Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

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	$1.44
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	$1.44
Rate for Payer: Amerigroup Medicare	$1.44
Rate for Payer: APIPA Medicare/Medicaid	$3.36
Rate for Payer: AZCH Complete Medicare	$1.44
Rate for Payer: Banner UC Health Medicare	$1.44
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	$1.44
Rate for Payer: Self Pay Self Pay	$7.20
Rate for Payer: TriWest Medicare	$1.44
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	$9.92
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	$9.92
Rate for Payer: Amerigroup Medicare	$9.92
Rate for Payer: APIPA Medicare/Medicaid	$23.16
Rate for Payer: AZCH Complete Medicare	$9.92
Rate for Payer: Banner UC Health Medicare	$9.92
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	$15.35
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	$9.92
Rate for Payer: Self Pay Self Pay	$49.60
Rate for Payer: TriWest Medicare	$9.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$36.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$11.16

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 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	$9.92
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	$9.92
Rate for Payer: Amerigroup Medicare	$9.92
Rate for Payer: APIPA Medicare/Medicaid	$23.16
Rate for Payer: AZCH Complete Medicare	$9.92
Rate for Payer: Banner UC Health Medicare	$9.92
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	$15.35
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	$9.92
Rate for Payer: Self Pay Self Pay	$49.60
Rate for Payer: TriWest Medicare	$9.92
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	$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 8F CONE TIP

Facility

$995.00

Hospital Charge Code	22354212
Hospital Revenue Code	270
Min. Negotiated Rate	$159.20
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	$159.20
Rate for Payer: Amerigroup Medicare	$159.20
Rate for Payer: APIPA Medicare/Medicaid	$371.63
Rate for Payer: AZCH Complete Medicare	$159.20
Rate for Payer: Banner UC Health Medicare	$159.20
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	$159.20
Rate for Payer: Self Pay Self Pay	$796.00
Rate for Payer: TriWest Medicare	$159.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$580.09
Rate for Payer: UnitedHealth Group of AZ Medicare	$179.10

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	$9.28
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	$9.28
Rate for Payer: Amerigroup Medicare	$9.28
Rate for Payer: APIPA Medicare/Medicaid	$21.66
Rate for Payer: AZCH Complete Medicare	$9.28
Rate for Payer: Banner UC Health Medicare	$9.28
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	$9.28
Rate for Payer: Self Pay Self Pay	$46.40
Rate for Payer: TriWest Medicare	$9.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$33.81
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.44

CBG With Free Cortisol LC

Facility

$271.00

Service Code	CPT 82533
Hospital Charge Code	22956825
Hospital Revenue Code	306
Min. Negotiated Rate	$43.36
Max. Negotiated Rate	$243.90
Rate for Payer: Aetna of AZ Commercial	$243.90
Rate for Payer: Aetna of AZ Medicare	$75.88
Rate for Payer: Allwell Medicare	$43.36
Rate for Payer: Amerigroup Medicare	$43.36
Rate for Payer: APIPA Medicare/Medicaid	$101.22
Rate for Payer: AZCH Complete Medicare	$43.36
Rate for Payer: Banner UC Health Medicare	$43.36
Rate for Payer: Bisbee Police All Plans	$70.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$184.28
Rate for Payer: Cash Price	$216.80
Rate for Payer: Cigna of AZ Commercial	$176.15
Rate for Payer: Copperpoint Commercial	$67.07
Rate for Payer: Health Net of AZ Commercial	$162.60
Rate for Payer: Health Net of AZ Medicare	$75.88
Rate for Payer: Humana of AZ Medicare	$43.36
Rate for Payer: Self Pay Self Pay	$216.80
Rate for Payer: TriWest Medicare	$43.36
Rate for Payer: UnitedHealth Group of AZ Commercial	$157.99
Rate for Payer: UnitedHealth Group of AZ Medicare	$48.78

