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Service Code CPT 12055
Hospital Charge Code 22282798
Hospital Revenue Code 450
Min. Negotiated Rate $415.74
Max. Negotiated Rate $1,439.10
Rate for Payer: Aetna of AZ Commercial $1,439.10
Rate for Payer: Bisbee Police All Plans $415.74
Rate for Payer: Cash Price $1,279.20
Rate for Payer: Self Pay Self Pay $1,279.20
Service Code CPT 12055
Hospital Charge Code 22282798
Hospital Revenue Code 450
Min. Negotiated Rate $239.85
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,439.10
Rate for Payer: Aetna of AZ Medicare $447.72
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $239.85
Rate for Payer: Amerigroup Medicare $239.85
Rate for Payer: APIPA Medicare/Medicaid $597.23
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $239.85
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $239.85
Rate for Payer: Bisbee Police All Plans $415.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,087.32
Rate for Payer: Cash Price $1,279.20
Rate for Payer: Cash Price $1,279.20
Rate for Payer: Cigna of AZ Commercial $1,119.30
Rate for Payer: Copperpoint Commercial $395.75
Rate for Payer: Health Net of AZ Commercial $959.40
Rate for Payer: Health Net of AZ Medicare $447.72
Rate for Payer: Humana of AZ Medicare $239.85
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,279.20
Rate for Payer: TriWest Medicare $239.85
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $287.82
Service Code CPT 12056
Hospital Charge Code 22282799
Hospital Revenue Code 450
Min. Negotiated Rate $491.66
Max. Negotiated Rate $1,701.90
Rate for Payer: Aetna of AZ Commercial $1,701.90
Rate for Payer: Bisbee Police All Plans $491.66
Rate for Payer: Cash Price $1,512.80
Rate for Payer: Self Pay Self Pay $1,512.80
Service Code CPT 12056
Hospital Charge Code 22282799
Hospital Revenue Code 450
Min. Negotiated Rate $283.65
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,701.90
Rate for Payer: Aetna of AZ Medicare $529.48
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $283.65
Rate for Payer: Amerigroup Medicare $283.65
Rate for Payer: APIPA Medicare/Medicaid $706.29
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $283.65
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $283.65
Rate for Payer: Bisbee Police All Plans $491.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,285.88
Rate for Payer: Cash Price $1,512.80
Rate for Payer: Cash Price $1,512.80
Rate for Payer: Cigna of AZ Commercial $1,323.70
Rate for Payer: Copperpoint Commercial $468.02
Rate for Payer: Health Net of AZ Commercial $1,134.60
Rate for Payer: Health Net of AZ Medicare $529.48
Rate for Payer: Humana of AZ Medicare $283.65
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,512.80
Rate for Payer: TriWest Medicare $283.65
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $340.38
Service Code CPT 12057
Hospital Charge Code 22282800
Hospital Revenue Code 450
Min. Negotiated Rate $328.05
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,968.30
Rate for Payer: Aetna of AZ Medicare $612.36
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $328.05
Rate for Payer: Amerigroup Medicare $328.05
Rate for Payer: APIPA Medicare/Medicaid $816.84
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $328.05
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $328.05
Rate for Payer: Bisbee Police All Plans $568.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,487.16
Rate for Payer: Cash Price $1,749.60
Rate for Payer: Cash Price $1,749.60
Rate for Payer: Cigna of AZ Commercial $1,530.90
Rate for Payer: Copperpoint Commercial $541.28
Rate for Payer: Health Net of AZ Commercial $1,312.20
Rate for Payer: Health Net of AZ Medicare $612.36
Rate for Payer: Humana of AZ Medicare $328.05
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,749.60
Rate for Payer: TriWest Medicare $328.05
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $393.66
Service Code CPT 12057
Hospital Charge Code 22282800
Hospital Revenue Code 450
Min. Negotiated Rate $568.62
Max. Negotiated Rate $1,968.30
Rate for Payer: Aetna of AZ Commercial $1,968.30
Rate for Payer: Bisbee Police All Plans $568.62
Rate for Payer: Cash Price $1,749.60
Rate for Payer: Self Pay Self Pay $1,749.60
Service Code CPT 13100
Hospital Charge Code 22282801
Hospital Revenue Code 450
Min. Negotiated Rate $133.65
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $801.90
Rate for Payer: Aetna of AZ Medicare $249.48
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $133.65
Rate for Payer: Amerigroup Medicare $133.65
