Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

CATH SUCT 10FR

Facility

$11.00

Hospital Charge Code	22355570
Hospital Revenue Code	270
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$9.90
Rate for Payer: Aetna of AZ Commercial	$9.90
Rate for Payer: Bisbee Police All Plans	$2.86
Rate for Payer: Cash Price	$8.80
Rate for Payer: Self Pay Self Pay	$8.80

CATH SUCT 10FR

Facility

$11.00

Hospital Charge Code	22355570
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$9.90
Rate for Payer: Aetna of AZ Commercial	$9.90
Rate for Payer: Aetna of AZ Medicare	$3.08
Rate for Payer: Allwell Medicare	$1.65
Rate for Payer: Amerigroup Medicare	$1.65
Rate for Payer: APIPA Medicare/Medicaid	$4.11
Rate for Payer: AZCH Complete Medicare	$1.65
Rate for Payer: Banner UC Health Medicare	$1.65
Rate for Payer: Bisbee Police All Plans	$2.86
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$7.48
Rate for Payer: Cash Price	$8.80
Rate for Payer: Cigna of AZ Commercial	$7.70
Rate for Payer: Copperpoint Commercial	$2.72
Rate for Payer: Health Net of AZ Commercial	$6.60
Rate for Payer: Health Net of AZ Medicare	$3.08
Rate for Payer: Humana of AZ Medicare	$1.65
Rate for Payer: Self Pay Self Pay	$8.80
Rate for Payer: TriWest Medicare	$1.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$6.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.98

CATH SUCT 6FR

Facility

$8.00

Hospital Charge Code	22355573
Hospital Revenue Code	270
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$7.20
Rate for Payer: Aetna of AZ Commercial	$7.20
Rate for Payer: Bisbee Police All Plans	$2.08
Rate for Payer: Cash Price	$6.40
Rate for Payer: Self Pay Self Pay	$6.40

CATH SUCT 6FR

Facility

$8.00

Hospital Charge Code	22355573
Hospital Revenue Code	270
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$7.20
Rate for Payer: Aetna of AZ Commercial	$7.20
Rate for Payer: Aetna of AZ Medicare	$2.24
Rate for Payer: Allwell Medicare	$1.20
Rate for Payer: Amerigroup Medicare	$1.20
Rate for Payer: APIPA Medicare/Medicaid	$2.99
Rate for Payer: AZCH Complete Medicare	$1.20
Rate for Payer: Banner UC Health Medicare	$1.20
Rate for Payer: Bisbee Police All Plans	$2.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$5.44
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cigna of AZ Commercial	$5.60
Rate for Payer: Copperpoint Commercial	$1.98
Rate for Payer: Health Net of AZ Commercial	$4.80
Rate for Payer: Health Net of AZ Medicare	$2.24
Rate for Payer: Humana of AZ Medicare	$1.20
Rate for Payer: Self Pay Self Pay	$6.40
Rate for Payer: TriWest Medicare	$1.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$4.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.44

CATH SUCT 8FR

Facility

$8.00

Hospital Charge Code	22355569
Hospital Revenue Code	270
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$7.20
Rate for Payer: Aetna of AZ Commercial	$7.20
Rate for Payer: Aetna of AZ Medicare	$2.24
Rate for Payer: Allwell Medicare	$1.20
Rate for Payer: Amerigroup Medicare	$1.20
Rate for Payer: APIPA Medicare/Medicaid	$2.99
Rate for Payer: AZCH Complete Medicare	$1.20
Rate for Payer: Banner UC Health Medicare	$1.20
Rate for Payer: Bisbee Police All Plans	$2.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$5.44
Rate for Payer: Cash Price	$6.40
Rate for Payer: Cigna of AZ Commercial	$5.60
Rate for Payer: Copperpoint Commercial	$1.98
Rate for Payer: Health Net of AZ Commercial	$4.80
Rate for Payer: Health Net of AZ Medicare	$2.24
Rate for Payer: Humana of AZ Medicare	$1.20
Rate for Payer: Self Pay Self Pay	$6.40
Rate for Payer: TriWest Medicare	$1.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$4.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.44

CATH SUCT 8FR

Facility

$8.00

Hospital Charge Code	22355569
Hospital Revenue Code	270
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$7.20
Rate for Payer: Aetna of AZ Commercial	$7.20
Rate for Payer: Bisbee Police All Plans	$2.08
Rate for Payer: Cash Price	$6.40
Rate for Payer: Self Pay Self Pay	$6.40

