Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$5,088.66

Service Code	APR-DRG 6211
Hospital Charge Code	APRDRG6214
Min. Negotiated Rate	$5,088.66
Max. Negotiated Rate	$5,088.66
Rate for Payer: AHCCCS Medicaid	$5,088.66
Rate for Payer: Allwell Medicaid	$5,088.66
Rate for Payer: AZCH Complete Medicaid	$5,088.66
Rate for Payer: Banner UC Health Medicaid	$5,088.66
Rate for Payer: Mercy Care Medicaid	$5,088.66

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$47,287.69

Service Code	APR-DRG 6214
Hospital Charge Code	APRDRG6212
Min. Negotiated Rate	$47,287.69
Max. Negotiated Rate	$47,287.69
Rate for Payer: AHCCCS Medicaid	$47,287.69
Rate for Payer: Allwell Medicaid	$47,287.69
Rate for Payer: AZCH Complete Medicaid	$47,287.69
Rate for Payer: Banner UC Health Medicaid	$47,287.69
Rate for Payer: Mercy Care Medicaid	$47,287.69

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$14,645.93

Service Code	APR-DRG 6212
Hospital Charge Code	APRDRG6212
Min. Negotiated Rate	$14,645.93
Max. Negotiated Rate	$14,645.93
Rate for Payer: AHCCCS Medicaid	$14,645.93
Rate for Payer: Allwell Medicaid	$14,645.93
Rate for Payer: AZCH Complete Medicaid	$14,645.93
Rate for Payer: Banner UC Health Medicaid	$14,645.93
Rate for Payer: Mercy Care Medicaid	$14,645.93

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$27,217.83

Service Code	APR-DRG 6213
Hospital Charge Code	APRDRG6212
Min. Negotiated Rate	$27,217.83
Max. Negotiated Rate	$27,217.83
Rate for Payer: AHCCCS Medicaid	$27,217.83
Rate for Payer: Allwell Medicaid	$27,217.83
Rate for Payer: AZCH Complete Medicaid	$27,217.83
Rate for Payer: Banner UC Health Medicaid	$27,217.83
Rate for Payer: Mercy Care Medicaid	$27,217.83

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$14,645.93

Service Code	APR-DRG 6212
Hospital Charge Code	APRDRG6211
Min. Negotiated Rate	$14,645.93
Max. Negotiated Rate	$14,645.93
Rate for Payer: AHCCCS Medicaid	$14,645.93
Rate for Payer: Allwell Medicaid	$14,645.93
Rate for Payer: AZCH Complete Medicaid	$14,645.93
Rate for Payer: Banner UC Health Medicaid	$14,645.93
Rate for Payer: Mercy Care Medicaid	$14,645.93

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$47,287.69

Service Code	APR-DRG 6214
Hospital Charge Code	APRDRG6213
Min. Negotiated Rate	$47,287.69
Max. Negotiated Rate	$47,287.69
Rate for Payer: AHCCCS Medicaid	$47,287.69
Rate for Payer: Allwell Medicaid	$47,287.69
Rate for Payer: AZCH Complete Medicaid	$47,287.69
Rate for Payer: Banner UC Health Medicaid	$47,287.69
Rate for Payer: Mercy Care Medicaid	$47,287.69

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$14,645.93

Service Code	APR-DRG 6212
Hospital Charge Code	APRDRG6214
Min. Negotiated Rate	$14,645.93
Max. Negotiated Rate	$14,645.93
Rate for Payer: AHCCCS Medicaid	$14,645.93
Rate for Payer: Allwell Medicaid	$14,645.93
Rate for Payer: AZCH Complete Medicaid	$14,645.93
Rate for Payer: Banner UC Health Medicaid	$14,645.93
Rate for Payer: Mercy Care Medicaid	$14,645.93

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$5,088.66

Service Code	APR-DRG 6211
Hospital Charge Code	APRDRG6212
Min. Negotiated Rate	$5,088.66
Max. Negotiated Rate	$5,088.66
Rate for Payer: AHCCCS Medicaid	$5,088.66
Rate for Payer: Allwell Medicaid	$5,088.66
Rate for Payer: AZCH Complete Medicaid	$5,088.66
Rate for Payer: Banner UC Health Medicaid	$5,088.66
Rate for Payer: Mercy Care Medicaid	$5,088.66

