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Charge Type Setting Price  
Service Code APR-DRG 1151
Hospital Charge Code APRDRG1153
Min. Negotiated Rate $3,431.25
Max. Negotiated Rate $3,431.25
Rate for Payer: AHCCCS Medicaid $3,431.25
Rate for Payer: Allwell Medicaid $3,431.25
Rate for Payer: AZCH Complete Medicaid $3,431.25
Rate for Payer: Banner UC Health Medicaid $3,431.25
Rate for Payer: Mercy Care Medicaid $3,431.25
Service Code APR-DRG 1151
Hospital Charge Code APRDRG1154
Min. Negotiated Rate $3,431.25
Max. Negotiated Rate $3,431.25
Rate for Payer: AHCCCS Medicaid $3,431.25
Rate for Payer: Allwell Medicaid $3,431.25
Rate for Payer: AZCH Complete Medicaid $3,431.25
Rate for Payer: Banner UC Health Medicaid $3,431.25
Rate for Payer: Mercy Care Medicaid $3,431.25
Service Code APR-DRG 1154
Hospital Charge Code APRDRG1152
Min. Negotiated Rate $13,565.78
Max. Negotiated Rate $13,565.78
Rate for Payer: AHCCCS Medicaid $13,565.78
Rate for Payer: Allwell Medicaid $13,565.78
Rate for Payer: AZCH Complete Medicaid $13,565.78
Rate for Payer: Banner UC Health Medicaid $13,565.78
Rate for Payer: Mercy Care Medicaid $13,565.78
Service Code APR-DRG 1154
Hospital Charge Code APRDRG1154
Min. Negotiated Rate $13,565.78
Max. Negotiated Rate $13,565.78
Rate for Payer: AHCCCS Medicaid $13,565.78
Rate for Payer: Allwell Medicaid $13,565.78
Rate for Payer: AZCH Complete Medicaid $13,565.78
Rate for Payer: Banner UC Health Medicaid $13,565.78
Rate for Payer: Mercy Care Medicaid $13,565.78
Service Code APR-DRG 1153
Hospital Charge Code APRDRG1154
Min. Negotiated Rate $7,185.14
Max. Negotiated Rate $7,185.14
Rate for Payer: AHCCCS Medicaid $7,185.14
Rate for Payer: Allwell Medicaid $7,185.14
Rate for Payer: AZCH Complete Medicaid $7,185.14
Rate for Payer: Banner UC Health Medicaid $7,185.14
Rate for Payer: Mercy Care Medicaid $7,185.14
Service Code APR-DRG 1153
Hospital Charge Code APRDRG1152
Min. Negotiated Rate $7,185.14
Max. Negotiated Rate $7,185.14
Rate for Payer: AHCCCS Medicaid $7,185.14
Rate for Payer: Allwell Medicaid $7,185.14
Rate for Payer: AZCH Complete Medicaid $7,185.14
Rate for Payer: Banner UC Health Medicaid $7,185.14
Rate for Payer: Mercy Care Medicaid $7,185.14
Service Code APR-DRG 1151
Hospital Charge Code APRDRG1151
Min. Negotiated Rate $3,431.25
Max. Negotiated Rate $3,431.25
Rate for Payer: AHCCCS Medicaid $3,431.25
Rate for Payer: Allwell Medicaid $3,431.25
Rate for Payer: AZCH Complete Medicaid $3,431.25
Rate for Payer: Banner UC Health Medicaid $3,431.25
Rate for Payer: Mercy Care Medicaid $3,431.25
Service Code APR-DRG 1152
Hospital Charge Code APRDRG1152
Min. Negotiated Rate $4,564.71
Max. Negotiated Rate $4,564.71
Rate for Payer: AHCCCS Medicaid $4,564.71
Rate for Payer: Allwell Medicaid $4,564.71
Rate for Payer: AZCH Complete Medicaid $4,564.71
Rate for Payer: Banner UC Health Medicaid $4,564.71
Rate for Payer: Mercy Care Medicaid $4,564.71
Service Code APR-DRG 4243
Hospital Charge Code APRDRG4243
