Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6123
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69
Rate for Payer: NaphCare Correctional Healthcare	$24,091.69

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6121
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62
Rate for Payer: NaphCare Correctional Healthcare	$33,076.62

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$24,091.69

Service Code	APR-DRG 6122
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$24,091.69
Max. Negotiated Rate	$24,091.69
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,091.69
Rate for Payer: Mercy Care Medicaid	$24,091.69
Rate for Payer: NaphCare Correctional Healthcare	$24,091.69

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$15,807.45

Service Code	APR-DRG 6121
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$15,807.45
Max. Negotiated Rate	$15,807.45
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$15,807.45
Rate for Payer: Mercy Care Medicaid	$15,807.45
Rate for Payer: NaphCare Correctional Healthcare	$15,807.45

Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition

Facility

IP

$33,076.62

Service Code	APR-DRG 6123
Hospital Charge Code	APRDRG6122
Min. Negotiated Rate	$33,076.62
Max. Negotiated Rate	$33,076.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$33,076.62
Rate for Payer: Mercy Care Medicaid	$33,076.62
Rate for Payer: NaphCare Correctional Healthcare	$33,076.62

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6092
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63
Rate for Payer: NaphCare Correctional Healthcare	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63
Rate for Payer: NaphCare Correctional Healthcare	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6092
Min. Negotiated Rate	$138,340.63
Max. Negotiated Rate	$138,340.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$138,340.63
Rate for Payer: Mercy Care Medicaid	$138,340.63
Rate for Payer: NaphCare Correctional Healthcare	$138,340.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6094
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63
Rate for Payer: NaphCare Correctional Healthcare	$55,323.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6092
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6091
Min. Negotiated Rate	$138,340.63
Max. Negotiated Rate	$138,340.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$138,340.63
Rate for Payer: Mercy Care Medicaid	$138,340.63
Rate for Payer: NaphCare Correctional Healthcare	$138,340.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6091
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6091
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6091
Hospital Charge Code	APRDRG6094
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6094
Min. Negotiated Rate	$138,340.63
Max. Negotiated Rate	$138,340.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$138,340.63
Rate for Payer: Mercy Care Medicaid	$138,340.63
Rate for Payer: NaphCare Correctional Healthcare	$138,340.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6094
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6092
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$138,340.63

Service Code	APR-DRG 6094
Hospital Charge Code	APRDRG6093
Min. Negotiated Rate	$138,340.63
Max. Negotiated Rate	$138,340.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$138,340.63
Rate for Payer: Mercy Care Medicaid	$138,340.63
Rate for Payer: NaphCare Correctional Healthcare	$138,340.63

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6091
Hospital Charge Code	APRDRG6092
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$37,504.56

Service Code	APR-DRG 6091
Hospital Charge Code	APRDRG6091
Min. Negotiated Rate	$37,504.56
Max. Negotiated Rate	$37,504.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,504.56
Rate for Payer: Mercy Care Medicaid	$37,504.56
Rate for Payer: NaphCare Correctional Healthcare	$37,504.56

Neonate Birth Weight 1500-2499 Grams With Major Procedure

Facility

IP

$55,323.63

Service Code	APR-DRG 6093
Hospital Charge Code	APRDRG6091
Min. Negotiated Rate	$55,323.63
Max. Negotiated Rate	$55,323.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$55,323.63
Rate for Payer: Mercy Care Medicaid	$55,323.63
Rate for Payer: NaphCare Correctional Healthcare	$55,323.63

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$126,083.66

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$126,083.66
Max. Negotiated Rate	$126,083.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$126,083.66
Rate for Payer: Mercy Care Medicaid	$126,083.66
Rate for Payer: NaphCare Correctional Healthcare	$126,083.66

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56
Rate for Payer: NaphCare Correctional Healthcare	$206,843.56

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$60,868.89

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG5882
Min. Negotiated Rate	$60,868.89
Max. Negotiated Rate	$60,868.89
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$60,868.89
Rate for Payer: Mercy Care Medicaid	$60,868.89
Rate for Payer: NaphCare Correctional Healthcare	$60,868.89

Neonate Birth Weight < 1500 Grams With Major Procedure

Facility

IP

$206,843.56

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG5881
Min. Negotiated Rate	$206,843.56
Max. Negotiated Rate	$206,843.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$206,843.56
Rate for Payer: Mercy Care Medicaid	$206,843.56
Rate for Payer: NaphCare Correctional Healthcare	$206,843.56

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