Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

1 Silk Ties

Facility

$9.00

Hospital Charge Code	22926441
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Cash Price	$7.20
Rate for Payer: Self Pay Self Pay	$7.20

1 Silk Ties

Facility

$9.00

Hospital Charge Code	22926441
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Aetna of AZ Medicare	$2.52
Rate for Payer: Allwell Medicare	$1.44
Rate for Payer: Amerigroup Medicare	$1.44
Rate for Payer: APIPA Medicare/Medicaid	$3.36
Rate for Payer: AZCH Complete Medicare	$1.44
Rate for Payer: Banner UC Health Medicare	$1.44
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$6.12
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna of AZ Commercial	$6.30
Rate for Payer: Copperpoint Commercial	$2.23
Rate for Payer: Health Net of AZ Commercial	$5.40
Rate for Payer: Health Net of AZ Medicare	$2.52
Rate for Payer: Humana of AZ Medicare	$1.44
Rate for Payer: Self Pay Self Pay	$7.20
Rate for Payer: TriWest Medicare	$1.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$5.25
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.62

2019 Novel Coronavirus (CoVID-19), NAA LC

Facility

$200.00

Service Code	CPT 87635
Hospital Charge Code	23925248
Hospital Revenue Code	300
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna of AZ Commercial	$180.00
Rate for Payer: Aetna of AZ Medicare	$56.00
Rate for Payer: Allwell Medicare	$32.00
Rate for Payer: Amerigroup Medicare	$32.00
Rate for Payer: APIPA Medicare/Medicaid	$74.70
Rate for Payer: AZCH Complete Medicare	$32.00
Rate for Payer: Banner UC Health Medicare	$32.00
Rate for Payer: Bisbee Police All Plans	$52.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$136.00
Rate for Payer: Cash Price	$160.00
Rate for Payer: Cigna of AZ Commercial	$130.00
Rate for Payer: Copperpoint Commercial	$49.50
Rate for Payer: Health Net of AZ Commercial	$120.00
Rate for Payer: Health Net of AZ Medicare	$56.00
Rate for Payer: Humana of AZ Medicare	$32.00
Rate for Payer: Self Pay Self Pay	$160.00
Rate for Payer: TriWest Medicare	$32.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$116.60
Rate for Payer: UnitedHealth Group of AZ Medicare	$36.00

2019 Novel Coronavirus (CoVID-19), NAA LC

Facility

$200.00

Service Code	CPT 87635
Hospital Charge Code	23925248
Hospital Revenue Code	300
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna of AZ Commercial	$180.00
Rate for Payer: Bisbee Police All Plans	$52.00
Rate for Payer: Cash Price	$160.00
Rate for Payer: Self Pay Self Pay	$160.00

20520 RMV FB MSCL/TDN SMPL

Facility

$710.00

Service Code	CPT 20520
Hospital Charge Code	22282820
Hospital Revenue Code	450
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,507.00
Rate for Payer: Aetna of AZ Commercial	$639.00
Rate for Payer: Aetna of AZ Medicare	$198.80
Rate for Payer: AHCCCS Medicaid	$1,020.08
Rate for Payer: Allwell Medicaid	$1,020.08
Rate for Payer: Allwell Medicare	$113.60
Rate for Payer: Amerigroup Medicare	$113.60
Rate for Payer: APIPA Medicare/Medicaid	$265.19
Rate for Payer: AZCH Complete Medicaid	$1,020.08
Rate for Payer: AZCH Complete Medicare	$113.60
Rate for Payer: Banner UC Health Medicaid	$1,020.08
Rate for Payer: Banner UC Health Medicare	$113.60
Rate for Payer: Bisbee Police All Plans	$184.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$482.80
Rate for Payer: Cash Price	$568.00
Rate for Payer: Cash Price	$568.00
Rate for Payer: Cigna of AZ Commercial	$497.00
Rate for Payer: Copperpoint Commercial	$175.72
Rate for Payer: Health Net of AZ Commercial	$426.00
Rate for Payer: Health Net of AZ Medicare	$198.80
Rate for Payer: Humana of AZ Medicare	$113.60
Rate for Payer: Mercy Care Medicaid	$1,020.08
Rate for Payer: Self Pay Self Pay	$568.00
Rate for Payer: TriWest Medicare	$113.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,507.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$127.80

