Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

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	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

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

$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

$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	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	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

$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

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

COOK FLEXOR URETERAL ACCESS SHEATH 28CM

Facility

OP

$776.00

Hospital Charge Code	22354222
Hospital Revenue Code	270
Min. Negotiated Rate	$124.16
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	$124.16
Rate for Payer: Amerigroup Medicare	$124.16
Rate for Payer: APIPA Medicare/Medicaid	$289.84
Rate for Payer: AZCH Complete Medicare	$124.16
Rate for Payer: Banner UC Health Medicare	$124.16
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	$124.16
Rate for Payer: Self Pay Self Pay	$620.80
Rate for Payer: TriWest Medicare	$124.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$452.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$139.68

COOK FLEX PARALLEL URETRL ACCESS SHTH 28

Facility

IP

$534.00

Hospital Charge Code	22354209
Hospital Revenue Code	270
Min. Negotiated Rate	$138.84
Max. Negotiated Rate	$480.60
Rate for Payer: Aetna of AZ Commercial	$480.60
Rate for Payer: Bisbee Police All Plans	$138.84
Rate for Payer: Cash Price	$427.20
Rate for Payer: Self Pay Self Pay	$427.20

COOK FLEX PARALLEL URETRL ACCESS SHTH 28

Facility

OP

$534.00

Hospital Charge Code	22354209
Hospital Revenue Code	270
Min. Negotiated Rate	$85.44
Max. Negotiated Rate	$480.60
Rate for Payer: Aetna of AZ Commercial	$480.60
Rate for Payer: Aetna of AZ Medicare	$149.52
Rate for Payer: Allwell Medicare	$85.44
Rate for Payer: Amerigroup Medicare	$85.44
Rate for Payer: APIPA Medicare/Medicaid	$199.45
Rate for Payer: AZCH Complete Medicare	$85.44
Rate for Payer: Banner UC Health Medicare	$85.44
Rate for Payer: Bisbee Police All Plans	$138.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$363.12
Rate for Payer: Cash Price	$427.20
Rate for Payer: Cigna of AZ Commercial	$373.80
Rate for Payer: Copperpoint Commercial	$132.16
Rate for Payer: Health Net of AZ Commercial	$320.40
Rate for Payer: Health Net of AZ Medicare	$149.52
Rate for Payer: Humana of AZ Medicare	$85.44
Rate for Payer: Self Pay Self Pay	$427.20
Rate for Payer: TriWest Medicare	$85.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$311.32
Rate for Payer: UnitedHealth Group of AZ Medicare	$96.12

COOK G14255

Facility

OP

$90.00

Hospital Charge Code	22618969
Hospital Revenue Code	272
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna of AZ Commercial	$81.00
Rate for Payer: Aetna of AZ Medicare	$25.20
Rate for Payer: Allwell Medicare	$14.40
Rate for Payer: Amerigroup Medicare	$14.40
Rate for Payer: APIPA Medicare/Medicaid	$33.62
Rate for Payer: AZCH Complete Medicare	$14.40
Rate for Payer: Banner UC Health Medicare	$14.40
Rate for Payer: Bisbee Police All Plans	$23.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$61.20
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cigna of AZ Commercial	$63.00
Rate for Payer: Copperpoint Commercial	$22.27
Rate for Payer: Health Net of AZ Commercial	$54.00
Rate for Payer: Health Net of AZ Medicare	$25.20
Rate for Payer: Humana of AZ Medicare	$14.40
Rate for Payer: Self Pay Self Pay	$72.00
Rate for Payer: TriWest Medicare	$14.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$52.47
Rate for Payer: UnitedHealth Group of AZ Medicare	$16.20

COOK G14255

Facility

IP

$90.00

Hospital Charge Code	22618969
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna of AZ Commercial	$81.00
Rate for Payer: Bisbee Police All Plans	$23.40
Rate for Payer: Cash Price	$72.00
Rate for Payer: Self Pay Self Pay	$72.00

