Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Cord Gas Venous 1

Facility

OP

$309.00

Service Code	CPT 82803
Hospital Charge Code	5144987
Hospital Revenue Code	301
Min. Negotiated Rate	$26.07
Max. Negotiated Rate	$278.10
Rate for Payer: Aetna of AZ Commercial	$278.10
Rate for Payer: Aetna of AZ Medicare	$86.52
Rate for Payer: AHCCCS Medicaid	$26.07
Rate for Payer: Allwell Medicaid	$26.07
Rate for Payer: Allwell Medicare	$46.35
Rate for Payer: Amerigroup Medicare	$46.35
Rate for Payer: APIPA Medicare/Medicaid	$115.41
Rate for Payer: AZCH Complete Medicaid	$26.07
Rate for Payer: AZCH Complete Medicare	$46.35
Rate for Payer: Banner UC Health Medicaid	$26.07
Rate for Payer: Banner UC Health Medicare	$46.35
Rate for Payer: Bisbee Police All Plans	$80.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$210.12
Rate for Payer: Cash Price	$247.20
Rate for Payer: Cash Price	$247.20
Rate for Payer: Cigna of AZ Commercial	$200.85
Rate for Payer: Copperpoint Commercial	$76.48
Rate for Payer: Health Net of AZ Commercial	$185.40
Rate for Payer: Health Net of AZ Medicare	$86.52
Rate for Payer: Humana of AZ Medicare	$46.35
Rate for Payer: Mercy Care Medicaid	$26.07
Rate for Payer: Self Pay Self Pay	$247.20
Rate for Payer: TriWest Medicare	$46.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$180.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$55.62

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$27,271.13

Service Code	APR-DRG 1652
Hospital Charge Code	APRDRG1651
Min. Negotiated Rate	$27,271.13
Max. Negotiated Rate	$27,271.13
Rate for Payer: AHCCCS Medicaid	$27,271.13
Rate for Payer: Allwell Medicaid	$27,271.13
Rate for Payer: AZCH Complete Medicaid	$27,271.13
Rate for Payer: Banner UC Health Medicaid	$27,271.13
Rate for Payer: Mercy Care Medicaid	$27,271.13

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$23,090.79

Service Code	APR-DRG 1651
Hospital Charge Code	APRDRG1652
Min. Negotiated Rate	$23,090.79
Max. Negotiated Rate	$23,090.79
Rate for Payer: AHCCCS Medicaid	$23,090.79
Rate for Payer: Allwell Medicaid	$23,090.79
Rate for Payer: AZCH Complete Medicaid	$23,090.79
Rate for Payer: Banner UC Health Medicaid	$23,090.79
Rate for Payer: Mercy Care Medicaid	$23,090.79

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$27,271.13

Service Code	APR-DRG 1652
Hospital Charge Code	APRDRG1652
Min. Negotiated Rate	$27,271.13
Max. Negotiated Rate	$27,271.13
Rate for Payer: AHCCCS Medicaid	$27,271.13
Rate for Payer: Allwell Medicaid	$27,271.13
Rate for Payer: AZCH Complete Medicaid	$27,271.13
Rate for Payer: Banner UC Health Medicaid	$27,271.13
Rate for Payer: Mercy Care Medicaid	$27,271.13

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$50,697.89

Service Code	APR-DRG 1654
Hospital Charge Code	APRDRG1654
Min. Negotiated Rate	$50,697.89
Max. Negotiated Rate	$50,697.89
Rate for Payer: AHCCCS Medicaid	$50,697.89
Rate for Payer: Allwell Medicaid	$50,697.89
Rate for Payer: AZCH Complete Medicaid	$50,697.89
Rate for Payer: Banner UC Health Medicaid	$50,697.89
Rate for Payer: Mercy Care Medicaid	$50,697.89

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$50,697.89

Service Code	APR-DRG 1654
Hospital Charge Code	APRDRG1652
Min. Negotiated Rate	$50,697.89
Max. Negotiated Rate	$50,697.89
Rate for Payer: AHCCCS Medicaid	$50,697.89
Rate for Payer: Allwell Medicaid	$50,697.89
Rate for Payer: AZCH Complete Medicaid	$50,697.89
Rate for Payer: Banner UC Health Medicaid	$50,697.89
Rate for Payer: Mercy Care Medicaid	$50,697.89

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$34,605.67

Service Code	APR-DRG 1653
Hospital Charge Code	APRDRG1651
Min. Negotiated Rate	$34,605.67
Max. Negotiated Rate	$34,605.67
Rate for Payer: AHCCCS Medicaid	$34,605.67
Rate for Payer: Allwell Medicaid	$34,605.67
Rate for Payer: AZCH Complete Medicaid	$34,605.67
Rate for Payer: Banner UC Health Medicaid	$34,605.67
Rate for Payer: Mercy Care Medicaid	$34,605.67

