Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Chronic Obstructive Pulmonary Disease

Facility

IP

$5,325.73

Service Code	APR-DRG 1403
Hospital Charge Code	APRDRG1402
Min. Negotiated Rate	$5,325.73
Max. Negotiated Rate	$5,325.73
Rate for Payer: AHCCCS Medicaid	$5,325.73
Rate for Payer: Allwell Medicaid	$5,325.73
Rate for Payer: AZCH Complete Medicaid	$5,325.73
Rate for Payer: Banner UC Health Medicaid	$5,325.73
Rate for Payer: Mercy Care Medicaid	$5,325.73

Chronic Obstructive Pulmonary Disease

Facility

IP

$3,418.62

Service Code	APR-DRG 1401
Hospital Charge Code	APRDRG1403
Min. Negotiated Rate	$3,418.62
Max. Negotiated Rate	$3,418.62
Rate for Payer: AHCCCS Medicaid	$3,418.62
Rate for Payer: Allwell Medicaid	$3,418.62
Rate for Payer: AZCH Complete Medicaid	$3,418.62
Rate for Payer: Banner UC Health Medicaid	$3,418.62
Rate for Payer: Mercy Care Medicaid	$3,418.62

Chronic Obstructive Pulmonary Disease

Facility

IP

$5,325.73

Service Code	APR-DRG 1403
Hospital Charge Code	APRDRG1403
Min. Negotiated Rate	$5,325.73
Max. Negotiated Rate	$5,325.73
Rate for Payer: AHCCCS Medicaid	$5,325.73
Rate for Payer: Allwell Medicaid	$5,325.73
Rate for Payer: AZCH Complete Medicaid	$5,325.73
Rate for Payer: Banner UC Health Medicaid	$5,325.73
Rate for Payer: Mercy Care Medicaid	$5,325.73

Chronic Obstructive Pulmonary Disease

Facility

IP

$4,269.42

Service Code	APR-DRG 1402
Hospital Charge Code	APRDRG1403
Min. Negotiated Rate	$4,269.42
Max. Negotiated Rate	$4,269.42
Rate for Payer: AHCCCS Medicaid	$4,269.42
Rate for Payer: Allwell Medicaid	$4,269.42
Rate for Payer: AZCH Complete Medicaid	$4,269.42
Rate for Payer: Banner UC Health Medicaid	$4,269.42
Rate for Payer: Mercy Care Medicaid	$4,269.42

Chronic Obstructive Pulmonary Disease

Facility

IP

$8,423.11

Service Code	APR-DRG 1404
Hospital Charge Code	APRDRG1404
Min. Negotiated Rate	$8,423.11
Max. Negotiated Rate	$8,423.11
Rate for Payer: AHCCCS Medicaid	$8,423.11
Rate for Payer: Allwell Medicaid	$8,423.11
Rate for Payer: AZCH Complete Medicaid	$8,423.11
Rate for Payer: Banner UC Health Medicaid	$8,423.11
Rate for Payer: Mercy Care Medicaid	$8,423.11

Chronic Obstructive Pulmonary Disease

Facility

IP

$8,423.11

Service Code	APR-DRG 1404
Hospital Charge Code	APRDRG1401
Min. Negotiated Rate	$8,423.11
Max. Negotiated Rate	$8,423.11
Rate for Payer: AHCCCS Medicaid	$8,423.11
Rate for Payer: Allwell Medicaid	$8,423.11
Rate for Payer: AZCH Complete Medicaid	$8,423.11
Rate for Payer: Banner UC Health Medicaid	$8,423.11
Rate for Payer: Mercy Care Medicaid	$8,423.11

Chronic Obstructive Pulmonary Disease

Facility

IP

$8,423.11

Service Code	APR-DRG 1404
Hospital Charge Code	APRDRG1402
Min. Negotiated Rate	$8,423.11
Max. Negotiated Rate	$8,423.11
Rate for Payer: AHCCCS Medicaid	$8,423.11
Rate for Payer: Allwell Medicaid	$8,423.11
Rate for Payer: AZCH Complete Medicaid	$8,423.11
Rate for Payer: Banner UC Health Medicaid	$8,423.11
Rate for Payer: Mercy Care Medicaid	$8,423.11

