Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition

Facility

IP

$39,212.47

Service Code	APR-DRG 6144
Hospital Charge Code	APRDRG6141
Min. Negotiated Rate	$39,212.47
Max. Negotiated Rate	$39,212.47
Rate for Payer: AHCCCS Medicaid	$39,212.47
Rate for Payer: Allwell Medicaid	$39,212.47
Rate for Payer: AZCH Complete Medicaid	$39,212.47
Rate for Payer: Banner UC Health Medicaid	$39,212.47
Rate for Payer: Mercy Care Medicaid	$39,212.47

Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition

Facility

IP

$28,286.76

Service Code	APR-DRG 6143
Hospital Charge Code	APRDRG6142
Min. Negotiated Rate	$28,286.76
Max. Negotiated Rate	$28,286.76
Rate for Payer: AHCCCS Medicaid	$28,286.76
Rate for Payer: Allwell Medicaid	$28,286.76
Rate for Payer: AZCH Complete Medicaid	$28,286.76
Rate for Payer: Banner UC Health Medicaid	$28,286.76
Rate for Payer: Mercy Care Medicaid	$28,286.76

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6124
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: AHCCCS Medicaid	$24,091.69
Rate for Payer: Allwell Medicaid	$24,091.69
Rate for Payer: AZCH Complete Medicaid	$24,091.69
Rate for Payer: Banner UC Health Medicaid	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$15,807.45

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$15,807.45
Max. Negotiated Rate	$15,807.45
Rate for Payer: AHCCCS Medicaid	$15,807.45
Rate for Payer: Allwell Medicaid	$15,807.45
Rate for Payer: AZCH Complete Medicaid	$15,807.45
Rate for Payer: Banner UC Health Medicaid	$15,807.45
Rate for Payer: Mercy Care Medicaid	$15,807.45

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: AHCCCS Medicaid	$24,091.69
Rate for Payer: Allwell Medicaid	$24,091.69
Rate for Payer: AZCH Complete Medicaid	$24,091.69
Rate for Payer: Banner UC Health Medicaid	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$50,039.98

Service Code	APR-DRG 6124
Hospital Charge Code	APRDRG6121
Min. Negotiated Rate	$50,039.98
Max. Negotiated Rate	$50,039.98
Rate for Payer: AHCCCS Medicaid	$50,039.98
Rate for Payer: Allwell Medicaid	$50,039.98
Rate for Payer: AZCH Complete Medicaid	$50,039.98
Rate for Payer: Banner UC Health Medicaid	$50,039.98
Rate for Payer: Mercy Care Medicaid	$50,039.98

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$50,039.98

Service Code	APR-DRG 6124
Hospital Charge Code	APRDRG6123
Min. Negotiated Rate	$50,039.98
Max. Negotiated Rate	$50,039.98
Rate for Payer: AHCCCS Medicaid	$50,039.98
Rate for Payer: Allwell Medicaid	$50,039.98
Rate for Payer: AZCH Complete Medicaid	$50,039.98
Rate for Payer: Banner UC Health Medicaid	$50,039.98
Rate for Payer: Mercy Care Medicaid	$50,039.98

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6123
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: AHCCCS Medicaid	$33,076.62
Rate for Payer: Allwell Medicaid	$33,076.62
Rate for Payer: AZCH Complete Medicaid	$33,076.62
Rate for Payer: Banner UC Health Medicaid	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$50,039.98

Service Code	APR-DRG 6124
Hospital Charge Code	APRDRG6124
Min. Negotiated Rate	$50,039.98
Max. Negotiated Rate	$50,039.98
Rate for Payer: AHCCCS Medicaid	$50,039.98
Rate for Payer: Allwell Medicaid	$50,039.98
Rate for Payer: AZCH Complete Medicaid	$50,039.98
Rate for Payer: Banner UC Health Medicaid	$50,039.98
Rate for Payer: Mercy Care Medicaid	$50,039.98

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6121
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: AHCCCS Medicaid	$33,076.62
Rate for Payer: Allwell Medicaid	$33,076.62
Rate for Payer: AZCH Complete Medicaid	$33,076.62
Rate for Payer: Banner UC Health Medicaid	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$15,807.45

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG6124
Min. Negotiated Rate	$15,807.45
Max. Negotiated Rate	$15,807.45
Rate for Payer: AHCCCS Medicaid	$15,807.45
Rate for Payer: Allwell Medicaid	$15,807.45
Rate for Payer: AZCH Complete Medicaid	$15,807.45
Rate for Payer: Banner UC Health Medicaid	$15,807.45
Rate for Payer: Mercy Care Medicaid	$15,807.45

