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Service Code CPT 12035
Hospital Charge Code 22282785
Hospital Revenue Code 450
Min. Negotiated Rate $165.00
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $990.00
Rate for Payer: Aetna of AZ Medicare $308.00
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $165.00
Rate for Payer: Amerigroup Medicare $165.00
Rate for Payer: APIPA Medicare/Medicaid $410.85
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $165.00
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $165.00
Rate for Payer: Bisbee Police All Plans $286.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $748.00
Rate for Payer: Cash Price $880.00
Rate for Payer: Cash Price $880.00
Rate for Payer: Cigna of AZ Commercial $770.00
Rate for Payer: Copperpoint Commercial $272.25
Rate for Payer: Health Net of AZ Commercial $660.00
Rate for Payer: Health Net of AZ Medicare $308.00
Rate for Payer: Humana of AZ Medicare $165.00
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $880.00
Rate for Payer: TriWest Medicare $165.00
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $198.00
Service Code CPT 12036
Hospital Charge Code 22282786
Hospital Revenue Code 450
Min. Negotiated Rate $350.48
Max. Negotiated Rate $1,213.20
Rate for Payer: Aetna of AZ Commercial $1,213.20
Rate for Payer: Bisbee Police All Plans $350.48
Rate for Payer: Cash Price $1,078.40
Rate for Payer: Self Pay Self Pay $1,078.40
Service Code CPT 12036
Hospital Charge Code 22282786
Hospital Revenue Code 450
Min. Negotiated Rate $202.20
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,213.20
Rate for Payer: Aetna of AZ Medicare $377.44
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $202.20
Rate for Payer: Amerigroup Medicare $202.20
Rate for Payer: APIPA Medicare/Medicaid $503.48
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $202.20
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $202.20
Rate for Payer: Bisbee Police All Plans $350.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $916.64
Rate for Payer: Cash Price $1,078.40
Rate for Payer: Cash Price $1,078.40
Rate for Payer: Cigna of AZ Commercial $943.60
Rate for Payer: Copperpoint Commercial $333.63
Rate for Payer: Health Net of AZ Commercial $808.80
Rate for Payer: Health Net of AZ Medicare $377.44
Rate for Payer: Humana of AZ Medicare $202.20
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $1,078.40
Rate for Payer: TriWest Medicare $202.20
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $242.64
Service Code CPT 12037
Hospital Charge Code 22282787
Hospital Revenue Code 450
Min. Negotiated Rate $416.00
Max. Negotiated Rate $1,440.00
Rate for Payer: Aetna of AZ Commercial $1,440.00
Rate for Payer: Bisbee Police All Plans $416.00
Rate for Payer: Cash Price $1,280.00
Rate for Payer: Self Pay Self Pay $1,280.00
Service Code CPT 12037
Hospital Charge Code 22282787
Hospital Revenue Code 450
Min. Negotiated Rate $240.00
Max. Negotiated Rate $2,909.00
Rate for Payer: Aetna of AZ Commercial $1,440.00
Rate for Payer: Aetna of AZ Medicare $448.00
Rate for Payer: AHCCCS Medicaid $2,487.28
Rate for Payer: Allwell Medicaid $2,487.28
Rate for Payer: Allwell Medicare $240.00
Rate for Payer: Amerigroup Medicare $240.00
Rate for Payer: APIPA Medicare/Medicaid $597.60
Rate for Payer: AZCH Complete Medicaid $2,487.28
Rate for Payer: AZCH Complete Medicare $240.00
Rate for Payer: Banner UC Health Medicaid $2,487.28
Rate for Payer: Banner UC Health Medicare $240.00
Rate for Payer: Bisbee Police All Plans $416.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,088.00
Rate for Payer: Cash Price $1,280.00
Rate for Payer: Cash Price $1,280.00
Rate for Payer: Cigna of AZ Commercial $1,120.00
Rate for Payer: Copperpoint Commercial $396.00
Rate for Payer: Health Net of AZ Commercial $960.00
Rate for Payer: Health Net of AZ Medicare $448.00
Rate for Payer: Humana of AZ Medicare $240.00
Rate for Payer: Mercy Care Medicaid $2,487.28
Rate for Payer: Self Pay Self Pay $1,280.00
Rate for Payer: TriWest Medicare $240.00
Rate for Payer: UnitedHealth Group of AZ Commercial $2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare $288.00
Service Code CPT 12041
Hospital Charge Code 22282788
Hospital Revenue Code 450
Min. Negotiated Rate $172.64
Max. Negotiated Rate $597.60
Rate for Payer: Aetna of AZ Commercial $597.60
Rate for Payer: Bisbee Police All Plans $172.64
Rate for Payer: Cash Price $531.20
Rate for Payer: Self Pay Self Pay $531.20
Service Code CPT 12041
Hospital Charge Code 22282788
Hospital Revenue Code 450
