Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Connective Tissue Disorders

Facility

IP

$22,866.34

Service Code	APR-DRG 3464
Hospital Charge Code	APRDRG3462
Min. Negotiated Rate	$22,866.34
Max. Negotiated Rate	$22,866.34
Rate for Payer: AHCCCS Medicaid	$22,866.34
Rate for Payer: Allwell Medicaid	$22,866.34
Rate for Payer: AZCH Complete Medicaid	$22,866.34
Rate for Payer: Banner UC Health Medicaid	$22,866.34
Rate for Payer: Mercy Care Medicaid	$22,866.34

Connective Tissue Disorders

Facility

IP

$5,984.34

Service Code	APR-DRG 3462
Hospital Charge Code	APRDRG3461
Min. Negotiated Rate	$5,984.34
Max. Negotiated Rate	$5,984.34
Rate for Payer: AHCCCS Medicaid	$5,984.34
Rate for Payer: Allwell Medicaid	$5,984.34
Rate for Payer: AZCH Complete Medicaid	$5,984.34
Rate for Payer: Banner UC Health Medicaid	$5,984.34
Rate for Payer: Mercy Care Medicaid	$5,984.34

Connective Tissue Disorders

Facility

IP

$9,961.98

Service Code	APR-DRG 3463
Hospital Charge Code	APRDRG3462
Min. Negotiated Rate	$9,961.98
Max. Negotiated Rate	$9,961.98
Rate for Payer: AHCCCS Medicaid	$9,961.98
Rate for Payer: Allwell Medicaid	$9,961.98
Rate for Payer: AZCH Complete Medicaid	$9,961.98
Rate for Payer: Banner UC Health Medicaid	$9,961.98
Rate for Payer: Mercy Care Medicaid	$9,961.98

Connective Tissue Disorders

Facility

IP

$9,961.98

Service Code	APR-DRG 3463
Hospital Charge Code	APRDRG3464
Min. Negotiated Rate	$9,961.98
Max. Negotiated Rate	$9,961.98
Rate for Payer: AHCCCS Medicaid	$9,961.98
Rate for Payer: Allwell Medicaid	$9,961.98
Rate for Payer: AZCH Complete Medicaid	$9,961.98
Rate for Payer: Banner UC Health Medicaid	$9,961.98
Rate for Payer: Mercy Care Medicaid	$9,961.98

Connective Tissue Disorders

Facility

IP

$9,961.98

Service Code	APR-DRG 3463
Hospital Charge Code	APRDRG3461
Min. Negotiated Rate	$9,961.98
Max. Negotiated Rate	$9,961.98
Rate for Payer: AHCCCS Medicaid	$9,961.98
Rate for Payer: Allwell Medicaid	$9,961.98
Rate for Payer: AZCH Complete Medicaid	$9,961.98
Rate for Payer: Banner UC Health Medicaid	$9,961.98
Rate for Payer: Mercy Care Medicaid	$9,961.98

Connective Tissue Disorders

Facility

IP

$9,961.98

Service Code	APR-DRG 3463
Hospital Charge Code	APRDRG3463
Min. Negotiated Rate	$9,961.98
Max. Negotiated Rate	$9,961.98
Rate for Payer: AHCCCS Medicaid	$9,961.98
Rate for Payer: Allwell Medicaid	$9,961.98
Rate for Payer: AZCH Complete Medicaid	$9,961.98
Rate for Payer: Banner UC Health Medicaid	$9,961.98
Rate for Payer: Mercy Care Medicaid	$9,961.98

Connective Tissue Disorders

Facility

IP

$22,866.34

Service Code	APR-DRG 3464
Hospital Charge Code	APRDRG3463
Min. Negotiated Rate	$22,866.34
Max. Negotiated Rate	$22,866.34
Rate for Payer: AHCCCS Medicaid	$22,866.34
Rate for Payer: Allwell Medicaid	$22,866.34
Rate for Payer: AZCH Complete Medicaid	$22,866.34
Rate for Payer: Banner UC Health Medicaid	$22,866.34
Rate for Payer: Mercy Care Medicaid	$22,866.34