COOK G14519

Facility

OP

$155.00

Hospital Charge Code	22618967
Hospital Revenue Code	272
Min. Negotiated Rate	$24.80
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna of AZ Commercial	$139.50
Rate for Payer: Aetna of AZ Medicare	$43.40
Rate for Payer: Allwell Medicare	$24.80
Rate for Payer: Amerigroup Medicare	$24.80
Rate for Payer: APIPA Medicare/Medicaid	$57.89
Rate for Payer: AZCH Complete Medicare	$24.80
Rate for Payer: Banner UC Health Medicare	$24.80
Rate for Payer: Bisbee Police All Plans	$40.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$105.40
Rate for Payer: Cash Price	$124.00
Rate for Payer: Cigna of AZ Commercial	$108.50
Rate for Payer: Copperpoint Commercial	$38.36
Rate for Payer: Health Net of AZ Commercial	$93.00
Rate for Payer: Health Net of AZ Medicare	$43.40
Rate for Payer: Humana of AZ Medicare	$24.80
Rate for Payer: Self Pay Self Pay	$124.00
Rate for Payer: TriWest Medicare	$24.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$90.36
Rate for Payer: UnitedHealth Group of AZ Medicare	$27.90

COOK G14519

Facility

IP

$155.00

Hospital Charge Code	22618967
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna of AZ Commercial	$139.50
Rate for Payer: Bisbee Police All Plans	$40.30
Rate for Payer: Cash Price	$124.00
Rate for Payer: Self Pay Self Pay	$124.00

COOK G17976

Facility

OP

$123.00

Hospital Charge Code	22619412
Hospital Revenue Code	272
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$110.70
Rate for Payer: Aetna of AZ Commercial	$110.70
Rate for Payer: Aetna of AZ Medicare	$34.44
Rate for Payer: Allwell Medicare	$19.68
Rate for Payer: Amerigroup Medicare	$19.68
Rate for Payer: APIPA Medicare/Medicaid	$45.94
Rate for Payer: AZCH Complete Medicare	$19.68
Rate for Payer: Banner UC Health Medicare	$19.68
Rate for Payer: Bisbee Police All Plans	$31.98
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$83.64
Rate for Payer: Cash Price	$98.40
Rate for Payer: Cigna of AZ Commercial	$86.10
Rate for Payer: Copperpoint Commercial	$30.44
Rate for Payer: Health Net of AZ Commercial	$73.80
Rate for Payer: Health Net of AZ Medicare	$34.44
Rate for Payer: Humana of AZ Medicare	$19.68
Rate for Payer: Self Pay Self Pay	$98.40
Rate for Payer: TriWest Medicare	$19.68
Rate for Payer: UnitedHealth Group of AZ Commercial	$71.71
Rate for Payer: UnitedHealth Group of AZ Medicare	$22.14

COOK G17976

Facility

IP

$123.00

Hospital Charge Code	22619412
Hospital Revenue Code	272
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$110.70
Rate for Payer: Aetna of AZ Commercial	$110.70
Rate for Payer: Bisbee Police All Plans	$31.98
Rate for Payer: Cash Price	$98.40
Rate for Payer: Self Pay Self Pay	$98.40

COOK G18063

Facility

IP

$222.00

Hospital Charge Code	22619410
Hospital Revenue Code	272
Min. Negotiated Rate	$57.72
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna of AZ Commercial	$199.80
Rate for Payer: Bisbee Police All Plans	$57.72
Rate for Payer: Cash Price	$177.60
Rate for Payer: Self Pay Self Pay	$177.60

COOK G18063

Facility

OP

$222.00

Hospital Charge Code	22619410
Hospital Revenue Code	272
Min. Negotiated Rate	$35.52
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna of AZ Commercial	$199.80
Rate for Payer: Aetna of AZ Medicare	$62.16
Rate for Payer: Allwell Medicare	$35.52
Rate for Payer: Amerigroup Medicare	$35.52
Rate for Payer: APIPA Medicare/Medicaid	$82.92
Rate for Payer: AZCH Complete Medicare	$35.52
Rate for Payer: Banner UC Health Medicare	$35.52
Rate for Payer: Bisbee Police All Plans	$57.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$150.96
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cigna of AZ Commercial	$155.40
Rate for Payer: Copperpoint Commercial	$54.95
Rate for Payer: Health Net of AZ Commercial	$133.20
Rate for Payer: Health Net of AZ Medicare	$62.16
Rate for Payer: Humana of AZ Medicare	$35.52
Rate for Payer: Self Pay Self Pay	$177.60
Rate for Payer: TriWest Medicare	$35.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$129.43
Rate for Payer: UnitedHealth Group of AZ Medicare	$39.96

