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Charge Type Setting Price  
Service Code APR-DRG 5002
Hospital Charge Code APRDRG5001
Min. Negotiated Rate $5,268.22
Max. Negotiated Rate $5,268.22
Rate for Payer: AHCCCS Medicaid $5,268.22
Rate for Payer: Allwell Medicaid $5,268.22
Rate for Payer: AZCH Complete Medicaid $5,268.22
Rate for Payer: Banner UC Health Medicaid $5,268.22
Rate for Payer: Mercy Care Medicaid $5,268.22
Service Code APR-DRG 5002
Hospital Charge Code APRDRG5004
Min. Negotiated Rate $5,268.22
Max. Negotiated Rate $5,268.22
Rate for Payer: AHCCCS Medicaid $5,268.22
Rate for Payer: Allwell Medicaid $5,268.22
Rate for Payer: AZCH Complete Medicaid $5,268.22
Rate for Payer: Banner UC Health Medicaid $5,268.22
Rate for Payer: Mercy Care Medicaid $5,268.22
Service Code APR-DRG 5003
Hospital Charge Code APRDRG5002
Min. Negotiated Rate $7,583.54
Max. Negotiated Rate $7,583.54
Rate for Payer: AHCCCS Medicaid $7,583.54
Rate for Payer: Allwell Medicaid $7,583.54
Rate for Payer: AZCH Complete Medicaid $7,583.54
Rate for Payer: Banner UC Health Medicaid $7,583.54
Rate for Payer: Mercy Care Medicaid $7,583.54
Service Code APR-DRG 5001
Hospital Charge Code APRDRG5004
Min. Negotiated Rate $4,259.60
Max. Negotiated Rate $4,259.60
Rate for Payer: AHCCCS Medicaid $4,259.60
Rate for Payer: Allwell Medicaid $4,259.60
Rate for Payer: AZCH Complete Medicaid $4,259.60
Rate for Payer: Banner UC Health Medicaid $4,259.60
Rate for Payer: Mercy Care Medicaid $4,259.60
Service Code APR-DRG 5004
Hospital Charge Code APRDRG5004
Min. Negotiated Rate $13,371.49
Max. Negotiated Rate $13,371.49
Rate for Payer: AHCCCS Medicaid $13,371.49
Rate for Payer: Allwell Medicaid $13,371.49
Rate for Payer: AZCH Complete Medicaid $13,371.49
Rate for Payer: Banner UC Health Medicaid $13,371.49
Rate for Payer: Mercy Care Medicaid $13,371.49
Service Code APR-DRG 5003
Hospital Charge Code APRDRG5001
Min. Negotiated Rate $7,583.54
Max. Negotiated Rate $7,583.54
Rate for Payer: AHCCCS Medicaid $7,583.54
Rate for Payer: Allwell Medicaid $7,583.54
Rate for Payer: AZCH Complete Medicaid $7,583.54
Rate for Payer: Banner UC Health Medicaid $7,583.54
Rate for Payer: Mercy Care Medicaid $7,583.54
Service Code APR-DRG 5001
Hospital Charge Code APRDRG5002
Min. Negotiated Rate $4,259.60
Max. Negotiated Rate $4,259.60
Rate for Payer: AHCCCS Medicaid $4,259.60
Rate for Payer: Allwell Medicaid $4,259.60
Rate for Payer: AZCH Complete Medicaid $4,259.60
Rate for Payer: Banner UC Health Medicaid $4,259.60
Rate for Payer: Mercy Care Medicaid $4,259.60
Service Code APR-DRG 5001
Hospital Charge Code APRDRG5001
Min. Negotiated Rate $4,259.60
Max. Negotiated Rate $4,259.60
Rate for Payer: AHCCCS Medicaid $4,259.60
Rate for Payer: Allwell Medicaid $4,259.60
Rate for Payer: AZCH Complete Medicaid $4,259.60
Rate for Payer: Banner UC Health Medicaid $4,259.60
Rate for Payer: Mercy Care Medicaid $4,259.60
Service Code APR-DRG 5004
Hospital Charge Code APRDRG5003