CATH TEXAS 2-IN

Facility

$9.00

Hospital Charge Code	22355432
Hospital Revenue Code	270
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Aetna of AZ Medicare	$2.52
Rate for Payer: Allwell Medicare	$1.35
Rate for Payer: Amerigroup Medicare	$1.35
Rate for Payer: APIPA Medicare/Medicaid	$3.36
Rate for Payer: AZCH Complete Medicare	$1.35
Rate for Payer: Banner UC Health Medicare	$1.35
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$6.12
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna of AZ Commercial	$6.30
Rate for Payer: Copperpoint Commercial	$2.23
Rate for Payer: Health Net of AZ Commercial	$5.40
Rate for Payer: Health Net of AZ Medicare	$2.52
Rate for Payer: Humana of AZ Medicare	$1.35
Rate for Payer: Self Pay Self Pay	$7.20
Rate for Payer: TriWest Medicare	$1.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$5.25
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.62

CATH TEXAS 2-IN

Facility

$9.00

Hospital Charge Code	22355432
Hospital Revenue Code	270
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Cash Price	$7.20
Rate for Payer: Self Pay Self Pay	$7.20

CATH THORACIC 24F STRAIGHT STERILE

Facility

$62.00

Hospital Charge Code	22354944
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 THORACIC 24F STRAIGHT STERILE

Facility

$62.00

Hospital Charge Code	22354944
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 THORACIC 32F STRAIGHT STERILE

Facility

$62.00

Hospital Charge Code	22354945
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 THORACIC 32F STRAIGHT STERILE

Facility

$62.00

Hospital Charge Code	22354945
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 URETERAL 8F CONE TIP

Facility

$995.00

Hospital Charge Code	22354212
Hospital Revenue Code	270
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$895.50
Rate for Payer: Aetna of AZ Commercial	$895.50
Rate for Payer: Aetna of AZ Medicare	$278.60
Rate for Payer: Allwell Medicare	$149.25
Rate for Payer: Amerigroup Medicare	$149.25
Rate for Payer: APIPA Medicare/Medicaid	$371.63
Rate for Payer: AZCH Complete Medicare	$149.25
Rate for Payer: Banner UC Health Medicare	$149.25
Rate for Payer: Bisbee Police All Plans	$258.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$676.60
Rate for Payer: Cash Price	$796.00
Rate for Payer: Cigna of AZ Commercial	$696.50
Rate for Payer: Copperpoint Commercial	$246.26
Rate for Payer: Health Net of AZ Commercial	$597.00
Rate for Payer: Health Net of AZ Medicare	$278.60
Rate for Payer: Humana of AZ Medicare	$149.25
Rate for Payer: Self Pay Self Pay	$796.00
Rate for Payer: TriWest Medicare	$149.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$580.08
Rate for Payer: UnitedHealth Group of AZ Medicare	$179.10

CATH URETERAL 8F CONE TIP

Facility

$995.00

Hospital Charge Code	22354212
Hospital Revenue Code	270
Min. Negotiated Rate	$258.70
Max. Negotiated Rate	$895.50
Rate for Payer: Aetna of AZ Commercial	$895.50
Rate for Payer: Bisbee Police All Plans	$258.70
Rate for Payer: Cash Price	$796.00
Rate for Payer: Self Pay Self Pay	$796.00

CATH URETERAL OPEN 6FR

Facility

$61.00

Hospital Charge Code	22354443
Hospital Revenue Code	272
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$54.90
Rate for Payer: Aetna of AZ Commercial	$54.90
Rate for Payer: Bisbee Police All Plans	$15.86
Rate for Payer: Cash Price	$48.80
Rate for Payer: Self Pay Self Pay	$48.80

CATH URETERAL OPEN 6FR

Facility

$61.00

Hospital Charge Code	22354443
Hospital Revenue Code	272
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$54.90
Rate for Payer: Aetna of AZ Commercial	$54.90
Rate for Payer: Aetna of AZ Medicare	$17.08
Rate for Payer: Allwell Medicare	$9.15
Rate for Payer: Amerigroup Medicare	$9.15
Rate for Payer: APIPA Medicare/Medicaid	$22.78
Rate for Payer: AZCH Complete Medicare	$9.15
Rate for Payer: Banner UC Health Medicare	$9.15
Rate for Payer: Bisbee Police All Plans	$15.86
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$41.48
Rate for Payer: Cash Price	$48.80
Rate for Payer: Cigna of AZ Commercial	$42.70
Rate for Payer: Copperpoint Commercial	$15.10
Rate for Payer: Health Net of AZ Commercial	$36.60
Rate for Payer: Health Net of AZ Medicare	$17.08
Rate for Payer: Humana of AZ Medicare	$9.15
Rate for Payer: Self Pay Self Pay	$48.80
Rate for Payer: TriWest Medicare	$9.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$35.56
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.98

CAUTERY PEN DISPOSABLE

Facility

$58.00

Hospital Charge Code	22575511
Hospital Revenue Code	279
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of AZ Commercial	$52.20
Rate for Payer: Bisbee Police All Plans	$15.08
Rate for Payer: Cash Price	$46.40
Rate for Payer: Self Pay Self Pay	$46.40

