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Charge Type Setting Price  
Service Code APR-DRG 4412
Hospital Charge Code APRDRG4413
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
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 APRDRG4414
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
Service Code APR-DRG 4413
Hospital Charge Code APRDRG4413
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 APRDRG4411
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 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 1604
Hospital Charge Code APRDRG1601
Min. Negotiated Rate $75,687.37
Max. Negotiated Rate $75,687.37
Rate for Payer: AHCCCS Medicaid $75,687.37
Rate for Payer: Allwell Medicaid $75,687.37
Rate for Payer: AZCH Complete Medicaid $75,687.37
Rate for Payer: Banner UC Health Medicaid $75,687.37
Rate for Payer: Mercy Care Medicaid $75,687.37
Service Code APR-DRG 1602
Hospital Charge Code APRDRG1603
Min. Negotiated Rate $26,470.84
Max. Negotiated Rate $26,470.84
Rate for Payer: AHCCCS Medicaid $26,470.84
Rate for Payer: Allwell Medicaid $26,470.84
Rate for Payer: AZCH Complete Medicaid $26,470.84
Rate for Payer: Banner UC Health Medicaid $26,470.84
Rate for Payer: Mercy Care Medicaid $26,470.84
Service Code APR-DRG 1603
Hospital Charge Code APRDRG1602
Min. Negotiated Rate $35,903.96
Max. Negotiated Rate $35,903.96
Rate for Payer: AHCCCS Medicaid $35,903.96
Rate for Payer: Allwell Medicaid $35,903.96
Rate for Payer: AZCH Complete Medicaid $35,903.96
Rate for Payer: Banner UC Health Medicaid $35,903.96
Rate for Payer: Mercy Care Medicaid $35,903.96
Service Code APR-DRG 1604
Hospital Charge Code APRDRG1604
Min. Negotiated Rate $75,687.37
Max. Negotiated Rate $75,687.37
Rate for Payer: AHCCCS Medicaid $75,687.37
Rate for Payer: Allwell Medicaid $75,687.37
Rate for Payer: AZCH Complete Medicaid $75,687.37
Rate for Payer: Banner UC Health Medicaid $75,687.37
Rate for Payer: Mercy Care Medicaid $75,687.37
Service Code APR-DRG 1602
Hospital Charge Code APRDRG1604
Min. Negotiated Rate $26,470.84
Max. Negotiated Rate $26,470.84
Rate for Payer: AHCCCS Medicaid $26,470.84
Rate for Payer: Allwell Medicaid $26,470.84
Rate for Payer: AZCH Complete Medicaid $26,470.84
Rate for Payer: Banner UC Health Medicaid $26,470.84
Rate for Payer: Mercy Care Medicaid $26,470.84
Service Code APR-DRG 1604
Hospital Charge Code APRDRG1602
Min. Negotiated Rate $75,687.37
Max. Negotiated Rate $75,687.37
Rate for Payer: AHCCCS Medicaid $75,687.37
Rate for Payer: Allwell Medicaid $75,687.37
Rate for Payer: AZCH Complete Medicaid $75,687.37
Rate for Payer: Banner UC Health Medicaid $75,687.37
Rate for Payer: Mercy Care Medicaid $75,687.37
Service Code APR-DRG 1602
Hospital Charge Code APRDRG1602
Min. Negotiated Rate $26,470.84
Max. Negotiated Rate $26,470.84
Rate for Payer: AHCCCS Medicaid $26,470.84
Rate for Payer: Allwell Medicaid $26,470.84
Rate for Payer: AZCH Complete Medicaid $26,470.84
Rate for Payer: Banner UC Health Medicaid $26,470.84
Rate for Payer: Mercy Care Medicaid $26,470.84
Service Code APR-DRG 1601
Hospital Charge Code APRDRG1602
Min. Negotiated Rate $22,453.92
Max. Negotiated Rate $22,453.92
Rate for Payer: AHCCCS Medicaid $22,453.92
Rate for Payer: Allwell Medicaid $22,453.92
Rate for Payer: AZCH Complete Medicaid $22,453.92
Rate for Payer: Banner UC Health Medicaid $22,453.92
Rate for Payer: Mercy Care Medicaid $22,453.92
Service Code APR-DRG 1604
Hospital Charge Code APRDRG1603
Min. Negotiated Rate $75,687.37