Min. Negotiated Rate $7,105.88
Max. Negotiated Rate $7,105.88
Rate for Payer: AHCCCS Medicaid $7,105.88
Rate for Payer: Allwell Medicaid $7,105.88
Rate for Payer: AZCH Complete Medicaid $7,105.88
Rate for Payer: Banner UC Health Medicaid $7,105.88
Rate for Payer: Mercy Care Medicaid $7,105.88
Service Code APR-DRG 4242
Hospital Charge Code APRDRG4244
Min. Negotiated Rate $4,780.04
Max. Negotiated Rate $4,780.04
Rate for Payer: AHCCCS Medicaid $4,780.04
Rate for Payer: Allwell Medicaid $4,780.04
Rate for Payer: AZCH Complete Medicaid $4,780.04
Rate for Payer: Banner UC Health Medicaid $4,780.04
Rate for Payer: Mercy Care Medicaid $4,780.04
Service Code APR-DRG 4242
Hospital Charge Code APRDRG4242
Min. Negotiated Rate $4,780.04
Max. Negotiated Rate $4,780.04
Rate for Payer: AHCCCS Medicaid $4,780.04
Rate for Payer: Allwell Medicaid $4,780.04
Rate for Payer: AZCH Complete Medicaid $4,780.04
Rate for Payer: Banner UC Health Medicaid $4,780.04
Rate for Payer: Mercy Care Medicaid $4,780.04
Service Code APR-DRG 4243
Hospital Charge Code APRDRG4242
Min. Negotiated Rate $7,105.88
Max. Negotiated Rate $7,105.88
Rate for Payer: AHCCCS Medicaid $7,105.88
Rate for Payer: Allwell Medicaid $7,105.88
Rate for Payer: AZCH Complete Medicaid $7,105.88
Rate for Payer: Banner UC Health Medicaid $7,105.88
Rate for Payer: Mercy Care Medicaid $7,105.88
Service Code APR-DRG 4241
Hospital Charge Code APRDRG4242
Min. Negotiated Rate $3,579.24
Max. Negotiated Rate $3,579.24
Rate for Payer: AHCCCS Medicaid $3,579.24
Rate for Payer: Allwell Medicaid $3,579.24
Rate for Payer: AZCH Complete Medicaid $3,579.24
Rate for Payer: Banner UC Health Medicaid $3,579.24
Rate for Payer: Mercy Care Medicaid $3,579.24
Service Code APR-DRG 4241
Hospital Charge Code APRDRG4241
Min. Negotiated Rate $3,579.24
Max. Negotiated Rate $3,579.24
Rate for Payer: AHCCCS Medicaid $3,579.24
Rate for Payer: Allwell Medicaid $3,579.24
Rate for Payer: AZCH Complete Medicaid $3,579.24
Rate for Payer: Banner UC Health Medicaid $3,579.24
Rate for Payer: Mercy Care Medicaid $3,579.24
Service Code APR-DRG 4244
Hospital Charge Code APRDRG4242
Min. Negotiated Rate $13,603.65
Max. Negotiated Rate $13,603.65
Rate for Payer: AHCCCS Medicaid $13,603.65
Rate for Payer: Allwell Medicaid $13,603.65
Rate for Payer: AZCH Complete Medicaid $13,603.65
Rate for Payer: Banner UC Health Medicaid $13,603.65
Rate for Payer: Mercy Care Medicaid $13,603.65
Service Code APR-DRG 4242
Hospital Charge Code APRDRG4243
Min. Negotiated Rate $4,780.04
Max. Negotiated Rate $4,780.04
Rate for Payer: AHCCCS Medicaid $4,780.04
Rate for Payer: Allwell Medicaid $4,780.04
Rate for Payer: AZCH Complete Medicaid $4,780.04
Rate for Payer: Banner UC Health Medicaid $4,780.04
Rate for Payer: Mercy Care Medicaid $4,780.04
Service Code APR-DRG 4241
Hospital Charge Code APRDRG4243
Min. Negotiated Rate $3,579.24
Max. Negotiated Rate $3,579.24
Rate for Payer: AHCCCS Medicaid $3,579.24
Rate for Payer: Allwell Medicaid $3,579.24
