Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$1,031.06

Service Code	APR-DRG 5812
Hospital Charge Code	APRDRG5811
Min. Negotiated Rate	$1,031.06
Max. Negotiated Rate	$1,031.06
Rate for Payer: AHCCCS Medicaid	$1,031.06
Rate for Payer: Allwell Medicaid	$1,031.06
Rate for Payer: AZCH Complete Medicaid	$1,031.06
Rate for Payer: Banner UC Health Medicaid	$1,031.06
Rate for Payer: Mercy Care Medicaid	$1,031.06

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$3,284.66

Service Code	APR-DRG 5814
Hospital Charge Code	APRDRG5813
Min. Negotiated Rate	$3,284.66
Max. Negotiated Rate	$3,284.66
Rate for Payer: AHCCCS Medicaid	$3,284.66
Rate for Payer: Allwell Medicaid	$3,284.66
Rate for Payer: AZCH Complete Medicaid	$3,284.66
Rate for Payer: Banner UC Health Medicaid	$3,284.66
Rate for Payer: Mercy Care Medicaid	$3,284.66

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$3,284.66

Service Code	APR-DRG 5814
Hospital Charge Code	APRDRG5814
Min. Negotiated Rate	$3,284.66
Max. Negotiated Rate	$3,284.66
Rate for Payer: AHCCCS Medicaid	$3,284.66
Rate for Payer: Allwell Medicaid	$3,284.66
Rate for Payer: AZCH Complete Medicaid	$3,284.66
Rate for Payer: Banner UC Health Medicaid	$3,284.66
Rate for Payer: Mercy Care Medicaid	$3,284.66

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$1,031.06

Service Code	APR-DRG 5812
Hospital Charge Code	APRDRG5812
Min. Negotiated Rate	$1,031.06
Max. Negotiated Rate	$1,031.06
Rate for Payer: AHCCCS Medicaid	$1,031.06
Rate for Payer: Allwell Medicaid	$1,031.06
Rate for Payer: AZCH Complete Medicaid	$1,031.06
Rate for Payer: Banner UC Health Medicaid	$1,031.06
Rate for Payer: Mercy Care Medicaid	$1,031.06

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$1,778.75

Service Code	APR-DRG 5813
Hospital Charge Code	APRDRG5811
Min. Negotiated Rate	$1,778.75
Max. Negotiated Rate	$1,778.75
Rate for Payer: AHCCCS Medicaid	$1,778.75
Rate for Payer: Allwell Medicaid	$1,778.75
Rate for Payer: AZCH Complete Medicaid	$1,778.75
Rate for Payer: Banner UC Health Medicaid	$1,778.75
Rate for Payer: Mercy Care Medicaid	$1,778.75

Neonate, Transferred < 5 Days Old, Born Here

Facility

IP

$1,031.06

Service Code	APR-DRG 5812
Hospital Charge Code	APRDRG5814
Min. Negotiated Rate	$1,031.06
Max. Negotiated Rate	$1,031.06
Rate for Payer: AHCCCS Medicaid	$1,031.06
Rate for Payer: Allwell Medicaid	$1,031.06
Rate for Payer: AZCH Complete Medicaid	$1,031.06
Rate for Payer: Banner UC Health Medicaid	$1,031.06
Rate for Payer: Mercy Care Medicaid	$1,031.06

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$3,941.17

Service Code	APR-DRG 5803
Hospital Charge Code	APRDRG5802
Min. Negotiated Rate	$3,941.17
Max. Negotiated Rate	$3,941.17
Rate for Payer: AHCCCS Medicaid	$3,941.17
Rate for Payer: Allwell Medicaid	$3,941.17
Rate for Payer: AZCH Complete Medicaid	$3,941.17
Rate for Payer: Banner UC Health Medicaid	$3,941.17
Rate for Payer: Mercy Care Medicaid	$3,941.17

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$2,324.44

Service Code	APR-DRG 5802
Hospital Charge Code	APRDRG5804
Min. Negotiated Rate	$2,324.44
Max. Negotiated Rate	$2,324.44
Rate for Payer: AHCCCS Medicaid	$2,324.44
Rate for Payer: Allwell Medicaid	$2,324.44
Rate for Payer: AZCH Complete Medicaid	$2,324.44
Rate for Payer: Banner UC Health Medicaid	$2,324.44
Rate for Payer: Mercy Care Medicaid	$2,324.44