CBG With Free Cortisol LC

Facility

$271.00

Service Code	CPT 82533
Hospital Charge Code	22956825
Hospital Revenue Code	306
Min. Negotiated Rate	$70.46
Max. Negotiated Rate	$243.90
Rate for Payer: Aetna of AZ Commercial	$243.90
Rate for Payer: Bisbee Police All Plans	$70.46
Rate for Payer: Cash Price	$216.80
Rate for Payer: Self Pay Self Pay	$216.80

CCP Antibodies IgG/IgA LC

Facility

$372.00

Service Code	CPT 86200
Hospital Charge Code	1285795
Hospital Revenue Code	301
Min. Negotiated Rate	$59.52
Max. Negotiated Rate	$334.80
Rate for Payer: Aetna of AZ Commercial	$334.80
Rate for Payer: Aetna of AZ Medicare	$104.16
Rate for Payer: Allwell Medicare	$59.52
Rate for Payer: Amerigroup Medicare	$59.52
Rate for Payer: APIPA Medicare/Medicaid	$138.94
Rate for Payer: AZCH Complete Medicare	$59.52
Rate for Payer: Banner UC Health Medicare	$59.52
Rate for Payer: Bisbee Police All Plans	$96.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$252.96
Rate for Payer: Cash Price	$297.60
Rate for Payer: Cigna of AZ Commercial	$241.80
Rate for Payer: Copperpoint Commercial	$92.07
Rate for Payer: Health Net of AZ Commercial	$223.20
Rate for Payer: Health Net of AZ Medicare	$104.16
Rate for Payer: Humana of AZ Medicare	$59.52
Rate for Payer: Self Pay Self Pay	$297.60
Rate for Payer: TriWest Medicare	$59.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$216.88
Rate for Payer: UnitedHealth Group of AZ Medicare	$66.96

CCP Antibodies IgG/IgA LC

Facility

$372.00

Service Code	CPT 86200
Hospital Charge Code	1285795
Hospital Revenue Code	301
Min. Negotiated Rate	$96.72
Max. Negotiated Rate	$334.80
Rate for Payer: Aetna of AZ Commercial	$334.80
Rate for Payer: Bisbee Police All Plans	$96.72
Rate for Payer: Cash Price	$297.60
Rate for Payer: Self Pay Self Pay	$297.60

C CSF

Facility

$116.00

Service Code	CPT 87070
Hospital Charge Code	858011
Hospital Revenue Code	306
Min. Negotiated Rate	$30.16
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna of AZ Commercial	$104.40
Rate for Payer: Bisbee Police All Plans	$30.16
Rate for Payer: Cash Price	$92.80
Rate for Payer: Self Pay Self Pay	$92.80

C CSF

Facility

$116.00

Service Code	CPT 87070
Hospital Charge Code	858011
Hospital Revenue Code	306
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna of AZ Commercial	$104.40
Rate for Payer: Aetna of AZ Medicare	$32.48
Rate for Payer: Allwell Medicare	$18.56
Rate for Payer: Amerigroup Medicare	$18.56
Rate for Payer: APIPA Medicare/Medicaid	$43.33
Rate for Payer: AZCH Complete Medicare	$18.56
Rate for Payer: Banner UC Health Medicare	$18.56
Rate for Payer: Bisbee Police All Plans	$30.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$78.88
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cigna of AZ Commercial	$75.40
Rate for Payer: Copperpoint Commercial	$28.71
Rate for Payer: Health Net of AZ Commercial	$69.60
Rate for Payer: Health Net of AZ Medicare	$32.48
Rate for Payer: Humana of AZ Medicare	$18.56
Rate for Payer: Self Pay Self Pay	$92.80
Rate for Payer: TriWest Medicare	$18.56
Rate for Payer: UnitedHealth Group of AZ Commercial	$67.63
Rate for Payer: UnitedHealth Group of AZ Medicare	$20.88

CD4/CD8 Ratio Profile LC

Facility

$556.00

Service Code	CPT 86360
Hospital Charge Code	2269448
Hospital Revenue Code	306
Min. Negotiated Rate	$144.56
Max. Negotiated Rate	$500.40
Rate for Payer: Aetna of AZ Commercial	$500.40
Rate for Payer: Bisbee Police All Plans	$144.56
Rate for Payer: Cash Price	$444.80
Rate for Payer: Self Pay Self Pay	$444.80