Rate for Payer: APIPA Medicare/Medicaid $332.79
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $133.65
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $133.65
Rate for Payer: Bisbee Police All Plans $231.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $605.88
Rate for Payer: Cash Price $712.80
Rate for Payer: Cash Price $712.80
Rate for Payer: Cigna of AZ Commercial $623.70
Rate for Payer: Copperpoint Commercial $220.52
Rate for Payer: Health Net of AZ Commercial $534.60
Rate for Payer: Health Net of AZ Medicare $249.48
Rate for Payer: Humana of AZ Medicare $133.65
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $712.80
Rate for Payer: TriWest Medicare $133.65
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $160.38
Service Code CPT 13100
Hospital Charge Code 22282801
Hospital Revenue Code 450
Min. Negotiated Rate $231.66
Max. Negotiated Rate $801.90
Rate for Payer: Aetna of AZ Commercial $801.90
Rate for Payer: Bisbee Police All Plans $231.66
Rate for Payer: Cash Price $712.80
Rate for Payer: Self Pay Self Pay $712.80
Service Code CPT 13101
Hospital Charge Code 22282802
Hospital Revenue Code 450
Min. Negotiated Rate $296.40
Max. Negotiated Rate $1,026.00
Rate for Payer: Aetna of AZ Commercial $1,026.00
Rate for Payer: Bisbee Police All Plans $296.40
Rate for Payer: Cash Price $912.00
Rate for Payer: Self Pay Self Pay $912.00
Service Code CPT 13101
Hospital Charge Code 22282802
Hospital Revenue Code 450
Min. Negotiated Rate $171.00
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,026.00
Rate for Payer: Aetna of AZ Medicare $319.20
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $171.00
Rate for Payer: Amerigroup Medicare $171.00
Rate for Payer: APIPA Medicare/Medicaid $425.79
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $171.00
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $171.00
Rate for Payer: Bisbee Police All Plans $296.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $775.20
Rate for Payer: Cash Price $912.00
Rate for Payer: Cash Price $912.00
Rate for Payer: Cigna of AZ Commercial $798.00
Rate for Payer: Copperpoint Commercial $282.15
Rate for Payer: Health Net of AZ Commercial $684.00
Rate for Payer: Health Net of AZ Medicare $319.20
Rate for Payer: Humana of AZ Medicare $171.00
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $912.00
Rate for Payer: TriWest Medicare $171.00
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $205.20
Service Code CPT 13102
Hospital Charge Code 22282803
Hospital Revenue Code 450
Min. Negotiated Rate $134.16
Max. Negotiated Rate $464.40
Rate for Payer: Aetna of AZ Commercial $464.40
Rate for Payer: Bisbee Police All Plans $134.16
Rate for Payer: Cash Price $412.80
Rate for Payer: Self Pay Self Pay $412.80
Service Code CPT 13102
Hospital Charge Code 22282803
Hospital Revenue Code 450
Min. Negotiated Rate $77.40
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $464.40
Rate for Payer: Aetna of AZ Medicare $144.48
Rate for Payer: AHCCCS Medicaid $485.00
Rate for Payer: Allwell Medicaid $485.00
Rate for Payer: Allwell Medicare $77.40
Rate for Payer: Amerigroup Medicare $77.40
Rate for Payer: APIPA Medicare/Medicaid $192.73
Rate for Payer: AZCH Complete Medicaid $485.00
Rate for Payer: AZCH Complete Medicare $77.40
Rate for Payer: Banner UC Health Medicaid $485.00
Rate for Payer: Banner UC Health Medicare $77.40
Rate for Payer: Bisbee Police All Plans $134.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $350.88
Rate for Payer: Cash Price $412.80
Rate for Payer: Cash Price $412.80
Rate for Payer: Cigna of AZ Commercial $361.20
Rate for Payer: Copperpoint Commercial $127.71
Rate for Payer: Health Net of AZ Commercial $309.60
Rate for Payer: Health Net of AZ Medicare $144.48
Rate for Payer: Humana of AZ Medicare $77.40
Rate for Payer: Mercy Care Medicaid $485.00
Rate for Payer: Self Pay Self Pay $412.80
Rate for Payer: TriWest Medicare $77.40
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $92.88
Service Code CPT 13120
Hospital Charge Code 22282804
Hospital Revenue Code 450
Min. Negotiated Rate $397.28
Max. Negotiated Rate $1,375.20
Rate for Payer: Aetna of AZ Commercial $1,375.20
Rate for Payer: Bisbee Police All Plans $397.28
Rate for Payer: Cash Price $1,222.40
Rate for Payer: Self Pay Self Pay $1,222.40
Service Code CPT 13120
Hospital Charge Code 22282804
Hospital Revenue Code 450
Min. Negotiated Rate $229.20
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,375.20
Rate for Payer: Aetna of AZ Medicare $427.84
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $229.20