Chronic Obstructive Pulmonary Disease

Facility

IP

$4,269.42

Service Code	APR-DRG 1402
Hospital Charge Code	APRDRG1402
Min. Negotiated Rate	$4,269.42
Max. Negotiated Rate	$4,269.42
Rate for Payer: AHCCCS Medicaid	$4,269.42
Rate for Payer: Allwell Medicaid	$4,269.42
Rate for Payer: AZCH Complete Medicaid	$4,269.42
Rate for Payer: Banner UC Health Medicaid	$4,269.42
Rate for Payer: Mercy Care Medicaid	$4,269.42

Chronic Obstructive Pulmonary Disease

Facility

IP

$4,269.42

Service Code	APR-DRG 1402
Hospital Charge Code	APRDRG1404
Min. Negotiated Rate	$4,269.42
Max. Negotiated Rate	$4,269.42
Rate for Payer: AHCCCS Medicaid	$4,269.42
Rate for Payer: Allwell Medicaid	$4,269.42
Rate for Payer: AZCH Complete Medicaid	$4,269.42
Rate for Payer: Banner UC Health Medicaid	$4,269.42
Rate for Payer: Mercy Care Medicaid	$4,269.42

Chronic Obstructive Pulmonary Disease

Facility

IP

$3,418.62

Service Code	APR-DRG 1401
Hospital Charge Code	APRDRG1402
Min. Negotiated Rate	$3,418.62
Max. Negotiated Rate	$3,418.62
Rate for Payer: AHCCCS Medicaid	$3,418.62
Rate for Payer: Allwell Medicaid	$3,418.62
Rate for Payer: AZCH Complete Medicaid	$3,418.62
Rate for Payer: Banner UC Health Medicaid	$3,418.62
Rate for Payer: Mercy Care Medicaid	$3,418.62

Chronic Obstructive Pulmonary Disease

Facility

IP

$5,325.73

Service Code	APR-DRG 1403
Hospital Charge Code	APRDRG1404
Min. Negotiated Rate	$5,325.73
Max. Negotiated Rate	$5,325.73
Rate for Payer: AHCCCS Medicaid	$5,325.73
Rate for Payer: Allwell Medicaid	$5,325.73
Rate for Payer: AZCH Complete Medicaid	$5,325.73
Rate for Payer: Banner UC Health Medicaid	$5,325.73
Rate for Payer: Mercy Care Medicaid	$5,325.73

ciprofloxacin 400 mg Premix IVPB [CQCH]

Facility

OP

$0.01

Service Code	HCPCS J0706
Hospital Charge Code	105916460
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Aetna of AZ Medicare	$0.00
Rate for Payer: Allwell Medicare	$0.00
Rate for Payer: Amerigroup Medicare	$0.00
Rate for Payer: APIPA Medicare/Medicaid	$0.00
Rate for Payer: AZCH Complete Medicare	$0.00
Rate for Payer: Banner UC Health Medicare	$0.00
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of AZ Commercial	$0.01
Rate for Payer: Copperpoint Commercial	$0.00
Rate for Payer: Health Net of AZ Commercial	$0.01
Rate for Payer: Health Net of AZ Medicare	$0.00
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Self Pay Self Pay	$0.01
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.01
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.00

ciprofloxacin 400 mg Premix IVPB [CQCH]

Facility

IP

$0.01

Service Code	HCPCS J0706
Hospital Charge Code	105916460
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

ciprofloxacin 500 mg Tab [CQCH]

Facility

IP

$0.16

Service Code	NDC 63739055910
Hospital Charge Code	105916393
Hospital Revenue Code	251
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.14
Rate for Payer: Aetna of AZ Commercial	$0.14
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Cash Price	$0.13
Rate for Payer: Self Pay Self Pay	$0.13

ciprofloxacin 500 mg Tab [CQCH]

