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Charge Type Setting Price  
Service Code APR-DRG 4803
Hospital Charge Code APRDRG4804
Min. Negotiated Rate $14,384.31
Max. Negotiated Rate $14,384.31
Rate for Payer: AHCCCS Medicaid $14,384.31
Rate for Payer: Allwell Medicaid $14,384.31
Rate for Payer: AZCH Complete Medicaid $14,384.31
Rate for Payer: Banner UC Health Medicaid $14,384.31
Rate for Payer: Mercy Care Medicaid $14,384.31
Service Code APR-DRG 6803
Hospital Charge Code APRDRG6801
Min. Negotiated Rate $24,020.85
Max. Negotiated Rate $24,020.85
Rate for Payer: AHCCCS Medicaid $24,020.85
Rate for Payer: Allwell Medicaid $24,020.85
Rate for Payer: AZCH Complete Medicaid $24,020.85
Rate for Payer: Banner UC Health Medicaid $24,020.85
Rate for Payer: Mercy Care Medicaid $24,020.85
Service Code APR-DRG 6804
Hospital Charge Code APRDRG6801
Min. Negotiated Rate $51,210.62
Max. Negotiated Rate $51,210.62
Rate for Payer: AHCCCS Medicaid $51,210.62
Rate for Payer: Allwell Medicaid $51,210.62
Rate for Payer: AZCH Complete Medicaid $51,210.62
Rate for Payer: Banner UC Health Medicaid $51,210.62
Rate for Payer: Mercy Care Medicaid $51,210.62
Service Code APR-DRG 6802
Hospital Charge Code APRDRG6802
Min. Negotiated Rate $14,706.96
Max. Negotiated Rate $14,706.96
Rate for Payer: AHCCCS Medicaid $14,706.96
Rate for Payer: Allwell Medicaid $14,706.96
Rate for Payer: AZCH Complete Medicaid $14,706.96
Rate for Payer: Banner UC Health Medicaid $14,706.96
Rate for Payer: Mercy Care Medicaid $14,706.96
Service Code APR-DRG 6801
Hospital Charge Code APRDRG6801
Min. Negotiated Rate $10,380.02
Max. Negotiated Rate $10,380.02
Rate for Payer: AHCCCS Medicaid $10,380.02
Rate for Payer: Allwell Medicaid $10,380.02
Rate for Payer: AZCH Complete Medicaid $10,380.02
Rate for Payer: Banner UC Health Medicaid $10,380.02
Rate for Payer: Mercy Care Medicaid $10,380.02
Service Code APR-DRG 6801
Hospital Charge Code APRDRG6802
Min. Negotiated Rate $10,380.02
Max. Negotiated Rate $10,380.02
Rate for Payer: AHCCCS Medicaid $10,380.02
Rate for Payer: Allwell Medicaid $10,380.02
Rate for Payer: AZCH Complete Medicaid $10,380.02
Rate for Payer: Banner UC Health Medicaid $10,380.02
Rate for Payer: Mercy Care Medicaid $10,380.02
Service Code APR-DRG 6801
Hospital Charge Code APRDRG6804
Min. Negotiated Rate $10,380.02
Max. Negotiated Rate $10,380.02
Rate for Payer: AHCCCS Medicaid $10,380.02
Rate for Payer: Allwell Medicaid $10,380.02
Rate for Payer: AZCH Complete Medicaid $10,380.02
Rate for Payer: Banner UC Health Medicaid $10,380.02
Rate for Payer: Mercy Care Medicaid $10,380.02
Service Code APR-DRG 6802
Hospital Charge Code APRDRG6801
Min. Negotiated Rate $14,706.96
Max. Negotiated Rate $14,706.96
Rate for Payer: AHCCCS Medicaid $14,706.96
Rate for Payer: Allwell Medicaid $14,706.96
Rate for Payer: AZCH Complete Medicaid $14,706.96
Rate for Payer: Banner UC Health Medicaid $14,706.96
Rate for Payer: Mercy Care Medicaid $14,706.96
Service Code APR-DRG 6802
Hospital Charge Code APRDRG6804