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: AHCCCS Medicaid	$33,076.62
Rate for Payer: Allwell Medicaid	$33,076.62
Rate for Payer: AZCH Complete Medicaid	$33,076.62
Rate for Payer: Banner UC Health Medicaid	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$15,807.45

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG6123
Min. Negotiated Rate	$15,807.45
Max. Negotiated Rate	$15,807.45
Rate for Payer: AHCCCS Medicaid	$15,807.45
Rate for Payer: Allwell Medicaid	$15,807.45
Rate for Payer: AZCH Complete Medicaid	$15,807.45
Rate for Payer: Banner UC Health Medicaid	$15,807.45
Rate for Payer: Mercy Care Medicaid	$15,807.45

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6124
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: AHCCCS Medicaid	$33,076.62
Rate for Payer: Allwell Medicaid	$33,076.62
Rate for Payer: AZCH Complete Medicaid	$33,076.62
Rate for Payer: Banner UC Health Medicaid	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$50,039.98

Service Code	APR-DRG 6124
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$50,039.98
Max. Negotiated Rate	$50,039.98
Rate for Payer: AHCCCS Medicaid	$50,039.98
Rate for Payer: Allwell Medicaid	$50,039.98
Rate for Payer: AZCH Complete Medicaid	$50,039.98
Rate for Payer: Banner UC Health Medicaid	$50,039.98
Rate for Payer: Mercy Care Medicaid	$50,039.98

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$15,807.45

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG6121
Min. Negotiated Rate	$15,807.45
Max. Negotiated Rate	$15,807.45
Rate for Payer: AHCCCS Medicaid	$15,807.45
Rate for Payer: Allwell Medicaid	$15,807.45
Rate for Payer: AZCH Complete Medicaid	$15,807.45
Rate for Payer: Banner UC Health Medicaid	$15,807.45
Rate for Payer: Mercy Care Medicaid	$15,807.45

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6123
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: AHCCCS Medicaid	$24,091.69
Rate for Payer: Allwell Medicaid	$24,091.69
Rate for Payer: AZCH Complete Medicaid	$24,091.69
Rate for Payer: Banner UC Health Medicaid	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6121
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: AHCCCS Medicaid	$24,091.69
Rate for Payer: Allwell Medicaid	$24,091.69
Rate for Payer: AZCH Complete Medicaid	$24,091.69
Rate for Payer: Banner UC Health Medicaid	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6091
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: AHCCCS Medicaid	$55,323.63
Rate for Payer: Allwell Medicaid	$55,323.63
Rate for Payer: AZCH Complete Medicaid	$55,323.63
Rate for Payer: Banner UC Health Medicaid	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6092
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: AHCCCS Medicaid	$55,323.63
Rate for Payer: Allwell Medicaid	$55,323.63
Rate for Payer: AZCH Complete Medicaid	$55,323.63
Rate for Payer: Banner UC Health Medicaid	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6094
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: AHCCCS Medicaid	$55,323.63
Rate for Payer: Allwell Medicaid	$55,323.63
Rate for Payer: AZCH Complete Medicaid	$55,323.63
Rate for Payer: Banner UC Health Medicaid	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6091
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: AHCCCS Medicaid	$37,504.56
Rate for Payer: Allwell Medicaid	$37,504.56
Rate for Payer: AZCH Complete Medicaid	$37,504.56
Rate for Payer: Banner UC Health Medicaid	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: AHCCCS Medicaid	$55,323.63
Rate for Payer: Allwell Medicaid	$55,323.63
Rate for Payer: AZCH Complete Medicaid	$55,323.63
Rate for Payer: Banner UC Health Medicaid	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: AHCCCS Medicaid	$37,504.56
Rate for Payer: Allwell Medicaid	$37,504.56
Rate for Payer: AZCH Complete Medicaid	$37,504.56
Rate for Payer: Banner UC Health Medicaid	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$138,340.63
Max. Negotiated Rate	$138,340.63
Rate for Payer: AHCCCS Medicaid	$138,340.63
Rate for Payer: Allwell Medicaid	$138,340.63
Rate for Payer: AZCH Complete Medicaid	$138,340.63
Rate for Payer: Banner UC Health Medicaid	$138,340.63
Rate for Payer: Mercy Care Medicaid	$138,340.63

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