CATH FOLEY 24FR 30CC 2-WAY ST
|
Facility
|
OP
|
$97.00
|
|
Hospital Charge Code |
22355151
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$14.55 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Aetna of AZ Medicare |
$27.16
|
Rate for Payer: Allwell Medicare |
$14.55
|
Rate for Payer: Amerigroup Medicare |
$14.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$36.23
|
Rate for Payer: AZCH Complete Medicare |
$14.55
|
Rate for Payer: Banner UC Health Medicare |
$14.55
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$65.96
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Cigna of AZ Commercial |
$67.90
|
Rate for Payer: Copperpoint Commercial |
$24.01
|
Rate for Payer: Health Net of AZ Commercial |
$58.20
|
Rate for Payer: Health Net of AZ Medicare |
$27.16
|
Rate for Payer: Humana of AZ Medicare |
$14.55
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
Rate for Payer: TriWest Medicare |
$14.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$56.55
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.46
|
|
CATH FOLEY 24FR 5CC 2-WAY ST
|
Facility
|
IP
|
$75.00
|
|
Hospital Charge Code |
22355139
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$19.50 |
Max. Negotiated Rate |
$67.50 |
Rate for Payer: Aetna of AZ Commercial |
$67.50
|
Rate for Payer: Bisbee Police All Plans |
$19.50
|
Rate for Payer: Cash Price |
$60.00
|
Rate for Payer: Self Pay Self Pay |
$60.00
|
|
CATH FOLEY 24FR 5CC 2-WAY ST
|
Facility
|
OP
|
$75.00
|
|
Hospital Charge Code |
22355139
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$11.25 |
Max. Negotiated Rate |
$67.50 |
Rate for Payer: Aetna of AZ Commercial |
$67.50
|
Rate for Payer: Aetna of AZ Medicare |
$21.00
|
Rate for Payer: Allwell Medicare |
$11.25
|
Rate for Payer: Amerigroup Medicare |
$11.25
|
Rate for Payer: APIPA Medicare/Medicaid |
$28.01
|
Rate for Payer: AZCH Complete Medicare |
$11.25
|
Rate for Payer: Banner UC Health Medicare |
$11.25
|
Rate for Payer: Bisbee Police All Plans |
$19.50
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$51.00
|
Rate for Payer: Cash Price |
$60.00
|
Rate for Payer: Cigna of AZ Commercial |
$52.50
|
Rate for Payer: Copperpoint Commercial |
$18.56
|
Rate for Payer: Health Net of AZ Commercial |
$45.00
|
Rate for Payer: Health Net of AZ Medicare |
$21.00
|
Rate for Payer: Humana of AZ Medicare |
$11.25
|
Rate for Payer: Self Pay Self Pay |
$60.00
|
Rate for Payer: TriWest Medicare |
$11.25
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$43.72
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$13.50
|
|
CATH FOLEY 26FR 30CC 2-WAY ST
|
Facility
|
OP
|
$97.00
|
|
Hospital Charge Code |
22355152
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$14.55 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Aetna of AZ Medicare |
$27.16
|
Rate for Payer: Allwell Medicare |
$14.55
|
Rate for Payer: Amerigroup Medicare |
$14.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$36.23
|
Rate for Payer: AZCH Complete Medicare |
$14.55
|
Rate for Payer: Banner UC Health Medicare |
$14.55
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$65.96
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Cigna of AZ Commercial |
$67.90
|
Rate for Payer: Copperpoint Commercial |
$24.01
|
Rate for Payer: Health Net of AZ Commercial |
$58.20
|
Rate for Payer: Health Net of AZ Medicare |
$27.16
|
Rate for Payer: Humana of AZ Medicare |
$14.55
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
Rate for Payer: TriWest Medicare |
$14.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$56.55
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.46
