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Charge Type Setting Price  
Service Code APR-DRG 2481
Hospital Charge Code APRDRG2482
Min. Negotiated Rate $3,445.98
Max. Negotiated Rate $3,445.98
Rate for Payer: AHCCCS Medicaid $3,445.98
Rate for Payer: Allwell Medicaid $3,445.98
Rate for Payer: AZCH Complete Medicaid $3,445.98
Rate for Payer: Banner UC Health Medicaid $3,445.98
Rate for Payer: Mercy Care Medicaid $3,445.98
Service Code APR-DRG 2482
Hospital Charge Code APRDRG2481
Min. Negotiated Rate $4,683.95
Max. Negotiated Rate $4,683.95
Rate for Payer: AHCCCS Medicaid $4,683.95
Rate for Payer: Allwell Medicaid $4,683.95
Rate for Payer: AZCH Complete Medicaid $4,683.95
Rate for Payer: Banner UC Health Medicaid $4,683.95
Rate for Payer: Mercy Care Medicaid $4,683.95
Service Code APR-DRG 2484
Hospital Charge Code APRDRG2483
Min. Negotiated Rate $13,927.00
Max. Negotiated Rate $13,927.00
Rate for Payer: AHCCCS Medicaid $13,927.00
Rate for Payer: Allwell Medicaid $13,927.00
Rate for Payer: AZCH Complete Medicaid $13,927.00
Rate for Payer: Banner UC Health Medicaid $13,927.00
Rate for Payer: Mercy Care Medicaid $13,927.00
Service Code APR-DRG 6602
Hospital Charge Code APRDRG6603
Min. Negotiated Rate $5,365.71
Max. Negotiated Rate $5,365.71
Rate for Payer: AHCCCS Medicaid $5,365.71
Rate for Payer: Allwell Medicaid $5,365.71
Rate for Payer: AZCH Complete Medicaid $5,365.71
Rate for Payer: Banner UC Health Medicaid $5,365.71
Rate for Payer: Mercy Care Medicaid $5,365.71
Service Code APR-DRG 6602
Hospital Charge Code APRDRG6604
Min. Negotiated Rate $5,365.71
Max. Negotiated Rate $5,365.71
Rate for Payer: AHCCCS Medicaid $5,365.71
Rate for Payer: Allwell Medicaid $5,365.71
Rate for Payer: AZCH Complete Medicaid $5,365.71
Rate for Payer: Banner UC Health Medicaid $5,365.71
Rate for Payer: Mercy Care Medicaid $5,365.71
Service Code APR-DRG 6601
Hospital Charge Code APRDRG6602
Min. Negotiated Rate $4,660.10
Max. Negotiated Rate $4,660.10
Rate for Payer: AHCCCS Medicaid $4,660.10
Rate for Payer: Allwell Medicaid $4,660.10
Rate for Payer: AZCH Complete Medicaid $4,660.10
Rate for Payer: Banner UC Health Medicaid $4,660.10
Rate for Payer: Mercy Care Medicaid $4,660.10
Service Code APR-DRG 6601
Hospital Charge Code APRDRG6601
Min. Negotiated Rate $4,660.10
Max. Negotiated Rate $4,660.10
Rate for Payer: AHCCCS Medicaid $4,660.10
Rate for Payer: Allwell Medicaid $4,660.10
Rate for Payer: AZCH Complete Medicaid $4,660.10
Rate for Payer: Banner UC Health Medicaid $4,660.10
Rate for Payer: Mercy Care Medicaid $4,660.10
Service Code APR-DRG 6602
Hospital Charge Code APRDRG6602
Min. Negotiated Rate $5,365.71
Max. Negotiated Rate $5,365.71
Rate for Payer: AHCCCS Medicaid $5,365.71
Rate for Payer: Allwell Medicaid $5,365.71
Rate for Payer: AZCH Complete Medicaid $5,365.71
Rate for Payer: Banner UC Health Medicaid $5,365.71
Rate for Payer: Mercy Care Medicaid $5,365.71
Service Code APR-DRG 6604
Hospital Charge Code APRDRG6601
Min. Negotiated Rate $24,310.52
