|
00140 ANES EYE PROCEDURE ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00140
|
| Hospital Charge Code |
22406078
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00140 ANES EYE PROCEDURE ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00140
|
| Hospital Charge Code |
22406078
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00140 ANES EYE PROCEDURE ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00140
|
| Hospital Charge Code |
22406079
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
00140 ANES EYE PROCEDURE ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00140
|
| Hospital Charge Code |
22406079
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00164 ANES NOSE SINUS BIOPSY ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00164
|
| Hospital Charge Code |
22406081
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00164 ANES NOSE SINUS BIOPSY ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00164
|
| Hospital Charge Code |
22406081
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00164 ANES NOSE SINUS BIOPSY ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00164
|
| Hospital Charge Code |
22406082
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
00164 ANES NOSE SINUS BIOPSY ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00164
|
| Hospital Charge Code |
22406082
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00300 ANES HEAD NECK POSTERIOR PROC ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406217
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00300 ANES HEAD NECK POSTERIOR PROC ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406217
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00300 ANES HEAD NECK POSTERIOR PROC ADDNL 30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406218
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00300 ANES HEAD NECK POSTERIOR PROC ADDNL 30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406218
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
00300 ANES HEAD NECK POSTERIOR PROCEDURE BASE CHG AND 1ST MI
|
Facility
OP
|
$467.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406215
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Aetna Medicare |
$130.76
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$174.42
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Cigna All Products |
$326.90
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: HealthNet Commercial |
$280.20
|
| Rate for Payer: HealthNet Medicare |
$130.76
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$272.26
|
| Rate for Payer: United Healthcare Medicare |
$84.06
|
|
|
00300 ANES HEAD NECK POSTERIOR PROCEDURE BASE CHG AND 1ST MI
|
Facility
IP
|
$467.00
|
|
|
Service Code
|
CPT 00300
|
| Hospital Charge Code |
22406215
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
|
|
00400 ANES INTEGUMENTARY SYSTEM ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00400
|
| Hospital Charge Code |
22406084
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00400 ANES INTEGUMENTARY SYSTEM ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00400
|
| Hospital Charge Code |
22406084
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00400 ANES INTEGUMENTARY SYSTEM ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00400
|
| Hospital Charge Code |
22406085
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00400 ANES INTEGUMENTARY SYSTEM ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00400
|
| Hospital Charge Code |
22406085
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
007012 Lacosamide
|
Facility
IP
|
$991.00
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
23173817
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$168.47 |
| Max. Negotiated Rate |
$891.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$891.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$168.47
|
| Rate for Payer: Amerigroup Medicare |
$168.47
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$168.47
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$168.47
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$257.66
|
| Rate for Payer: Copperpoint |
$277.98
|
| Rate for Payer: Humana Medicare |
$168.47
|
| Rate for Payer: SELF PAY |
$792.80
|
| Rate for Payer: Veterans (Triwest) |
$168.47
|
|
|
007012 Lacosamide
|
Facility
OP
|
$991.00
|
|
|
Service Code
|
CPT 80339
|
| Hospital Charge Code |
23173817
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$168.47 |
| Max. Negotiated Rate |
$891.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$891.90
|
| Rate for Payer: Aetna Medicare |
$277.48
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$168.47
|
| Rate for Payer: Amerigroup Medicare |
$168.47
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$370.14
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$168.47
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$168.47
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$257.66
|
| Rate for Payer: Cigna All Products |
$644.15
|
| Rate for Payer: Copperpoint |
$277.98
|
| Rate for Payer: HealthNet Commercial |
$594.60
|
| Rate for Payer: HealthNet Medicare |
$277.48
|
| Rate for Payer: Humana Medicare |
$168.47
|
| Rate for Payer: SELF PAY |
$792.80
|
| Rate for Payer: Veterans (Triwest) |
$168.47
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$577.75
|
| Rate for Payer: United Healthcare Medicare |
$178.38
|
|
|
00731 ANES UPPER GASTRO ENDO ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00731
|
| Hospital Charge Code |
22406087
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00731 ANES UPPER GASTRO ENDO ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00731
|
| Hospital Charge Code |
22406087
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00731 ANES UPPER GASTRO ENDO ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00731
|
| Hospital Charge Code |
22406088
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00731 ANES UPPER GASTRO ENDO ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00731
|
| Hospital Charge Code |
22406088
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
00790 ANES INTRAPER UPPER ABDOMEN ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00790
|
| Hospital Charge Code |
22406094
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|