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Charge Type Setting Price  
Service Code APR-DRG 1431
Hospital Charge Code APRDRG1431
Min. Negotiated Rate $3,290.27
Max. Negotiated Rate $3,290.27
Rate for Payer: AHCCCS Medicaid $3,290.27
Rate for Payer: Allwell Medicaid $3,290.27
Rate for Payer: AZCH Complete Medicaid $3,290.27
Rate for Payer: Banner UC Health Medicaid $3,290.27
Rate for Payer: Mercy Care Medicaid $3,290.27
Service Code APR-DRG 1434
Hospital Charge Code APRDRG1434
Min. Negotiated Rate $10,721.60
Max. Negotiated Rate $10,721.60
Rate for Payer: AHCCCS Medicaid $10,721.60
Rate for Payer: Allwell Medicaid $10,721.60
Rate for Payer: AZCH Complete Medicaid $10,721.60
Rate for Payer: Banner UC Health Medicaid $10,721.60
Rate for Payer: Mercy Care Medicaid $10,721.60
Service Code APR-DRG 1433
Hospital Charge Code APRDRG1431
Min. Negotiated Rate $6,897.57
Max. Negotiated Rate $6,897.57
Rate for Payer: AHCCCS Medicaid $6,897.57
Rate for Payer: Allwell Medicaid $6,897.57
Rate for Payer: AZCH Complete Medicaid $6,897.57
Rate for Payer: Banner UC Health Medicaid $6,897.57
Rate for Payer: Mercy Care Medicaid $6,897.57
Service Code APR-DRG 1432
Hospital Charge Code APRDRG1434
Min. Negotiated Rate $4,782.85
Max. Negotiated Rate $4,782.85
Rate for Payer: AHCCCS Medicaid $4,782.85
Rate for Payer: Allwell Medicaid $4,782.85
Rate for Payer: AZCH Complete Medicaid $4,782.85
Rate for Payer: Banner UC Health Medicaid $4,782.85
Rate for Payer: Mercy Care Medicaid $4,782.85
Service Code APR-DRG 1431
Hospital Charge Code APRDRG1433
Min. Negotiated Rate $3,290.27
Max. Negotiated Rate $3,290.27
Rate for Payer: AHCCCS Medicaid $3,290.27
Rate for Payer: Allwell Medicaid $3,290.27
Rate for Payer: AZCH Complete Medicaid $3,290.27
Rate for Payer: Banner UC Health Medicaid $3,290.27
Rate for Payer: Mercy Care Medicaid $3,290.27
Service Code APR-DRG 1434
Hospital Charge Code APRDRG1433
Min. Negotiated Rate $10,721.60
Max. Negotiated Rate $10,721.60
Rate for Payer: AHCCCS Medicaid $10,721.60
Rate for Payer: Allwell Medicaid $10,721.60
Rate for Payer: AZCH Complete Medicaid $10,721.60
Rate for Payer: Banner UC Health Medicaid $10,721.60
Rate for Payer: Mercy Care Medicaid $10,721.60
Service Code APR-DRG 1433
Hospital Charge Code APRDRG1434
Min. Negotiated Rate $6,897.57
Max. Negotiated Rate $6,897.57
Rate for Payer: AHCCCS Medicaid $6,897.57
Rate for Payer: Allwell Medicaid $6,897.57
Rate for Payer: AZCH Complete Medicaid $6,897.57
Rate for Payer: Banner UC Health Medicaid $6,897.57
Rate for Payer: Mercy Care Medicaid $6,897.57
Service Code APR-DRG 1431
Hospital Charge Code APRDRG1432
Min. Negotiated Rate $3,290.27
Max. Negotiated Rate $3,290.27
Rate for Payer: AHCCCS Medicaid $3,290.27
Rate for Payer: Allwell Medicaid $3,290.27
Rate for Payer: AZCH Complete Medicaid $3,290.27
Rate for Payer: Banner UC Health Medicaid $3,290.27
Rate for Payer: Mercy Care Medicaid $3,290.27
Service Code APR-DRG 3093
Hospital Charge Code APRDRG3094
Min. Negotiated Rate $17,915.86
