Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Cholecystectomy

Facility

$23,209.33

Service Code	APR-DRG 2634
Hospital Charge Code	APRDRG2632
Min. Negotiated Rate	$23,209.33
Max. Negotiated Rate	$23,209.33
Rate for Payer: AHCCCS Medicaid	$23,209.33
Rate for Payer: Allwell Medicaid	$23,209.33
Rate for Payer: AZCH Complete Medicaid	$23,209.33
Rate for Payer: Banner UC Health Medicaid	$23,209.33
Rate for Payer: Mercy Care Medicaid	$23,209.33

Cholecystectomy

Facility

$8,723.31

Service Code	APR-DRG 2632
Hospital Charge Code	APRDRG2631
Min. Negotiated Rate	$8,723.31
Max. Negotiated Rate	$8,723.31
Rate for Payer: AHCCCS Medicaid	$8,723.31
Rate for Payer: Allwell Medicaid	$8,723.31
Rate for Payer: AZCH Complete Medicaid	$8,723.31
Rate for Payer: Banner UC Health Medicaid	$8,723.31
Rate for Payer: Mercy Care Medicaid	$8,723.31

Cholecystectomy

Facility

$8,723.31

Service Code	APR-DRG 2632
Hospital Charge Code	APRDRG2633
Min. Negotiated Rate	$8,723.31
Max. Negotiated Rate	$8,723.31
Rate for Payer: AHCCCS Medicaid	$8,723.31
Rate for Payer: Allwell Medicaid	$8,723.31
Rate for Payer: AZCH Complete Medicaid	$8,723.31
Rate for Payer: Banner UC Health Medicaid	$8,723.31
Rate for Payer: Mercy Care Medicaid	$8,723.31

Cholecystectomy

Facility

$23,209.33

Service Code	APR-DRG 2634
Hospital Charge Code	APRDRG2634
Min. Negotiated Rate	$23,209.33
Max. Negotiated Rate	$23,209.33
Rate for Payer: AHCCCS Medicaid	$23,209.33
Rate for Payer: Allwell Medicaid	$23,209.33
Rate for Payer: AZCH Complete Medicaid	$23,209.33
Rate for Payer: Banner UC Health Medicaid	$23,209.33
Rate for Payer: Mercy Care Medicaid	$23,209.33

Cholecystectomy

Facility

$23,209.33

Service Code	APR-DRG 2634
Hospital Charge Code	APRDRG2633
Min. Negotiated Rate	$23,209.33
Max. Negotiated Rate	$23,209.33
Rate for Payer: AHCCCS Medicaid	$23,209.33
Rate for Payer: Allwell Medicaid	$23,209.33
Rate for Payer: AZCH Complete Medicaid	$23,209.33
Rate for Payer: Banner UC Health Medicaid	$23,209.33
Rate for Payer: Mercy Care Medicaid	$23,209.33

Cholecystectomy

Facility

$23,209.33

Service Code	APR-DRG 2634
Hospital Charge Code	APRDRG2631
Min. Negotiated Rate	$23,209.33
Max. Negotiated Rate	$23,209.33
Rate for Payer: AHCCCS Medicaid	$23,209.33
Rate for Payer: Allwell Medicaid	$23,209.33
Rate for Payer: AZCH Complete Medicaid	$23,209.33
Rate for Payer: Banner UC Health Medicaid	$23,209.33
Rate for Payer: Mercy Care Medicaid	$23,209.33

Cholecystectomy

Facility

$8,723.31

Service Code	APR-DRG 2632
Hospital Charge Code	APRDRG2634
Min. Negotiated Rate	$8,723.31
Max. Negotiated Rate	$8,723.31
Rate for Payer: AHCCCS Medicaid	$8,723.31
Rate for Payer: Allwell Medicaid	$8,723.31
Rate for Payer: AZCH Complete Medicaid	$8,723.31
Rate for Payer: Banner UC Health Medicaid	$8,723.31
Rate for Payer: Mercy Care Medicaid	$8,723.31