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$1,602.70

Service Code	APR-DRG 5801
Hospital Charge Code	APRDRG5804
Min. Negotiated Rate	$1,602.70
Max. Negotiated Rate	$1,602.70
Rate for Payer: AHCCCS Medicaid	$1,602.70
Rate for Payer: Allwell Medicaid	$1,602.70
Rate for Payer: AZCH Complete Medicaid	$1,602.70
Rate for Payer: Banner UC Health Medicaid	$1,602.70
Rate for Payer: Mercy Care Medicaid	$1,602.70

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$2,324.44

Service Code	APR-DRG 5802
Hospital Charge Code	APRDRG5802
Min. Negotiated Rate	$2,324.44
Max. Negotiated Rate	$2,324.44
Rate for Payer: AHCCCS Medicaid	$2,324.44
Rate for Payer: Allwell Medicaid	$2,324.44
Rate for Payer: AZCH Complete Medicaid	$2,324.44
Rate for Payer: Banner UC Health Medicaid	$2,324.44
Rate for Payer: Mercy Care Medicaid	$2,324.44

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$7,004.18

Service Code	APR-DRG 5804
Hospital Charge Code	APRDRG5804
Min. Negotiated Rate	$7,004.18
Max. Negotiated Rate	$7,004.18
Rate for Payer: AHCCCS Medicaid	$7,004.18
Rate for Payer: Allwell Medicaid	$7,004.18
Rate for Payer: AZCH Complete Medicaid	$7,004.18
Rate for Payer: Banner UC Health Medicaid	$7,004.18
Rate for Payer: Mercy Care Medicaid	$7,004.18

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$7,004.18

Service Code	APR-DRG 5804
Hospital Charge Code	APRDRG5801
Min. Negotiated Rate	$7,004.18
Max. Negotiated Rate	$7,004.18
Rate for Payer: AHCCCS Medicaid	$7,004.18
Rate for Payer: Allwell Medicaid	$7,004.18
Rate for Payer: AZCH Complete Medicaid	$7,004.18
Rate for Payer: Banner UC Health Medicaid	$7,004.18
Rate for Payer: Mercy Care Medicaid	$7,004.18

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$1,602.70

Service Code	APR-DRG 5801
Hospital Charge Code	APRDRG5803
Min. Negotiated Rate	$1,602.70
Max. Negotiated Rate	$1,602.70
Rate for Payer: AHCCCS Medicaid	$1,602.70
Rate for Payer: Allwell Medicaid	$1,602.70
Rate for Payer: AZCH Complete Medicaid	$1,602.70
Rate for Payer: Banner UC Health Medicaid	$1,602.70
Rate for Payer: Mercy Care Medicaid	$1,602.70

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$7,004.18

Service Code	APR-DRG 5804
Hospital Charge Code	APRDRG5802
Min. Negotiated Rate	$7,004.18
Max. Negotiated Rate	$7,004.18
Rate for Payer: AHCCCS Medicaid	$7,004.18
Rate for Payer: Allwell Medicaid	$7,004.18
Rate for Payer: AZCH Complete Medicaid	$7,004.18
Rate for Payer: Banner UC Health Medicaid	$7,004.18
Rate for Payer: Mercy Care Medicaid	$7,004.18

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$7,004.18

Service Code	APR-DRG 5804
Hospital Charge Code	APRDRG5803
Min. Negotiated Rate	$7,004.18
Max. Negotiated Rate	$7,004.18
Rate for Payer: AHCCCS Medicaid	$7,004.18
Rate for Payer: Allwell Medicaid	$7,004.18
Rate for Payer: AZCH Complete Medicaid	$7,004.18
Rate for Payer: Banner UC Health Medicaid	$7,004.18
Rate for Payer: Mercy Care Medicaid	$7,004.18

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$3,941.17

Service Code	APR-DRG 5803
Hospital Charge Code	APRDRG5801
Min. Negotiated Rate	$3,941.17
Max. Negotiated Rate	$3,941.17
Rate for Payer: AHCCCS Medicaid	$3,941.17
Rate for Payer: Allwell Medicaid	$3,941.17
Rate for Payer: AZCH Complete Medicaid	$3,941.17
Rate for Payer: Banner UC Health Medicaid	$3,941.17
Rate for Payer: Mercy Care Medicaid	$3,941.17

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$1,602.70

Service Code	APR-DRG 5801
Hospital Charge Code	APRDRG5801
Min. Negotiated Rate	$1,602.70
Max. Negotiated Rate	$1,602.70
Rate for Payer: AHCCCS Medicaid	$1,602.70
Rate for Payer: Allwell Medicaid	$1,602.70
Rate for Payer: AZCH Complete Medicaid	$1,602.70
Rate for Payer: Banner UC Health Medicaid	$1,602.70
Rate for Payer: Mercy Care Medicaid	$1,602.70

