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Charge Type Setting Price  
Service Code APR-DRG 8924
Hospital Charge Code APRDRG8921
Min. Negotiated Rate $13,882.81
Max. Negotiated Rate $13,882.81
Rate for Payer: AHCCCS Medicaid $13,882.81
Rate for Payer: Allwell Medicaid $13,882.81
Rate for Payer: AZCH Complete Medicaid $13,882.81
Rate for Payer: Banner UC Health Medicaid $13,882.81
Rate for Payer: Mercy Care Medicaid $13,882.81
Service Code APR-DRG 8924
Hospital Charge Code APRDRG8922
Min. Negotiated Rate $13,882.81
Max. Negotiated Rate $13,882.81
Rate for Payer: AHCCCS Medicaid $13,882.81
Rate for Payer: Allwell Medicaid $13,882.81
Rate for Payer: AZCH Complete Medicaid $13,882.81
Rate for Payer: Banner UC Health Medicaid $13,882.81
Rate for Payer: Mercy Care Medicaid $13,882.81
Service Code APR-DRG 8901
Hospital Charge Code APRDRG8904
Min. Negotiated Rate $5,891.76
Max. Negotiated Rate $5,891.76
Rate for Payer: AHCCCS Medicaid $5,891.76
Rate for Payer: Allwell Medicaid $5,891.76
Rate for Payer: AZCH Complete Medicaid $5,891.76
Rate for Payer: Banner UC Health Medicaid $5,891.76
Rate for Payer: Mercy Care Medicaid $5,891.76
Service Code APR-DRG 8904
Hospital Charge Code APRDRG8904
Min. Negotiated Rate $21,881.58
Max. Negotiated Rate $21,881.58
Rate for Payer: AHCCCS Medicaid $21,881.58
Rate for Payer: Allwell Medicaid $21,881.58
Rate for Payer: AZCH Complete Medicaid $21,881.58
Rate for Payer: Banner UC Health Medicaid $21,881.58
Rate for Payer: Mercy Care Medicaid $21,881.58
Service Code APR-DRG 8904
Hospital Charge Code APRDRG8901
Min. Negotiated Rate $21,881.58
Max. Negotiated Rate $21,881.58
Rate for Payer: AHCCCS Medicaid $21,881.58
Rate for Payer: Allwell Medicaid $21,881.58
Rate for Payer: AZCH Complete Medicaid $21,881.58
Rate for Payer: Banner UC Health Medicaid $21,881.58
Rate for Payer: Mercy Care Medicaid $21,881.58
Service Code APR-DRG 8904
Hospital Charge Code APRDRG8903
Min. Negotiated Rate $21,881.58
Max. Negotiated Rate $21,881.58
Rate for Payer: AHCCCS Medicaid $21,881.58
Rate for Payer: Allwell Medicaid $21,881.58
Rate for Payer: AZCH Complete Medicaid $21,881.58
Rate for Payer: Banner UC Health Medicaid $21,881.58
Rate for Payer: Mercy Care Medicaid $21,881.58
Service Code APR-DRG 8902
Hospital Charge Code APRDRG8901
Min. Negotiated Rate $6,368.71
Max. Negotiated Rate $6,368.71
Rate for Payer: AHCCCS Medicaid $6,368.71
Rate for Payer: Allwell Medicaid $6,368.71
Rate for Payer: AZCH Complete Medicaid $6,368.71
Rate for Payer: Banner UC Health Medicaid $6,368.71
Rate for Payer: Mercy Care Medicaid $6,368.71
Service Code APR-DRG 8902
Hospital Charge Code APRDRG8904
Min. Negotiated Rate $6,368.71
Max. Negotiated Rate $6,368.71
Rate for Payer: AHCCCS Medicaid $6,368.71
Rate for Payer: Allwell Medicaid $6,368.71
Rate for Payer: AZCH Complete Medicaid $6,368.71
Rate for Payer: Banner UC Health Medicaid $6,368.71
Rate for Payer: Mercy Care Medicaid $6,368.71
Service Code APR-DRG 8901
Hospital Charge Code APRDRG8901
