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Charge Type Setting Price  
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
Service Code APR-DRG 6342
Hospital Charge Code APRDRG6342
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
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
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
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
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
Service Code APR-DRG 6344
Hospital Charge Code APRDRG6342
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
Service Code APR-DRG 6341
Hospital Charge Code APRDRG6343
Min. Negotiated Rate $4,420.22
Max. Negotiated Rate $4,420.22
Rate for Payer: AHCCCS Medicaid $4,420.22
Rate for Payer: Allwell Medicaid $4,420.22
Rate for Payer: AZCH Complete Medicaid $4,420.22
Rate for Payer: Banner UC Health Medicaid $4,420.22
Rate for Payer: Mercy Care Medicaid $4,420.22
Service Code APR-DRG 6344
Hospital Charge Code APRDRG6341
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
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
Service Code APR-DRG 6343
Hospital Charge Code APRDRG6341
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
Service Code APR-DRG 6342
Hospital Charge Code APRDRG6343
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
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
Service Code APR-DRG 6341
Hospital Charge Code APRDRG6341
Min. Negotiated Rate $4,420.22
Max. Negotiated Rate $4,420.22
Rate for Payer: AHCCCS Medicaid $4,420.22
Rate for Payer: Allwell Medicaid $4,420.22
Rate for Payer: AZCH Complete Medicaid $4,420.22
Rate for Payer: Banner UC Health Medicaid $4,420.22
Rate for Payer: Mercy Care Medicaid $4,420.22
Service Code APR-DRG 6341
Hospital Charge Code APRDRG6344
Min. Negotiated Rate $4,420.22
Max. Negotiated Rate $4,420.22
Rate for Payer: AHCCCS Medicaid $4,420.22
Rate for Payer: Allwell Medicaid $4,420.22
Rate for Payer: AZCH Complete Medicaid $4,420.22
Rate for Payer: Banner UC Health Medicaid $4,420.22
Rate for Payer: Mercy Care Medicaid $4,420.22
Service Code APR-DRG 6341
Hospital Charge Code APRDRG6342
Min. Negotiated Rate $4,420.22
Max. Negotiated Rate $4,420.22
Rate for Payer: AHCCCS Medicaid $4,420.22
Rate for Payer: Allwell Medicaid $4,420.22
Rate for Payer: AZCH Complete Medicaid $4,420.22
Rate for Payer: Banner UC Health Medicaid $4,420.22
Rate for Payer: Mercy Care Medicaid $4,420.22
Service Code APR-DRG 6344
Hospital Charge Code APRDRG6344
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
Service Code APR-DRG 5912
Hospital Charge Code APRDRG5913
Min. Negotiated Rate $75,926.55
Max. Negotiated Rate $75,926.55
Rate for Payer: AHCCCS Medicaid $75,926.55
Rate for Payer: Allwell Medicaid $75,926.55
Rate for Payer: AZCH Complete Medicaid $75,926.55
Rate for Payer: Banner UC Health Medicaid $75,926.55
Rate for Payer: Mercy Care Medicaid $75,926.55
Service Code APR-DRG 5913
Hospital Charge Code APRDRG5914
Min. Negotiated Rate $83,928.82
Max. Negotiated Rate $83,928.82
Rate for Payer: AHCCCS Medicaid $83,928.82
Rate for Payer: Allwell Medicaid $83,928.82
Rate for Payer: AZCH Complete Medicaid $83,928.82
Rate for Payer: Banner UC Health Medicaid $83,928.82
Rate for Payer: Mercy Care Medicaid $83,928.82
Service Code APR-DRG 5913
Hospital Charge Code APRDRG5911
Min. Negotiated Rate $83,928.82
Max. Negotiated Rate $83,928.82
Rate for Payer: AHCCCS Medicaid $83,928.82
Rate for Payer: Allwell Medicaid $83,928.82
Rate for Payer: AZCH Complete Medicaid $83,928.82
Rate for Payer: Banner UC Health Medicaid $83,928.82
Rate for Payer: Mercy Care Medicaid $83,928.82
Service Code APR-DRG 5913
Hospital Charge Code APRDRG5913
Min. Negotiated Rate $83,928.82
Max. Negotiated Rate $83,928.82
Rate for Payer: AHCCCS Medicaid $83,928.82
Rate for Payer: Allwell Medicaid $83,928.82
Rate for Payer: AZCH Complete Medicaid $83,928.82
Rate for Payer: Banner UC Health Medicaid $83,928.82
Rate for Payer: Mercy Care Medicaid $83,928.82
Service Code APR-DRG 5914
Hospital Charge Code APRDRG5914
Min. Negotiated Rate $141,221.98
Max. Negotiated Rate $141,221.98
Rate for Payer: AHCCCS Medicaid $141,221.98
Rate for Payer: Allwell Medicaid $141,221.98
Rate for Payer: AZCH Complete Medicaid $141,221.98
Rate for Payer: Banner UC Health Medicaid $141,221.98
Rate for Payer: Mercy Care Medicaid $141,221.98
Service Code APR-DRG 5911
Hospital Charge Code APRDRG5913
Min. Negotiated Rate $54,742.87
Max. Negotiated Rate $54,742.87
Rate for Payer: AHCCCS Medicaid $54,742.87
Rate for Payer: Allwell Medicaid $54,742.87
Rate for Payer: AZCH Complete Medicaid $54,742.87
Rate for Payer: Banner UC Health Medicaid $54,742.87
Rate for Payer: Mercy Care Medicaid $54,742.87
Service Code APR-DRG 5911
Hospital Charge Code APRDRG5912
Min. Negotiated Rate $54,742.87
Max. Negotiated Rate $54,742.87
Rate for Payer: AHCCCS Medicaid $54,742.87
Rate for Payer: Allwell Medicaid $54,742.87
Rate for Payer: AZCH Complete Medicaid $54,742.87
Rate for Payer: Banner UC Health Medicaid $54,742.87
Rate for Payer: Mercy Care Medicaid $54,742.87
Service Code APR-DRG 5911
Hospital Charge Code APRDRG5914
Min. Negotiated Rate $54,742.87
Max. Negotiated Rate $54,742.87
Rate for Payer: AHCCCS Medicaid $54,742.87
Rate for Payer: Allwell Medicaid $54,742.87
Rate for Payer: AZCH Complete Medicaid $54,742.87
Rate for Payer: Banner UC Health Medicaid $54,742.87
Rate for Payer: Mercy Care Medicaid $54,742.87