Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight > 2499 Grams With Other Major Procedure

Facility

IP

$22,038.69

Service Code	APR-DRG 6312
Hospital Charge Code	APRDRG6314
Min. Negotiated Rate	$22,038.69
Max. Negotiated Rate	$22,038.69
Rate for Payer: AHCCCS Medicaid	$22,038.69
Rate for Payer: Allwell Medicaid	$22,038.69
Rate for Payer: AZCH Complete Medicaid	$22,038.69
Rate for Payer: Banner UC Health Medicaid	$22,038.69
Rate for Payer: Mercy Care Medicaid	$22,038.69

Neonate Birth Weight > 2499 Grams With Other Major Procedure

Facility

IP

$41,104.14

Service Code	APR-DRG 6313
Hospital Charge Code	APRDRG6312
Min. Negotiated Rate	$41,104.14
Max. Negotiated Rate	$41,104.14
Rate for Payer: AHCCCS Medicaid	$41,104.14
Rate for Payer: Allwell Medicaid	$41,104.14
Rate for Payer: AZCH Complete Medicaid	$41,104.14
Rate for Payer: Banner UC Health Medicaid	$41,104.14
Rate for Payer: Mercy Care Medicaid	$41,104.14

Neonate Birth Weight > 2499 Grams With Other Major Procedure

Facility

IP

$123,339.09

Service Code	APR-DRG 6314
Hospital Charge Code	APRDRG6314
Min. Negotiated Rate	$123,339.09
Max. Negotiated Rate	$123,339.09
Rate for Payer: AHCCCS Medicaid	$123,339.09
Rate for Payer: Allwell Medicaid	$123,339.09
Rate for Payer: AZCH Complete Medicaid	$123,339.09
Rate for Payer: Banner UC Health Medicaid	$123,339.09
Rate for Payer: Mercy Care Medicaid	$123,339.09

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$7,709.79

Service Code	APR-DRG 6392
Hospital Charge Code	APRDRG6393
Min. Negotiated Rate	$7,709.79
Max. Negotiated Rate	$7,709.79
Rate for Payer: AHCCCS Medicaid	$7,709.79
Rate for Payer: Allwell Medicaid	$7,709.79
Rate for Payer: AZCH Complete Medicaid	$7,709.79
Rate for Payer: Banner UC Health Medicaid	$7,709.79
Rate for Payer: Mercy Care Medicaid	$7,709.79

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$17,697.72

Service Code	APR-DRG 6394
Hospital Charge Code	APRDRG6394
Min. Negotiated Rate	$17,697.72
Max. Negotiated Rate	$17,697.72
Rate for Payer: AHCCCS Medicaid	$17,697.72
Rate for Payer: Allwell Medicaid	$17,697.72
Rate for Payer: AZCH Complete Medicaid	$17,697.72
Rate for Payer: Banner UC Health Medicaid	$17,697.72
Rate for Payer: Mercy Care Medicaid	$17,697.72

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$17,697.72

Service Code	APR-DRG 6394
Hospital Charge Code	APRDRG6391
Min. Negotiated Rate	$17,697.72
Max. Negotiated Rate	$17,697.72
Rate for Payer: AHCCCS Medicaid	$17,697.72
Rate for Payer: Allwell Medicaid	$17,697.72
Rate for Payer: AZCH Complete Medicaid	$17,697.72
Rate for Payer: Banner UC Health Medicaid	$17,697.72
Rate for Payer: Mercy Care Medicaid	$17,697.72

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$3,922.93

Service Code	APR-DRG 6391
Hospital Charge Code	APRDRG6393
Min. Negotiated Rate	$3,922.93
Max. Negotiated Rate	$3,922.93
Rate for Payer: AHCCCS Medicaid	$3,922.93
Rate for Payer: Allwell Medicaid	$3,922.93
Rate for Payer: AZCH Complete Medicaid	$3,922.93
Rate for Payer: Banner UC Health Medicaid	$3,922.93
Rate for Payer: Mercy Care Medicaid	$3,922.93

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$7,709.79

Service Code	APR-DRG 6392
Hospital Charge Code	APRDRG6392
Min. Negotiated Rate	$7,709.79
Max. Negotiated Rate	$7,709.79
Rate for Payer: AHCCCS Medicaid	$7,709.79
Rate for Payer: Allwell Medicaid	$7,709.79
Rate for Payer: AZCH Complete Medicaid	$7,709.79
Rate for Payer: Banner UC Health Medicaid	$7,709.79
Rate for Payer: Mercy Care Medicaid	$7,709.79

