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Charge Type Setting Price  
Service Code APR-DRG 2611
Hospital Charge Code APRDRG2613
Min. Negotiated Rate $9,297.06
Max. Negotiated Rate $9,297.06
Rate for Payer: AHCCCS Medicaid $9,297.06
Rate for Payer: Allwell Medicaid $9,297.06
Rate for Payer: AZCH Complete Medicaid $9,297.06
Rate for Payer: Banner UC Health Medicaid $9,297.06
Rate for Payer: Mercy Care Medicaid $9,297.06
Service Code APR-DRG 2614
Hospital Charge Code APRDRG2612
Min. Negotiated Rate $37,024.10
Max. Negotiated Rate $37,024.10
Rate for Payer: AHCCCS Medicaid $37,024.10
Rate for Payer: Allwell Medicaid $37,024.10
Rate for Payer: AZCH Complete Medicaid $37,024.10
Rate for Payer: Banner UC Health Medicaid $37,024.10
Rate for Payer: Mercy Care Medicaid $37,024.10
Service Code APR-DRG 2614
Hospital Charge Code APRDRG2611
Min. Negotiated Rate $37,024.10
Max. Negotiated Rate $37,024.10
Rate for Payer: AHCCCS Medicaid $37,024.10
Rate for Payer: Allwell Medicaid $37,024.10
Rate for Payer: AZCH Complete Medicaid $37,024.10
Rate for Payer: Banner UC Health Medicaid $37,024.10
Rate for Payer: Mercy Care Medicaid $37,024.10
Service Code APR-DRG 2612
Hospital Charge Code APRDRG2612
Min. Negotiated Rate $12,884.72
Max. Negotiated Rate $12,884.72
Rate for Payer: AHCCCS Medicaid $12,884.72
Rate for Payer: Allwell Medicaid $12,884.72
Rate for Payer: AZCH Complete Medicaid $12,884.72
Rate for Payer: Banner UC Health Medicaid $12,884.72
Rate for Payer: Mercy Care Medicaid $12,884.72
Service Code APR-DRG 2613
Hospital Charge Code APRDRG2613
Min. Negotiated Rate $19,266.76
Max. Negotiated Rate $19,266.76
Rate for Payer: AHCCCS Medicaid $19,266.76
Rate for Payer: Allwell Medicaid $19,266.76
Rate for Payer: AZCH Complete Medicaid $19,266.76
Rate for Payer: Banner UC Health Medicaid $19,266.76
Rate for Payer: Mercy Care Medicaid $19,266.76
Service Code APR-DRG 2612
Hospital Charge Code APRDRG2613
Min. Negotiated Rate $12,884.72
Max. Negotiated Rate $12,884.72
Rate for Payer: AHCCCS Medicaid $12,884.72
Rate for Payer: Allwell Medicaid $12,884.72
Rate for Payer: AZCH Complete Medicaid $12,884.72
Rate for Payer: Banner UC Health Medicaid $12,884.72
Rate for Payer: Mercy Care Medicaid $12,884.72
Service Code APR-DRG 2611
Hospital Charge Code APRDRG2611
Min. Negotiated Rate $9,297.06
Max. Negotiated Rate $9,297.06
Rate for Payer: AHCCCS Medicaid $9,297.06
Rate for Payer: Allwell Medicaid $9,297.06
Rate for Payer: AZCH Complete Medicaid $9,297.06
Rate for Payer: Banner UC Health Medicaid $9,297.06
Rate for Payer: Mercy Care Medicaid $9,297.06
Service Code APR-DRG 2614
Hospital Charge Code APRDRG2613
Min. Negotiated Rate $37,024.10
Max. Negotiated Rate $37,024.10
Rate for Payer: AHCCCS Medicaid $37,024.10
Rate for Payer: Allwell Medicaid $37,024.10
Rate for Payer: AZCH Complete Medicaid $37,024.10
Rate for Payer: Banner UC Health Medicaid $37,024.10
Rate for Payer: Mercy Care Medicaid $37,024.10
Service Code APR-DRG 2612
Hospital Charge Code APRDRG2614