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$27,217.83

Service Code	APR-DRG 6213
Hospital Charge Code	APRDRG6214
Min. Negotiated Rate	$27,217.83
Max. Negotiated Rate	$27,217.83
Rate for Payer: AHCCCS Medicaid	$27,217.83
Rate for Payer: Allwell Medicaid	$27,217.83
Rate for Payer: AZCH Complete Medicaid	$27,217.83
Rate for Payer: Banner UC Health Medicaid	$27,217.83
Rate for Payer: Mercy Care Medicaid	$27,217.83

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$5,088.66

Service Code	APR-DRG 6211
Hospital Charge Code	APRDRG6211
Min. Negotiated Rate	$5,088.66
Max. Negotiated Rate	$5,088.66
Rate for Payer: AHCCCS Medicaid	$5,088.66
Rate for Payer: Allwell Medicaid	$5,088.66
Rate for Payer: AZCH Complete Medicaid	$5,088.66
Rate for Payer: Banner UC Health Medicaid	$5,088.66
Rate for Payer: Mercy Care Medicaid	$5,088.66

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$47,287.69

Service Code	APR-DRG 6214
Hospital Charge Code	APRDRG6211
Min. Negotiated Rate	$47,287.69
Max. Negotiated Rate	$47,287.69
Rate for Payer: AHCCCS Medicaid	$47,287.69
Rate for Payer: Allwell Medicaid	$47,287.69
Rate for Payer: AZCH Complete Medicaid	$47,287.69
Rate for Payer: Banner UC Health Medicaid	$47,287.69
Rate for Payer: Mercy Care Medicaid	$47,287.69

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$5,088.66

Service Code	APR-DRG 6211
Hospital Charge Code	APRDRG6213
Min. Negotiated Rate	$5,088.66
Max. Negotiated Rate	$5,088.66
Rate for Payer: AHCCCS Medicaid	$5,088.66
Rate for Payer: Allwell Medicaid	$5,088.66
Rate for Payer: AZCH Complete Medicaid	$5,088.66
Rate for Payer: Banner UC Health Medicaid	$5,088.66
Rate for Payer: Mercy Care Medicaid	$5,088.66

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$47,287.69

Service Code	APR-DRG 6214
Hospital Charge Code	APRDRG6214
Min. Negotiated Rate	$47,287.69
Max. Negotiated Rate	$47,287.69
Rate for Payer: AHCCCS Medicaid	$47,287.69
Rate for Payer: Allwell Medicaid	$47,287.69
Rate for Payer: AZCH Complete Medicaid	$47,287.69
Rate for Payer: Banner UC Health Medicaid	$47,287.69
Rate for Payer: Mercy Care Medicaid	$47,287.69

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$27,217.83

Service Code	APR-DRG 6213
Hospital Charge Code	APRDRG6213
Min. Negotiated Rate	$27,217.83
Max. Negotiated Rate	$27,217.83
Rate for Payer: AHCCCS Medicaid	$27,217.83
Rate for Payer: Allwell Medicaid	$27,217.83
Rate for Payer: AZCH Complete Medicaid	$27,217.83
Rate for Payer: Banner UC Health Medicaid	$27,217.83
Rate for Payer: Mercy Care Medicaid	$27,217.83

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$14,645.93

Service Code	APR-DRG 6212
Hospital Charge Code	APRDRG6213
Min. Negotiated Rate	$14,645.93
Max. Negotiated Rate	$14,645.93
Rate for Payer: AHCCCS Medicaid	$14,645.93
Rate for Payer: Allwell Medicaid	$14,645.93
Rate for Payer: AZCH Complete Medicaid	$14,645.93
Rate for Payer: Banner UC Health Medicaid	$14,645.93
Rate for Payer: Mercy Care Medicaid	$14,645.93

Neonate Birth Weight 2000-2499 Grams With Major Anomaly

Facility

IP

$27,217.83

Service Code	APR-DRG 6213
Hospital Charge Code	APRDRG6211
Min. Negotiated Rate	$27,217.83
Max. Negotiated Rate	$27,217.83
Rate for Payer: AHCCCS Medicaid	$27,217.83
Rate for Payer: Allwell Medicaid	$27,217.83
Rate for Payer: AZCH Complete Medicaid	$27,217.83
Rate for Payer: Banner UC Health Medicaid	$27,217.83
Rate for Payer: Mercy Care Medicaid	$27,217.83