20520 RMV FB MSCL/TDN SMPL

Facility

$710.00

Service Code	CPT 20520
Hospital Charge Code	22282820
Hospital Revenue Code	450
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$639.00
Rate for Payer: Aetna of AZ Commercial	$639.00
Rate for Payer: Bisbee Police All Plans	$184.60
Rate for Payer: Cash Price	$568.00
Rate for Payer: Self Pay Self Pay	$568.00

20550 INJ TENDON ETC

Facility

$226.00

Service Code	CPT 20550
Hospital Charge Code	22282821
Hospital Revenue Code	450
Min. Negotiated Rate	$58.76
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Cash Price	$180.80
Rate for Payer: Self Pay Self Pay	$180.80

20550 INJ TENDON ETC

Facility

$226.00

Service Code	CPT 20550
Hospital Charge Code	22282821
Hospital Revenue Code	450
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Aetna of AZ Medicare	$63.28
Rate for Payer: AHCCCS Medicaid	$189.35
Rate for Payer: Allwell Medicaid	$189.35
Rate for Payer: Allwell Medicare	$36.16
Rate for Payer: Amerigroup Medicare	$36.16
Rate for Payer: APIPA Medicare/Medicaid	$84.41
Rate for Payer: AZCH Complete Medicaid	$189.35
Rate for Payer: AZCH Complete Medicare	$36.16
Rate for Payer: Banner UC Health Medicaid	$189.35
Rate for Payer: Banner UC Health Medicare	$36.16
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$153.68
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cigna of AZ Commercial	$158.20
Rate for Payer: Copperpoint Commercial	$55.94
Rate for Payer: Health Net of AZ Commercial	$135.60
Rate for Payer: Health Net of AZ Medicare	$63.28
Rate for Payer: Humana of AZ Medicare	$36.16
Rate for Payer: Mercy Care Medicaid	$189.35
Rate for Payer: Self Pay Self Pay	$180.80
Rate for Payer: TriWest Medicare	$36.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.68

20600 ASP / INJECTIONS JOINT SMALL

Facility

$258.00

Service Code	CPT 20600
Hospital Charge Code	22282822
Hospital Revenue Code	450
Min. Negotiated Rate	$41.28
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$232.20
Rate for Payer: Aetna of AZ Medicare	$72.24
Rate for Payer: AHCCCS Medicaid	$189.35
Rate for Payer: Allwell Medicaid	$189.35
Rate for Payer: Allwell Medicare	$41.28
Rate for Payer: Amerigroup Medicare	$41.28
Rate for Payer: APIPA Medicare/Medicaid	$96.36
Rate for Payer: AZCH Complete Medicaid	$189.35
Rate for Payer: AZCH Complete Medicare	$41.28
Rate for Payer: Banner UC Health Medicaid	$189.35
Rate for Payer: Banner UC Health Medicare	$41.28
Rate for Payer: Bisbee Police All Plans	$67.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$175.44
Rate for Payer: Cash Price	$206.40
Rate for Payer: Cash Price	$206.40
Rate for Payer: Cigna of AZ Commercial	$180.60
Rate for Payer: Copperpoint Commercial	$63.85
Rate for Payer: Health Net of AZ Commercial	$154.80
Rate for Payer: Health Net of AZ Medicare	$72.24
Rate for Payer: Humana of AZ Medicare	$41.28
Rate for Payer: Mercy Care Medicaid	$189.35
Rate for Payer: Self Pay Self Pay	$206.40
Rate for Payer: TriWest Medicare	$41.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$46.44

20600 ASP / INJECTIONS JOINT SMALL

Facility

$258.00

Service Code	CPT 20600
Hospital Charge Code	22282822
Hospital Revenue Code	450
Min. Negotiated Rate	$67.08
Max. Negotiated Rate	$232.20
Rate for Payer: Aetna of AZ Commercial	$232.20
Rate for Payer: Bisbee Police All Plans	$67.08
Rate for Payer: Cash Price	$206.40
Rate for Payer: Self Pay Self Pay	$206.40