Min. Negotiated Rate $99.60
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $597.60
Rate for Payer: Aetna of AZ Medicare $185.92
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $99.60
Rate for Payer: Amerigroup Medicare $99.60
Rate for Payer: APIPA Medicare/Medicaid $248.00
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $99.60
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $99.60
Rate for Payer: Bisbee Police All Plans $172.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $451.52
Rate for Payer: Cash Price $531.20
Rate for Payer: Cash Price $531.20
Rate for Payer: Cigna of AZ Commercial $464.80
Rate for Payer: Copperpoint Commercial $164.34
Rate for Payer: Health Net of AZ Commercial $398.40
Rate for Payer: Health Net of AZ Medicare $185.92
Rate for Payer: Humana of AZ Medicare $99.60
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $531.20
Rate for Payer: TriWest Medicare $99.60
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $119.52
Service Code CPT 12042
Hospital Charge Code 22282789
Hospital Revenue Code 450
Min. Negotiated Rate $115.65
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $693.90
Rate for Payer: Aetna of AZ Medicare $215.88
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $115.65
Rate for Payer: Amerigroup Medicare $115.65
Rate for Payer: APIPA Medicare/Medicaid $287.97
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $115.65
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $115.65
Rate for Payer: Bisbee Police All Plans $200.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $524.28
Rate for Payer: Cash Price $616.80
Rate for Payer: Cash Price $616.80
Rate for Payer: Cigna of AZ Commercial $539.70
Rate for Payer: Copperpoint Commercial $190.82
Rate for Payer: Health Net of AZ Commercial $462.60
Rate for Payer: Health Net of AZ Medicare $215.88
Rate for Payer: Humana of AZ Medicare $115.65
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $616.80
Rate for Payer: TriWest Medicare $115.65
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $138.78
Service Code CPT 12042
Hospital Charge Code 22282789
Hospital Revenue Code 450
Min. Negotiated Rate $200.46
Max. Negotiated Rate $693.90
Rate for Payer: Aetna of AZ Commercial $693.90
Rate for Payer: Bisbee Police All Plans $200.46
Rate for Payer: Cash Price $616.80
Rate for Payer: Self Pay Self Pay $616.80
Service Code CPT 12044
Hospital Charge Code 22282790
Hospital Revenue Code 450
Min. Negotiated Rate $148.65
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $891.90
Rate for Payer: Aetna of AZ Medicare $277.48
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $148.65
Rate for Payer: Amerigroup Medicare $148.65
Rate for Payer: APIPA Medicare/Medicaid $370.14
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $148.65
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $148.65
Rate for Payer: Bisbee Police All Plans $257.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $673.88
Rate for Payer: Cash Price $792.80
Rate for Payer: Cash Price $792.80
Rate for Payer: Cigna of AZ Commercial $693.70
Rate for Payer: Copperpoint Commercial $245.27
Rate for Payer: Health Net of AZ Commercial $594.60
Rate for Payer: Health Net of AZ Medicare $277.48
Rate for Payer: Humana of AZ Medicare $148.65
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $792.80
Rate for Payer: TriWest Medicare $148.65
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $178.38
Service Code CPT 12044
Hospital Charge Code 22282790
Hospital Revenue Code 450
Min. Negotiated Rate $257.66
Max. Negotiated Rate $891.90
Rate for Payer: Aetna of AZ Commercial $891.90
Rate for Payer: Bisbee Police All Plans $257.66
Rate for Payer: Cash Price $792.80
Rate for Payer: Self Pay Self Pay $792.80
Service Code CPT 12045
Hospital Charge Code 22282791
Hospital Revenue Code 450
Min. Negotiated Rate $176.85
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,061.10
Rate for Payer: Aetna of AZ Medicare $330.12
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $176.85
Rate for Payer: Amerigroup Medicare $176.85
Rate for Payer: APIPA Medicare/Medicaid $440.36
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $176.85
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $176.85
Rate for Payer: Bisbee Police All Plans $306.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $801.72
Rate for Payer: Cash Price $943.20
Rate for Payer: Cash Price $943.20
Rate for Payer: Cigna of AZ Commercial $825.30
Rate for Payer: Copperpoint Commercial $291.80
Rate for Payer: Health Net of AZ Commercial $707.40