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$27,271.13

Service Code	APR-DRG 1652
Hospital Charge Code	APRDRG1654
Min. Negotiated Rate	$27,271.13
Max. Negotiated Rate	$27,271.13
Rate for Payer: AHCCCS Medicaid	$27,271.13
Rate for Payer: Allwell Medicaid	$27,271.13
Rate for Payer: AZCH Complete Medicaid	$27,271.13
Rate for Payer: Banner UC Health Medicaid	$27,271.13
Rate for Payer: Mercy Care Medicaid	$27,271.13

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$34,605.67

Service Code	APR-DRG 1653
Hospital Charge Code	APRDRG1653
Min. Negotiated Rate	$34,605.67
Max. Negotiated Rate	$34,605.67
Rate for Payer: AHCCCS Medicaid	$34,605.67
Rate for Payer: Allwell Medicaid	$34,605.67
Rate for Payer: AZCH Complete Medicaid	$34,605.67
Rate for Payer: Banner UC Health Medicaid	$34,605.67
Rate for Payer: Mercy Care Medicaid	$34,605.67

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$50,697.89

Service Code	APR-DRG 1654
Hospital Charge Code	APRDRG1651
Min. Negotiated Rate	$50,697.89
Max. Negotiated Rate	$50,697.89
Rate for Payer: AHCCCS Medicaid	$50,697.89
Rate for Payer: Allwell Medicaid	$50,697.89
Rate for Payer: AZCH Complete Medicaid	$50,697.89
Rate for Payer: Banner UC Health Medicaid	$50,697.89
Rate for Payer: Mercy Care Medicaid	$50,697.89

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$23,090.79

Service Code	APR-DRG 1651
Hospital Charge Code	APRDRG1653
Min. Negotiated Rate	$23,090.79
Max. Negotiated Rate	$23,090.79
Rate for Payer: AHCCCS Medicaid	$23,090.79
Rate for Payer: Allwell Medicaid	$23,090.79
Rate for Payer: AZCH Complete Medicaid	$23,090.79
Rate for Payer: Banner UC Health Medicaid	$23,090.79
Rate for Payer: Mercy Care Medicaid	$23,090.79

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$27,271.13

Service Code	APR-DRG 1652
Hospital Charge Code	APRDRG1653
Min. Negotiated Rate	$27,271.13
Max. Negotiated Rate	$27,271.13
Rate for Payer: AHCCCS Medicaid	$27,271.13
Rate for Payer: Allwell Medicaid	$27,271.13
Rate for Payer: AZCH Complete Medicaid	$27,271.13
Rate for Payer: Banner UC Health Medicaid	$27,271.13
Rate for Payer: Mercy Care Medicaid	$27,271.13

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$34,605.67

Service Code	APR-DRG 1653
Hospital Charge Code	APRDRG1654
Min. Negotiated Rate	$34,605.67
Max. Negotiated Rate	$34,605.67
Rate for Payer: AHCCCS Medicaid	$34,605.67
Rate for Payer: Allwell Medicaid	$34,605.67
Rate for Payer: AZCH Complete Medicaid	$34,605.67
Rate for Payer: Banner UC Health Medicaid	$34,605.67
Rate for Payer: Mercy Care Medicaid	$34,605.67

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$50,697.89

Service Code	APR-DRG 1654
Hospital Charge Code	APRDRG1653
Min. Negotiated Rate	$50,697.89
Max. Negotiated Rate	$50,697.89
Rate for Payer: AHCCCS Medicaid	$50,697.89
Rate for Payer: Allwell Medicaid	$50,697.89
Rate for Payer: AZCH Complete Medicaid	$50,697.89
Rate for Payer: Banner UC Health Medicaid	$50,697.89
Rate for Payer: Mercy Care Medicaid	$50,697.89

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$23,090.79

Service Code	APR-DRG 1651
Hospital Charge Code	APRDRG1651
Min. Negotiated Rate	$23,090.79
Max. Negotiated Rate	$23,090.79
Rate for Payer: AHCCCS Medicaid	$23,090.79
Rate for Payer: Allwell Medicaid	$23,090.79
Rate for Payer: AZCH Complete Medicaid	$23,090.79
Rate for Payer: Banner UC Health Medicaid	$23,090.79
Rate for Payer: Mercy Care Medicaid	$23,090.79

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$23,090.79

Service Code	APR-DRG 1651
Hospital Charge Code	APRDRG1654
Min. Negotiated Rate	$23,090.79
Max. Negotiated Rate	$23,090.79
Rate for Payer: AHCCCS Medicaid	$23,090.79
Rate for Payer: Allwell Medicaid	$23,090.79
Rate for Payer: AZCH Complete Medicaid	$23,090.79
Rate for Payer: Banner UC Health Medicaid	$23,090.79
Rate for Payer: Mercy Care Medicaid	$23,090.79

