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Charge Type Setting Price  
Service Code APR-DRG 7112
Hospital Charge Code APRDRG7113
Min. Negotiated Rate $9,573.41
Max. Negotiated Rate $9,573.41
Rate for Payer: AHCCCS Medicaid $9,573.41
Rate for Payer: Allwell Medicaid $9,573.41
Rate for Payer: AZCH Complete Medicaid $9,573.41
Rate for Payer: Banner UC Health Medicaid $9,573.41
Rate for Payer: Mercy Care Medicaid $9,573.41
Service Code APR-DRG 7114
Hospital Charge Code APRDRG7113
Min. Negotiated Rate $33,120.81
Max. Negotiated Rate $33,120.81
Rate for Payer: AHCCCS Medicaid $33,120.81
Rate for Payer: Allwell Medicaid $33,120.81
Rate for Payer: AZCH Complete Medicaid $33,120.81
Rate for Payer: Banner UC Health Medicaid $33,120.81
Rate for Payer: Mercy Care Medicaid $33,120.81
Service Code APR-DRG 7111
Hospital Charge Code APRDRG7111
Min. Negotiated Rate $7,152.88
Max. Negotiated Rate $7,152.88
Rate for Payer: AHCCCS Medicaid $7,152.88
Rate for Payer: Allwell Medicaid $7,152.88
Rate for Payer: AZCH Complete Medicaid $7,152.88
Rate for Payer: Banner UC Health Medicaid $7,152.88
Rate for Payer: Mercy Care Medicaid $7,152.88
Service Code APR-DRG 7113
Hospital Charge Code APRDRG7111
Min. Negotiated Rate $16,744.52
Max. Negotiated Rate $16,744.52
Rate for Payer: AHCCCS Medicaid $16,744.52
Rate for Payer: Allwell Medicaid $16,744.52
Rate for Payer: AZCH Complete Medicaid $16,744.52
Rate for Payer: Banner UC Health Medicaid $16,744.52
Rate for Payer: Mercy Care Medicaid $16,744.52
Service Code APR-DRG 7213
Hospital Charge Code APRDRG7211
Min. Negotiated Rate $8,592.85
Max. Negotiated Rate $8,592.85
Rate for Payer: AHCCCS Medicaid $8,592.85
Rate for Payer: Allwell Medicaid $8,592.85
Rate for Payer: AZCH Complete Medicaid $8,592.85
Rate for Payer: Banner UC Health Medicaid $8,592.85
Rate for Payer: Mercy Care Medicaid $8,592.85
Service Code APR-DRG 7212
Hospital Charge Code APRDRG7213
Min. Negotiated Rate $5,287.85
Max. Negotiated Rate $5,287.85
Rate for Payer: AHCCCS Medicaid $5,287.85
Rate for Payer: Allwell Medicaid $5,287.85
Rate for Payer: AZCH Complete Medicaid $5,287.85
Rate for Payer: Banner UC Health Medicaid $5,287.85
Rate for Payer: Mercy Care Medicaid $5,287.85
Service Code APR-DRG 7211
Hospital Charge Code APRDRG7211
Min. Negotiated Rate $4,019.02
Max. Negotiated Rate $4,019.02
Rate for Payer: AHCCCS Medicaid $4,019.02
Rate for Payer: Allwell Medicaid $4,019.02
Rate for Payer: AZCH Complete Medicaid $4,019.02
Rate for Payer: Banner UC Health Medicaid $4,019.02
Rate for Payer: Mercy Care Medicaid $4,019.02
Service Code APR-DRG 7214
Hospital Charge Code APRDRG7212
Min. Negotiated Rate $15,622.28
Max. Negotiated Rate $15,622.28
Rate for Payer: AHCCCS Medicaid $15,622.28
Rate for Payer: Allwell Medicaid $15,622.28
Rate for Payer: AZCH Complete Medicaid $15,622.28
Rate for Payer: Banner UC Health Medicaid $15,622.28
Rate for Payer: Mercy Care Medicaid $15,622.28
Service Code APR-DRG 7211
Hospital Charge Code APRDRG7212