Max. Negotiated Rate $75,687.37
Rate for Payer: AHCCCS Medicaid $75,687.37
Rate for Payer: Allwell Medicaid $75,687.37
Rate for Payer: AZCH Complete Medicaid $75,687.37
Rate for Payer: Banner UC Health Medicaid $75,687.37
Rate for Payer: Mercy Care Medicaid $75,687.37
Service Code APR-DRG 1601
Hospital Charge Code APRDRG1601
Min. Negotiated Rate $22,453.92
Max. Negotiated Rate $22,453.92
Rate for Payer: AHCCCS Medicaid $22,453.92
Rate for Payer: Allwell Medicaid $22,453.92
Rate for Payer: AZCH Complete Medicaid $22,453.92
Rate for Payer: Banner UC Health Medicaid $22,453.92
Rate for Payer: Mercy Care Medicaid $22,453.92
Service Code APR-DRG 1601
Hospital Charge Code APRDRG1604
Min. Negotiated Rate $22,453.92
Max. Negotiated Rate $22,453.92
Rate for Payer: AHCCCS Medicaid $22,453.92
Rate for Payer: Allwell Medicaid $22,453.92
Rate for Payer: AZCH Complete Medicaid $22,453.92
Rate for Payer: Banner UC Health Medicaid $22,453.92
Rate for Payer: Mercy Care Medicaid $22,453.92
Service Code APR-DRG 1603
Hospital Charge Code APRDRG1601
Min. Negotiated Rate $35,903.96
Max. Negotiated Rate $35,903.96
Rate for Payer: AHCCCS Medicaid $35,903.96
Rate for Payer: Allwell Medicaid $35,903.96
Rate for Payer: AZCH Complete Medicaid $35,903.96
Rate for Payer: Banner UC Health Medicaid $35,903.96
Rate for Payer: Mercy Care Medicaid $35,903.96
Service Code APR-DRG 1601
Hospital Charge Code APRDRG1603
Min. Negotiated Rate $22,453.92
Max. Negotiated Rate $22,453.92
Rate for Payer: AHCCCS Medicaid $22,453.92
Rate for Payer: Allwell Medicaid $22,453.92
Rate for Payer: AZCH Complete Medicaid $22,453.92
Rate for Payer: Banner UC Health Medicaid $22,453.92
Rate for Payer: Mercy Care Medicaid $22,453.92
Service Code APR-DRG 1602
Hospital Charge Code APRDRG1601
Min. Negotiated Rate $26,470.84
Max. Negotiated Rate $26,470.84
Rate for Payer: AHCCCS Medicaid $26,470.84
Rate for Payer: Allwell Medicaid $26,470.84
Rate for Payer: AZCH Complete Medicaid $26,470.84
Rate for Payer: Banner UC Health Medicaid $26,470.84
Rate for Payer: Mercy Care Medicaid $26,470.84
Service Code APR-DRG 1603
Hospital Charge Code APRDRG1604
Min. Negotiated Rate $35,903.96
Max. Negotiated Rate $35,903.96
Rate for Payer: AHCCCS Medicaid $35,903.96
Rate for Payer: Allwell Medicaid $35,903.96
Rate for Payer: AZCH Complete Medicaid $35,903.96
Rate for Payer: Banner UC Health Medicaid $35,903.96
Rate for Payer: Mercy Care Medicaid $35,903.96
Service Code APR-DRG 1603
Hospital Charge Code APRDRG1603
Min. Negotiated Rate $35,903.96
Max. Negotiated Rate $35,903.96
Rate for Payer: AHCCCS Medicaid $35,903.96
Rate for Payer: Allwell Medicaid $35,903.96
Rate for Payer: AZCH Complete Medicaid $35,903.96
Rate for Payer: Banner UC Health Medicaid $35,903.96
Rate for Payer: Mercy Care Medicaid $35,903.96
Service Code APR-DRG 1351
Hospital Charge Code APRDRG1351
Min. Negotiated Rate $4,835.45
Max. Negotiated Rate $4,835.45
Rate for Payer: AHCCCS Medicaid $4,835.45
Rate for Payer: Allwell Medicaid $4,835.45
Rate for Payer: AZCH Complete Medicaid $4,835.45
Rate for Payer: Banner UC Health Medicaid $4,835.45
Rate for Payer: Mercy Care Medicaid $4,835.45
Service Code APR-DRG 1351
Hospital Charge Code APRDRG1354
Min. Negotiated Rate $4,835.45
Max. Negotiated Rate $4,835.45
Rate for Payer: AHCCCS Medicaid $4,835.45
Rate for Payer: Allwell Medicaid $4,835.45
Rate for Payer: AZCH Complete Medicaid $4,835.45
Rate for Payer: Banner UC Health Medicaid $4,835.45
Rate for Payer: Mercy Care Medicaid $4,835.45