CAUTERY PEN DISPOSABLE

Facility

$58.00

Hospital Charge Code	22575511
Hospital Revenue Code	279
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of AZ Commercial	$52.20
Rate for Payer: Aetna of AZ Medicare	$16.24
Rate for Payer: Allwell Medicare	$8.70
Rate for Payer: Amerigroup Medicare	$8.70
Rate for Payer: APIPA Medicare/Medicaid	$21.66
Rate for Payer: AZCH Complete Medicare	$8.70
Rate for Payer: Banner UC Health Medicare	$8.70
Rate for Payer: Bisbee Police All Plans	$15.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$39.44
Rate for Payer: Cash Price	$46.40
Rate for Payer: Cigna of AZ Commercial	$40.60
Rate for Payer: Copperpoint Commercial	$14.36
Rate for Payer: Health Net of AZ Commercial	$34.80
Rate for Payer: Health Net of AZ Medicare	$16.24
Rate for Payer: Humana of AZ Medicare	$8.70
Rate for Payer: Self Pay Self Pay	$46.40
Rate for Payer: TriWest Medicare	$8.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$33.81
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.44

CCP Antibodies IgG/IgA LC

Facility

$392.00

Service Code	CPT 86200
Hospital Charge Code	1285795
Hospital Revenue Code	301
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$352.80
Rate for Payer: Aetna of AZ Commercial	$352.80
Rate for Payer: Aetna of AZ Medicare	$109.76
Rate for Payer: AHCCCS Medicaid	$12.95
Rate for Payer: Allwell Medicaid	$12.95
Rate for Payer: Allwell Medicare	$58.80
Rate for Payer: Amerigroup Medicare	$58.80
Rate for Payer: APIPA Medicare/Medicaid	$146.41
Rate for Payer: AZCH Complete Medicaid	$12.95
Rate for Payer: AZCH Complete Medicare	$58.80
Rate for Payer: Banner UC Health Medicaid	$12.95
Rate for Payer: Banner UC Health Medicare	$58.80
Rate for Payer: Bisbee Police All Plans	$101.92
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$266.56
Rate for Payer: Cash Price	$313.60
Rate for Payer: Cash Price	$313.60
Rate for Payer: Cigna of AZ Commercial	$254.80
Rate for Payer: Copperpoint Commercial	$97.02
Rate for Payer: Health Net of AZ Commercial	$235.20
Rate for Payer: Health Net of AZ Medicare	$109.76
Rate for Payer: Humana of AZ Medicare	$58.80
Rate for Payer: Mercy Care Medicaid	$12.95
Rate for Payer: Self Pay Self Pay	$313.60
Rate for Payer: TriWest Medicare	$58.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$228.54
Rate for Payer: UnitedHealth Group of AZ Medicare	$70.56

CCP Antibodies IgG/IgA LC

Facility

$392.00

Service Code	CPT 86200
Hospital Charge Code	1285795
Hospital Revenue Code	301
Min. Negotiated Rate	$101.92
Max. Negotiated Rate	$352.80
Rate for Payer: Aetna of AZ Commercial	$352.80
Rate for Payer: Bisbee Police All Plans	$101.92
Rate for Payer: Cash Price	$313.60
Rate for Payer: Self Pay Self Pay	$313.60

CD4/CD8 Ratio Profile LC

Facility

$585.00

Service Code	CPT 86360
Hospital Charge Code	2269448
Hospital Revenue Code	306
Min. Negotiated Rate	$46.98
Max. Negotiated Rate	$526.50
Rate for Payer: Aetna of AZ Commercial	$526.50
Rate for Payer: Aetna of AZ Medicare	$163.80
Rate for Payer: AHCCCS Medicaid	$46.98
Rate for Payer: Allwell Medicaid	$46.98
Rate for Payer: Allwell Medicare	$87.75
Rate for Payer: Amerigroup Medicare	$87.75
Rate for Payer: APIPA Medicare/Medicaid	$218.50
Rate for Payer: AZCH Complete Medicaid	$46.98
Rate for Payer: AZCH Complete Medicare	$87.75
Rate for Payer: Banner UC Health Medicaid	$46.98
Rate for Payer: Banner UC Health Medicare	$87.75
Rate for Payer: Bisbee Police All Plans	$152.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$397.80
Rate for Payer: Cash Price	$468.00
Rate for Payer: Cash Price	$468.00
Rate for Payer: Cigna of AZ Commercial	$380.25
Rate for Payer: Copperpoint Commercial	$144.79
Rate for Payer: Health Net of AZ Commercial	$351.00
Rate for Payer: Health Net of AZ Medicare	$163.80
Rate for Payer: Humana of AZ Medicare	$87.75
Rate for Payer: Mercy Care Medicaid	$46.98
Rate for Payer: Self Pay Self Pay	$468.00
Rate for Payer: TriWest Medicare	$87.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$341.06
Rate for Payer: UnitedHealth Group of AZ Medicare	$105.30