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$3,922.93

Service Code	APR-DRG 6391
Hospital Charge Code	APRDRG6392
Min. Negotiated Rate	$3,922.93
Max. Negotiated Rate	$3,922.93
Rate for Payer: AHCCCS Medicaid	$3,922.93
Rate for Payer: Allwell Medicaid	$3,922.93
Rate for Payer: AZCH Complete Medicaid	$3,922.93
Rate for Payer: Banner UC Health Medicaid	$3,922.93
Rate for Payer: Mercy Care Medicaid	$3,922.93

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$13,297.84

Service Code	APR-DRG 6393
Hospital Charge Code	APRDRG6391
Min. Negotiated Rate	$13,297.84
Max. Negotiated Rate	$13,297.84
Rate for Payer: AHCCCS Medicaid	$13,297.84
Rate for Payer: Allwell Medicaid	$13,297.84
Rate for Payer: AZCH Complete Medicaid	$13,297.84
Rate for Payer: Banner UC Health Medicaid	$13,297.84
Rate for Payer: Mercy Care Medicaid	$13,297.84

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$3,922.93

Service Code	APR-DRG 6391
Hospital Charge Code	APRDRG6394
Min. Negotiated Rate	$3,922.93
Max. Negotiated Rate	$3,922.93
Rate for Payer: AHCCCS Medicaid	$3,922.93
Rate for Payer: Allwell Medicaid	$3,922.93
Rate for Payer: AZCH Complete Medicaid	$3,922.93
Rate for Payer: Banner UC Health Medicaid	$3,922.93
Rate for Payer: Mercy Care Medicaid	$3,922.93

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$17,697.72

Service Code	APR-DRG 6394
Hospital Charge Code	APRDRG6393
Min. Negotiated Rate	$17,697.72
Max. Negotiated Rate	$17,697.72
Rate for Payer: AHCCCS Medicaid	$17,697.72
Rate for Payer: Allwell Medicaid	$17,697.72
Rate for Payer: AZCH Complete Medicaid	$17,697.72
Rate for Payer: Banner UC Health Medicaid	$17,697.72
Rate for Payer: Mercy Care Medicaid	$17,697.72

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$13,297.84

Service Code	APR-DRG 6393
Hospital Charge Code	APRDRG6392
Min. Negotiated Rate	$13,297.84
Max. Negotiated Rate	$13,297.84
Rate for Payer: AHCCCS Medicaid	$13,297.84
Rate for Payer: Allwell Medicaid	$13,297.84
Rate for Payer: AZCH Complete Medicaid	$13,297.84
Rate for Payer: Banner UC Health Medicaid	$13,297.84
Rate for Payer: Mercy Care Medicaid	$13,297.84

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$7,709.79

Service Code	APR-DRG 6392
Hospital Charge Code	APRDRG6394
Min. Negotiated Rate	$7,709.79
Max. Negotiated Rate	$7,709.79
Rate for Payer: AHCCCS Medicaid	$7,709.79
Rate for Payer: Allwell Medicaid	$7,709.79
Rate for Payer: AZCH Complete Medicaid	$7,709.79
Rate for Payer: Banner UC Health Medicaid	$7,709.79
Rate for Payer: Mercy Care Medicaid	$7,709.79

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$13,297.84

Service Code	APR-DRG 6393
Hospital Charge Code	APRDRG6394
Min. Negotiated Rate	$13,297.84
Max. Negotiated Rate	$13,297.84
Rate for Payer: AHCCCS Medicaid	$13,297.84
Rate for Payer: Allwell Medicaid	$13,297.84
Rate for Payer: AZCH Complete Medicaid	$13,297.84
Rate for Payer: Banner UC Health Medicaid	$13,297.84
Rate for Payer: Mercy Care Medicaid	$13,297.84

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$17,697.72

Service Code	APR-DRG 6394
Hospital Charge Code	APRDRG6392
Min. Negotiated Rate	$17,697.72
Max. Negotiated Rate	$17,697.72
Rate for Payer: AHCCCS Medicaid	$17,697.72
Rate for Payer: Allwell Medicaid	$17,697.72
Rate for Payer: AZCH Complete Medicaid	$17,697.72
Rate for Payer: Banner UC Health Medicaid	$17,697.72
Rate for Payer: Mercy Care Medicaid	$17,697.72

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$7,709.79

Service Code	APR-DRG 6392
Hospital Charge Code	APRDRG6391
Min. Negotiated Rate	$7,709.79
Max. Negotiated Rate	$7,709.79
Rate for Payer: AHCCCS Medicaid	$7,709.79
Rate for Payer: Allwell Medicaid	$7,709.79
Rate for Payer: AZCH Complete Medicaid	$7,709.79
Rate for Payer: Banner UC Health Medicaid	$7,709.79
Rate for Payer: Mercy Care Medicaid	$7,709.79

