Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Cardiac Panel 2

Facility

OP

$295.00

Service Code	CPT 84484
Hospital Charge Code	2483894
Hospital Revenue Code	305
Min. Negotiated Rate	$18.08
Max. Negotiated Rate	$265.50
Rate for Payer: Aetna of AZ Commercial	$265.50
Rate for Payer: Arizona Complete Health Allwell	$47.20
Rate for Payer: Banner UC Health Medicare	$47.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$200.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$47.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$47.20
Rate for Payer: Cash Price	$236.00
Rate for Payer: Cash Price	$236.00
Rate for Payer: Cigna of AZ Commercial	$191.75
Rate for Payer: Devoted Health Medicare	$53.10
Rate for Payer: Humana of AZ Medicare	$47.20
Rate for Payer: Seven Corners Travel Insurance	$18.08
Rate for Payer: Southwest Service Administrators UFCW	$200.60
Rate for Payer: TriWest Medicare	$47.20
Rate for Payer: United Healthcare Commercial	$168.74
Rate for Payer: United Healthcare Medicare	$47.20
Rate for Payer: Veterans Affairs TRICARE	$46.73

Cardiac Panel Standard

Facility

OP

$311.00

Service Code	CPT 84484
Hospital Charge Code	22141052
Hospital Revenue Code	301
Min. Negotiated Rate	$18.08
Max. Negotiated Rate	$279.90
Rate for Payer: Aetna of AZ Commercial	$279.90
Rate for Payer: Arizona Complete Health Allwell	$49.76
Rate for Payer: Banner UC Health Medicare	$49.76
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$211.48
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$49.76
Rate for Payer: Care1st Health Plan Arizona Medicare	$49.76
Rate for Payer: Cash Price	$248.80
Rate for Payer: Cash Price	$248.80
Rate for Payer: Cigna of AZ Commercial	$202.15
Rate for Payer: Devoted Health Medicare	$55.98
Rate for Payer: Humana of AZ Medicare	$49.76
Rate for Payer: Seven Corners Travel Insurance	$18.08
Rate for Payer: Southwest Service Administrators UFCW	$211.48
Rate for Payer: TriWest Medicare	$49.76
Rate for Payer: United Healthcare Commercial	$177.89
Rate for Payer: United Healthcare Medicare	$49.76
Rate for Payer: Veterans Affairs TRICARE	$49.26

Cardiac Panel Standard

Facility

IP

$311.00

Service Code	CPT 84484
Hospital Charge Code	22141052
Hospital Revenue Code	301
Min. Negotiated Rate	$279.90
Max. Negotiated Rate	$279.90
Rate for Payer: Aetna of AZ Commercial	$279.90
Rate for Payer: Cash Price	$248.80

Cardiac Structural And Valvular Disorders

Facility

IP

$12,416.88

Service Code	APR-DRG 2004
Hospital Charge Code	APRDRG2002
Min. Negotiated Rate	$12,416.88
Max. Negotiated Rate	$12,416.88
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,416.88
Rate for Payer: Mercy Care Medicaid	$12,416.88
Rate for Payer: NaphCare Correctional Healthcare	$12,416.88

Cardiac Structural And Valvular Disorders

Facility

IP

$3,734.25

Service Code	APR-DRG 2001
Hospital Charge Code	APRDRG2003
Min. Negotiated Rate	$3,734.25
Max. Negotiated Rate	$3,734.25
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,734.25
Rate for Payer: Mercy Care Medicaid	$3,734.25
Rate for Payer: NaphCare Correctional Healthcare	$3,734.25

Cardiac Structural And Valvular Disorders

Facility

IP

$4,726.03

Service Code	APR-DRG 2002
Hospital Charge Code	APRDRG2003
Min. Negotiated Rate	$4,726.03
Max. Negotiated Rate	$4,726.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,726.03
Rate for Payer: Mercy Care Medicaid	$4,726.03
Rate for Payer: NaphCare Correctional Healthcare	$4,726.03

Cardiac Structural And Valvular Disorders

Facility

IP

$6,734.14

Service Code	APR-DRG 2003
Hospital Charge Code	APRDRG2001
Min. Negotiated Rate	$6,734.14
Max. Negotiated Rate	$6,734.14
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,734.14
Rate for Payer: Mercy Care Medicaid	$6,734.14
Rate for Payer: NaphCare Correctional Healthcare	$6,734.14

Cardiac Structural And Valvular Disorders

Facility

IP

$4,726.03

Service Code	APR-DRG 2002
Hospital Charge Code	APRDRG2004
Min. Negotiated Rate	$4,726.03
Max. Negotiated Rate	$4,726.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,726.03
Rate for Payer: Mercy Care Medicaid	$4,726.03
Rate for Payer: NaphCare Correctional Healthcare	$4,726.03

Cardiac Structural And Valvular Disorders

Facility

IP

$12,416.88

Service Code	APR-DRG 2004
Hospital Charge Code	APRDRG2001
Min. Negotiated Rate	$12,416.88
Max. Negotiated Rate	$12,416.88
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,416.88
Rate for Payer: Mercy Care Medicaid	$12,416.88
Rate for Payer: NaphCare Correctional Healthcare	$12,416.88