Max. Negotiated Rate $24,310.52
Rate for Payer: AHCCCS Medicaid $24,310.52
Rate for Payer: Allwell Medicaid $24,310.52
Rate for Payer: AZCH Complete Medicaid $24,310.52
Rate for Payer: Banner UC Health Medicaid $24,310.52
Rate for Payer: Mercy Care Medicaid $24,310.52
Service Code APR-DRG 6602
Hospital Charge Code APRDRG6601
Min. Negotiated Rate $5,365.71
Max. Negotiated Rate $5,365.71
Rate for Payer: AHCCCS Medicaid $5,365.71
Rate for Payer: Allwell Medicaid $5,365.71
Rate for Payer: AZCH Complete Medicaid $5,365.71
Rate for Payer: Banner UC Health Medicaid $5,365.71
Rate for Payer: Mercy Care Medicaid $5,365.71
Service Code APR-DRG 6604
Hospital Charge Code APRDRG6602
Min. Negotiated Rate $24,310.52
Max. Negotiated Rate $24,310.52
Rate for Payer: AHCCCS Medicaid $24,310.52
Rate for Payer: Allwell Medicaid $24,310.52
Rate for Payer: AZCH Complete Medicaid $24,310.52
Rate for Payer: Banner UC Health Medicaid $24,310.52
Rate for Payer: Mercy Care Medicaid $24,310.52
Service Code APR-DRG 6601
Hospital Charge Code APRDRG6604
Min. Negotiated Rate $4,660.10
Max. Negotiated Rate $4,660.10
Rate for Payer: AHCCCS Medicaid $4,660.10
Rate for Payer: Allwell Medicaid $4,660.10
Rate for Payer: AZCH Complete Medicaid $4,660.10
Rate for Payer: Banner UC Health Medicaid $4,660.10
Rate for Payer: Mercy Care Medicaid $4,660.10
Service Code APR-DRG 6604
Hospital Charge Code APRDRG6604
Min. Negotiated Rate $24,310.52
Max. Negotiated Rate $24,310.52
Rate for Payer: AHCCCS Medicaid $24,310.52
Rate for Payer: Allwell Medicaid $24,310.52
Rate for Payer: AZCH Complete Medicaid $24,310.52
Rate for Payer: Banner UC Health Medicaid $24,310.52
Rate for Payer: Mercy Care Medicaid $24,310.52
Service Code APR-DRG 6603
Hospital Charge Code APRDRG6603
Min. Negotiated Rate $9,175.71
Max. Negotiated Rate $9,175.71
Rate for Payer: AHCCCS Medicaid $9,175.71
Rate for Payer: Allwell Medicaid $9,175.71
Rate for Payer: AZCH Complete Medicaid $9,175.71
Rate for Payer: Banner UC Health Medicaid $9,175.71
Rate for Payer: Mercy Care Medicaid $9,175.71
Service Code APR-DRG 6604
Hospital Charge Code APRDRG6603
Min. Negotiated Rate $24,310.52
Max. Negotiated Rate $24,310.52
Rate for Payer: AHCCCS Medicaid $24,310.52
Rate for Payer: Allwell Medicaid $24,310.52
Rate for Payer: AZCH Complete Medicaid $24,310.52
Rate for Payer: Banner UC Health Medicaid $24,310.52
Rate for Payer: Mercy Care Medicaid $24,310.52
Service Code APR-DRG 6603
Hospital Charge Code APRDRG6604
Min. Negotiated Rate $9,175.71
Max. Negotiated Rate $9,175.71
Rate for Payer: AHCCCS Medicaid $9,175.71
Rate for Payer: Allwell Medicaid $9,175.71
Rate for Payer: AZCH Complete Medicaid $9,175.71
Rate for Payer: Banner UC Health Medicaid $9,175.71
Rate for Payer: Mercy Care Medicaid $9,175.71
Service Code APR-DRG 6603
Hospital Charge Code APRDRG6602
Min. Negotiated Rate $9,175.71
Max. Negotiated Rate $9,175.71
Rate for Payer: AHCCCS Medicaid $9,175.71
Rate for Payer: Allwell Medicaid $9,175.71