Cholecystectomy

Facility

$11,408.27

Service Code	APR-DRG 2633
Hospital Charge Code	APRDRG2633
Min. Negotiated Rate	$11,408.27
Max. Negotiated Rate	$11,408.27
Rate for Payer: AHCCCS Medicaid	$11,408.27
Rate for Payer: Allwell Medicaid	$11,408.27
Rate for Payer: AZCH Complete Medicaid	$11,408.27
Rate for Payer: Banner UC Health Medicaid	$11,408.27
Rate for Payer: Mercy Care Medicaid	$11,408.27

Cholecystectomy

Facility

$11,408.27

Service Code	APR-DRG 2633
Hospital Charge Code	APRDRG2634
Min. Negotiated Rate	$11,408.27
Max. Negotiated Rate	$11,408.27
Rate for Payer: AHCCCS Medicaid	$11,408.27
Rate for Payer: Allwell Medicaid	$11,408.27
Rate for Payer: AZCH Complete Medicaid	$11,408.27
Rate for Payer: Banner UC Health Medicaid	$11,408.27
Rate for Payer: Mercy Care Medicaid	$11,408.27

Cholecystectomy

Facility

$6,917.21

Service Code	APR-DRG 2631
Hospital Charge Code	APRDRG2632
Min. Negotiated Rate	$6,917.21
Max. Negotiated Rate	$6,917.21
Rate for Payer: AHCCCS Medicaid	$6,917.21
Rate for Payer: Allwell Medicaid	$6,917.21
Rate for Payer: AZCH Complete Medicaid	$6,917.21
Rate for Payer: Banner UC Health Medicaid	$6,917.21
Rate for Payer: Mercy Care Medicaid	$6,917.21

Cholecystectomy

Facility

$8,723.31

Service Code	APR-DRG 2632
Hospital Charge Code	APRDRG2632
Min. Negotiated Rate	$8,723.31
Max. Negotiated Rate	$8,723.31
Rate for Payer: AHCCCS Medicaid	$8,723.31
Rate for Payer: Allwell Medicaid	$8,723.31
Rate for Payer: AZCH Complete Medicaid	$8,723.31
Rate for Payer: Banner UC Health Medicaid	$8,723.31
Rate for Payer: Mercy Care Medicaid	$8,723.31

Cholecystectomy

Facility

$6,917.21

Service Code	APR-DRG 2631
Hospital Charge Code	APRDRG2634
Min. Negotiated Rate	$6,917.21
Max. Negotiated Rate	$6,917.21
Rate for Payer: AHCCCS Medicaid	$6,917.21
Rate for Payer: Allwell Medicaid	$6,917.21
Rate for Payer: AZCH Complete Medicaid	$6,917.21
Rate for Payer: Banner UC Health Medicaid	$6,917.21
Rate for Payer: Mercy Care Medicaid	$6,917.21

Cholecystectomy

Facility

$6,917.21

Service Code	APR-DRG 2631
Hospital Charge Code	APRDRG2633
Min. Negotiated Rate	$6,917.21
Max. Negotiated Rate	$6,917.21
Rate for Payer: AHCCCS Medicaid	$6,917.21
Rate for Payer: Allwell Medicaid	$6,917.21
Rate for Payer: AZCH Complete Medicaid	$6,917.21
Rate for Payer: Banner UC Health Medicaid	$6,917.21
Rate for Payer: Mercy Care Medicaid	$6,917.21

Cholecystectomy

Facility

$11,408.27

Service Code	APR-DRG 2633
Hospital Charge Code	APRDRG2631
Min. Negotiated Rate	$11,408.27
Max. Negotiated Rate	$11,408.27
Rate for Payer: AHCCCS Medicaid	$11,408.27
Rate for Payer: Allwell Medicaid	$11,408.27
Rate for Payer: AZCH Complete Medicaid	$11,408.27
Rate for Payer: Banner UC Health Medicaid	$11,408.27
Rate for Payer: Mercy Care Medicaid	$11,408.27