Min. Negotiated Rate $12,884.72
Max. Negotiated Rate $12,884.72
Rate for Payer: AHCCCS Medicaid $12,884.72
Rate for Payer: Allwell Medicaid $12,884.72
Rate for Payer: AZCH Complete Medicaid $12,884.72
Rate for Payer: Banner UC Health Medicaid $12,884.72
Rate for Payer: Mercy Care Medicaid $12,884.72
Service Code APR-DRG 2611
Hospital Charge Code APRDRG2614
Min. Negotiated Rate $9,297.06
Max. Negotiated Rate $9,297.06
Rate for Payer: AHCCCS Medicaid $9,297.06
Rate for Payer: Allwell Medicaid $9,297.06
Rate for Payer: AZCH Complete Medicaid $9,297.06
Rate for Payer: Banner UC Health Medicaid $9,297.06
Rate for Payer: Mercy Care Medicaid $9,297.06
Service Code APR-DRG 2614
Hospital Charge Code APRDRG2614
Min. Negotiated Rate $37,024.10
Max. Negotiated Rate $37,024.10
Rate for Payer: AHCCCS Medicaid $37,024.10
Rate for Payer: Allwell Medicaid $37,024.10
Rate for Payer: AZCH Complete Medicaid $37,024.10
Rate for Payer: Banner UC Health Medicaid $37,024.10
Rate for Payer: Mercy Care Medicaid $37,024.10
Service Code APR-DRG 2613
Hospital Charge Code APRDRG2611
Min. Negotiated Rate $19,266.76
Max. Negotiated Rate $19,266.76
Rate for Payer: AHCCCS Medicaid $19,266.76
Rate for Payer: Allwell Medicaid $19,266.76
Rate for Payer: AZCH Complete Medicaid $19,266.76
Rate for Payer: Banner UC Health Medicaid $19,266.76
Rate for Payer: Mercy Care Medicaid $19,266.76
Service Code APR-DRG 2612
Hospital Charge Code APRDRG2611
Min. Negotiated Rate $12,884.72
Max. Negotiated Rate $12,884.72
Rate for Payer: AHCCCS Medicaid $12,884.72
Rate for Payer: Allwell Medicaid $12,884.72
Rate for Payer: AZCH Complete Medicaid $12,884.72
Rate for Payer: Banner UC Health Medicaid $12,884.72
Rate for Payer: Mercy Care Medicaid $12,884.72
Service Code APR-DRG 2611
Hospital Charge Code APRDRG2612
Min. Negotiated Rate $9,297.06
Max. Negotiated Rate $9,297.06
Rate for Payer: AHCCCS Medicaid $9,297.06
Rate for Payer: Allwell Medicaid $9,297.06
Rate for Payer: AZCH Complete Medicaid $9,297.06
Rate for Payer: Banner UC Health Medicaid $9,297.06
Rate for Payer: Mercy Care Medicaid $9,297.06
Service Code APR-DRG 2613
Hospital Charge Code APRDRG2612
Min. Negotiated Rate $19,266.76
Max. Negotiated Rate $19,266.76
Rate for Payer: AHCCCS Medicaid $19,266.76
Rate for Payer: Allwell Medicaid $19,266.76
Rate for Payer: AZCH Complete Medicaid $19,266.76
Rate for Payer: Banner UC Health Medicaid $19,266.76
Rate for Payer: Mercy Care Medicaid $19,266.76
Service Code APR-DRG 2613
Hospital Charge Code APRDRG2614
Min. Negotiated Rate $19,266.76
Max. Negotiated Rate $19,266.76
Rate for Payer: AHCCCS Medicaid $19,266.76
Rate for Payer: Allwell Medicaid $19,266.76
Rate for Payer: AZCH Complete Medicaid $19,266.76
Rate for Payer: Banner UC Health Medicaid $19,266.76
Rate for Payer: Mercy Care Medicaid $19,266.76
Service Code APR-DRG 4413
Hospital Charge Code APRDRG4411
Min. Negotiated Rate $18,918.16
Max. Negotiated Rate $18,918.16
Rate for Payer: AHCCCS Medicaid $18,918.16
Rate for Payer: Allwell Medicaid $18,918.16