20605 ASP / INJECTIONS JOINT INTERMEDIATE

Facility

$367.00

Service Code	CPT 20605
Hospital Charge Code	22282823
Hospital Revenue Code	450
Min. Negotiated Rate	$58.72
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$330.30
Rate for Payer: Aetna of AZ Medicare	$102.76
Rate for Payer: AHCCCS Medicaid	$189.35
Rate for Payer: Allwell Medicaid	$189.35
Rate for Payer: Allwell Medicare	$58.72
Rate for Payer: Amerigroup Medicare	$58.72
Rate for Payer: APIPA Medicare/Medicaid	$137.07
Rate for Payer: AZCH Complete Medicaid	$189.35
Rate for Payer: AZCH Complete Medicare	$58.72
Rate for Payer: Banner UC Health Medicaid	$189.35
Rate for Payer: Banner UC Health Medicare	$58.72
Rate for Payer: Bisbee Police All Plans	$95.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$249.56
Rate for Payer: Cash Price	$293.60
Rate for Payer: Cash Price	$293.60
Rate for Payer: Cigna of AZ Commercial	$256.90
Rate for Payer: Copperpoint Commercial	$90.83
Rate for Payer: Health Net of AZ Commercial	$220.20
Rate for Payer: Health Net of AZ Medicare	$102.76
Rate for Payer: Humana of AZ Medicare	$58.72
Rate for Payer: Mercy Care Medicaid	$189.35
Rate for Payer: Self Pay Self Pay	$293.60
Rate for Payer: TriWest Medicare	$58.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$66.06

20605 ASP / INJECTIONS JOINT INTERMEDIATE

Facility

$367.00

Service Code	CPT 20605
Hospital Charge Code	22282823
Hospital Revenue Code	450
Min. Negotiated Rate	$95.42
Max. Negotiated Rate	$330.30
Rate for Payer: Aetna of AZ Commercial	$330.30
Rate for Payer: Bisbee Police All Plans	$95.42
Rate for Payer: Cash Price	$293.60
Rate for Payer: Self Pay Self Pay	$293.60

20610 ASP / INJECTIONS JOINT MAJOR

Facility

$450.00

Service Code	CPT 20610
Hospital Charge Code	22282824
Hospital Revenue Code	450
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Bisbee Police All Plans	$117.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Self Pay Self Pay	$360.00

20610 ASP / INJECTIONS JOINT MAJOR

Facility

$450.00

Service Code	CPT 20610
Hospital Charge Code	22282824
Hospital Revenue Code	450
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Aetna of AZ Medicare	$126.00
Rate for Payer: AHCCCS Medicaid	$189.35
Rate for Payer: Allwell Medicaid	$189.35
Rate for Payer: Allwell Medicare	$72.00
Rate for Payer: Amerigroup Medicare	$72.00
Rate for Payer: APIPA Medicare/Medicaid	$168.07
Rate for Payer: AZCH Complete Medicaid	$189.35
Rate for Payer: AZCH Complete Medicare	$72.00
Rate for Payer: Banner UC Health Medicaid	$189.35
Rate for Payer: Banner UC Health Medicare	$72.00
Rate for Payer: Bisbee Police All Plans	$117.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$306.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cigna of AZ Commercial	$315.00
Rate for Payer: Copperpoint Commercial	$111.38
Rate for Payer: Health Net of AZ Commercial	$270.00
Rate for Payer: Health Net of AZ Medicare	$126.00
Rate for Payer: Humana of AZ Medicare	$72.00
Rate for Payer: Mercy Care Medicaid	$189.35
Rate for Payer: Self Pay Self Pay	$360.00
Rate for Payer: TriWest Medicare	$72.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$81.00