Min. Negotiated Rate $13,371.49
Max. Negotiated Rate $13,371.49
Rate for Payer: AHCCCS Medicaid $13,371.49
Rate for Payer: Allwell Medicaid $13,371.49
Rate for Payer: AZCH Complete Medicaid $13,371.49
Rate for Payer: Banner UC Health Medicaid $13,371.49
Rate for Payer: Mercy Care Medicaid $13,371.49
Service Code APR-DRG 2812
Hospital Charge Code APRDRG2812
Min. Negotiated Rate $6,007.49
Max. Negotiated Rate $6,007.49
Rate for Payer: AHCCCS Medicaid $6,007.49
Rate for Payer: Allwell Medicaid $6,007.49
Rate for Payer: AZCH Complete Medicaid $6,007.49
Rate for Payer: Banner UC Health Medicaid $6,007.49
Rate for Payer: Mercy Care Medicaid $6,007.49
Service Code APR-DRG 2813
Hospital Charge Code APRDRG2811
Min. Negotiated Rate $7,898.47
Max. Negotiated Rate $7,898.47
Rate for Payer: AHCCCS Medicaid $7,898.47
Rate for Payer: Allwell Medicaid $7,898.47
Rate for Payer: AZCH Complete Medicaid $7,898.47
Rate for Payer: Banner UC Health Medicaid $7,898.47
Rate for Payer: Mercy Care Medicaid $7,898.47
Service Code APR-DRG 2812
Hospital Charge Code APRDRG2814
Min. Negotiated Rate $6,007.49
Max. Negotiated Rate $6,007.49
Rate for Payer: AHCCCS Medicaid $6,007.49
Rate for Payer: Allwell Medicaid $6,007.49
Rate for Payer: AZCH Complete Medicaid $6,007.49
Rate for Payer: Banner UC Health Medicaid $6,007.49
Rate for Payer: Mercy Care Medicaid $6,007.49
Service Code APR-DRG 2811
Hospital Charge Code APRDRG2814
Min. Negotiated Rate $4,715.51
Max. Negotiated Rate $4,715.51
Rate for Payer: AHCCCS Medicaid $4,715.51
Rate for Payer: Allwell Medicaid $4,715.51
Rate for Payer: AZCH Complete Medicaid $4,715.51
Rate for Payer: Banner UC Health Medicaid $4,715.51
Rate for Payer: Mercy Care Medicaid $4,715.51
Service Code APR-DRG 2813
Hospital Charge Code APRDRG2812
Min. Negotiated Rate $7,898.47
Max. Negotiated Rate $7,898.47
Rate for Payer: AHCCCS Medicaid $7,898.47
Rate for Payer: Allwell Medicaid $7,898.47
Rate for Payer: AZCH Complete Medicaid $7,898.47
Rate for Payer: Banner UC Health Medicaid $7,898.47
Rate for Payer: Mercy Care Medicaid $7,898.47
Service Code APR-DRG 2812
Hospital Charge Code APRDRG2811
Min. Negotiated Rate $6,007.49
Max. Negotiated Rate $6,007.49
Rate for Payer: AHCCCS Medicaid $6,007.49
Rate for Payer: Allwell Medicaid $6,007.49
Rate for Payer: AZCH Complete Medicaid $6,007.49
Rate for Payer: Banner UC Health Medicaid $6,007.49
Rate for Payer: Mercy Care Medicaid $6,007.49
Service Code APR-DRG 2812
Hospital Charge Code APRDRG2813
Min. Negotiated Rate $6,007.49
Max. Negotiated Rate $6,007.49
Rate for Payer: AHCCCS Medicaid $6,007.49
Rate for Payer: Allwell Medicaid $6,007.49
Rate for Payer: AZCH Complete Medicaid $6,007.49
Rate for Payer: Banner UC Health Medicaid $6,007.49
Rate for Payer: Mercy Care Medicaid $6,007.49
Service Code APR-DRG 2811
Hospital Charge Code APRDRG2811
Min. Negotiated Rate $4,715.51
Max. Negotiated Rate $4,715.51
Rate for Payer: AHCCCS Medicaid $4,715.51
Rate for Payer: Allwell Medicaid $4,715.51