Cardiac Structural And Valvular Disorders

Facility

IP

$3,734.25

Service Code	APR-DRG 2001
Hospital Charge Code	APRDRG2002
Min. Negotiated Rate	$3,734.25
Max. Negotiated Rate	$3,734.25
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,734.25
Rate for Payer: Mercy Care Medicaid	$3,734.25
Rate for Payer: NaphCare Correctional Healthcare	$3,734.25

Cardiac Structural And Valvular Disorders

Facility

IP

$6,734.14

Service Code	APR-DRG 2003
Hospital Charge Code	APRDRG2004
Min. Negotiated Rate	$6,734.14
Max. Negotiated Rate	$6,734.14
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,734.14
Rate for Payer: Mercy Care Medicaid	$6,734.14
Rate for Payer: NaphCare Correctional Healthcare	$6,734.14

Cardiac Structural And Valvular Disorders

Facility

IP

$4,726.03

Service Code	APR-DRG 2002
Hospital Charge Code	APRDRG2001
Min. Negotiated Rate	$4,726.03
Max. Negotiated Rate	$4,726.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,726.03
Rate for Payer: Mercy Care Medicaid	$4,726.03
Rate for Payer: NaphCare Correctional Healthcare	$4,726.03

Cardiac Structural And Valvular Disorders

Facility

IP

$3,734.25

Service Code	APR-DRG 2001
Hospital Charge Code	APRDRG2001
Min. Negotiated Rate	$3,734.25
Max. Negotiated Rate	$3,734.25
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,734.25
Rate for Payer: Mercy Care Medicaid	$3,734.25
Rate for Payer: NaphCare Correctional Healthcare	$3,734.25

Cardiac Structural And Valvular Disorders

Facility

IP

$12,416.88

Service Code	APR-DRG 2004
Hospital Charge Code	APRDRG2003
Min. Negotiated Rate	$12,416.88
Max. Negotiated Rate	$12,416.88
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,416.88
Rate for Payer: Mercy Care Medicaid	$12,416.88
Rate for Payer: NaphCare Correctional Healthcare	$12,416.88

Cardiac Structural And Valvular Disorders

Facility

IP

$4,726.03

Service Code	APR-DRG 2002
Hospital Charge Code	APRDRG2002
Min. Negotiated Rate	$4,726.03
Max. Negotiated Rate	$4,726.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,726.03
Rate for Payer: Mercy Care Medicaid	$4,726.03
Rate for Payer: NaphCare Correctional Healthcare	$4,726.03

Cardiac Structural And Valvular Disorders

Facility

IP

$6,734.14

Service Code	APR-DRG 2003
Hospital Charge Code	APRDRG2002
Min. Negotiated Rate	$6,734.14
Max. Negotiated Rate	$6,734.14
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,734.14
Rate for Payer: Mercy Care Medicaid	$6,734.14
Rate for Payer: NaphCare Correctional Healthcare	$6,734.14

Cardiac Structural And Valvular Disorders

Facility

IP

$3,734.25

Service Code	APR-DRG 2001
Hospital Charge Code	APRDRG2004
Min. Negotiated Rate	$3,734.25
Max. Negotiated Rate	$3,734.25
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,734.25
Rate for Payer: Mercy Care Medicaid	$3,734.25
Rate for Payer: NaphCare Correctional Healthcare	$3,734.25

Cardiac Structural And Valvular Disorders

Facility

IP

$12,416.88

Service Code	APR-DRG 2004
Hospital Charge Code	APRDRG2004
Min. Negotiated Rate	$12,416.88
Max. Negotiated Rate	$12,416.88
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,416.88
Rate for Payer: Mercy Care Medicaid	$12,416.88
Rate for Payer: NaphCare Correctional Healthcare	$12,416.88

Cardiac Structural And Valvular Disorders

Facility

IP

$6,734.14

Service Code	APR-DRG 2003
Hospital Charge Code	APRDRG2003
Min. Negotiated Rate	$6,734.14
Max. Negotiated Rate	$6,734.14
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,734.14
Rate for Payer: Mercy Care Medicaid	$6,734.14
Rate for Payer: NaphCare Correctional Healthcare	$6,734.14

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

IP

$84,980.09

Service Code	MSDRG 217
Min. Negotiated Rate	$84,980.09
Max. Negotiated Rate	$84,980.09
Rate for Payer: Seven Corners Travel Insurance	$84,980.09

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

IP

$126,434.30

Service Code	MSDRG 216
Min. Negotiated Rate	$126,434.30
Max. Negotiated Rate	$126,434.30
Rate for Payer: Seven Corners Travel Insurance	$126,434.30

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

IP

$84,980.09

Service Code	MSDRG 218
Min. Negotiated Rate	$84,980.09
Max. Negotiated Rate	$84,980.09
Rate for Payer: Seven Corners Travel Insurance	$84,980.09

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

IP

$68,921.85

Service Code	MSDRG 220
Min. Negotiated Rate	$68,921.85
Max. Negotiated Rate	$68,921.85
Rate for Payer: Seven Corners Travel Insurance	$68,921.85

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

IP

$99,235.42

Service Code	MSDRG 219
Min. Negotiated Rate	$99,235.42
Max. Negotiated Rate	$99,235.42
Rate for Payer: Seven Corners Travel Insurance	$99,235.42

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

IP

$65,140.28

Service Code	MSDRG 221
Min. Negotiated Rate	$65,140.28
Max. Negotiated Rate	$65,140.28
Rate for Payer: Seven Corners Travel Insurance	$65,140.28

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