CD4/CD8 Ratio Profile LC

Facility

$585.00

Service Code	CPT 86360
Hospital Charge Code	2269448
Hospital Revenue Code	306
Min. Negotiated Rate	$152.10
Max. Negotiated Rate	$526.50
Rate for Payer: Aetna of AZ Commercial	$526.50
Rate for Payer: Bisbee Police All Plans	$152.10
Rate for Payer: Cash Price	$468.00
Rate for Payer: Self Pay Self Pay	$468.00

CDC 2019 NOVEL CORONAVIRUS (2019-NCOV) REAL-TIME RT-PCR

Facility

$197.00

Service Code	CPT U0001
Hospital Charge Code	23934510
Hospital Revenue Code	301
Min. Negotiated Rate	$51.22
Max. Negotiated Rate	$177.30
Rate for Payer: Aetna of AZ Commercial	$177.30
Rate for Payer: Bisbee Police All Plans	$51.22
Rate for Payer: Cash Price	$157.60
Rate for Payer: Self Pay Self Pay	$157.60

CDC 2019 NOVEL CORONAVIRUS (2019-NCOV) REAL-TIME RT-PCR

Facility

$279.00

Service Code	CPT U0002
Hospital Charge Code	23934512
Hospital Revenue Code	301
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$251.10
Rate for Payer: Aetna of AZ Commercial	$251.10
Rate for Payer: Aetna of AZ Medicare	$78.12
Rate for Payer: AHCCCS Medicaid	$102.62
Rate for Payer: Allwell Medicaid	$102.62
Rate for Payer: Allwell Medicare	$41.85
Rate for Payer: Amerigroup Medicare	$41.85
Rate for Payer: APIPA Medicare/Medicaid	$104.21
Rate for Payer: AZCH Complete Medicaid	$102.62
Rate for Payer: AZCH Complete Medicare	$41.85
Rate for Payer: Banner UC Health Medicaid	$102.62
Rate for Payer: Banner UC Health Medicare	$41.85
Rate for Payer: Bisbee Police All Plans	$72.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$189.72
Rate for Payer: Cash Price	$223.20
Rate for Payer: Cash Price	$223.20
Rate for Payer: Cigna of AZ Commercial	$181.35
Rate for Payer: Copperpoint Commercial	$69.05
Rate for Payer: Health Net of AZ Commercial	$167.40
Rate for Payer: Health Net of AZ Medicare	$78.12
Rate for Payer: Humana of AZ Medicare	$41.85
Rate for Payer: Mercy Care Medicaid	$102.62
Rate for Payer: Self Pay Self Pay	$223.20
Rate for Payer: TriWest Medicare	$41.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$162.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.22

CDC 2019 NOVEL CORONAVIRUS (2019-NCOV) REAL-TIME RT-PCR

Facility

$197.00

Service Code	CPT U0001
Hospital Charge Code	23934510
Hospital Revenue Code	301
Min. Negotiated Rate	$29.55
Max. Negotiated Rate	$177.30
Rate for Payer: Aetna of AZ Commercial	$177.30
Rate for Payer: Aetna of AZ Medicare	$55.16
Rate for Payer: AHCCCS Medicaid	$71.82
Rate for Payer: Allwell Medicaid	$71.82
Rate for Payer: Allwell Medicare	$29.55
Rate for Payer: Amerigroup Medicare	$29.55
Rate for Payer: APIPA Medicare/Medicaid	$73.58
Rate for Payer: AZCH Complete Medicaid	$71.82
Rate for Payer: AZCH Complete Medicare	$29.55
Rate for Payer: Banner UC Health Medicaid	$71.82
Rate for Payer: Banner UC Health Medicare	$29.55
Rate for Payer: Bisbee Police All Plans	$51.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$133.96
Rate for Payer: Cash Price	$157.60
Rate for Payer: Cash Price	$157.60
Rate for Payer: Cigna of AZ Commercial	$128.05
Rate for Payer: Copperpoint Commercial	$48.76
Rate for Payer: Health Net of AZ Commercial	$118.20
Rate for Payer: Health Net of AZ Medicare	$55.16
Rate for Payer: Humana of AZ Medicare	$29.55
Rate for Payer: Mercy Care Medicaid	$71.82
Rate for Payer: Self Pay Self Pay	$157.60
Rate for Payer: TriWest Medicare	$29.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$114.85
Rate for Payer: UnitedHealth Group of AZ Medicare	$35.46

Know your out-of-pocket cost for care.

All Charges