Rate for Payer: Health Net of AZ Medicare $330.12
Rate for Payer: Humana of AZ Medicare $176.85
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $943.20
Rate for Payer: TriWest Medicare $176.85
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $212.22
Service Code CPT 12045
Hospital Charge Code 22282791
Hospital Revenue Code 450
Min. Negotiated Rate $306.54
Max. Negotiated Rate $1,061.10
Rate for Payer: Aetna of AZ Commercial $1,061.10
Rate for Payer: Bisbee Police All Plans $306.54
Rate for Payer: Cash Price $943.20
Rate for Payer: Self Pay Self Pay $943.20
Service Code CPT 12046
Hospital Charge Code 22282792
Hospital Revenue Code 450
Min. Negotiated Rate $231.15
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,386.90
Rate for Payer: Aetna of AZ Medicare $431.48
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $231.15
Rate for Payer: Amerigroup Medicare $231.15
Rate for Payer: APIPA Medicare/Medicaid $575.56
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $231.15
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $231.15
Rate for Payer: Bisbee Police All Plans $400.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,047.88
Rate for Payer: Cash Price $1,232.80
Rate for Payer: Cash Price $1,232.80
Rate for Payer: Cigna of AZ Commercial $1,078.70
Rate for Payer: Copperpoint Commercial $381.40
Rate for Payer: Health Net of AZ Commercial $924.60
Rate for Payer: Health Net of AZ Medicare $431.48
Rate for Payer: Humana of AZ Medicare $231.15
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $1,232.80
Rate for Payer: TriWest Medicare $231.15
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $277.38
Service Code CPT 12046
Hospital Charge Code 22282792
Hospital Revenue Code 450
Min. Negotiated Rate $400.66
Max. Negotiated Rate $1,386.90
Rate for Payer: Aetna of AZ Commercial $1,386.90
Rate for Payer: Bisbee Police All Plans $400.66
Rate for Payer: Cash Price $1,232.80
Rate for Payer: Self Pay Self Pay $1,232.80
Service Code CPT 12047
Hospital Charge Code 22282793
Hospital Revenue Code 450
Min. Negotiated Rate $471.90
Max. Negotiated Rate $1,633.50
Rate for Payer: Aetna of AZ Commercial $1,633.50
Rate for Payer: Bisbee Police All Plans $471.90
Rate for Payer: Cash Price $1,452.00
Rate for Payer: Self Pay Self Pay $1,452.00
Service Code CPT 12047
Hospital Charge Code 22282793
Hospital Revenue Code 450
Min. Negotiated Rate $272.25
Max. Negotiated Rate $2,909.00
Rate for Payer: Aetna of AZ Commercial $1,633.50
Rate for Payer: Aetna of AZ Medicare $508.20
Rate for Payer: AHCCCS Medicaid $2,487.28
Rate for Payer: Allwell Medicaid $2,487.28
Rate for Payer: Allwell Medicare $272.25
Rate for Payer: Amerigroup Medicare $272.25
Rate for Payer: APIPA Medicare/Medicaid $677.90
Rate for Payer: AZCH Complete Medicaid $2,487.28
Rate for Payer: AZCH Complete Medicare $272.25
Rate for Payer: Banner UC Health Medicaid $2,487.28
Rate for Payer: Banner UC Health Medicare $272.25
Rate for Payer: Bisbee Police All Plans $471.90
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,234.20
Rate for Payer: Cash Price $1,452.00
Rate for Payer: Cash Price $1,452.00
Rate for Payer: Cigna of AZ Commercial $1,270.50
Rate for Payer: Copperpoint Commercial $449.21
Rate for Payer: Health Net of AZ Commercial $1,089.00
Rate for Payer: Health Net of AZ Medicare $508.20
Rate for Payer: Humana of AZ Medicare $272.25
Rate for Payer: Mercy Care Medicaid $2,487.28
Rate for Payer: Self Pay Self Pay $1,452.00
Rate for Payer: TriWest Medicare $272.25
Rate for Payer: UnitedHealth Group of AZ Commercial $2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare $326.70
Service Code CPT 12051
Hospital Charge Code 22282794
Hospital Revenue Code 450
Min. Negotiated Rate $183.82
Max. Negotiated Rate $636.30
Rate for Payer: Aetna of AZ Commercial $636.30
Rate for Payer: Bisbee Police All Plans $183.82
Rate for Payer: Cash Price $565.60
Rate for Payer: Self Pay Self Pay $565.60
Service Code CPT 12051
Hospital Charge Code 22282794
Hospital Revenue Code 450
Min. Negotiated Rate $106.05
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $636.30
Rate for Payer: Aetna of AZ Medicare $197.96
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $106.05
Rate for Payer: Amerigroup Medicare $106.05
Rate for Payer: APIPA Medicare/Medicaid $264.06
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $106.05
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $106.05
Rate for Payer: Bisbee Police All Plans $183.82
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $480.76
Rate for Payer: Cash Price $565.60
Rate for Payer: Cash Price $565.60