Min. Negotiated Rate $14,706.96
Max. Negotiated Rate $14,706.96
Rate for Payer: AHCCCS Medicaid $14,706.96
Rate for Payer: Allwell Medicaid $14,706.96
Rate for Payer: AZCH Complete Medicaid $14,706.96
Rate for Payer: Banner UC Health Medicaid $14,706.96
Rate for Payer: Mercy Care Medicaid $14,706.96
Service Code APR-DRG 6801
Hospital Charge Code APRDRG6803
Min. Negotiated Rate $10,380.02
Max. Negotiated Rate $10,380.02
Rate for Payer: AHCCCS Medicaid $10,380.02
Rate for Payer: Allwell Medicaid $10,380.02
Rate for Payer: AZCH Complete Medicaid $10,380.02
Rate for Payer: Banner UC Health Medicaid $10,380.02
Rate for Payer: Mercy Care Medicaid $10,380.02
Service Code APR-DRG 6804
Hospital Charge Code APRDRG6803
Min. Negotiated Rate $51,210.62
Max. Negotiated Rate $51,210.62
Rate for Payer: AHCCCS Medicaid $51,210.62
Rate for Payer: Allwell Medicaid $51,210.62
Rate for Payer: AZCH Complete Medicaid $51,210.62
Rate for Payer: Banner UC Health Medicaid $51,210.62
Rate for Payer: Mercy Care Medicaid $51,210.62
Service Code APR-DRG 6804
Hospital Charge Code APRDRG6802
Min. Negotiated Rate $51,210.62
Max. Negotiated Rate $51,210.62
Rate for Payer: AHCCCS Medicaid $51,210.62
Rate for Payer: Allwell Medicaid $51,210.62
Rate for Payer: AZCH Complete Medicaid $51,210.62
Rate for Payer: Banner UC Health Medicaid $51,210.62
Rate for Payer: Mercy Care Medicaid $51,210.62
Service Code APR-DRG 6803
Hospital Charge Code APRDRG6804
Min. Negotiated Rate $24,020.85
Max. Negotiated Rate $24,020.85
Rate for Payer: AHCCCS Medicaid $24,020.85
Rate for Payer: Allwell Medicaid $24,020.85
Rate for Payer: AZCH Complete Medicaid $24,020.85
Rate for Payer: Banner UC Health Medicaid $24,020.85
Rate for Payer: Mercy Care Medicaid $24,020.85
Service Code APR-DRG 6803
Hospital Charge Code APRDRG6803
Min. Negotiated Rate $24,020.85
Max. Negotiated Rate $24,020.85
Rate for Payer: AHCCCS Medicaid $24,020.85
Rate for Payer: Allwell Medicaid $24,020.85
Rate for Payer: AZCH Complete Medicaid $24,020.85
Rate for Payer: Banner UC Health Medicaid $24,020.85
Rate for Payer: Mercy Care Medicaid $24,020.85
Service Code APR-DRG 6802
Hospital Charge Code APRDRG6803
Min. Negotiated Rate $14,706.96
Max. Negotiated Rate $14,706.96
Rate for Payer: AHCCCS Medicaid $14,706.96
Rate for Payer: Allwell Medicaid $14,706.96
Rate for Payer: AZCH Complete Medicaid $14,706.96
Rate for Payer: Banner UC Health Medicaid $14,706.96
Rate for Payer: Mercy Care Medicaid $14,706.96
Service Code APR-DRG 6803
Hospital Charge Code APRDRG6802
Min. Negotiated Rate $24,020.85
Max. Negotiated Rate $24,020.85
Rate for Payer: AHCCCS Medicaid $24,020.85
Rate for Payer: Allwell Medicaid $24,020.85
Rate for Payer: AZCH Complete Medicaid $24,020.85
Rate for Payer: Banner UC Health Medicaid $24,020.85
Rate for Payer: Mercy Care Medicaid $24,020.85
Service Code APR-DRG 6804
Hospital Charge Code APRDRG6804
Min. Negotiated Rate $51,210.62
Max. Negotiated Rate $51,210.62
Rate for Payer: AHCCCS Medicaid $51,210.62
Rate for Payer: Allwell Medicaid $51,210.62