Max. Negotiated Rate $17,915.86
Rate for Payer: AHCCCS Medicaid $17,915.86
Rate for Payer: Allwell Medicaid $17,915.86
Rate for Payer: AZCH Complete Medicaid $17,915.86
Rate for Payer: Banner UC Health Medicaid $17,915.86
Rate for Payer: Mercy Care Medicaid $17,915.86
Service Code APR-DRG 3094
Hospital Charge Code APRDRG3092
Min. Negotiated Rate $29,232.95
Max. Negotiated Rate $29,232.95
Rate for Payer: AHCCCS Medicaid $29,232.95
Rate for Payer: Allwell Medicaid $29,232.95
Rate for Payer: AZCH Complete Medicaid $29,232.95
Rate for Payer: Banner UC Health Medicaid $29,232.95
Rate for Payer: Mercy Care Medicaid $29,232.95
Service Code APR-DRG 3093
Hospital Charge Code APRDRG3093
Min. Negotiated Rate $17,915.86
Max. Negotiated Rate $17,915.86
Rate for Payer: AHCCCS Medicaid $17,915.86
Rate for Payer: Allwell Medicaid $17,915.86
Rate for Payer: AZCH Complete Medicaid $17,915.86
Rate for Payer: Banner UC Health Medicaid $17,915.86
Rate for Payer: Mercy Care Medicaid $17,915.86
Service Code APR-DRG 3092
Hospital Charge Code APRDRG3093
Min. Negotiated Rate $12,185.42
Max. Negotiated Rate $12,185.42
Rate for Payer: AHCCCS Medicaid $12,185.42
Rate for Payer: Allwell Medicaid $12,185.42
Rate for Payer: AZCH Complete Medicaid $12,185.42
Rate for Payer: Banner UC Health Medicaid $12,185.42
Rate for Payer: Mercy Care Medicaid $12,185.42
Service Code APR-DRG 3091
Hospital Charge Code APRDRG3093
Min. Negotiated Rate $9,220.60
Max. Negotiated Rate $9,220.60
Rate for Payer: AHCCCS Medicaid $9,220.60
Rate for Payer: Allwell Medicaid $9,220.60
Rate for Payer: AZCH Complete Medicaid $9,220.60
Rate for Payer: Banner UC Health Medicaid $9,220.60
Rate for Payer: Mercy Care Medicaid $9,220.60
Service Code APR-DRG 3094
Hospital Charge Code APRDRG3093
Min. Negotiated Rate $29,232.95
Max. Negotiated Rate $29,232.95
Rate for Payer: AHCCCS Medicaid $29,232.95
Rate for Payer: Allwell Medicaid $29,232.95
Rate for Payer: AZCH Complete Medicaid $29,232.95
Rate for Payer: Banner UC Health Medicaid $29,232.95
Rate for Payer: Mercy Care Medicaid $29,232.95
Service Code APR-DRG 3094
Hospital Charge Code APRDRG3094
Min. Negotiated Rate $29,232.95
Max. Negotiated Rate $29,232.95
Rate for Payer: AHCCCS Medicaid $29,232.95
Rate for Payer: Allwell Medicaid $29,232.95
Rate for Payer: AZCH Complete Medicaid $29,232.95
Rate for Payer: Banner UC Health Medicaid $29,232.95
Rate for Payer: Mercy Care Medicaid $29,232.95
Service Code APR-DRG 3092
Hospital Charge Code APRDRG3094
Min. Negotiated Rate $12,185.42
Max. Negotiated Rate $12,185.42
Rate for Payer: AHCCCS Medicaid $12,185.42
Rate for Payer: Allwell Medicaid $12,185.42
Rate for Payer: AZCH Complete Medicaid $12,185.42
Rate for Payer: Banner UC Health Medicaid $12,185.42
Rate for Payer: Mercy Care Medicaid $12,185.42
Service Code APR-DRG 3091
Hospital Charge Code APRDRG3092
Min. Negotiated Rate $9,220.60
Max. Negotiated Rate $9,220.60
Rate for Payer: AHCCCS Medicaid $9,220.60
Rate for Payer: Allwell Medicaid $9,220.60