Min. Negotiated Rate $5,891.76
Max. Negotiated Rate $5,891.76
Rate for Payer: AHCCCS Medicaid $5,891.76
Rate for Payer: Allwell Medicaid $5,891.76
Rate for Payer: AZCH Complete Medicaid $5,891.76
Rate for Payer: Banner UC Health Medicaid $5,891.76
Rate for Payer: Mercy Care Medicaid $5,891.76
Service Code APR-DRG 8904
Hospital Charge Code APRDRG8902
Min. Negotiated Rate $21,881.58
Max. Negotiated Rate $21,881.58
Rate for Payer: AHCCCS Medicaid $21,881.58
Rate for Payer: Allwell Medicaid $21,881.58
Rate for Payer: AZCH Complete Medicaid $21,881.58
Rate for Payer: Banner UC Health Medicaid $21,881.58
Rate for Payer: Mercy Care Medicaid $21,881.58
Service Code APR-DRG 8902
Hospital Charge Code APRDRG8903
Min. Negotiated Rate $6,368.71
Max. Negotiated Rate $6,368.71
Rate for Payer: AHCCCS Medicaid $6,368.71
Rate for Payer: Allwell Medicaid $6,368.71
Rate for Payer: AZCH Complete Medicaid $6,368.71
Rate for Payer: Banner UC Health Medicaid $6,368.71
Rate for Payer: Mercy Care Medicaid $6,368.71
Service Code APR-DRG 8903
Hospital Charge Code APRDRG8901
Min. Negotiated Rate $10,661.28
Max. Negotiated Rate $10,661.28
Rate for Payer: AHCCCS Medicaid $10,661.28
Rate for Payer: Allwell Medicaid $10,661.28
Rate for Payer: AZCH Complete Medicaid $10,661.28
Rate for Payer: Banner UC Health Medicaid $10,661.28
Rate for Payer: Mercy Care Medicaid $10,661.28
Service Code APR-DRG 8903
Hospital Charge Code APRDRG8903
Min. Negotiated Rate $10,661.28
Max. Negotiated Rate $10,661.28
Rate for Payer: AHCCCS Medicaid $10,661.28
Rate for Payer: Allwell Medicaid $10,661.28
Rate for Payer: AZCH Complete Medicaid $10,661.28
Rate for Payer: Banner UC Health Medicaid $10,661.28
Rate for Payer: Mercy Care Medicaid $10,661.28
Service Code APR-DRG 8902
Hospital Charge Code APRDRG8902
Min. Negotiated Rate $6,368.71
Max. Negotiated Rate $6,368.71
Rate for Payer: AHCCCS Medicaid $6,368.71
Rate for Payer: Allwell Medicaid $6,368.71
Rate for Payer: AZCH Complete Medicaid $6,368.71
Rate for Payer: Banner UC Health Medicaid $6,368.71
Rate for Payer: Mercy Care Medicaid $6,368.71
Service Code APR-DRG 8901
Hospital Charge Code APRDRG8902
Min. Negotiated Rate $5,891.76
Max. Negotiated Rate $5,891.76
Rate for Payer: AHCCCS Medicaid $5,891.76
Rate for Payer: Allwell Medicaid $5,891.76
Rate for Payer: AZCH Complete Medicaid $5,891.76
Rate for Payer: Banner UC Health Medicaid $5,891.76
Rate for Payer: Mercy Care Medicaid $5,891.76
Service Code APR-DRG 8903
Hospital Charge Code APRDRG8904
Min. Negotiated Rate $10,661.28
Max. Negotiated Rate $10,661.28
Rate for Payer: AHCCCS Medicaid $10,661.28
Rate for Payer: Allwell Medicaid $10,661.28
Rate for Payer: AZCH Complete Medicaid $10,661.28
Rate for Payer: Banner UC Health Medicaid $10,661.28
Rate for Payer: Mercy Care Medicaid $10,661.28
Service Code APR-DRG 8901
Hospital Charge Code APRDRG8903
Min. Negotiated Rate $5,891.76
Max. Negotiated Rate $5,891.76
Rate for Payer: AHCCCS Medicaid $5,891.76
Rate for Payer: Allwell Medicaid $5,891.76