Rate for Payer: AZCH Complete Medicaid $51,210.62
Rate for Payer: Banner UC Health Medicaid $51,210.62
Rate for Payer: Mercy Care Medicaid $51,210.62
Service Code APR-DRG 2602
Hospital Charge Code APRDRG2604
Min. Negotiated Rate $15,280.00
Max. Negotiated Rate $15,280.00
Rate for Payer: AHCCCS Medicaid $15,280.00
Rate for Payer: Allwell Medicaid $15,280.00
Rate for Payer: AZCH Complete Medicaid $15,280.00
Rate for Payer: Banner UC Health Medicaid $15,280.00
Rate for Payer: Mercy Care Medicaid $15,280.00
Service Code APR-DRG 2603
Hospital Charge Code APRDRG2603
Min. Negotiated Rate $22,261.73
Max. Negotiated Rate $22,261.73
Rate for Payer: AHCCCS Medicaid $22,261.73
Rate for Payer: Allwell Medicaid $22,261.73
Rate for Payer: AZCH Complete Medicaid $22,261.73
Rate for Payer: Banner UC Health Medicaid $22,261.73
Rate for Payer: Mercy Care Medicaid $22,261.73
Service Code APR-DRG 2604
Hospital Charge Code APRDRG2601
Min. Negotiated Rate $47,113.04
Max. Negotiated Rate $47,113.04
Rate for Payer: AHCCCS Medicaid $47,113.04
Rate for Payer: Allwell Medicaid $47,113.04
Rate for Payer: AZCH Complete Medicaid $47,113.04
Rate for Payer: Banner UC Health Medicaid $47,113.04
Rate for Payer: Mercy Care Medicaid $47,113.04
Service Code APR-DRG 2603
Hospital Charge Code APRDRG2604
Min. Negotiated Rate $22,261.73
Max. Negotiated Rate $22,261.73
Rate for Payer: AHCCCS Medicaid $22,261.73
Rate for Payer: Allwell Medicaid $22,261.73
Rate for Payer: AZCH Complete Medicaid $22,261.73
Rate for Payer: Banner UC Health Medicaid $22,261.73
Rate for Payer: Mercy Care Medicaid $22,261.73
Service Code APR-DRG 2601
Hospital Charge Code APRDRG2604
Min. Negotiated Rate $12,095.64
Max. Negotiated Rate $12,095.64
Rate for Payer: AHCCCS Medicaid $12,095.64
Rate for Payer: Allwell Medicaid $12,095.64
Rate for Payer: AZCH Complete Medicaid $12,095.64
Rate for Payer: Banner UC Health Medicaid $12,095.64
Rate for Payer: Mercy Care Medicaid $12,095.64
Service Code APR-DRG 2602
Hospital Charge Code APRDRG2602
Min. Negotiated Rate $15,280.00
Max. Negotiated Rate $15,280.00
Rate for Payer: AHCCCS Medicaid $15,280.00
Rate for Payer: Allwell Medicaid $15,280.00
Rate for Payer: AZCH Complete Medicaid $15,280.00
Rate for Payer: Banner UC Health Medicaid $15,280.00
Rate for Payer: Mercy Care Medicaid $15,280.00
Service Code APR-DRG 2601
Hospital Charge Code APRDRG2601
Min. Negotiated Rate $12,095.64
Max. Negotiated Rate $12,095.64
Rate for Payer: AHCCCS Medicaid $12,095.64
Rate for Payer: Allwell Medicaid $12,095.64
Rate for Payer: AZCH Complete Medicaid $12,095.64
Rate for Payer: Banner UC Health Medicaid $12,095.64
Rate for Payer: Mercy Care Medicaid $12,095.64
Service Code APR-DRG 2603
Hospital Charge Code APRDRG2602
Min. Negotiated Rate $22,261.73
Max. Negotiated Rate $22,261.73
Rate for Payer: AHCCCS Medicaid $22,261.73
Rate for Payer: Allwell Medicaid $22,261.73
Rate for Payer: AZCH Complete Medicaid $22,261.73
Rate for Payer: Banner UC Health Medicaid $22,261.73
Rate for Payer: Mercy Care Medicaid $22,261.73