Cholecystectomy

Facility

$11,408.27

Service Code	APR-DRG 2633
Hospital Charge Code	APRDRG2632
Min. Negotiated Rate	$11,408.27
Max. Negotiated Rate	$11,408.27
Rate for Payer: AHCCCS Medicaid	$11,408.27
Rate for Payer: Allwell Medicaid	$11,408.27
Rate for Payer: AZCH Complete Medicaid	$11,408.27
Rate for Payer: Banner UC Health Medicaid	$11,408.27
Rate for Payer: Mercy Care Medicaid	$11,408.27

Cholesterol High Density Lipid

Facility

$99.00

Service Code	CPT 83718
Hospital Charge Code	633703
Hospital Revenue Code	301
Min. Negotiated Rate	$15.84
Max. Negotiated Rate	$89.10
Rate for Payer: Aetna of AZ Commercial	$89.10
Rate for Payer: Aetna of AZ Medicare	$27.72
Rate for Payer: Allwell Medicare	$15.84
Rate for Payer: Amerigroup Medicare	$15.84
Rate for Payer: APIPA Medicare/Medicaid	$36.98
Rate for Payer: AZCH Complete Medicare	$15.84
Rate for Payer: Banner UC Health Medicare	$15.84
Rate for Payer: Bisbee Police All Plans	$25.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$67.32
Rate for Payer: Cash Price	$79.20
Rate for Payer: Cigna of AZ Commercial	$64.35
Rate for Payer: Copperpoint Commercial	$24.50
Rate for Payer: Health Net of AZ Commercial	$59.40
Rate for Payer: Health Net of AZ Medicare	$27.72
Rate for Payer: Humana of AZ Medicare	$15.84
Rate for Payer: Self Pay Self Pay	$79.20
Rate for Payer: TriWest Medicare	$15.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$57.72
Rate for Payer: UnitedHealth Group of AZ Medicare	$17.82

Cholesterol High Density Lipid

Facility

$99.00

Service Code	CPT 83718
Hospital Charge Code	633703
Hospital Revenue Code	301
Min. Negotiated Rate	$25.74
Max. Negotiated Rate	$89.10
Rate for Payer: Aetna of AZ Commercial	$89.10
Rate for Payer: Bisbee Police All Plans	$25.74
Rate for Payer: Cash Price	$79.20
Rate for Payer: Self Pay Self Pay	$79.20

Cholesterol Total

Facility

$76.00

Service Code	CPT 82465
Hospital Charge Code	633705
Hospital Revenue Code	301
Min. Negotiated Rate	$12.16
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Aetna of AZ Medicare	$21.28
Rate for Payer: Allwell Medicare	$12.16
Rate for Payer: Amerigroup Medicare	$12.16
Rate for Payer: APIPA Medicare/Medicaid	$28.39
Rate for Payer: AZCH Complete Medicare	$12.16
Rate for Payer: Banner UC Health Medicare	$12.16
Rate for Payer: Bisbee Police All Plans	$19.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$51.68
Rate for Payer: Cash Price	$60.80
Rate for Payer: Cigna of AZ Commercial	$49.40
Rate for Payer: Copperpoint Commercial	$18.81
Rate for Payer: Health Net of AZ Commercial	$45.60
Rate for Payer: Health Net of AZ Medicare	$21.28
Rate for Payer: Humana of AZ Medicare	$12.16
Rate for Payer: Self Pay Self Pay	$60.80
Rate for Payer: TriWest Medicare	$12.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$44.31
Rate for Payer: UnitedHealth Group of AZ Medicare	$13.68

Cholesterol Total

Facility

$76.00

Service Code	CPT 82465
Hospital Charge Code	633705
Hospital Revenue Code	301
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Bisbee Police All Plans	$19.76
Rate for Payer: Cash Price	$60.80
Rate for Payer: Self Pay Self Pay	$60.80

cholestyramine 4 g/ PKT UD [CQCH]

Facility

$0.77

Service Code	NDC 245003642
Hospital Charge Code	105916320
Hospital Revenue Code	251
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.69
Rate for Payer: Aetna of AZ Commercial	$0.69
Rate for Payer: Bisbee Police All Plans	$0.20
Rate for Payer: Cash Price	$0.62
Rate for Payer: Self Pay Self Pay	$0.62

cholestyramine 4 g/ PKT UD [CQCH]