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$22,888.08

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG6253
Min. Negotiated Rate	$22,888.08
Max. Negotiated Rate	$22,888.08
Rate for Payer: AHCCCS Medicaid	$22,888.08
Rate for Payer: Allwell Medicaid	$22,888.08
Rate for Payer: AZCH Complete Medicaid	$22,888.08
Rate for Payer: Banner UC Health Medicaid	$22,888.08
Rate for Payer: Mercy Care Medicaid	$22,888.08

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$8,854.47

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG6252
Min. Negotiated Rate	$8,854.47
Max. Negotiated Rate	$8,854.47
Rate for Payer: AHCCCS Medicaid	$8,854.47
Rate for Payer: Allwell Medicaid	$8,854.47
Rate for Payer: AZCH Complete Medicaid	$8,854.47
Rate for Payer: Banner UC Health Medicaid	$8,854.47
Rate for Payer: Mercy Care Medicaid	$8,854.47

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$13,673.09

Service Code	APR-DRG 6252
Hospital Charge Code	APRDRG6251
Min. Negotiated Rate	$13,673.09
Max. Negotiated Rate	$13,673.09
Rate for Payer: AHCCCS Medicaid	$13,673.09
Rate for Payer: Allwell Medicaid	$13,673.09
Rate for Payer: AZCH Complete Medicaid	$13,673.09
Rate for Payer: Banner UC Health Medicaid	$13,673.09
Rate for Payer: Mercy Care Medicaid	$13,673.09

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$22,888.08

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG6254
Min. Negotiated Rate	$22,888.08
Max. Negotiated Rate	$22,888.08
Rate for Payer: AHCCCS Medicaid	$22,888.08
Rate for Payer: Allwell Medicaid	$22,888.08
Rate for Payer: AZCH Complete Medicaid	$22,888.08
Rate for Payer: Banner UC Health Medicaid	$22,888.08
Rate for Payer: Mercy Care Medicaid	$22,888.08

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$8,854.47

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG6254
Min. Negotiated Rate	$8,854.47
Max. Negotiated Rate	$8,854.47
Rate for Payer: AHCCCS Medicaid	$8,854.47
Rate for Payer: Allwell Medicaid	$8,854.47
Rate for Payer: AZCH Complete Medicaid	$8,854.47
Rate for Payer: Banner UC Health Medicaid	$8,854.47
Rate for Payer: Mercy Care Medicaid	$8,854.47

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$51,634.96

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG6254
Min. Negotiated Rate	$51,634.96
Max. Negotiated Rate	$51,634.96
Rate for Payer: AHCCCS Medicaid	$51,634.96
Rate for Payer: Allwell Medicaid	$51,634.96
Rate for Payer: AZCH Complete Medicaid	$51,634.96
Rate for Payer: Banner UC Health Medicaid	$51,634.96
Rate for Payer: Mercy Care Medicaid	$51,634.96

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$13,673.09

Service Code	APR-DRG 6252
Hospital Charge Code	APRDRG6252
Min. Negotiated Rate	$13,673.09
Max. Negotiated Rate	$13,673.09
Rate for Payer: AHCCCS Medicaid	$13,673.09
Rate for Payer: Allwell Medicaid	$13,673.09
Rate for Payer: AZCH Complete Medicaid	$13,673.09
Rate for Payer: Banner UC Health Medicaid	$13,673.09
Rate for Payer: Mercy Care Medicaid	$13,673.09

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$22,888.08

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG6252
Min. Negotiated Rate	$22,888.08
Max. Negotiated Rate	$22,888.08
Rate for Payer: AHCCCS Medicaid	$22,888.08
Rate for Payer: Allwell Medicaid	$22,888.08
Rate for Payer: AZCH Complete Medicaid	$22,888.08
Rate for Payer: Banner UC Health Medicaid	$22,888.08
Rate for Payer: Mercy Care Medicaid	$22,888.08

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$8,854.47

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG6251
Min. Negotiated Rate	$8,854.47
Max. Negotiated Rate	$8,854.47
Rate for Payer: AHCCCS Medicaid	$8,854.47
Rate for Payer: Allwell Medicaid	$8,854.47
Rate for Payer: AZCH Complete Medicaid	$8,854.47
Rate for Payer: Banner UC Health Medicaid	$8,854.47
Rate for Payer: Mercy Care Medicaid	$8,854.47

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