Facility

OP

$0.16

Service Code	NDC 63739055910
Hospital Charge Code	105916393
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.14
Rate for Payer: Aetna of AZ Commercial	$0.14
Rate for Payer: Aetna of AZ Medicare	$0.04
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.06
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.11
Rate for Payer: Cash Price	$0.13
Rate for Payer: Cigna of AZ Commercial	$0.10
Rate for Payer: Copperpoint Commercial	$0.04
Rate for Payer: Health Net of AZ Commercial	$0.10
Rate for Payer: Health Net of AZ Medicare	$0.04
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.13
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.09
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.03

ciprofloxacin-dexamethasone otic Sus 7.5 mL [CQCH]

Facility

IP

$231.68

Service Code	NDC 65853302
Hospital Charge Code	107994705
Hospital Revenue Code	250
Min. Negotiated Rate	$60.24
Max. Negotiated Rate	$208.51
Rate for Payer: Aetna of AZ Commercial	$208.51
Rate for Payer: Bisbee Police All Plans	$60.24
Rate for Payer: Cash Price	$185.34
Rate for Payer: Self Pay Self Pay	$185.34

ciprofloxacin-dexamethasone otic Sus 7.5 mL [CQCH]

Facility

OP

$231.68

Service Code	NDC 65853302
Hospital Charge Code	107994705
Hospital Revenue Code	250
Min. Negotiated Rate	$37.07
Max. Negotiated Rate	$208.51
Rate for Payer: Aetna of AZ Commercial	$208.51
Rate for Payer: Aetna of AZ Medicare	$64.87
Rate for Payer: Allwell Medicare	$37.07
Rate for Payer: Amerigroup Medicare	$37.07
Rate for Payer: APIPA Medicare/Medicaid	$86.53
Rate for Payer: AZCH Complete Medicare	$37.07
Rate for Payer: Banner UC Health Medicare	$37.07
Rate for Payer: Bisbee Police All Plans	$60.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$157.54
Rate for Payer: Cash Price	$185.34
Rate for Payer: Cigna of AZ Commercial	$150.59
Rate for Payer: Copperpoint Commercial	$57.34
Rate for Payer: Health Net of AZ Commercial	$139.01
Rate for Payer: Health Net of AZ Medicare	$64.87
Rate for Payer: Humana of AZ Medicare	$37.07
Rate for Payer: Self Pay Self Pay	$185.34
Rate for Payer: TriWest Medicare	$37.07
Rate for Payer: UnitedHealth Group of AZ Commercial	$135.07
Rate for Payer: UnitedHealth Group of AZ Medicare	$41.70

CIT AC 24HR

Facility

IP

$344.00

Service Code	CPT 82507
Hospital Charge Code	22481467
Hospital Revenue Code	301
Min. Negotiated Rate	$89.44
Max. Negotiated Rate	$309.60
Rate for Payer: Aetna of AZ Commercial	$309.60
Rate for Payer: Bisbee Police All Plans	$89.44
Rate for Payer: Cash Price	$275.20
Rate for Payer: Self Pay Self Pay	$275.20

CIT AC 24HR

Facility

OP

$344.00

Service Code	CPT 82507
Hospital Charge Code	22481467
Hospital Revenue Code	301
Min. Negotiated Rate	$55.04
Max. Negotiated Rate	$309.60
Rate for Payer: Aetna of AZ Commercial	$309.60
Rate for Payer: Aetna of AZ Medicare	$96.32
Rate for Payer: Allwell Medicare	$55.04
Rate for Payer: Amerigroup Medicare	$55.04
Rate for Payer: APIPA Medicare/Medicaid	$128.48
Rate for Payer: AZCH Complete Medicare	$55.04
Rate for Payer: Banner UC Health Medicare	$55.04
Rate for Payer: Bisbee Police All Plans	$89.44
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$233.92
Rate for Payer: Cash Price	$275.20
Rate for Payer: Cigna of AZ Commercial	$223.60
Rate for Payer: Copperpoint Commercial	$85.14
Rate for Payer: Health Net of AZ Commercial	$206.40
Rate for Payer: Health Net of AZ Medicare	$96.32
Rate for Payer: Humana of AZ Medicare	$55.04
Rate for Payer: Self Pay Self Pay	$275.20
Rate for Payer: TriWest Medicare	$55.04
Rate for Payer: UnitedHealth Group of AZ Commercial	$200.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$61.92

citalopram 20 mg Tab [CQCH]