Rate for Payer: Amerigroup Medicare $229.20
Rate for Payer: APIPA Medicare/Medicaid $570.71
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $229.20
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $229.20
Rate for Payer: Bisbee Police All Plans $397.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,039.04
Rate for Payer: Cash Price $1,222.40
Rate for Payer: Cash Price $1,222.40
Rate for Payer: Cigna of AZ Commercial $1,069.60
Rate for Payer: Copperpoint Commercial $378.18
Rate for Payer: Health Net of AZ Commercial $916.80
Rate for Payer: Health Net of AZ Medicare $427.84
Rate for Payer: Humana of AZ Medicare $229.20
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $1,222.40
Rate for Payer: TriWest Medicare $229.20
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $275.04
Service Code CPT 13121
Hospital Charge Code 22282805
Hospital Revenue Code 450
Min. Negotiated Rate $312.45
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,874.70
Rate for Payer: Aetna of AZ Medicare $583.24
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $312.45
Rate for Payer: Amerigroup Medicare $312.45
Rate for Payer: APIPA Medicare/Medicaid $778.00
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $312.45
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $312.45
Rate for Payer: Bisbee Police All Plans $541.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,416.44
Rate for Payer: Cash Price $1,666.40
Rate for Payer: Cash Price $1,666.40
Rate for Payer: Cigna of AZ Commercial $1,458.10
Rate for Payer: Copperpoint Commercial $515.54
Rate for Payer: Health Net of AZ Commercial $1,249.80
Rate for Payer: Health Net of AZ Medicare $583.24
Rate for Payer: Humana of AZ Medicare $312.45
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $1,666.40
Rate for Payer: TriWest Medicare $312.45
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $374.94
Service Code CPT 13121
Hospital Charge Code 22282805
Hospital Revenue Code 450
Min. Negotiated Rate $541.58
Max. Negotiated Rate $1,874.70
Rate for Payer: Aetna of AZ Commercial $1,874.70
Rate for Payer: Bisbee Police All Plans $541.58
Rate for Payer: Cash Price $1,666.40
Rate for Payer: Self Pay Self Pay $1,666.40
Service Code CPT 13122
Hospital Charge Code 22282806
Hospital Revenue Code 450
Min. Negotiated Rate $112.32
Max. Negotiated Rate $388.80
Rate for Payer: Aetna of AZ Commercial $388.80
Rate for Payer: Bisbee Police All Plans $112.32
Rate for Payer: Cash Price $345.60
Rate for Payer: Self Pay Self Pay $345.60
Service Code CPT 13122
Hospital Charge Code 22282806
Hospital Revenue Code 450
Min. Negotiated Rate $64.80
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $388.80
Rate for Payer: Aetna of AZ Medicare $120.96
Rate for Payer: AHCCCS Medicaid $165.38
Rate for Payer: Allwell Medicaid $165.38
Rate for Payer: Allwell Medicare $64.80
Rate for Payer: Amerigroup Medicare $64.80
Rate for Payer: APIPA Medicare/Medicaid $161.35
Rate for Payer: AZCH Complete Medicaid $165.38
Rate for Payer: AZCH Complete Medicare $64.80
Rate for Payer: Banner UC Health Medicaid $165.38
Rate for Payer: Banner UC Health Medicare $64.80
Rate for Payer: Bisbee Police All Plans $112.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $293.76
Rate for Payer: Cash Price $345.60
Rate for Payer: Cash Price $345.60
Rate for Payer: Cigna of AZ Commercial $302.40
Rate for Payer: Copperpoint Commercial $106.92
Rate for Payer: Health Net of AZ Commercial $259.20
Rate for Payer: Health Net of AZ Medicare $120.96
Rate for Payer: Humana of AZ Medicare $64.80
Rate for Payer: Mercy Care Medicaid $165.38
Rate for Payer: Self Pay Self Pay $345.60
Rate for Payer: TriWest Medicare $64.80
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $77.76
Service Code CPT 13131
Hospital Charge Code 22282807
Hospital Revenue Code 450
Min. Negotiated Rate $288.34
Max. Negotiated Rate $998.10
Rate for Payer: Aetna of AZ Commercial $998.10
Rate for Payer: Bisbee Police All Plans $288.34
Rate for Payer: Cash Price $887.20
Rate for Payer: Self Pay Self Pay $887.20
Service Code CPT 13131
Hospital Charge Code 22282807
Hospital Revenue Code 450
Min. Negotiated Rate $166.35
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $998.10
Rate for Payer: Aetna of AZ Medicare $310.52
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $166.35
Rate for Payer: Amerigroup Medicare $166.35
Rate for Payer: APIPA Medicare/Medicaid $414.21
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $166.35
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $166.35