|
|
CATH FOLEY 26FR 30CC 2-WAY ST
|
Facility
|
IP
|
$97.00
|
|
Hospital Charge Code |
22355152
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$25.22 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
|
CATH FOLEY 28FR 30CC 2-WAY ST
|
Facility
|
OP
|
$97.00
|
|
Hospital Charge Code |
22355155
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$14.55 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Aetna of AZ Medicare |
$27.16
|
Rate for Payer: Allwell Medicare |
$14.55
|
Rate for Payer: Amerigroup Medicare |
$14.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$36.23
|
Rate for Payer: AZCH Complete Medicare |
$14.55
|
Rate for Payer: Banner UC Health Medicare |
$14.55
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$65.96
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Cigna of AZ Commercial |
$67.90
|
Rate for Payer: Copperpoint Commercial |
$24.01
|
Rate for Payer: Health Net of AZ Commercial |
$58.20
|
Rate for Payer: Health Net of AZ Medicare |
$27.16
|
Rate for Payer: Humana of AZ Medicare |
$14.55
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
Rate for Payer: TriWest Medicare |
$14.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$56.55
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.46
|
|
CATH FOLEY 28FR 30CC 2-WAY ST
|
Facility
|
IP
|
$97.00
|
|
Hospital Charge Code |
22355155
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$25.22 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
|
CATH FOLEY 28FR 5CC 2-WAY ST
|
Facility
|
OP
|
$62.00
|
|
Hospital Charge Code |
22355164
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$9.30 |
Max. Negotiated Rate |
$55.80 |
Rate for Payer: Aetna of AZ Commercial |
$55.80
|
Rate for Payer: Aetna of AZ Medicare |
$17.36
|
Rate for Payer: Allwell Medicare |
$9.30
|
Rate for Payer: Amerigroup Medicare |
$9.30
|
Rate for Payer: APIPA Medicare/Medicaid |
$23.16
|
Rate for Payer: AZCH Complete Medicare |
$9.30
|
Rate for Payer: Banner UC Health Medicare |
$9.30
|
Rate for Payer: Bisbee Police All Plans |
$16.12
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$42.16
|
Rate for Payer: Cash Price |
$49.60
|
Rate for Payer: Cigna of AZ Commercial |
$43.40
|
Rate for Payer: Copperpoint Commercial |
$15.34
|
Rate for Payer: Health Net of AZ Commercial |
$37.20
|
Rate for Payer: Health Net of AZ Medicare |
$17.36
|
Rate for Payer: Humana of AZ Medicare |
$9.30
|
Rate for Payer: Self Pay Self Pay |
$49.60
|
Rate for Payer: TriWest Medicare |
$9.30
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$36.15
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$11.16
|
|
CATH FOLEY 28FR 5CC 2-WAY ST
|
Facility
|
IP
|
$62.00
|
|
Hospital Charge Code |
22355164
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$16.12 |
Max. Negotiated Rate |
$55.80 |
Rate for Payer: Aetna of AZ Commercial |
$55.80
|
Rate for Payer: Bisbee Police All Plans |
$16.12
|
Rate for Payer: Cash Price |
$49.60
|
Rate for Payer: Self Pay Self Pay |
$49.60
|
|
CATH FOLEY 30CC 18FR 3-WAY
|
Facility
|
OP
|
$71.00
|
|
Hospital Charge Code |
22355168
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$10.65 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Aetna of AZ Medicare |
$19.88
|
Rate for Payer: Allwell Medicare |
$10.65
|
Rate for Payer: Amerigroup Medicare |
$10.65
|
Rate for Payer: APIPA Medicare/Medicaid |
$26.52
|
Rate for Payer: AZCH Complete Medicare |
$10.65
|
Rate for Payer: Banner UC Health Medicare |
$10.65
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$48.28
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Cigna of AZ Commercial |