2-0 Ethibond Excel CT-1

Facility

$13.00

Hospital Charge Code	22926439
Hospital Revenue Code	272
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Aetna of AZ Medicare	$3.64
Rate for Payer: Allwell Medicare	$2.08
Rate for Payer: Amerigroup Medicare	$2.08
Rate for Payer: APIPA Medicare/Medicaid	$4.86
Rate for Payer: AZCH Complete Medicare	$2.08
Rate for Payer: Banner UC Health Medicare	$2.08
Rate for Payer: Bisbee Police All Plans	$3.38
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$8.84
Rate for Payer: Cash Price	$10.40
Rate for Payer: Cigna of AZ Commercial	$9.10
Rate for Payer: Copperpoint Commercial	$3.22
Rate for Payer: Health Net of AZ Commercial	$7.80
Rate for Payer: Health Net of AZ Medicare	$3.64
Rate for Payer: Humana of AZ Medicare	$2.08
Rate for Payer: Self Pay Self Pay	$10.40
Rate for Payer: TriWest Medicare	$2.08
Rate for Payer: UnitedHealth Group of AZ Commercial	$7.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.34

2-0 Ethibond Excel CT-1

Facility

$13.00

Hospital Charge Code	22926439
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Bisbee Police All Plans	$3.38
Rate for Payer: Cash Price	$10.40
Rate for Payer: Self Pay Self Pay	$10.40

2-0 Ethibond Excel MO-7

Facility

$84.00

Hospital Charge Code	22926438
Hospital Revenue Code	272
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Bisbee Police All Plans	$21.84
Rate for Payer: Cash Price	$67.20
Rate for Payer: Self Pay Self Pay	$67.20

2-0 Ethibond Excel MO-7

Facility

$84.00

Hospital Charge Code	22926438
Hospital Revenue Code	272
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Aetna of AZ Medicare	$23.52
Rate for Payer: Allwell Medicare	$13.44
Rate for Payer: Amerigroup Medicare	$13.44
Rate for Payer: APIPA Medicare/Medicaid	$31.37
Rate for Payer: AZCH Complete Medicare	$13.44
Rate for Payer: Banner UC Health Medicare	$13.44
Rate for Payer: Bisbee Police All Plans	$21.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$57.12
Rate for Payer: Cash Price	$67.20
Rate for Payer: Cigna of AZ Commercial	$58.80
Rate for Payer: Copperpoint Commercial	$20.79
Rate for Payer: Health Net of AZ Commercial	$50.40
Rate for Payer: Health Net of AZ Medicare	$23.52
Rate for Payer: Humana of AZ Medicare	$13.44
Rate for Payer: Self Pay Self Pay	$67.20
Rate for Payer: TriWest Medicare	$13.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$48.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$15.12

20G INTROCAN SAFETY STRAIGHT FEP IV CATH

Facility

$7.16

Hospital Charge Code	27527452
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$6.44
Rate for Payer: Aetna of AZ Commercial	$6.44
Rate for Payer: Aetna of AZ Medicare	$2.00
Rate for Payer: Allwell Medicare	$1.15
Rate for Payer: Amerigroup Medicare	$1.15
Rate for Payer: APIPA Medicare/Medicaid	$2.67
Rate for Payer: AZCH Complete Medicare	$1.15
Rate for Payer: Banner UC Health Medicare	$1.15
Rate for Payer: Bisbee Police All Plans	$1.86
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$4.87
Rate for Payer: Cash Price	$5.73
Rate for Payer: Cigna of AZ Commercial	$5.01
Rate for Payer: Copperpoint Commercial	$1.77
Rate for Payer: Health Net of AZ Commercial	$4.30
Rate for Payer: Health Net of AZ Medicare	$2.00
Rate for Payer: Humana of AZ Medicare	$1.15
Rate for Payer: Self Pay Self Pay	$5.73
Rate for Payer: TriWest Medicare	$1.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$4.17
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.29

20G INTROCAN SAFETY STRAIGHT FEP IV CATH

Facility

$7.16

Hospital Charge Code	27527452
Hospital Revenue Code	270
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$6.44
Rate for Payer: Aetna of AZ Commercial	$6.44
Rate for Payer: Bisbee Police All Plans	$1.86
Rate for Payer: Cash Price	$5.73
Rate for Payer: Self Pay Self Pay	$5.73

