Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6091
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

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6092
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 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5881
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$126,083.66

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$126,083.66
Max. Negotiated Rate	$126,083.66
Rate for Payer: AHCCCS Medicaid	$126,083.66
Rate for Payer: Allwell Medicaid	$126,083.66
Rate for Payer: AZCH Complete Medicaid	$126,083.66
Rate for Payer: Banner UC Health Medicaid	$126,083.66
Rate for Payer: Mercy Care Medicaid	$126,083.66

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$126,083.66

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$126,083.66
Max. Negotiated Rate	$126,083.66
Rate for Payer: AHCCCS Medicaid	$126,083.66
Rate for Payer: Allwell Medicaid	$126,083.66
Rate for Payer: AZCH Complete Medicaid	$126,083.66
Rate for Payer: Banner UC Health Medicaid	$126,083.66
Rate for Payer: Mercy Care Medicaid	$126,083.66

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$126,083.66

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG5883
Min. Negotiated Rate	$126,083.66
Max. Negotiated Rate	$126,083.66
Rate for Payer: AHCCCS Medicaid	$126,083.66
Rate for Payer: Allwell Medicaid	$126,083.66
Rate for Payer: AZCH Complete Medicaid	$126,083.66
Rate for Payer: Banner UC Health Medicaid	$126,083.66
Rate for Payer: Mercy Care Medicaid	$126,083.66

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5881
Hospital Charge Code	APRDRG5884
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5881
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG5883
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5881
Hospital Charge Code	APRDRG5883
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: AHCCCS Medicaid	$206,843.56
Rate for Payer: Allwell Medicaid	$206,843.56
Rate for Payer: AZCH Complete Medicaid	$206,843.56
Rate for Payer: Banner UC Health Medicaid	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: AHCCCS Medicaid	$206,843.56
Rate for Payer: Allwell Medicaid	$206,843.56
Rate for Payer: AZCH Complete Medicaid	$206,843.56
Rate for Payer: Banner UC Health Medicaid	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG5884
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: AHCCCS Medicaid	$60,868.89
Rate for Payer: Allwell Medicaid	$60,868.89
Rate for Payer: AZCH Complete Medicaid	$60,868.89
Rate for Payer: Banner UC Health Medicaid	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5884
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: AHCCCS Medicaid	$206,843.56
Rate for Payer: Allwell Medicaid	$206,843.56
Rate for Payer: AZCH Complete Medicaid	$206,843.56
Rate for Payer: Banner UC Health Medicaid	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5883
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: AHCCCS Medicaid	$206,843.56
Rate for Payer: Allwell Medicaid	$206,843.56
Rate for Payer: AZCH Complete Medicaid	$206,843.56
Rate for Payer: Banner UC Health Medicaid	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$126,083.66

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG5884
Min. Negotiated Rate	$126,083.66
Max. Negotiated Rate	$126,083.66
Rate for Payer: AHCCCS Medicaid	$126,083.66
Rate for Payer: Allwell Medicaid	$126,083.66
Rate for Payer: AZCH Complete Medicaid	$126,083.66
Rate for Payer: Banner UC Health Medicaid	$126,083.66
Rate for Payer: Mercy Care Medicaid	$126,083.66

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$1,761.92

Service Code	APR-DRG 6262
Hospital Charge Code	APRDRG6262
Min. Negotiated Rate	$1,761.92
Max. Negotiated Rate	$1,761.92
Rate for Payer: AHCCCS Medicaid	$1,761.92
Rate for Payer: Allwell Medicaid	$1,761.92
Rate for Payer: AZCH Complete Medicaid	$1,761.92
Rate for Payer: Banner UC Health Medicaid	$1,761.92
Rate for Payer: Mercy Care Medicaid	$1,761.92

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$4,627.84

Service Code	APR-DRG 6263
Hospital Charge Code	APRDRG6263
Min. Negotiated Rate	$4,627.84
Max. Negotiated Rate	$4,627.84
Rate for Payer: AHCCCS Medicaid	$4,627.84
Rate for Payer: Allwell Medicaid	$4,627.84
Rate for Payer: AZCH Complete Medicaid	$4,627.84
Rate for Payer: Banner UC Health Medicaid	$4,627.84
Rate for Payer: Mercy Care Medicaid	$4,627.84

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$1,226.05

Service Code	APR-DRG 6261
Hospital Charge Code	APRDRG6261
Min. Negotiated Rate	$1,226.05
Max. Negotiated Rate	$1,226.05
Rate for Payer: AHCCCS Medicaid	$1,226.05
Rate for Payer: Allwell Medicaid	$1,226.05
Rate for Payer: AZCH Complete Medicaid	$1,226.05
Rate for Payer: Banner UC Health Medicaid	$1,226.05
Rate for Payer: Mercy Care Medicaid	$1,226.05

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$1,226.05

Service Code	APR-DRG 6261
Hospital Charge Code	APRDRG6263
Min. Negotiated Rate	$1,226.05
Max. Negotiated Rate	$1,226.05
Rate for Payer: AHCCCS Medicaid	$1,226.05
Rate for Payer: Allwell Medicaid	$1,226.05
Rate for Payer: AZCH Complete Medicaid	$1,226.05
Rate for Payer: Banner UC Health Medicaid	$1,226.05
Rate for Payer: Mercy Care Medicaid	$1,226.05

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$16,892.52

Service Code	APR-DRG 6264
Hospital Charge Code	APRDRG6263
Min. Negotiated Rate	$16,892.52
Max. Negotiated Rate	$16,892.52
Rate for Payer: AHCCCS Medicaid	$16,892.52
Rate for Payer: Allwell Medicaid	$16,892.52
Rate for Payer: AZCH Complete Medicaid	$16,892.52
Rate for Payer: Banner UC Health Medicaid	$16,892.52
Rate for Payer: Mercy Care Medicaid	$16,892.52

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$4,627.84

Service Code	APR-DRG 6263
Hospital Charge Code	APRDRG6261
Min. Negotiated Rate	$4,627.84
Max. Negotiated Rate	$4,627.84
Rate for Payer: AHCCCS Medicaid	$4,627.84
Rate for Payer: Allwell Medicaid	$4,627.84
Rate for Payer: AZCH Complete Medicaid	$4,627.84
Rate for Payer: Banner UC Health Medicaid	$4,627.84
Rate for Payer: Mercy Care Medicaid	$4,627.84

Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem

Facility

IP

$16,892.52

Service Code	APR-DRG 6264
Hospital Charge Code	APRDRG6262
Min. Negotiated Rate	$16,892.52
Max. Negotiated Rate	$16,892.52
Rate for Payer: AHCCCS Medicaid	$16,892.52
Rate for Payer: Allwell Medicaid	$16,892.52
Rate for Payer: AZCH Complete Medicaid	$16,892.52
Rate for Payer: Banner UC Health Medicaid	$16,892.52
Rate for Payer: Mercy Care Medicaid	$16,892.52

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