CD4/CD8 Ratio Profile LC

Facility

$556.00

Service Code	CPT 86360
Hospital Charge Code	2269448
Hospital Revenue Code	306
Min. Negotiated Rate	$88.96
Max. Negotiated Rate	$500.40
Rate for Payer: Aetna of AZ Commercial	$500.40
Rate for Payer: Aetna of AZ Medicare	$155.68
Rate for Payer: Allwell Medicare	$88.96
Rate for Payer: Amerigroup Medicare	$88.96
Rate for Payer: APIPA Medicare/Medicaid	$207.67
Rate for Payer: AZCH Complete Medicare	$88.96
Rate for Payer: Banner UC Health Medicare	$88.96
Rate for Payer: Bisbee Police All Plans	$144.56
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$378.08
Rate for Payer: Cash Price	$444.80
Rate for Payer: Cigna of AZ Commercial	$361.40
Rate for Payer: Copperpoint Commercial	$137.61
Rate for Payer: Health Net of AZ Commercial	$333.60
Rate for Payer: Health Net of AZ Medicare	$155.68
Rate for Payer: Humana of AZ Medicare	$88.96
Rate for Payer: Self Pay Self Pay	$444.80
Rate for Payer: TriWest Medicare	$88.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$324.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$100.08

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	$44.64
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: Allwell Medicare	$44.64
Rate for Payer: Amerigroup Medicare	$44.64
Rate for Payer: APIPA Medicare/Medicaid	$104.21
Rate for Payer: AZCH Complete Medicare	$44.64
Rate for Payer: Banner UC Health Medicare	$44.64
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: 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	$44.64
Rate for Payer: Self Pay Self Pay	$223.20
Rate for Payer: TriWest Medicare	$44.64
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	$31.52
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: Allwell Medicare	$31.52
Rate for Payer: Amerigroup Medicare	$31.52
Rate for Payer: APIPA Medicare/Medicaid	$73.58
Rate for Payer: AZCH Complete Medicare	$31.52
Rate for Payer: Banner UC Health Medicare	$31.52
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: 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	$31.52
Rate for Payer: Self Pay Self Pay	$157.60
Rate for Payer: TriWest Medicare	$31.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$114.85
Rate for Payer: UnitedHealth Group of AZ Medicare	$35.46

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	$72.54
Max. Negotiated Rate	$251.10
Rate for Payer: Aetna of AZ Commercial	$251.10
Rate for Payer: Bisbee Police All Plans	$72.54
Rate for Payer: Cash Price	$223.20
Rate for Payer: Self Pay Self Pay	$223.20

C Diff Ag and Toxin

Facility

$159.00

Service Code	CPT 87324
Hospital Charge Code	22414087
Hospital Revenue Code	306
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Cash Price	$127.20
Rate for Payer: Self Pay Self Pay	$127.20

C Diff Ag and Toxin

Facility

$159.00

Service Code	CPT 87324
Hospital Charge Code	22414087
Hospital Revenue Code	306
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Aetna of AZ Medicare	$44.52
Rate for Payer: Allwell Medicare	$25.44
Rate for Payer: Amerigroup Medicare	$25.44
Rate for Payer: APIPA Medicare/Medicaid	$59.39
Rate for Payer: AZCH Complete Medicare	$25.44
Rate for Payer: Banner UC Health Medicare	$25.44
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$108.12
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cigna of AZ Commercial	$103.35
Rate for Payer: Copperpoint Commercial	$39.35
Rate for Payer: Health Net of AZ Commercial	$95.40
Rate for Payer: Health Net of AZ Medicare	$44.52
Rate for Payer: Humana of AZ Medicare	$25.44
Rate for Payer: Self Pay Self Pay	$127.20
Rate for Payer: TriWest Medicare	$25.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$92.70
Rate for Payer: UnitedHealth Group of AZ Medicare	$28.62

Know your out-of-pocket cost for care.

All Charges