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$3,958.00

Service Code	APR-DRG 3841
Hospital Charge Code	APRDRG3844
Min. Negotiated Rate	$3,958.00
Max. Negotiated Rate	$3,958.00
Rate for Payer: AHCCCS Medicaid	$3,958.00
Rate for Payer: Allwell Medicaid	$3,958.00
Rate for Payer: AZCH Complete Medicaid	$3,958.00
Rate for Payer: Banner UC Health Medicaid	$3,958.00
Rate for Payer: Mercy Care Medicaid	$3,958.00

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$3,958.00

Service Code	APR-DRG 3841
Hospital Charge Code	APRDRG3841
Min. Negotiated Rate	$3,958.00
Max. Negotiated Rate	$3,958.00
Rate for Payer: AHCCCS Medicaid	$3,958.00
Rate for Payer: Allwell Medicaid	$3,958.00
Rate for Payer: AZCH Complete Medicaid	$3,958.00
Rate for Payer: Banner UC Health Medicaid	$3,958.00
Rate for Payer: Mercy Care Medicaid	$3,958.00

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$4,782.85

Service Code	APR-DRG 3842
Hospital Charge Code	APRDRG3841
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$13,242.43

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG3843
Min. Negotiated Rate	$13,242.43
Max. Negotiated Rate	$13,242.43
Rate for Payer: AHCCCS Medicaid	$13,242.43
Rate for Payer: Allwell Medicaid	$13,242.43
Rate for Payer: AZCH Complete Medicaid	$13,242.43
Rate for Payer: Banner UC Health Medicaid	$13,242.43
Rate for Payer: Mercy Care Medicaid	$13,242.43

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$3,958.00

Service Code	APR-DRG 3841
Hospital Charge Code	APRDRG3842
Min. Negotiated Rate	$3,958.00
Max. Negotiated Rate	$3,958.00
Rate for Payer: AHCCCS Medicaid	$3,958.00
Rate for Payer: Allwell Medicaid	$3,958.00
Rate for Payer: AZCH Complete Medicaid	$3,958.00
Rate for Payer: Banner UC Health Medicaid	$3,958.00
Rate for Payer: Mercy Care Medicaid	$3,958.00

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$13,242.43

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG3842
Min. Negotiated Rate	$13,242.43
Max. Negotiated Rate	$13,242.43
Rate for Payer: AHCCCS Medicaid	$13,242.43
Rate for Payer: Allwell Medicaid	$13,242.43
Rate for Payer: AZCH Complete Medicaid	$13,242.43
Rate for Payer: Banner UC Health Medicaid	$13,242.43
Rate for Payer: Mercy Care Medicaid	$13,242.43

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$7,002.78

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG3842
Min. Negotiated Rate	$7,002.78
Max. Negotiated Rate	$7,002.78
Rate for Payer: AHCCCS Medicaid	$7,002.78
Rate for Payer: Allwell Medicaid	$7,002.78
Rate for Payer: AZCH Complete Medicaid	$7,002.78
Rate for Payer: Banner UC Health Medicaid	$7,002.78
Rate for Payer: Mercy Care Medicaid	$7,002.78

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$7,002.78

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG3843
Min. Negotiated Rate	$7,002.78
Max. Negotiated Rate	$7,002.78
Rate for Payer: AHCCCS Medicaid	$7,002.78
Rate for Payer: Allwell Medicaid	$7,002.78
Rate for Payer: AZCH Complete Medicaid	$7,002.78
Rate for Payer: Banner UC Health Medicaid	$7,002.78
Rate for Payer: Mercy Care Medicaid	$7,002.78

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$4,782.85

Service Code	APR-DRG 3842
Hospital Charge Code	APRDRG3844
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$13,242.43

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG3844
Min. Negotiated Rate	$13,242.43
Max. Negotiated Rate	$13,242.43
Rate for Payer: AHCCCS Medicaid	$13,242.43
Rate for Payer: Allwell Medicaid	$13,242.43
Rate for Payer: AZCH Complete Medicaid	$13,242.43
Rate for Payer: Banner UC Health Medicaid	$13,242.43
Rate for Payer: Mercy Care Medicaid	$13,242.43