Rate for Payer: Bisbee Police All Plans $288.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $754.12
Rate for Payer: Cash Price $887.20
Rate for Payer: Cash Price $887.20
Rate for Payer: Cigna of AZ Commercial $776.30
Rate for Payer: Copperpoint Commercial $274.48
Rate for Payer: Health Net of AZ Commercial $665.40
Rate for Payer: Health Net of AZ Medicare $310.52
Rate for Payer: Humana of AZ Medicare $166.35
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $887.20
Rate for Payer: TriWest Medicare $166.35
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $199.62
Service Code CPT 13132
Hospital Charge Code 22282808
Hospital Revenue Code 450
Min. Negotiated Rate $345.80
Max. Negotiated Rate $1,197.00
Rate for Payer: Aetna of AZ Commercial $1,197.00
Rate for Payer: Bisbee Police All Plans $345.80
Rate for Payer: Cash Price $1,064.00
Rate for Payer: Self Pay Self Pay $1,064.00
Service Code CPT 13132
Hospital Charge Code 22282808
Hospital Revenue Code 450
Min. Negotiated Rate $199.50
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,197.00
Rate for Payer: Aetna of AZ Medicare $372.40
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $199.50
Rate for Payer: Amerigroup Medicare $199.50
Rate for Payer: APIPA Medicare/Medicaid $496.76
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $199.50
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $199.50
Rate for Payer: Bisbee Police All Plans $345.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $904.40
Rate for Payer: Cash Price $1,064.00
Rate for Payer: Cash Price $1,064.00
Rate for Payer: Cigna of AZ Commercial $931.00
Rate for Payer: Copperpoint Commercial $329.18
Rate for Payer: Health Net of AZ Commercial $798.00
Rate for Payer: Health Net of AZ Medicare $372.40
Rate for Payer: Humana of AZ Medicare $199.50
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $1,064.00
Rate for Payer: TriWest Medicare $199.50
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $239.40
Service Code CPT 13133
Hospital Charge Code 22282809
Hospital Revenue Code 450
Min. Negotiated Rate $169.00
Max. Negotiated Rate $585.00
Rate for Payer: Aetna of AZ Commercial $585.00
Rate for Payer: Bisbee Police All Plans $169.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Self Pay Self Pay $520.00
Service Code CPT 13133
Hospital Charge Code 22282809
Hospital Revenue Code 450
Min. Negotiated Rate $97.50
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $585.00
Rate for Payer: Aetna of AZ Medicare $182.00
Rate for Payer: AHCCCS Medicaid $485.00
Rate for Payer: Allwell Medicaid $485.00
Rate for Payer: Allwell Medicare $97.50
Rate for Payer: Amerigroup Medicare $97.50
Rate for Payer: APIPA Medicare/Medicaid $242.78
Rate for Payer: AZCH Complete Medicaid $485.00
Rate for Payer: AZCH Complete Medicare $97.50
Rate for Payer: Banner UC Health Medicaid $485.00
Rate for Payer: Banner UC Health Medicare $97.50
Rate for Payer: Bisbee Police All Plans $169.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $442.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cash Price $520.00
Rate for Payer: Cigna of AZ Commercial $455.00
Rate for Payer: Copperpoint Commercial $160.88
Rate for Payer: Health Net of AZ Commercial $390.00
Rate for Payer: Health Net of AZ Medicare $182.00
Rate for Payer: Humana of AZ Medicare $97.50
Rate for Payer: Mercy Care Medicaid $485.00
Rate for Payer: Self Pay Self Pay $520.00
Rate for Payer: TriWest Medicare $97.50
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $117.00
Service Code CPT 13150
Hospital Charge Code 22282810
Hospital Revenue Code 450
Min. Negotiated Rate $184.95
Max. Negotiated Rate $1,109.70
Rate for Payer: Aetna of AZ Commercial $1,109.70
Rate for Payer: Aetna of AZ Medicare $345.24
Rate for Payer: Allwell Medicare $184.95
Rate for Payer: Amerigroup Medicare $184.95
Rate for Payer: APIPA Medicare/Medicaid $460.53
Rate for Payer: AZCH Complete Medicare $184.95
Rate for Payer: Banner UC Health Medicare $184.95
Rate for Payer: Bisbee Police All Plans $320.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $838.44
Rate for Payer: Cash Price $986.40
Rate for Payer: Cigna of AZ Commercial $863.10
Rate for Payer: Copperpoint Commercial $305.17
Rate for Payer: Health Net of AZ Commercial $739.80
Rate for Payer: Health Net of AZ Medicare $345.24
Rate for Payer: Humana of AZ Medicare $184.95
Rate for Payer: Self Pay Self Pay $986.40
Rate for Payer: TriWest Medicare $184.95
Rate for Payer: UnitedHealth Group of AZ Commercial $718.84
Rate for Payer: UnitedHealth Group of AZ Medicare $221.94