Coronary Bypass With Ami Or Complex Principal Diagnosis

Facility

IP

$34,605.67

Service Code	APR-DRG 1653
Hospital Charge Code	APRDRG1652
Min. Negotiated Rate	$34,605.67
Max. Negotiated Rate	$34,605.67
Rate for Payer: AHCCCS Medicaid	$34,605.67
Rate for Payer: Allwell Medicaid	$34,605.67
Rate for Payer: AZCH Complete Medicaid	$34,605.67
Rate for Payer: Banner UC Health Medicaid	$34,605.67
Rate for Payer: Mercy Care Medicaid	$34,605.67

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$43,690.21

Service Code	APR-DRG 1664
Hospital Charge Code	APRDRG1663
Min. Negotiated Rate	$43,690.21
Max. Negotiated Rate	$43,690.21
Rate for Payer: AHCCCS Medicaid	$43,690.21
Rate for Payer: Allwell Medicaid	$43,690.21
Rate for Payer: AZCH Complete Medicaid	$43,690.21
Rate for Payer: Banner UC Health Medicaid	$43,690.21
Rate for Payer: Mercy Care Medicaid	$43,690.21

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$20,292.90

Service Code	APR-DRG 1661
Hospital Charge Code	APRDRG1662
Min. Negotiated Rate	$20,292.90
Max. Negotiated Rate	$20,292.90
Rate for Payer: AHCCCS Medicaid	$20,292.90
Rate for Payer: Allwell Medicaid	$20,292.90
Rate for Payer: AZCH Complete Medicaid	$20,292.90
Rate for Payer: Banner UC Health Medicaid	$20,292.90
Rate for Payer: Mercy Care Medicaid	$20,292.90

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$22,646.80

Service Code	APR-DRG 1662
Hospital Charge Code	APRDRG1662
Min. Negotiated Rate	$22,646.80
Max. Negotiated Rate	$22,646.80
Rate for Payer: AHCCCS Medicaid	$22,646.80
Rate for Payer: Allwell Medicaid	$22,646.80
Rate for Payer: AZCH Complete Medicaid	$22,646.80
Rate for Payer: Banner UC Health Medicaid	$22,646.80
Rate for Payer: Mercy Care Medicaid	$22,646.80

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$43,690.21

Service Code	APR-DRG 1664
Hospital Charge Code	APRDRG1662
Min. Negotiated Rate	$43,690.21
Max. Negotiated Rate	$43,690.21
Rate for Payer: AHCCCS Medicaid	$43,690.21
Rate for Payer: Allwell Medicaid	$43,690.21
Rate for Payer: AZCH Complete Medicaid	$43,690.21
Rate for Payer: Banner UC Health Medicaid	$43,690.21
Rate for Payer: Mercy Care Medicaid	$43,690.21

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$20,292.90

Service Code	APR-DRG 1661
Hospital Charge Code	APRDRG1661
Min. Negotiated Rate	$20,292.90
Max. Negotiated Rate	$20,292.90
Rate for Payer: AHCCCS Medicaid	$20,292.90
Rate for Payer: Allwell Medicaid	$20,292.90
Rate for Payer: AZCH Complete Medicaid	$20,292.90
Rate for Payer: Banner UC Health Medicaid	$20,292.90
Rate for Payer: Mercy Care Medicaid	$20,292.90

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$28,395.48

Service Code	APR-DRG 1663
Hospital Charge Code	APRDRG1663
Min. Negotiated Rate	$28,395.48
Max. Negotiated Rate	$28,395.48
Rate for Payer: AHCCCS Medicaid	$28,395.48
Rate for Payer: Allwell Medicaid	$28,395.48
Rate for Payer: AZCH Complete Medicaid	$28,395.48
Rate for Payer: Banner UC Health Medicaid	$28,395.48
Rate for Payer: Mercy Care Medicaid	$28,395.48

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$28,395.48

Service Code	APR-DRG 1663
Hospital Charge Code	APRDRG1664
Min. Negotiated Rate	$28,395.48
Max. Negotiated Rate	$28,395.48
Rate for Payer: AHCCCS Medicaid	$28,395.48
Rate for Payer: Allwell Medicaid	$28,395.48
Rate for Payer: AZCH Complete Medicaid	$28,395.48
Rate for Payer: Banner UC Health Medicaid	$28,395.48
Rate for Payer: Mercy Care Medicaid	$28,395.48

Coronary Bypass Without Ami Or Complex Principal Diagnosis

Facility

IP

$43,690.21

Service Code	APR-DRG 1664
Hospital Charge Code	APRDRG1661
Min. Negotiated Rate	$43,690.21
Max. Negotiated Rate	$43,690.21
Rate for Payer: AHCCCS Medicaid	$43,690.21
Rate for Payer: Allwell Medicaid	$43,690.21
Rate for Payer: AZCH Complete Medicaid	$43,690.21
Rate for Payer: Banner UC Health Medicaid	$43,690.21
Rate for Payer: Mercy Care Medicaid	$43,690.21

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