Min. Negotiated Rate $4,019.02
Max. Negotiated Rate $4,019.02
Rate for Payer: AHCCCS Medicaid $4,019.02
Rate for Payer: Allwell Medicaid $4,019.02
Rate for Payer: AZCH Complete Medicaid $4,019.02
Rate for Payer: Banner UC Health Medicaid $4,019.02
Rate for Payer: Mercy Care Medicaid $4,019.02
Service Code APR-DRG 7212
Hospital Charge Code APRDRG7214
Min. Negotiated Rate $5,287.85
Max. Negotiated Rate $5,287.85
Rate for Payer: AHCCCS Medicaid $5,287.85
Rate for Payer: Allwell Medicaid $5,287.85
Rate for Payer: AZCH Complete Medicaid $5,287.85
Rate for Payer: Banner UC Health Medicaid $5,287.85
Rate for Payer: Mercy Care Medicaid $5,287.85
Service Code APR-DRG 7212
Hospital Charge Code APRDRG7212
Min. Negotiated Rate $5,287.85
Max. Negotiated Rate $5,287.85
Rate for Payer: AHCCCS Medicaid $5,287.85
Rate for Payer: Allwell Medicaid $5,287.85
Rate for Payer: AZCH Complete Medicaid $5,287.85
Rate for Payer: Banner UC Health Medicaid $5,287.85
Rate for Payer: Mercy Care Medicaid $5,287.85
Service Code APR-DRG 7213
Hospital Charge Code APRDRG7214
Min. Negotiated Rate $8,592.85
Max. Negotiated Rate $8,592.85
Rate for Payer: AHCCCS Medicaid $8,592.85
Rate for Payer: Allwell Medicaid $8,592.85
Rate for Payer: AZCH Complete Medicaid $8,592.85
Rate for Payer: Banner UC Health Medicaid $8,592.85
Rate for Payer: Mercy Care Medicaid $8,592.85
Service Code APR-DRG 7212
Hospital Charge Code APRDRG7211
Min. Negotiated Rate $5,287.85
Max. Negotiated Rate $5,287.85
Rate for Payer: AHCCCS Medicaid $5,287.85
Rate for Payer: Allwell Medicaid $5,287.85
Rate for Payer: AZCH Complete Medicaid $5,287.85
Rate for Payer: Banner UC Health Medicaid $5,287.85
Rate for Payer: Mercy Care Medicaid $5,287.85
Service Code APR-DRG 7214
Hospital Charge Code APRDRG7214
Min. Negotiated Rate $15,622.28
Max. Negotiated Rate $15,622.28
Rate for Payer: AHCCCS Medicaid $15,622.28
Rate for Payer: Allwell Medicaid $15,622.28
Rate for Payer: AZCH Complete Medicaid $15,622.28
Rate for Payer: Banner UC Health Medicaid $15,622.28
Rate for Payer: Mercy Care Medicaid $15,622.28
Service Code APR-DRG 7214
Hospital Charge Code APRDRG7211
Min. Negotiated Rate $15,622.28
Max. Negotiated Rate $15,622.28
Rate for Payer: AHCCCS Medicaid $15,622.28
Rate for Payer: Allwell Medicaid $15,622.28
Rate for Payer: AZCH Complete Medicaid $15,622.28
Rate for Payer: Banner UC Health Medicaid $15,622.28
Rate for Payer: Mercy Care Medicaid $15,622.28
Service Code APR-DRG 7211
Hospital Charge Code APRDRG7214
Min. Negotiated Rate $4,019.02
Max. Negotiated Rate $4,019.02
Rate for Payer: AHCCCS Medicaid $4,019.02
Rate for Payer: Allwell Medicaid $4,019.02
Rate for Payer: AZCH Complete Medicaid $4,019.02
Rate for Payer: Banner UC Health Medicaid $4,019.02
Rate for Payer: Mercy Care Medicaid $4,019.02
Service Code APR-DRG 7214
Hospital Charge Code APRDRG7213
Min. Negotiated Rate $15,622.28
Max. Negotiated Rate $15,622.28
Rate for Payer: AHCCCS Medicaid $15,622.28
Rate for Payer: Allwell Medicaid $15,622.28