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$7,002.78

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG3841
Min. Negotiated Rate	$7,002.78
Max. Negotiated Rate	$7,002.78
Rate for Payer: AHCCCS Medicaid	$7,002.78
Rate for Payer: Allwell Medicaid	$7,002.78
Rate for Payer: AZCH Complete Medicaid	$7,002.78
Rate for Payer: Banner UC Health Medicaid	$7,002.78
Rate for Payer: Mercy Care Medicaid	$7,002.78

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$7,002.78

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG3844
Min. Negotiated Rate	$7,002.78
Max. Negotiated Rate	$7,002.78
Rate for Payer: AHCCCS Medicaid	$7,002.78
Rate for Payer: Allwell Medicaid	$7,002.78
Rate for Payer: AZCH Complete Medicaid	$7,002.78
Rate for Payer: Banner UC Health Medicaid	$7,002.78
Rate for Payer: Mercy Care Medicaid	$7,002.78

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$13,242.43

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG3841
Min. Negotiated Rate	$13,242.43
Max. Negotiated Rate	$13,242.43
Rate for Payer: AHCCCS Medicaid	$13,242.43
Rate for Payer: Allwell Medicaid	$13,242.43
Rate for Payer: AZCH Complete Medicaid	$13,242.43
Rate for Payer: Banner UC Health Medicaid	$13,242.43
Rate for Payer: Mercy Care Medicaid	$13,242.43

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$4,782.85

Service Code	APR-DRG 3842
Hospital Charge Code	APRDRG3842
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$3,958.00

Service Code	APR-DRG 3841
Hospital Charge Code	APRDRG3843
Min. Negotiated Rate	$3,958.00
Max. Negotiated Rate	$3,958.00
Rate for Payer: AHCCCS Medicaid	$3,958.00
Rate for Payer: Allwell Medicaid	$3,958.00
Rate for Payer: AZCH Complete Medicaid	$3,958.00
Rate for Payer: Banner UC Health Medicaid	$3,958.00
Rate for Payer: Mercy Care Medicaid	$3,958.00

Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue

Facility

IP

$4,782.85

Service Code	APR-DRG 3842
Hospital Charge Code	APRDRG3843
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

COOK FLEXOR URETERAL ACCESS SHEATH 28CM

Facility

OP

$776.00

Hospital Charge Code	22354222
Hospital Revenue Code	270
Min. Negotiated Rate	$116.40
Max. Negotiated Rate	$698.40
Rate for Payer: Aetna of AZ Commercial	$698.40
Rate for Payer: Aetna of AZ Medicare	$217.28
Rate for Payer: Allwell Medicare	$116.40
Rate for Payer: Amerigroup Medicare	$116.40
Rate for Payer: APIPA Medicare/Medicaid	$289.84
Rate for Payer: AZCH Complete Medicare	$116.40
Rate for Payer: Banner UC Health Medicare	$116.40
Rate for Payer: Bisbee Police All Plans	$201.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$527.68
Rate for Payer: Cash Price	$620.80
Rate for Payer: Cigna of AZ Commercial	$543.20
Rate for Payer: Copperpoint Commercial	$192.06
Rate for Payer: Health Net of AZ Commercial	$465.60
Rate for Payer: Health Net of AZ Medicare	$217.28
Rate for Payer: Humana of AZ Medicare	$116.40
Rate for Payer: Self Pay Self Pay	$620.80
Rate for Payer: TriWest Medicare	$116.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$452.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$139.68

COOK FLEXOR URETERAL ACCESS SHEATH 28CM

Facility

IP

$776.00

Hospital Charge Code	22354222
Hospital Revenue Code	270
Min. Negotiated Rate	$201.76
Max. Negotiated Rate	$698.40
Rate for Payer: Aetna of AZ Commercial	$698.40
Rate for Payer: Bisbee Police All Plans	$201.76
Rate for Payer: Cash Price	$620.80
Rate for Payer: Self Pay Self Pay	$620.80

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