COOK G30357

Facility

OP

$948.00

Hospital Charge Code	22619312
Hospital Revenue Code	272
Min. Negotiated Rate	$151.68
Max. Negotiated Rate	$853.20
Rate for Payer: Aetna of AZ Commercial	$853.20
Rate for Payer: Aetna of AZ Medicare	$265.44
Rate for Payer: Allwell Medicare	$151.68
Rate for Payer: Amerigroup Medicare	$151.68
Rate for Payer: APIPA Medicare/Medicaid	$354.08
Rate for Payer: AZCH Complete Medicare	$151.68
Rate for Payer: Banner UC Health Medicare	$151.68
Rate for Payer: Bisbee Police All Plans	$246.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$644.64
Rate for Payer: Cash Price	$758.40
Rate for Payer: Cigna of AZ Commercial	$663.60
Rate for Payer: Copperpoint Commercial	$234.63
Rate for Payer: Health Net of AZ Commercial	$568.80
Rate for Payer: Health Net of AZ Medicare	$265.44
Rate for Payer: Humana of AZ Medicare	$151.68
Rate for Payer: Self Pay Self Pay	$758.40
Rate for Payer: TriWest Medicare	$151.68
Rate for Payer: UnitedHealth Group of AZ Commercial	$552.68
Rate for Payer: UnitedHealth Group of AZ Medicare	$170.64

COOK G30357

Facility

IP

$948.00

Hospital Charge Code	22619312
Hospital Revenue Code	272
Min. Negotiated Rate	$246.48
Max. Negotiated Rate	$853.20
Rate for Payer: Aetna of AZ Commercial	$853.20
Rate for Payer: Bisbee Police All Plans	$246.48
Rate for Payer: Cash Price	$758.40
Rate for Payer: Self Pay Self Pay	$758.40

COOK G34931

Facility

OP

$792.00

Hospital Charge Code	22619414
Hospital Revenue Code	272
Min. Negotiated Rate	$126.72
Max. Negotiated Rate	$712.80
Rate for Payer: Aetna of AZ Commercial	$712.80
Rate for Payer: Aetna of AZ Medicare	$221.76
Rate for Payer: Allwell Medicare	$126.72
Rate for Payer: Amerigroup Medicare	$126.72
Rate for Payer: APIPA Medicare/Medicaid	$295.81
Rate for Payer: AZCH Complete Medicare	$126.72
Rate for Payer: Banner UC Health Medicare	$126.72
Rate for Payer: Bisbee Police All Plans	$205.92
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$538.56
Rate for Payer: Cash Price	$633.60
Rate for Payer: Cigna of AZ Commercial	$554.40
Rate for Payer: Copperpoint Commercial	$196.02
Rate for Payer: Health Net of AZ Commercial	$475.20
Rate for Payer: Health Net of AZ Medicare	$221.76
Rate for Payer: Humana of AZ Medicare	$126.72
Rate for Payer: Self Pay Self Pay	$633.60
Rate for Payer: TriWest Medicare	$126.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$461.74
Rate for Payer: UnitedHealth Group of AZ Medicare	$142.56

COOK G34931

Facility

IP

$792.00

Hospital Charge Code	22619414
Hospital Revenue Code	272
Min. Negotiated Rate	$205.92
Max. Negotiated Rate	$712.80
Rate for Payer: Aetna of AZ Commercial	$712.80
Rate for Payer: Bisbee Police All Plans	$205.92
Rate for Payer: Cash Price	$633.60
Rate for Payer: Self Pay Self Pay	$633.60

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