Rate for Payer: AZCH Complete Medicaid $15,622.28
Rate for Payer: Banner UC Health Medicaid $15,622.28
Rate for Payer: Mercy Care Medicaid $15,622.28
Service Code APR-DRG 7213
Hospital Charge Code APRDRG7212
Min. Negotiated Rate $8,592.85
Max. Negotiated Rate $8,592.85
Rate for Payer: AHCCCS Medicaid $8,592.85
Rate for Payer: Allwell Medicaid $8,592.85
Rate for Payer: AZCH Complete Medicaid $8,592.85
Rate for Payer: Banner UC Health Medicaid $8,592.85
Rate for Payer: Mercy Care Medicaid $8,592.85
Service Code APR-DRG 7213
Hospital Charge Code APRDRG7213
Min. Negotiated Rate $8,592.85
Max. Negotiated Rate $8,592.85
Rate for Payer: AHCCCS Medicaid $8,592.85
Rate for Payer: Allwell Medicaid $8,592.85
Rate for Payer: AZCH Complete Medicaid $8,592.85
Rate for Payer: Banner UC Health Medicaid $8,592.85
Rate for Payer: Mercy Care Medicaid $8,592.85
Service Code APR-DRG 7211
Hospital Charge Code APRDRG7213
Min. Negotiated Rate $4,019.02
Max. Negotiated Rate $4,019.02
Rate for Payer: AHCCCS Medicaid $4,019.02
Rate for Payer: Allwell Medicaid $4,019.02
Rate for Payer: AZCH Complete Medicaid $4,019.02
Rate for Payer: Banner UC Health Medicaid $4,019.02
Rate for Payer: Mercy Care Medicaid $4,019.02
Service Code APR-DRG 5611
Hospital Charge Code APRDRG5611
Min. Negotiated Rate $1,845.38
Max. Negotiated Rate $1,845.38
Rate for Payer: AHCCCS Medicaid $1,845.38
Rate for Payer: Allwell Medicaid $1,845.38
Rate for Payer: AZCH Complete Medicaid $1,845.38
Rate for Payer: Banner UC Health Medicaid $1,845.38
Rate for Payer: Mercy Care Medicaid $1,845.38
Service Code APR-DRG 5614
Hospital Charge Code APRDRG5611
Min. Negotiated Rate $9,424.71
Max. Negotiated Rate $9,424.71
Rate for Payer: AHCCCS Medicaid $9,424.71
Rate for Payer: Allwell Medicaid $9,424.71
Rate for Payer: AZCH Complete Medicaid $9,424.71
Rate for Payer: Banner UC Health Medicaid $9,424.71
Rate for Payer: Mercy Care Medicaid $9,424.71
Service Code APR-DRG 5611
Hospital Charge Code APRDRG5612
Min. Negotiated Rate $1,845.38
Max. Negotiated Rate $1,845.38
Rate for Payer: AHCCCS Medicaid $1,845.38
Rate for Payer: Allwell Medicaid $1,845.38
Rate for Payer: AZCH Complete Medicaid $1,845.38
Rate for Payer: Banner UC Health Medicaid $1,845.38
Rate for Payer: Mercy Care Medicaid $1,845.38
Service Code APR-DRG 5613
Hospital Charge Code APRDRG5613
Min. Negotiated Rate $4,461.61
Max. Negotiated Rate $4,461.61
Rate for Payer: AHCCCS Medicaid $4,461.61
Rate for Payer: Allwell Medicaid $4,461.61
Rate for Payer: AZCH Complete Medicaid $4,461.61
Rate for Payer: Banner UC Health Medicaid $4,461.61
Rate for Payer: Mercy Care Medicaid $4,461.61
Service Code APR-DRG 5611
Hospital Charge Code APRDRG5613
Min. Negotiated Rate $1,845.38
Max. Negotiated Rate $1,845.38
Rate for Payer: AHCCCS Medicaid $1,845.38
Rate for Payer: Allwell Medicaid $1,845.38
Rate for Payer: AZCH Complete Medicaid $1,845.38
Rate for Payer: Banner UC Health Medicaid $1,845.38
Rate for Payer: Mercy Care Medicaid $1,845.38