$49.70
|
Rate for Payer: Copperpoint Commercial |
$17.57
|
Rate for Payer: Health Net of AZ Commercial |
$42.60
|
Rate for Payer: Health Net of AZ Medicare |
$19.88
|
Rate for Payer: Humana of AZ Medicare |
$10.65
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
Rate for Payer: TriWest Medicare |
$10.65
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$41.39
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$12.78
|
|
CATH FOLEY 30CC 18FR 3-WAY
|
Facility
|
IP
|
$71.00
|
|
Hospital Charge Code |
22355168
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$18.46 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
|
CATH FOLEY 30CC 20FR 3-WAY
|
Facility
|
IP
|
$71.00
|
|
Hospital Charge Code |
22355169
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$18.46 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
|
CATH FOLEY 30CC 20FR 3-WAY
|
Facility
|
OP
|
$71.00
|
|
Hospital Charge Code |
22355169
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$10.65 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Aetna of AZ Medicare |
$19.88
|
Rate for Payer: Allwell Medicare |
$10.65
|
Rate for Payer: Amerigroup Medicare |
$10.65
|
Rate for Payer: APIPA Medicare/Medicaid |
$26.52
|
Rate for Payer: AZCH Complete Medicare |
$10.65
|
Rate for Payer: Banner UC Health Medicare |
$10.65
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$48.28
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Cigna of AZ Commercial |
$49.70
|
Rate for Payer: Copperpoint Commercial |
$17.57
|
Rate for Payer: Health Net of AZ Commercial |
$42.60
|
Rate for Payer: Health Net of AZ Medicare |
$19.88
|
Rate for Payer: Humana of AZ Medicare |
$10.65
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
Rate for Payer: TriWest Medicare |
$10.65
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$41.39
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$12.78
|
|
CATH FOLEY 30CC 20FR 3-WAY ST
|
Facility
|
OP
|
$54.00
|
|
Hospital Charge Code |
22355148
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$8.10 |
Max. Negotiated Rate |
$48.60 |
Rate for Payer: Aetna of AZ Commercial |
$48.60
|
Rate for Payer: Aetna of AZ Medicare |
$15.12
|
Rate for Payer: Allwell Medicare |
$8.10
|
Rate for Payer: Amerigroup Medicare |
$8.10
|
Rate for Payer: APIPA Medicare/Medicaid |
$20.17
|
Rate for Payer: AZCH Complete Medicare |
$8.10
|
Rate for Payer: Banner UC Health Medicare |
$8.10
|
Rate for Payer: Bisbee Police All Plans |
$14.04
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$36.72
|
Rate for Payer: Cash Price |
$43.20
|
Rate for Payer: Cigna of AZ Commercial |
$37.80
|
Rate for Payer: Copperpoint Commercial |
$13.36
|
Rate for Payer: Health Net of AZ Commercial |
$32.40
|
Rate for Payer: Health Net of AZ Medicare |
$15.12
|
Rate for Payer: Humana of AZ Medicare |
$8.10
|
Rate for Payer: Self Pay Self Pay |
$43.20
|
Rate for Payer: TriWest Medicare |
$8.10
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$31.48
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$9.72
|
|
CATH FOLEY 30CC 20FR 3-WAY ST
|
Facility
|
IP
|
$54.00
|
|
Hospital Charge Code |
22355148
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$14.04 |
Max. Negotiated Rate |
$48.60 |
Rate for Payer: Aetna of AZ Commercial |
$48.60
|
Rate for Payer: Bisbee Police All Plans |
$14.04
|
Rate for Payer: Cash Price |
$43.20
|
Rate for Payer: Self Pay Self Pay |
$43.20
|
|
CATH FOLEY 30CC 22FR 3-WAY
|
Facility
|
IP
|
$49.00
|
|
Hospital Charge Code |
22355187
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$12.74 |
Max. Negotiated Rate |
