rate for Payer: Allwell Medicaid $10,958.67
Rate for Payer: AZCH Complete Medicaid $10,958.67
Rate for Payer: Banner UC Health Medicaid $10,958.67
Rate for Payer: Mercy Care Medicaid $10,958.67
Service Code APR-DRG 3412
Hospital Charge Code APRDRG3411
Min. Negotiated Rate $3,893.47
Max. Negotiated Rate $3,893.47
Rate for Payer: AHCCCS Medicaid $3,893.47
Rate for Payer: Allwell Medicaid $3,893.47
Rate for Payer: AZCH Complete Medicaid $3,893.47
Rate for Payer: Banner UC Health Medicaid $3,893.47
Rate for Payer: Mercy Care Medicaid $3,893.47
Service Code APR-DRG 3423
Hospital Charge Code APRDRG3424
Min. Negotiated Rate $6,444.46
Max. Negotiated Rate $6,444.46
Rate for Payer: AHCCCS Medicaid $6,444.46
Rate for Payer: Allwell Medicaid $6,444.46
Rate for Payer: AZCH Complete Medicaid $6,444.46
Rate for Payer: Banner UC Health Medicaid $6,444.46
Rate for Payer: Mercy Care Medicaid $6,444.46
Service Code APR-DRG 3424
Hospital Charge Code APRDRG3421
Min. Negotiated Rate $12,648.35
Max. Negotiated Rate $12,648.35
Rate for Payer: AHCCCS Medicaid $12,648.35
Rate for Payer: Allwell Medicaid $12,648.35
Rate for Payer: AZCH Complete Medicaid $12,648.35
Rate for Payer: Banner UC Health Medicaid $12,648.35
Rate for Payer: Mercy Care Medicaid $12,648.35
Service Code APR-DRG 3424
Hospital Charge Code APRDRG3423
Min. Negotiated Rate $12,648.35
Max. Negotiated Rate $12,648.35
Rate for Payer: AHCCCS Medicaid $12,648.35
Rate for Payer: Allwell Medicaid $12,648.35
Rate for Payer: AZCH Complete Medicaid $12,648.35
Rate for Payer: Banner UC Health Medicaid $12,648.35
Rate for Payer: Mercy Care Medicaid $12,648.35
Service Code APR-DRG 3422
Hospital Charge Code APRDRG3422
Min. Negotiated Rate $4,588.56
Max. Negotiated Rate $4,588.56
Rate for Payer: AHCCCS Medicaid $4,588.56
Rate for Payer: Allwell Medicaid $4,588.56
Rate for Payer: AZCH Complete Medicaid $4,588.56
Rate for Payer: Banner UC Health Medicaid $4,588.56
Rate for Payer: Mercy Care Medicaid $4,588.56
Service Code APR-DRG 3423
Hospital Charge Code APRDRG3421
Min. Negotiated Rate $6,444.46
Max. Negotiated Rate $6,444.46
Rate for Payer: AHCCCS Medicaid $6,444.46
Rate for Payer: Allwell Medicaid $6,444.46
Rate for Payer: AZCH Complete Medicaid $6,444.46
Rate for Payer: Banner UC Health Medicaid $6,444.46
Rate for Payer: Mercy Care Medicaid $6,444.46
Service Code APR-DRG 3424
Hospital Charge Code APRDRG3424
Min. Negotiated Rate $12,648.35
Max. Negotiated Rate $12,648.35
Rate for Payer: AHCCCS Medicaid $12,648.35
Rate for Payer: Allwell Medicaid $12,648.35
Rate for Payer: AZCH Complete Medicaid $12,648.35
Rate for Payer: Banner UC Health Medicaid $12,648.35
Rate for Payer: Mercy Care Medicaid $12,648.35
Service Code APR-DRG 3422
Hospital Charge Code APRDRG3424
Min. Negotiated Rate $4,588.56
Max. Negotiated Rate $4,588.56
Rate for Payer: AHCCCS Medicaid $4,588.56
Rate for Payer: Allwell Medicaid $4,588.56
Rate for Payer: AZCH Complete Medicaid $4,588.56
Rate for Payer: Banner UC Health Medicaid $4,588.56
Rate for Payer: Mercy Care Medicaid $4,588.56
Service Code APR-DRG 3421
Hospital Charge Code APRDRG3422
Min. Negotiated Rate $3,642.37
Max. Negotiated Rate $3,642.37
Rate for Payer: AHCCCS Medicaid $3,642.37
Rate for Payer: Allwell Medicaid $3,642.37
Rate for Payer: AZCH Complete Medicaid $3,642.37
Rate for Payer: Banner UC Health Medicaid $3,642.37
Rate for Payer: Mercy Care Medicaid $3,642.37
Service Code APR-DRG 3423
Hospital Charge Code APRDRG3422
Min. Negotiated Rate $6,444.46
Max. Negotiated Rate $6,444.46
Rate for Payer: AHCCCS Medicaid $6,444.46
Rate for Payer: Allwell Medicaid $6,444.46
Rate for Payer: AZCH Complete Medicaid $6,444.46
Rate for Payer: Banner UC Health Medicaid $6,444.46
Rate for Payer: Mercy Care Medicaid $6,444.46
Service Code APR-DRG 3421
Hospital Charge Code APRDRG3421
Min. Negotiated Rate $3,642.37
Max. Negotiated Rate $3,642.37
Rate for Payer: AHCCCS Medicaid $3,642.37
Rate for Payer: Allwell Medicaid $3,642.37
Rate for Payer: AZCH Complete Medicaid $3,642.37
Rate for Payer: Banner UC Health Medicaid $3,642.37
Rate for Payer: Mercy Care Medicaid $3,642.37