Facility

$0.77

Service Code	NDC 245003642
Hospital Charge Code	105916320
Hospital Revenue Code	251
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.69
Rate for Payer: Aetna of AZ Commercial	$0.69
Rate for Payer: Aetna of AZ Medicare	$0.22
Rate for Payer: Allwell Medicare	$0.12
Rate for Payer: Amerigroup Medicare	$0.12
Rate for Payer: APIPA Medicare/Medicaid	$0.29
Rate for Payer: AZCH Complete Medicare	$0.12
Rate for Payer: Banner UC Health Medicare	$0.12
Rate for Payer: Bisbee Police All Plans	$0.20
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.52
Rate for Payer: Cash Price	$0.62
Rate for Payer: Cigna of AZ Commercial	$0.50
Rate for Payer: Copperpoint Commercial	$0.19
Rate for Payer: Health Net of AZ Commercial	$0.46
Rate for Payer: Health Net of AZ Medicare	$0.22
Rate for Payer: Humana of AZ Medicare	$0.12
Rate for Payer: Self Pay Self Pay	$0.62
Rate for Payer: TriWest Medicare	$0.12
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.45
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.14

Chromium LC

Facility

$284.00

Service Code	CPT 82495
Hospital Charge Code	6738684
Hospital Revenue Code	301
Min. Negotiated Rate	$45.44
Max. Negotiated Rate	$255.60
Rate for Payer: Aetna of AZ Commercial	$255.60
Rate for Payer: Aetna of AZ Medicare	$79.52
Rate for Payer: Allwell Medicare	$45.44
Rate for Payer: Amerigroup Medicare	$45.44
Rate for Payer: APIPA Medicare/Medicaid	$106.07
Rate for Payer: AZCH Complete Medicare	$45.44
Rate for Payer: Banner UC Health Medicare	$45.44
Rate for Payer: Bisbee Police All Plans	$73.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$193.12
Rate for Payer: Cash Price	$227.20
Rate for Payer: Cigna of AZ Commercial	$184.60
Rate for Payer: Copperpoint Commercial	$70.29
Rate for Payer: Health Net of AZ Commercial	$170.40
Rate for Payer: Health Net of AZ Medicare	$79.52
Rate for Payer: Humana of AZ Medicare	$45.44
Rate for Payer: Self Pay Self Pay	$227.20
Rate for Payer: TriWest Medicare	$45.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$165.57
Rate for Payer: UnitedHealth Group of AZ Medicare	$51.12

Chromium LC

Facility

$284.00

Service Code	CPT 82495
Hospital Charge Code	6738684
Hospital Revenue Code	301
Min. Negotiated Rate	$73.84
Max. Negotiated Rate	$255.60
Rate for Payer: Aetna of AZ Commercial	$255.60
Rate for Payer: Bisbee Police All Plans	$73.84
Rate for Payer: Cash Price	$227.20
Rate for Payer: Self Pay Self Pay	$227.20

Chromogranin A LC

Facility

$392.00

Service Code	CPT 86316
Hospital Charge Code	2029214
Hospital Revenue Code	302
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

Chromogranin A LC

Facility

$392.00

Service Code	CPT 86316
Hospital Charge Code	2029214
Hospital Revenue Code	302
Min. Negotiated Rate	$62.72
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: Allwell Medicare	$62.72
Rate for Payer: Amerigroup Medicare	$62.72
Rate for Payer: APIPA Medicare/Medicaid	$146.41
Rate for Payer: AZCH Complete Medicare	$62.72
Rate for Payer: Banner UC Health Medicare	$62.72
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: 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	$62.72
Rate for Payer: Self Pay Self Pay	$313.60
Rate for Payer: TriWest Medicare	$62.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$228.54
Rate for Payer: UnitedHealth Group of AZ Medicare	$70.56

Know your out-of-pocket cost for care.

All Charges