$44.10 |
Rate for Payer: Aetna of AZ Commercial |
$44.10
|
Rate for Payer: Bisbee Police All Plans |
$12.74
|
Rate for Payer: Cash Price |
$39.20
|
Rate for Payer: Self Pay Self Pay |
$39.20
|
|
CATH FOLEY 30CC 22FR 3-WAY
|
Facility
|
OP
|
$49.00
|
|
Hospital Charge Code |
22355187
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$7.35 |
Max. Negotiated Rate |
$44.10 |
Rate for Payer: Aetna of AZ Commercial |
$44.10
|
Rate for Payer: Aetna of AZ Medicare |
$13.72
|
Rate for Payer: Allwell Medicare |
$7.35
|
Rate for Payer: Amerigroup Medicare |
$7.35
|
Rate for Payer: APIPA Medicare/Medicaid |
$18.30
|
Rate for Payer: AZCH Complete Medicare |
$7.35
|
Rate for Payer: Banner UC Health Medicare |
$7.35
|
Rate for Payer: Bisbee Police All Plans |
$12.74
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$33.32
|
Rate for Payer: Cash Price |
$39.20
|
Rate for Payer: Cigna of AZ Commercial |
$34.30
|
Rate for Payer: Copperpoint Commercial |
$12.13
|
Rate for Payer: Health Net of AZ Commercial |
$29.40
|
Rate for Payer: Health Net of AZ Medicare |
$13.72
|
Rate for Payer: Humana of AZ Medicare |
$7.35
|
Rate for Payer: Self Pay Self Pay |
$39.20
|
Rate for Payer: TriWest Medicare |
$7.35
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$28.57
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$8.82
|
|
CATH FOLEY 30CC 24FR 3-WAY
|
Facility
|
OP
|
$71.00
|
|
Hospital Charge Code |
22355167
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$10.65 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Aetna of AZ Medicare |
$19.88
|
Rate for Payer: Allwell Medicare |
$10.65
|
Rate for Payer: Amerigroup Medicare |
$10.65
|
Rate for Payer: APIPA Medicare/Medicaid |
$26.52
|
Rate for Payer: AZCH Complete Medicare |
$10.65
|
Rate for Payer: Banner UC Health Medicare |
$10.65
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$48.28
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Cigna of AZ Commercial |
$49.70
|
Rate for Payer: Copperpoint Commercial |
$17.57
|
Rate for Payer: Health Net of AZ Commercial |
$42.60
|
Rate for Payer: Health Net of AZ Medicare |
$19.88
|
Rate for Payer: Humana of AZ Medicare |
$10.65
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
Rate for Payer: TriWest Medicare |
$10.65
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$41.39
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$12.78
|
|
CATH FOLEY 30CC 24FR 3-WAY
|
Facility
|
IP
|
$71.00
|
|
Hospital Charge Code |
22355167
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$18.46 |
Max. Negotiated Rate |
$63.90 |
Rate for Payer: Aetna of AZ Commercial |
$63.90
|
Rate for Payer: Bisbee Police All Plans |
$18.46
|
Rate for Payer: Cash Price |
$56.80
|
Rate for Payer: Self Pay Self Pay |
$56.80
|
|
CATH FOLEY 30CC 26FR 3-WAY
|
Facility
|
IP
|
$158.00
|
|
Hospital Charge Code |
22355181
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$41.08 |
Max. Negotiated Rate |
$142.20 |
Rate for Payer: Aetna of AZ Commercial |
$142.20
|
Rate for Payer: Bisbee Police All Plans |
$41.08
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Self Pay Self Pay |
$126.40
|
|
CATH FOLEY 30CC 26FR 3-WAY
|
Facility
|
OP
|
$158.00
|
|
Hospital Charge Code |
22355181
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$23.70 |
Max. Negotiated Rate |
$142.20 |
Rate for Payer: Aetna of AZ Commercial |
$142.20
|
Rate for Payer: Aetna of AZ Medicare |
$44.24
|
Rate for Payer: Allwell Medicare |
$23.70
|
Rate for Payer: Amerigroup Medicare |
$23.70
|
Rate for Payer: APIPA Medicare/Medicaid |
$59.01
|
Rate for Payer: AZCH Complete Medicare |
$23.70
|