Rate for Payer: AZCH Complete Medicaid $9,175.71
Rate for Payer: Banner UC Health Medicaid $9,175.71
Rate for Payer: Mercy Care Medicaid $9,175.71
Service Code APR-DRG 6603
Hospital Charge Code APRDRG6601
Min. Negotiated Rate $9,175.71
Max. Negotiated Rate $9,175.71
Rate for Payer: AHCCCS Medicaid $9,175.71
Rate for Payer: Allwell Medicaid $9,175.71
Rate for Payer: AZCH Complete Medicaid $9,175.71
Rate for Payer: Banner UC Health Medicaid $9,175.71
Rate for Payer: Mercy Care Medicaid $9,175.71
Service Code APR-DRG 6601
Hospital Charge Code APRDRG6603
Min. Negotiated Rate $4,660.10
Max. Negotiated Rate $4,660.10
Rate for Payer: AHCCCS Medicaid $4,660.10
Rate for Payer: Allwell Medicaid $4,660.10
Rate for Payer: AZCH Complete Medicaid $4,660.10
Rate for Payer: Banner UC Health Medicaid $4,660.10
Rate for Payer: Mercy Care Medicaid $4,660.10
Service Code APR-DRG 2311
Hospital Charge Code APRDRG2311
Min. Negotiated Rate $9,038.24
Max. Negotiated Rate $9,038.24
Rate for Payer: AHCCCS Medicaid $9,038.24
Rate for Payer: Allwell Medicaid $9,038.24
Rate for Payer: AZCH Complete Medicaid $9,038.24
Rate for Payer: Banner UC Health Medicaid $9,038.24
Rate for Payer: Mercy Care Medicaid $9,038.24
Service Code APR-DRG 2313
Hospital Charge Code APRDRG2312
Min. Negotiated Rate $17,794.52
Max. Negotiated Rate $17,794.52
Rate for Payer: AHCCCS Medicaid $17,794.52
Rate for Payer: Allwell Medicaid $17,794.52
Rate for Payer: AZCH Complete Medicaid $17,794.52
Rate for Payer: Banner UC Health Medicaid $17,794.52
Rate for Payer: Mercy Care Medicaid $17,794.52
Service Code APR-DRG 2314
Hospital Charge Code APRDRG2312
Min. Negotiated Rate $30,310.30
Max. Negotiated Rate $30,310.30
Rate for Payer: AHCCCS Medicaid $30,310.30
Rate for Payer: Allwell Medicaid $30,310.30
Rate for Payer: AZCH Complete Medicaid $30,310.30
Rate for Payer: Banner UC Health Medicaid $30,310.30
Rate for Payer: Mercy Care Medicaid $30,310.30
Service Code APR-DRG 2314
Hospital Charge Code APRDRG2314
Min. Negotiated Rate $30,310.30
Max. Negotiated Rate $30,310.30
Rate for Payer: AHCCCS Medicaid $30,310.30
Rate for Payer: Allwell Medicaid $30,310.30
Rate for Payer: AZCH Complete Medicaid $30,310.30
Rate for Payer: Banner UC Health Medicaid $30,310.30
Rate for Payer: Mercy Care Medicaid $30,310.30
Service Code APR-DRG 2312
Hospital Charge Code APRDRG2314
Min. Negotiated Rate $11,551.36
Max. Negotiated Rate $11,551.36
Rate for Payer: AHCCCS Medicaid $11,551.36
Rate for Payer: Allwell Medicaid $11,551.36
Rate for Payer: AZCH Complete Medicaid $11,551.36
Rate for Payer: Banner UC Health Medicaid $11,551.36
Rate for Payer: Mercy Care Medicaid $11,551.36
Service Code APR-DRG 2311
Hospital Charge Code APRDRG2314
Min. Negotiated Rate $9,038.24
Max. Negotiated Rate $9,038.24
Rate for Payer: AHCCCS Medicaid $9,038.24
Rate for Payer: Allwell Medicaid $9,038.24
Rate for Payer: AZCH Complete Medicaid $9,038.24
Rate for Payer: Banner UC Health Medicaid $9,038.24
Rate for Payer: Mercy Care Medicaid $9,038.24