Facility

OP

$0.06

Service Code	NDC 904608561
Hospital Charge Code	105916535
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Aetna of AZ Medicare	$0.02
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.02
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.04
Rate for Payer: Cash Price	$0.05
Rate for Payer: Cigna of AZ Commercial	$0.04
Rate for Payer: Copperpoint Commercial	$0.01
Rate for Payer: Health Net of AZ Commercial	$0.04
Rate for Payer: Health Net of AZ Medicare	$0.02
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Self Pay Self Pay	$0.05
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

citalopram 20 mg Tab [CQCH]

Facility

IP

$0.06

Service Code	NDC 904608561
Hospital Charge Code	105916535
Hospital Revenue Code	251
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Cash Price	$0.05
Rate for Payer: Self Pay Self Pay	$0.05

Citric Acid (Citrate), Urine LC

Facility

IP

$327.00

Service Code	CPT 82507
Hospital Charge Code	2029186
Hospital Revenue Code	302
Min. Negotiated Rate	$85.02
Max. Negotiated Rate	$294.30
Rate for Payer: Aetna of AZ Commercial	$294.30
Rate for Payer: Bisbee Police All Plans	$85.02
Rate for Payer: Cash Price	$261.60
Rate for Payer: Self Pay Self Pay	$261.60

Citric Acid (Citrate), Urine LC

Facility

OP

$327.00

Service Code	CPT 82507
Hospital Charge Code	2029186
Hospital Revenue Code	302
Min. Negotiated Rate	$52.32
Max. Negotiated Rate	$294.30
Rate for Payer: Aetna of AZ Commercial	$294.30
Rate for Payer: Aetna of AZ Medicare	$91.56
Rate for Payer: Allwell Medicare	$52.32
Rate for Payer: Amerigroup Medicare	$52.32
Rate for Payer: APIPA Medicare/Medicaid	$122.13
Rate for Payer: AZCH Complete Medicare	$52.32
Rate for Payer: Banner UC Health Medicare	$52.32
Rate for Payer: Bisbee Police All Plans	$85.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$222.36
Rate for Payer: Cash Price	$261.60
Rate for Payer: Cigna of AZ Commercial	$212.55
Rate for Payer: Copperpoint Commercial	$80.93
Rate for Payer: Health Net of AZ Commercial	$196.20
Rate for Payer: Health Net of AZ Medicare	$91.56
Rate for Payer: Humana of AZ Medicare	$52.32
Rate for Payer: Self Pay Self Pay	$261.60
Rate for Payer: TriWest Medicare	$52.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$190.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$58.86

citric acid-sodium citrate Oral Sol 30 mL UD [CQCH]

Facility

IP

$0.02

Service Code	NDC 121059530
Hospital Charge Code	105916602
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna of AZ Commercial	$0.02
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Cash Price	$0.02
Rate for Payer: Self Pay Self Pay	$0.02

citric acid-sodium citrate Oral Sol 30 mL UD [CQCH]

Facility

OP

$0.02

Service Code	NDC 121059530
Hospital Charge Code	105916602
Hospital Revenue Code	251
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna of AZ Commercial	$0.02
Rate for Payer: Aetna of AZ Medicare	$0.01
Rate for Payer: Allwell Medicare	$0.00
Rate for Payer: Amerigroup Medicare	$0.00
Rate for Payer: APIPA Medicare/Medicaid	$0.01
Rate for Payer: AZCH Complete Medicare	$0.00
Rate for Payer: Banner UC Health Medicare	$0.00
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.01
Rate for Payer: Cash Price	$0.02
Rate for Payer: Cigna of AZ Commercial	$0.01
Rate for Payer: Copperpoint Commercial	$0.00
Rate for Payer: Health Net of AZ Commercial	$0.01
Rate for Payer: Health Net of AZ Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Self Pay Self Pay	$0.02
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.01
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.00

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