Rate for Payer: Cigna of AZ Commercial $494.90
Rate for Payer: Copperpoint Commercial $174.98
Rate for Payer: Health Net of AZ Commercial $424.20
Rate for Payer: Health Net of AZ Medicare $197.96
Rate for Payer: Humana of AZ Medicare $106.05
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $565.60
Rate for Payer: TriWest Medicare $106.05
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $127.26
Service Code CPT 12052
Hospital Charge Code 22282795
Hospital Revenue Code 450
Min. Negotiated Rate $272.74
Max. Negotiated Rate $944.10
Rate for Payer: Aetna of AZ Commercial $944.10
Rate for Payer: Bisbee Police All Plans $272.74
Rate for Payer: Cash Price $839.20
Rate for Payer: Self Pay Self Pay $839.20
Service Code CPT 12052
Hospital Charge Code 22282795
Hospital Revenue Code 450
Min. Negotiated Rate $157.35
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $944.10
Rate for Payer: Aetna of AZ Medicare $293.72
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $157.35
Rate for Payer: Amerigroup Medicare $157.35
Rate for Payer: APIPA Medicare/Medicaid $391.80
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $157.35
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $157.35
Rate for Payer: Bisbee Police All Plans $272.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $713.32
Rate for Payer: Cash Price $839.20
Rate for Payer: Cash Price $839.20
Rate for Payer: Cigna of AZ Commercial $734.30
Rate for Payer: Copperpoint Commercial $259.63
Rate for Payer: Health Net of AZ Commercial $629.40
Rate for Payer: Health Net of AZ Medicare $293.72
Rate for Payer: Humana of AZ Medicare $157.35
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $839.20
Rate for Payer: TriWest Medicare $157.35
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $188.82
Service Code CPT 12053
Hospital Charge Code 22282796
Hospital Revenue Code 450
Min. Negotiated Rate $257.40
Max. Negotiated Rate $891.00
Rate for Payer: Aetna of AZ Commercial $891.00
Rate for Payer: Bisbee Police All Plans $257.40
Rate for Payer: Cash Price $792.00
Rate for Payer: Self Pay Self Pay $792.00
Service Code CPT 12053
Hospital Charge Code 22282796
Hospital Revenue Code 450
Min. Negotiated Rate $148.50
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $891.00
Rate for Payer: Aetna of AZ Medicare $277.20
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $148.50
Rate for Payer: Amerigroup Medicare $148.50
Rate for Payer: APIPA Medicare/Medicaid $369.76
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $148.50
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $148.50
Rate for Payer: Bisbee Police All Plans $257.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $673.20
Rate for Payer: Cash Price $792.00
Rate for Payer: Cash Price $792.00
Rate for Payer: Cigna of AZ Commercial $693.00
Rate for Payer: Copperpoint Commercial $245.02
Rate for Payer: Health Net of AZ Commercial $594.00
Rate for Payer: Health Net of AZ Medicare $277.20
Rate for Payer: Humana of AZ Medicare $148.50
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $792.00
Rate for Payer: TriWest Medicare $148.50
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $178.20
Service Code CPT 12054
Hospital Charge Code 22282797
Hospital Revenue Code 450
Min. Negotiated Rate $186.75
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,120.50
Rate for Payer: Aetna of AZ Medicare $348.60
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $186.75
Rate for Payer: Amerigroup Medicare $186.75
Rate for Payer: APIPA Medicare/Medicaid $465.01
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $186.75
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $186.75
Rate for Payer: Bisbee Police All Plans $323.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $846.60
Rate for Payer: Cash Price $996.00
Rate for Payer: Cash Price $996.00
Rate for Payer: Cigna of AZ Commercial $871.50
Rate for Payer: Copperpoint Commercial $308.14
Rate for Payer: Health Net of AZ Commercial $747.00
Rate for Payer: Health Net of AZ Medicare $348.60
Rate for Payer: Humana of AZ Medicare $186.75
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $996.00
Rate for Payer: TriWest Medicare $186.75
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $224.10
Service Code CPT 12054
Hospital Charge Code 22282797
Hospital Revenue Code 450
Min. Negotiated Rate $323.70
Max. Negotiated Rate $1,120.50
Rate for Payer: Aetna of AZ Commercial $1,120.50
Rate for Payer: Bisbee Police All Plans $323.70
Rate for Payer: Cash Price $996.00
Rate for Payer: Self Pay Self Pay $996.00