Rate for Payer: Banner UC Health Medicare |
$23.70
|
Rate for Payer: Bisbee Police All Plans |
$41.08
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$107.44
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cigna of AZ Commercial |
$110.60
|
Rate for Payer: Copperpoint Commercial |
$39.10
|
Rate for Payer: Health Net of AZ Commercial |
$94.80
|
Rate for Payer: Health Net of AZ Medicare |
$44.24
|
Rate for Payer: Humana of AZ Medicare |
$23.70
|
Rate for Payer: Self Pay Self Pay |
$126.40
|
Rate for Payer: TriWest Medicare |
$23.70
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$92.11
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$28.44
|
|
CATH FOLEY 30FR 30CC 2-WAY ST
|
Facility
|
OP
|
$97.00
|
|
Hospital Charge Code |
22355153
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$14.55 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Aetna of AZ Medicare |
$27.16
|
Rate for Payer: Allwell Medicare |
$14.55
|
Rate for Payer: Amerigroup Medicare |
$14.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$36.23
|
Rate for Payer: AZCH Complete Medicare |
$14.55
|
Rate for Payer: Banner UC Health Medicare |
$14.55
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$65.96
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Cigna of AZ Commercial |
$67.90
|
Rate for Payer: Copperpoint Commercial |
$24.01
|
Rate for Payer: Health Net of AZ Commercial |
$58.20
|
Rate for Payer: Health Net of AZ Medicare |
$27.16
|
Rate for Payer: Humana of AZ Medicare |
$14.55
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
Rate for Payer: TriWest Medicare |
$14.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$56.55
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.46
|
|
CATH FOLEY 30FR 30CC 2-WAY ST
|
Facility
|
IP
|
$97.00
|
|
Hospital Charge Code |
22355153
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$25.22 |
Max. Negotiated Rate |
$87.30 |
Rate for Payer: Aetna of AZ Commercial |
$87.30
|
Rate for Payer: Bisbee Police All Plans |
$25.22
|
Rate for Payer: Cash Price |
$77.60
|
Rate for Payer: Self Pay Self Pay |
$77.60
|
|
CATH FOLEY 30FR 5CC 2-WAY ST
|
Facility
|
IP
|
$62.00
|
|
Hospital Charge Code |
22355166
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$16.12 |
Max. Negotiated Rate |
$55.80 |
Rate for Payer: Aetna of AZ Commercial |
$55.80
|
Rate for Payer: Bisbee Police All Plans |
$16.12
|
Rate for Payer: Cash Price |
$49.60
|
Rate for Payer: Self Pay Self Pay |
$49.60
|
|
CATH FOLEY 30FR 5CC 2-WAY ST
|
Facility
|
OP
|
$62.00
|
|
Hospital Charge Code |
22355166
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$9.30 |
Max. Negotiated Rate |
$55.80 |
Rate for Payer: Aetna of AZ Commercial |
$55.80
|
Rate for Payer: Aetna of AZ Medicare |
$17.36
|
Rate for Payer: Allwell Medicare |
$9.30
|
Rate for Payer: Amerigroup Medicare |
$9.30
|
Rate for Payer: APIPA Medicare/Medicaid |
$23.16
|
Rate for Payer: AZCH Complete Medicare |
$9.30
|
Rate for Payer: Banner UC Health Medicare |
$9.30
|
Rate for Payer: Bisbee Police All Plans |
$16.12
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$42.16
|
Rate for Payer: Cash Price |
$49.60
|
Rate for Payer: Cigna of AZ Commercial |
$43.40
|
Rate for Payer: Copperpoint Commercial |
$15.34
|
Rate for Payer: Health Net of AZ Commercial |
$37.20
|
Rate for Payer: Health Net of AZ Medicare |
$17.36
|
Rate for Payer: Humana of AZ Medicare |
$9.30
|
Rate for Payer: Self Pay Self Pay |
$49.60
|
Rate for Payer: TriWest Medicare |
$9.30
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$36.15
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$11.16
|
|