Rate for Payer: AZCH Complete Medicaid $5,891.76
Rate for Payer: Banner UC Health Medicaid $5,891.76
Rate for Payer: Mercy Care Medicaid $5,891.76
Service Code APR-DRG 8903
Hospital Charge Code APRDRG8902
Min. Negotiated Rate $10,661.28
Max. Negotiated Rate $10,661.28
Rate for Payer: AHCCCS Medicaid $10,661.28
Rate for Payer: Allwell Medicaid $10,661.28
Rate for Payer: AZCH Complete Medicaid $10,661.28
Rate for Payer: Banner UC Health Medicaid $10,661.28
Rate for Payer: Mercy Care Medicaid $10,661.28
Service Code APR-DRG 8931
Hospital Charge Code APRDRG8933
Min. Negotiated Rate $4,080.04
Max. Negotiated Rate $4,080.04
Rate for Payer: AHCCCS Medicaid $4,080.04
Rate for Payer: Allwell Medicaid $4,080.04
Rate for Payer: AZCH Complete Medicaid $4,080.04
Rate for Payer: Banner UC Health Medicaid $4,080.04
Rate for Payer: Mercy Care Medicaid $4,080.04
Service Code APR-DRG 8933
Hospital Charge Code APRDRG8932
Min. Negotiated Rate $8,735.94
Max. Negotiated Rate $8,735.94
Rate for Payer: AHCCCS Medicaid $8,735.94
Rate for Payer: Allwell Medicaid $8,735.94
Rate for Payer: AZCH Complete Medicaid $8,735.94
Rate for Payer: Banner UC Health Medicaid $8,735.94
Rate for Payer: Mercy Care Medicaid $8,735.94
Service Code APR-DRG 8934
Hospital Charge Code APRDRG8931
Min. Negotiated Rate $12,978.71
Max. Negotiated Rate $12,978.71
Rate for Payer: AHCCCS Medicaid $12,978.71
Rate for Payer: Allwell Medicaid $12,978.71
Rate for Payer: AZCH Complete Medicaid $12,978.71
Rate for Payer: Banner UC Health Medicaid $12,978.71
Rate for Payer: Mercy Care Medicaid $12,978.71
Service Code APR-DRG 8931
Hospital Charge Code APRDRG8934
Min. Negotiated Rate $4,080.04
Max. Negotiated Rate $4,080.04
Rate for Payer: AHCCCS Medicaid $4,080.04
Rate for Payer: Allwell Medicaid $4,080.04
Rate for Payer: AZCH Complete Medicaid $4,080.04
Rate for Payer: Banner UC Health Medicaid $4,080.04
Rate for Payer: Mercy Care Medicaid $4,080.04
Service Code APR-DRG 8933
Hospital Charge Code APRDRG8934
Min. Negotiated Rate $8,735.94
Max. Negotiated Rate $8,735.94
Rate for Payer: AHCCCS Medicaid $8,735.94
Rate for Payer: Allwell Medicaid $8,735.94
Rate for Payer: AZCH Complete Medicaid $8,735.94
Rate for Payer: Banner UC Health Medicaid $8,735.94
Rate for Payer: Mercy Care Medicaid $8,735.94
Service Code APR-DRG 8932
Hospital Charge Code APRDRG8934
Min. Negotiated Rate $5,884.04
Max. Negotiated Rate $5,884.04
Rate for Payer: AHCCCS Medicaid $5,884.04
Rate for Payer: Allwell Medicaid $5,884.04
Rate for Payer: AZCH Complete Medicaid $5,884.04
Rate for Payer: Banner UC Health Medicaid $5,884.04
Rate for Payer: Mercy Care Medicaid $5,884.04
Service Code APR-DRG 8932
Hospital Charge Code APRDRG8932
Min. Negotiated Rate $5,884.04
Max. Negotiated Rate $5,884.04
Rate for Payer: AHCCCS Medicaid $5,884.04
Rate for Payer: Allwell Medicaid $5,884.04
Rate for Payer: AZCH Complete Medicaid $5,884.04
Rate for Payer: Banner UC Health Medicaid $5,884.04
Rate for Payer: Mercy Care Medicaid $5,884.04