2-0 Plain Gut FN-2

Facility

$22.00

Hospital Charge Code	22926444
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$19.80
Rate for Payer: Aetna of AZ Commercial	$19.80
Rate for Payer: Aetna of AZ Medicare	$6.16
Rate for Payer: Allwell Medicare	$3.52
Rate for Payer: Amerigroup Medicare	$3.52
Rate for Payer: APIPA Medicare/Medicaid	$8.22
Rate for Payer: AZCH Complete Medicare	$3.52
Rate for Payer: Banner UC Health Medicare	$3.52
Rate for Payer: Bisbee Police All Plans	$5.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$14.96
Rate for Payer: Cash Price	$17.60
Rate for Payer: Cigna of AZ Commercial	$15.40
Rate for Payer: Copperpoint Commercial	$5.45
Rate for Payer: Health Net of AZ Commercial	$13.20
Rate for Payer: Health Net of AZ Medicare	$6.16
Rate for Payer: Humana of AZ Medicare	$3.52
Rate for Payer: Self Pay Self Pay	$17.60
Rate for Payer: TriWest Medicare	$3.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$12.83
Rate for Payer: UnitedHealth Group of AZ Medicare	$3.96

2-0 Plain Gut FN-2

Facility

$22.00

Hospital Charge Code	22926444
Hospital Revenue Code	272
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$19.80
Rate for Payer: Aetna of AZ Commercial	$19.80
Rate for Payer: Bisbee Police All Plans	$5.72
Rate for Payer: Cash Price	$17.60
Rate for Payer: Self Pay Self Pay	$17.60

2-0 Surgical Steel FSLX

Facility

$14.00

Hospital Charge Code	22926440
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Cash Price	$11.20
Rate for Payer: Self Pay Self Pay	$11.20

2-0 Surgical Steel FSLX

Facility

$14.00

Hospital Charge Code	22926440
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Aetna of AZ Medicare	$3.92
Rate for Payer: Allwell Medicare	$2.24
Rate for Payer: Amerigroup Medicare	$2.24
Rate for Payer: APIPA Medicare/Medicaid	$5.23
Rate for Payer: AZCH Complete Medicare	$2.24
Rate for Payer: Banner UC Health Medicare	$2.24
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$9.52
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cigna of AZ Commercial	$9.80
Rate for Payer: Copperpoint Commercial	$3.46
Rate for Payer: Health Net of AZ Commercial	$8.40
Rate for Payer: Health Net of AZ Medicare	$3.92
Rate for Payer: Humana of AZ Medicare	$2.24
Rate for Payer: Self Pay Self Pay	$11.20
Rate for Payer: TriWest Medicare	$2.24
Rate for Payer: UnitedHealth Group of AZ Commercial	$8.16
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.52

21315 CLSD TX NOSEFX W/O STABL

Facility

$822.00

Service Code	CPT 21315
Hospital Charge Code	22282826
Hospital Revenue Code	450
Min. Negotiated Rate	$131.52
Max. Negotiated Rate	$2,909.00
Rate for Payer: Aetna of AZ Commercial	$739.80
Rate for Payer: Aetna of AZ Medicare	$230.16
Rate for Payer: AHCCCS Medicaid	$980.77
Rate for Payer: Allwell Medicaid	$980.77
Rate for Payer: Allwell Medicare	$131.52
Rate for Payer: Amerigroup Medicare	$131.52
Rate for Payer: APIPA Medicare/Medicaid	$307.02
Rate for Payer: AZCH Complete Medicaid	$980.77
Rate for Payer: AZCH Complete Medicare	$131.52
Rate for Payer: Banner UC Health Medicaid	$980.77
Rate for Payer: Banner UC Health Medicare	$131.52
Rate for Payer: Bisbee Police All Plans	$213.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$558.96
Rate for Payer: Cash Price	$657.60
Rate for Payer: Cash Price	$657.60
Rate for Payer: Cigna of AZ Commercial	$575.40
Rate for Payer: Copperpoint Commercial	$203.44
Rate for Payer: Health Net of AZ Commercial	$493.20
Rate for Payer: Health Net of AZ Medicare	$230.16
Rate for Payer: Humana of AZ Medicare	$131.52
Rate for Payer: Mercy Care Medicaid	$980.77
Rate for Payer: Self Pay Self Pay	$657.60
Rate for Payer: TriWest Medicare	$131.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$147.96

Know your out-of-pocket cost for care.

All Charges