Rate for Payer: AZCH Complete Medicaid $18,918.16
Rate for Payer: Banner UC Health Medicaid $18,918.16
Rate for Payer: Mercy Care Medicaid $18,918.16
Service Code APR-DRG 4411
Hospital Charge Code APRDRG4414
Min. Negotiated Rate $9,977.42
Max. Negotiated Rate $9,977.42
Rate for Payer: AHCCCS Medicaid $9,977.42
Rate for Payer: Allwell Medicaid $9,977.42
Rate for Payer: AZCH Complete Medicaid $9,977.42
Rate for Payer: Banner UC Health Medicaid $9,977.42
Rate for Payer: Mercy Care Medicaid $9,977.42
Service Code APR-DRG 4414
Hospital Charge Code APRDRG4414
Min. Negotiated Rate $39,319.78
Max. Negotiated Rate $39,319.78
Rate for Payer: AHCCCS Medicaid $39,319.78
Rate for Payer: Allwell Medicaid $39,319.78
Rate for Payer: AZCH Complete Medicaid $39,319.78
Rate for Payer: Banner UC Health Medicaid $39,319.78
Rate for Payer: Mercy Care Medicaid $39,319.78
Service Code APR-DRG 4413
Hospital Charge Code APRDRG4414
Min. Negotiated Rate $18,918.16
Max. Negotiated Rate $18,918.16
Rate for Payer: AHCCCS Medicaid $18,918.16
Rate for Payer: Allwell Medicaid $18,918.16
Rate for Payer: AZCH Complete Medicaid $18,918.16
Rate for Payer: Banner UC Health Medicaid $18,918.16
Rate for Payer: Mercy Care Medicaid $18,918.16
Service Code APR-DRG 4411
Hospital Charge Code APRDRG4412
Min. Negotiated Rate $9,977.42
Max. Negotiated Rate $9,977.42
Rate for Payer: AHCCCS Medicaid $9,977.42
Rate for Payer: Allwell Medicaid $9,977.42
Rate for Payer: AZCH Complete Medicaid $9,977.42
Rate for Payer: Banner UC Health Medicaid $9,977.42
Rate for Payer: Mercy Care Medicaid $9,977.42
Service Code APR-DRG 4414
Hospital Charge Code APRDRG4412
Min. Negotiated Rate $39,319.78
Max. Negotiated Rate $39,319.78
Rate for Payer: AHCCCS Medicaid $39,319.78
Rate for Payer: Allwell Medicaid $39,319.78
Rate for Payer: AZCH Complete Medicaid $39,319.78
Rate for Payer: Banner UC Health Medicaid $39,319.78
Rate for Payer: Mercy Care Medicaid $39,319.78
Service Code APR-DRG 4414
Hospital Charge Code APRDRG4411
Min. Negotiated Rate $39,319.78
Max. Negotiated Rate $39,319.78
Rate for Payer: AHCCCS Medicaid $39,319.78
Rate for Payer: Allwell Medicaid $39,319.78
Rate for Payer: AZCH Complete Medicaid $39,319.78
Rate for Payer: Banner UC Health Medicaid $39,319.78
Rate for Payer: Mercy Care Medicaid $39,319.78
Service Code APR-DRG 4413
Hospital Charge Code APRDRG4412
Min. Negotiated Rate $18,918.16
Max. Negotiated Rate $18,918.16
Rate for Payer: AHCCCS Medicaid $18,918.16
Rate for Payer: Allwell Medicaid $18,918.16
Rate for Payer: AZCH Complete Medicaid $18,918.16
Rate for Payer: Banner UC Health Medicaid $18,918.16
Rate for Payer: Mercy Care Medicaid $18,918.16
Service Code APR-DRG 4412
Hospital Charge Code APRDRG4411
Min. Negotiated Rate $14,750.44
Max. Negotiated Rate $14,750.44
Rate for Payer: AHCCCS Medicaid $14,750.44
Rate for Payer: Allwell Medicaid $14,750.44
Rate for Payer: AZCH Complete Medicaid $14,750.44
Rate for Payer: Banner UC Health Medicaid $14,750.44
Rate for Payer: Mercy Care Medicaid $14,750.44