Rate for Payer: AZCH Complete Medicaid $9,220.60
Rate for Payer: Banner UC Health Medicaid $9,220.60
Rate for Payer: Mercy Care Medicaid $9,220.60
Service Code APR-DRG 3093
Hospital Charge Code APRDRG3092
Min. Negotiated Rate $17,915.86
Max. Negotiated Rate $17,915.86
Rate for Payer: AHCCCS Medicaid $17,915.86
Rate for Payer: Allwell Medicaid $17,915.86
Rate for Payer: AZCH Complete Medicaid $17,915.86
Rate for Payer: Banner UC Health Medicaid $17,915.86
Rate for Payer: Mercy Care Medicaid $17,915.86
Service Code APR-DRG 3092
Hospital Charge Code APRDRG3092
Min. Negotiated Rate $12,185.42
Max. Negotiated Rate $12,185.42
Rate for Payer: AHCCCS Medicaid $12,185.42
Rate for Payer: Allwell Medicaid $12,185.42
Rate for Payer: AZCH Complete Medicaid $12,185.42
Rate for Payer: Banner UC Health Medicaid $12,185.42
Rate for Payer: Mercy Care Medicaid $12,185.42
Service Code APR-DRG 3092
Hospital Charge Code APRDRG3091
Min. Negotiated Rate $12,185.42
Max. Negotiated Rate $12,185.42
Rate for Payer: AHCCCS Medicaid $12,185.42
Rate for Payer: Allwell Medicaid $12,185.42
Rate for Payer: AZCH Complete Medicaid $12,185.42
Rate for Payer: Banner UC Health Medicaid $12,185.42
Rate for Payer: Mercy Care Medicaid $12,185.42
Service Code APR-DRG 3091
Hospital Charge Code APRDRG3094
Min. Negotiated Rate $9,220.60
Max. Negotiated Rate $9,220.60
Rate for Payer: AHCCCS Medicaid $9,220.60
Rate for Payer: Allwell Medicaid $9,220.60
Rate for Payer: AZCH Complete Medicaid $9,220.60
Rate for Payer: Banner UC Health Medicaid $9,220.60
Rate for Payer: Mercy Care Medicaid $9,220.60
Service Code APR-DRG 3093
Hospital Charge Code APRDRG3091
Min. Negotiated Rate $17,915.86
Max. Negotiated Rate $17,915.86
Rate for Payer: AHCCCS Medicaid $17,915.86
Rate for Payer: Allwell Medicaid $17,915.86
Rate for Payer: AZCH Complete Medicaid $17,915.86
Rate for Payer: Banner UC Health Medicaid $17,915.86
Rate for Payer: Mercy Care Medicaid $17,915.86
Service Code APR-DRG 3091
Hospital Charge Code APRDRG3091
Min. Negotiated Rate $9,220.60
Max. Negotiated Rate $9,220.60
Rate for Payer: AHCCCS Medicaid $9,220.60
Rate for Payer: Allwell Medicaid $9,220.60
Rate for Payer: AZCH Complete Medicaid $9,220.60
Rate for Payer: Banner UC Health Medicaid $9,220.60
Rate for Payer: Mercy Care Medicaid $9,220.60
Service Code APR-DRG 3094
Hospital Charge Code APRDRG3091
Min. Negotiated Rate $29,232.95
Max. Negotiated Rate $29,232.95
Rate for Payer: AHCCCS Medicaid $29,232.95
Rate for Payer: Allwell Medicaid $29,232.95
Rate for Payer: AZCH Complete Medicaid $29,232.95
Rate for Payer: Banner UC Health Medicaid $29,232.95
Rate for Payer: Mercy Care Medicaid $29,232.95
Service Code APR-DRG 3854
Hospital Charge Code APRDRG3853
Min. Negotiated Rate $13,174.40
Max. Negotiated Rate $13,174.40
Rate for Payer: AHCCCS Medicaid $13,174.40
Rate for Payer: Allwell Medicaid $13,174.40
Rate for Payer: AZCH Complete Medicaid $13,174.40
Rate for Payer: Banner UC Health Medicaid $13,174.40
Rate for Payer: Mercy Care Medicaid $13,174.40