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$3,922.93

Service Code	APR-DRG 6391
Hospital Charge Code	APRDRG6391
Min. Negotiated Rate	$3,922.93
Max. Negotiated Rate	$3,922.93
Rate for Payer: AHCCCS Medicaid	$3,922.93
Rate for Payer: Allwell Medicaid	$3,922.93
Rate for Payer: AZCH Complete Medicaid	$3,922.93
Rate for Payer: Banner UC Health Medicaid	$3,922.93
Rate for Payer: Mercy Care Medicaid	$3,922.93

Neonate Birth Weight > 2499 Grams With Other Significant Condition

Facility

IP

$13,297.84

Service Code	APR-DRG 6393
Hospital Charge Code	APRDRG6393
Min. Negotiated Rate	$13,297.84
Max. Negotiated Rate	$13,297.84
Rate for Payer: AHCCCS Medicaid	$13,297.84
Rate for Payer: Allwell Medicaid	$13,297.84
Rate for Payer: AZCH Complete Medicaid	$13,297.84
Rate for Payer: Banner UC Health Medicaid	$13,297.84
Rate for Payer: Mercy Care Medicaid	$13,297.84

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

Facility

IP

$8,599.16

Service Code	APR-DRG 6342
Hospital Charge Code	APRDRG6341
Min. Negotiated Rate	$8,599.16
Max. Negotiated Rate	$8,599.16
Rate for Payer: AHCCCS Medicaid	$8,599.16
Rate for Payer: Allwell Medicaid	$8,599.16
Rate for Payer: AZCH Complete Medicaid	$8,599.16
Rate for Payer: Banner UC Health Medicaid	$8,599.16
Rate for Payer: Mercy Care Medicaid	$8,599.16

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

Facility

IP

$8,599.16

Service Code	APR-DRG 6342
Hospital Charge Code	APRDRG6344
Min. Negotiated Rate	$8,599.16
Max. Negotiated Rate	$8,599.16
Rate for Payer: AHCCCS Medicaid	$8,599.16
Rate for Payer: Allwell Medicaid	$8,599.16
Rate for Payer: AZCH Complete Medicaid	$8,599.16
Rate for Payer: Banner UC Health Medicaid	$8,599.16
Rate for Payer: Mercy Care Medicaid	$8,599.16

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

Facility

IP

$12,446.34

Service Code	APR-DRG 6343
Hospital Charge Code	APRDRG6342
Min. Negotiated Rate	$12,446.34
Max. Negotiated Rate	$12,446.34
Rate for Payer: AHCCCS Medicaid	$12,446.34
Rate for Payer: Allwell Medicaid	$12,446.34
Rate for Payer: AZCH Complete Medicaid	$12,446.34
Rate for Payer: Banner UC Health Medicaid	$12,446.34
Rate for Payer: Mercy Care Medicaid	$12,446.34

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

Facility

IP

$12,446.34

Service Code	APR-DRG 6343
Hospital Charge Code	APRDRG6343
Min. Negotiated Rate	$12,446.34
Max. Negotiated Rate	$12,446.34
Rate for Payer: AHCCCS Medicaid	$12,446.34
Rate for Payer: Allwell Medicaid	$12,446.34
Rate for Payer: AZCH Complete Medicaid	$12,446.34
Rate for Payer: Banner UC Health Medicaid	$12,446.34
Rate for Payer: Mercy Care Medicaid	$12,446.34

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

Facility

IP

$31,339.25

Service Code	APR-DRG 6344
Hospital Charge Code	APRDRG6343
Min. Negotiated Rate	$31,339.25
Max. Negotiated Rate	$31,339.25
Rate for Payer: AHCCCS Medicaid	$31,339.25
Rate for Payer: Allwell Medicaid	$31,339.25
Rate for Payer: AZCH Complete Medicaid	$31,339.25
Rate for Payer: Banner UC Health Medicaid	$31,339.25
Rate for Payer: Mercy Care Medicaid	$31,339.25

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

Facility

IP

$12,446.34

Service Code	APR-DRG 6343
Hospital Charge Code	APRDRG6344
Min. Negotiated Rate	$12,446.34
Max. Negotiated Rate	$12,446.34
Rate for Payer: AHCCCS Medicaid	$12,446.34
Rate for Payer: Allwell Medicaid	$12,446.34
Rate for Payer: AZCH Complete Medicaid	$12,446.34
Rate for Payer: Banner UC Health Medicaid	$12,446.34
Rate for Payer: Mercy Care Medicaid	$12,446.34

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