Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight 2000-2499 Grams With Other Significant Condition

Facility

IP

$22,888.08

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG6251
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

$51,634.96

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG6253
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

$51,634.96

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG6251
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

$8,854.47

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG6253
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

$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

$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	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

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

$51,634.96

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG6252
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	APRDRG6254
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

$13,673.09

Service Code	APR-DRG 6252
Hospital Charge Code	APRDRG6253
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

$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

$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 Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$36,513.48

Service Code	APR-DRG 6224
Hospital Charge Code	APRDRG6221
Min. Negotiated Rate	$36,513.48
Max. Negotiated Rate	$36,513.48
Rate for Payer: AHCCCS Medicaid	$36,513.48
Rate for Payer: Allwell Medicaid	$36,513.48
Rate for Payer: AZCH Complete Medicaid	$36,513.48
Rate for Payer: Banner UC Health Medicaid	$36,513.48
Rate for Payer: Mercy Care Medicaid	$36,513.48

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$36,513.48

Service Code	APR-DRG 6224
Hospital Charge Code	APRDRG6223
Min. Negotiated Rate	$36,513.48
Max. Negotiated Rate	$36,513.48
Rate for Payer: AHCCCS Medicaid	$36,513.48
Rate for Payer: Allwell Medicaid	$36,513.48
Rate for Payer: AZCH Complete Medicaid	$36,513.48
Rate for Payer: Banner UC Health Medicaid	$36,513.48
Rate for Payer: Mercy Care Medicaid	$36,513.48

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$36,513.48

Service Code	APR-DRG 6224
Hospital Charge Code	APRDRG6224
Min. Negotiated Rate	$36,513.48
Max. Negotiated Rate	$36,513.48
Rate for Payer: AHCCCS Medicaid	$36,513.48
Rate for Payer: Allwell Medicaid	$36,513.48
Rate for Payer: AZCH Complete Medicaid	$36,513.48
Rate for Payer: Banner UC Health Medicaid	$36,513.48
Rate for Payer: Mercy Care Medicaid	$36,513.48

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$14,906.15

Service Code	APR-DRG 6222
Hospital Charge Code	APRDRG6224
Min. Negotiated Rate	$14,906.15
Max. Negotiated Rate	$14,906.15
Rate for Payer: AHCCCS Medicaid	$14,906.15
Rate for Payer: Allwell Medicaid	$14,906.15
Rate for Payer: AZCH Complete Medicaid	$14,906.15
Rate for Payer: Banner UC Health Medicaid	$14,906.15
Rate for Payer: Mercy Care Medicaid	$14,906.15

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$10,227.11

Service Code	APR-DRG 6221
Hospital Charge Code	APRDRG6222
Min. Negotiated Rate	$10,227.11
Max. Negotiated Rate	$10,227.11
Rate for Payer: AHCCCS Medicaid	$10,227.11
Rate for Payer: Allwell Medicaid	$10,227.11
Rate for Payer: AZCH Complete Medicaid	$10,227.11
Rate for Payer: Banner UC Health Medicaid	$10,227.11
Rate for Payer: Mercy Care Medicaid	$10,227.11

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$20,407.23

Service Code	APR-DRG 6223
Hospital Charge Code	APRDRG6221
Min. Negotiated Rate	$20,407.23
Max. Negotiated Rate	$20,407.23
Rate for Payer: AHCCCS Medicaid	$20,407.23
Rate for Payer: Allwell Medicaid	$20,407.23
Rate for Payer: AZCH Complete Medicaid	$20,407.23
Rate for Payer: Banner UC Health Medicaid	$20,407.23
Rate for Payer: Mercy Care Medicaid	$20,407.23

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$20,407.23

Service Code	APR-DRG 6223
Hospital Charge Code	APRDRG6223
Min. Negotiated Rate	$20,407.23
Max. Negotiated Rate	$20,407.23
Rate for Payer: AHCCCS Medicaid	$20,407.23
Rate for Payer: Allwell Medicaid	$20,407.23
Rate for Payer: AZCH Complete Medicaid	$20,407.23
Rate for Payer: Banner UC Health Medicaid	$20,407.23
Rate for Payer: Mercy Care Medicaid	$20,407.23

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$10,227.11

Service Code	APR-DRG 6221
Hospital Charge Code	APRDRG6223
Min. Negotiated Rate	$10,227.11
Max. Negotiated Rate	$10,227.11
Rate for Payer: AHCCCS Medicaid	$10,227.11
Rate for Payer: Allwell Medicaid	$10,227.11
Rate for Payer: AZCH Complete Medicaid	$10,227.11
Rate for Payer: Banner UC Health Medicaid	$10,227.11
Rate for Payer: Mercy Care Medicaid	$10,227.11

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$36,513.48

Service Code	APR-DRG 6224
Hospital Charge Code	APRDRG6222
Min. Negotiated Rate	$36,513.48
Max. Negotiated Rate	$36,513.48
Rate for Payer: AHCCCS Medicaid	$36,513.48
Rate for Payer: Allwell Medicaid	$36,513.48
Rate for Payer: AZCH Complete Medicaid	$36,513.48
Rate for Payer: Banner UC Health Medicaid	$36,513.48
Rate for Payer: Mercy Care Medicaid	$36,513.48

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$20,407.23

Service Code	APR-DRG 6223
Hospital Charge Code	APRDRG6222
Min. Negotiated Rate	$20,407.23
Max. Negotiated Rate	$20,407.23
Rate for Payer: AHCCCS Medicaid	$20,407.23
Rate for Payer: Allwell Medicaid	$20,407.23
Rate for Payer: AZCH Complete Medicaid	$20,407.23
Rate for Payer: Banner UC Health Medicaid	$20,407.23
Rate for Payer: Mercy Care Medicaid	$20,407.23

Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$10,227.11

Service Code	APR-DRG 6221
Hospital Charge Code	APRDRG6224
Min. Negotiated Rate	$10,227.11
Max. Negotiated Rate	$10,227.11
Rate for Payer: AHCCCS Medicaid	$10,227.11
Rate for Payer: Allwell Medicaid	$10,227.11
Rate for Payer: AZCH Complete Medicaid	$10,227.11
Rate for Payer: Banner UC Health Medicaid	$10,227.11
Rate for Payer: Mercy Care Medicaid	$10,227.11

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