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$1,602.70

Service Code	APR-DRG 5801
Hospital Charge Code	APRDRG5802
Min. Negotiated Rate	$1,602.70
Max. Negotiated Rate	$1,602.70
Rate for Payer: AHCCCS Medicaid	$1,602.70
Rate for Payer: Allwell Medicaid	$1,602.70
Rate for Payer: AZCH Complete Medicaid	$1,602.70
Rate for Payer: Banner UC Health Medicaid	$1,602.70
Rate for Payer: Mercy Care Medicaid	$1,602.70

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$3,941.17

Service Code	APR-DRG 5803
Hospital Charge Code	APRDRG5804
Min. Negotiated Rate	$3,941.17
Max. Negotiated Rate	$3,941.17
Rate for Payer: AHCCCS Medicaid	$3,941.17
Rate for Payer: Allwell Medicaid	$3,941.17
Rate for Payer: AZCH Complete Medicaid	$3,941.17
Rate for Payer: Banner UC Health Medicaid	$3,941.17
Rate for Payer: Mercy Care Medicaid	$3,941.17

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$3,941.17

Service Code	APR-DRG 5803
Hospital Charge Code	APRDRG5803
Min. Negotiated Rate	$3,941.17
Max. Negotiated Rate	$3,941.17
Rate for Payer: AHCCCS Medicaid	$3,941.17
Rate for Payer: Allwell Medicaid	$3,941.17
Rate for Payer: AZCH Complete Medicaid	$3,941.17
Rate for Payer: Banner UC Health Medicaid	$3,941.17
Rate for Payer: Mercy Care Medicaid	$3,941.17

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$2,324.44

Service Code	APR-DRG 5802
Hospital Charge Code	APRDRG5803
Min. Negotiated Rate	$2,324.44
Max. Negotiated Rate	$2,324.44
Rate for Payer: AHCCCS Medicaid	$2,324.44
Rate for Payer: Allwell Medicaid	$2,324.44
Rate for Payer: AZCH Complete Medicaid	$2,324.44
Rate for Payer: Banner UC Health Medicaid	$2,324.44
Rate for Payer: Mercy Care Medicaid	$2,324.44

Neonate, Transferred < 5 Days Old, Not Born Here

Facility

IP

$2,324.44

Service Code	APR-DRG 5802
Hospital Charge Code	APRDRG5801
Min. Negotiated Rate	$2,324.44
Max. Negotiated Rate	$2,324.44
Rate for Payer: AHCCCS Medicaid	$2,324.44
Rate for Payer: Allwell Medicaid	$2,324.44
Rate for Payer: AZCH Complete Medicaid	$2,324.44
Rate for Payer: Banner UC Health Medicaid	$2,324.44
Rate for Payer: Mercy Care Medicaid	$2,324.44

Neonate With Ecmo

Facility

IP

$209,775.41

Service Code	APR-DRG 5833
Hospital Charge Code	APRDRG5834
Min. Negotiated Rate	$209,775.41
Max. Negotiated Rate	$209,775.41
Rate for Payer: AHCCCS Medicaid	$209,775.41
Rate for Payer: Allwell Medicaid	$209,775.41
Rate for Payer: AZCH Complete Medicaid	$209,775.41
Rate for Payer: Banner UC Health Medicaid	$209,775.41
Rate for Payer: Mercy Care Medicaid	$209,775.41

Neonate With Ecmo

Facility

IP

$112,462.48

Service Code	APR-DRG 5831
Hospital Charge Code	APRDRG5832
Min. Negotiated Rate	$112,462.48
Max. Negotiated Rate	$112,462.48
Rate for Payer: AHCCCS Medicaid	$112,462.48
Rate for Payer: Allwell Medicaid	$112,462.48
Rate for Payer: AZCH Complete Medicaid	$112,462.48
Rate for Payer: Banner UC Health Medicaid	$112,462.48
Rate for Payer: Mercy Care Medicaid	$112,462.48

Neonate With Ecmo

Facility

IP

$142,335.80

Service Code	APR-DRG 5832
Hospital Charge Code	APRDRG5831
Min. Negotiated Rate	$142,335.80
Max. Negotiated Rate	$142,335.80
Rate for Payer: AHCCCS Medicaid	$142,335.80
Rate for Payer: Allwell Medicaid	$142,335.80
Rate for Payer: AZCH Complete Medicaid	$142,335.80
Rate for Payer: Banner UC Health Medicaid	$142,335.80
Rate for Payer: Mercy Care Medicaid	$142,335.80

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