Rate for Payer: AZCH Complete Medicaid $4,715.51
Rate for Payer: Banner UC Health Medicaid $4,715.51
Rate for Payer: Mercy Care Medicaid $4,715.51
Service Code APR-DRG 2811
Hospital Charge Code APRDRG2812
Min. Negotiated Rate $4,715.51
Max. Negotiated Rate $4,715.51
Rate for Payer: AHCCCS Medicaid $4,715.51
Rate for Payer: Allwell Medicaid $4,715.51
Rate for Payer: AZCH Complete Medicaid $4,715.51
Rate for Payer: Banner UC Health Medicaid $4,715.51
Rate for Payer: Mercy Care Medicaid $4,715.51
Service Code APR-DRG 2814
Hospital Charge Code APRDRG2812
Min. Negotiated Rate $12,783.72
Max. Negotiated Rate $12,783.72
Rate for Payer: AHCCCS Medicaid $12,783.72
Rate for Payer: Allwell Medicaid $12,783.72
Rate for Payer: AZCH Complete Medicaid $12,783.72
Rate for Payer: Banner UC Health Medicaid $12,783.72
Rate for Payer: Mercy Care Medicaid $12,783.72
Service Code APR-DRG 2814
Hospital Charge Code APRDRG2811
Min. Negotiated Rate $12,783.72
Max. Negotiated Rate $12,783.72
Rate for Payer: AHCCCS Medicaid $12,783.72
Rate for Payer: Allwell Medicaid $12,783.72
Rate for Payer: AZCH Complete Medicaid $12,783.72
Rate for Payer: Banner UC Health Medicaid $12,783.72
Rate for Payer: Mercy Care Medicaid $12,783.72
Service Code APR-DRG 2813
Hospital Charge Code APRDRG2814
Min. Negotiated Rate $7,898.47
Max. Negotiated Rate $7,898.47
Rate for Payer: AHCCCS Medicaid $7,898.47
Rate for Payer: Allwell Medicaid $7,898.47
Rate for Payer: AZCH Complete Medicaid $7,898.47
Rate for Payer: Banner UC Health Medicaid $7,898.47
Rate for Payer: Mercy Care Medicaid $7,898.47
Service Code APR-DRG 2814
Hospital Charge Code APRDRG2814
Min. Negotiated Rate $12,783.72
Max. Negotiated Rate $12,783.72
Rate for Payer: AHCCCS Medicaid $12,783.72
Rate for Payer: Allwell Medicaid $12,783.72
Rate for Payer: AZCH Complete Medicaid $12,783.72
Rate for Payer: Banner UC Health Medicaid $12,783.72
Rate for Payer: Mercy Care Medicaid $12,783.72
Service Code APR-DRG 2814
Hospital Charge Code APRDRG2813
Min. Negotiated Rate $12,783.72
Max. Negotiated Rate $12,783.72
Rate for Payer: AHCCCS Medicaid $12,783.72
Rate for Payer: Allwell Medicaid $12,783.72
Rate for Payer: AZCH Complete Medicaid $12,783.72
Rate for Payer: Banner UC Health Medicaid $12,783.72
Rate for Payer: Mercy Care Medicaid $12,783.72
Service Code APR-DRG 2811
Hospital Charge Code APRDRG2813
Min. Negotiated Rate $4,715.51
Max. Negotiated Rate $4,715.51
Rate for Payer: AHCCCS Medicaid $4,715.51
Rate for Payer: Allwell Medicaid $4,715.51
Rate for Payer: AZCH Complete Medicaid $4,715.51
Rate for Payer: Banner UC Health Medicaid $4,715.51
Rate for Payer: Mercy Care Medicaid $4,715.51
Service Code APR-DRG 2813
Hospital Charge Code APRDRG2813
Min. Negotiated Rate $7,898.47
Max. Negotiated Rate $7,898.47
Rate for Payer: AHCCCS Medicaid $7,898.47
Rate for Payer: Allwell Medicaid $7,898.47
Rate for Payer: AZCH Complete Medicaid $7,898.47
Rate for Payer: Banner UC Health Medicaid $7,898.47
Rate for Payer: Mercy Care Medicaid $7,898.47