Rate for Payer: AZCH Complete Medicaid $3,579.24
Rate for Payer: Banner UC Health Medicaid $3,579.24
Rate for Payer: Mercy Care Medicaid $3,579.24
Service Code APR-DRG 4243
Hospital Charge Code APRDRG4244
Min. Negotiated Rate $7,105.88
Max. Negotiated Rate $7,105.88
Rate for Payer: AHCCCS Medicaid $7,105.88
Rate for Payer: Allwell Medicaid $7,105.88
Rate for Payer: AZCH Complete Medicaid $7,105.88
Rate for Payer: Banner UC Health Medicaid $7,105.88
Rate for Payer: Mercy Care Medicaid $7,105.88
Service Code APR-DRG 4243
Hospital Charge Code APRDRG4241
Min. Negotiated Rate $7,105.88
Max. Negotiated Rate $7,105.88
Rate for Payer: AHCCCS Medicaid $7,105.88
Rate for Payer: Allwell Medicaid $7,105.88
Rate for Payer: AZCH Complete Medicaid $7,105.88
Rate for Payer: Banner UC Health Medicaid $7,105.88
Rate for Payer: Mercy Care Medicaid $7,105.88
Service Code APR-DRG 4241
Hospital Charge Code APRDRG4244
Min. Negotiated Rate $3,579.24
Max. Negotiated Rate $3,579.24
Rate for Payer: AHCCCS Medicaid $3,579.24
Rate for Payer: Allwell Medicaid $3,579.24
Rate for Payer: AZCH Complete Medicaid $3,579.24
Rate for Payer: Banner UC Health Medicaid $3,579.24
Rate for Payer: Mercy Care Medicaid $3,579.24
Service Code APR-DRG 4242
Hospital Charge Code APRDRG4241
Min. Negotiated Rate $4,780.04
Max. Negotiated Rate $4,780.04
Rate for Payer: AHCCCS Medicaid $4,780.04
Rate for Payer: Allwell Medicaid $4,780.04
Rate for Payer: AZCH Complete Medicaid $4,780.04
Rate for Payer: Banner UC Health Medicaid $4,780.04
Rate for Payer: Mercy Care Medicaid $4,780.04
Service Code APR-DRG 4244
Hospital Charge Code APRDRG4244
Min. Negotiated Rate $13,603.65
Max. Negotiated Rate $13,603.65
Rate for Payer: AHCCCS Medicaid $13,603.65
Rate for Payer: Allwell Medicaid $13,603.65
Rate for Payer: AZCH Complete Medicaid $13,603.65
Rate for Payer: Banner UC Health Medicaid $13,603.65
Rate for Payer: Mercy Care Medicaid $13,603.65
Service Code APR-DRG 4244
Hospital Charge Code APRDRG4243
Min. Negotiated Rate $13,603.65
Max. Negotiated Rate $13,603.65
Rate for Payer: AHCCCS Medicaid $13,603.65
Rate for Payer: Allwell Medicaid $13,603.65
Rate for Payer: AZCH Complete Medicaid $13,603.65
Rate for Payer: Banner UC Health Medicaid $13,603.65
Rate for Payer: Mercy Care Medicaid $13,603.65
Service Code APR-DRG 4244
Hospital Charge Code APRDRG4241
Min. Negotiated Rate $13,603.65
Max. Negotiated Rate $13,603.65
Rate for Payer: AHCCCS Medicaid $13,603.65
Rate for Payer: Allwell Medicaid $13,603.65
Rate for Payer: AZCH Complete Medicaid $13,603.65
Rate for Payer: Banner UC Health Medicaid $13,603.65
Rate for Payer: Mercy Care Medicaid $13,603.65
Service Code APR-DRG 2434
Hospital Charge Code APRDRG2432
Min. Negotiated Rate $13,180.71
Max. Negotiated Rate $13,180.71
Rate for Payer: AHCCCS Medicaid $13,180.71
Rate for Payer: Allwell Medicaid $13,180.71
Rate for Payer: AZCH Complete Medicaid $13,180.71
Rate for Payer: Banner UC Health Medicaid $13,180.71
Rate for Payer: Mercy Care Medicaid $13,180.71