|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
Facility
|
IP
|
$22,646.80
|
|
|
Service Code
|
APR-DRG 1662
|
| Hospital Charge Code |
APRDRG1661
|
| 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
|
$20,292.90
|
|
|
Service Code
|
APR-DRG 1661
|
| Hospital Charge Code |
APRDRG1664
|
| 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
|
$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
|
|
|
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
|
$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 |
APRDRG1661
|
| 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
|
$22,646.80
|
|
|
Service Code
|
APR-DRG 1662
|
| Hospital Charge Code |
APRDRG1663
|
| 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
|
$28,395.48
|
|
|
Service Code
|
APR-DRG 1663
|
| Hospital Charge Code |
APRDRG1662
|
| 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
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY
|
Facility
|
IP
|
$2,518.00
|
|
|
Service Code
|
CPT 28296
|
| Hospital Charge Code |
24043261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$654.68 |
| Max. Negotiated Rate |
$2,266.20 |
| Rate for Payer: Aetna of AZ Commercial |
$2,266.20
|
| Rate for Payer: Bisbee Police All Plans |
$654.68
|
| Rate for Payer: Cash Price |
$2,014.40
|
| Rate for Payer: Self Pay Self Pay |
$2,014.40
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY
|
Facility
|
OP
|
$2,518.00
|
|
|
Service Code
|
CPT 28296
|
| Hospital Charge Code |
24043261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$377.70 |
| Max. Negotiated Rate |
$4,104.08 |
| Rate for Payer: Aetna of AZ Commercial |
$2,266.20
|
| Rate for Payer: Aetna of AZ Medicare |
$705.04
|
| Rate for Payer: AHCCCS Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicare |
$377.70
|
| Rate for Payer: Amerigroup Medicare |
$377.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$940.47
|
| Rate for Payer: AZCH Complete Medicaid |
$4,104.08
|
| Rate for Payer: AZCH Complete Medicare |
$377.70
|
| Rate for Payer: Banner UC Health Medicaid |
$4,104.08
|
| Rate for Payer: Banner UC Health Medicare |
$377.70
|
| Rate for Payer: Bisbee Police All Plans |
$654.68
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,712.24
|
| Rate for Payer: Cash Price |
$2,014.40
|
| Rate for Payer: Cash Price |
$2,014.40
|
| Rate for Payer: Cigna of AZ Commercial |
$1,259.00
|
| Rate for Payer: Copperpoint Commercial |
$623.20
|
| Rate for Payer: Health Net of AZ Commercial |
$1,510.80
|
| Rate for Payer: Health Net of AZ Medicare |
$705.04
|
| Rate for Payer: Humana of AZ Medicare |
$377.70
|
| Rate for Payer: Mercy Care Medicaid |
$4,104.08
|
| Rate for Payer: Self Pay Self Pay |
$2,014.40
|
| Rate for Payer: TriWest Medicare |
$377.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$453.24
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; BY DOUBLE
|
Facility
|
OP
|
$2,851.00
|
|
|
Service Code
|
CPT 28299
|
| Hospital Charge Code |
24043262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$427.65 |
| Max. Negotiated Rate |
$9,084.18 |
| Rate for Payer: Aetna of AZ Commercial |
$2,565.90
|
| Rate for Payer: Aetna of AZ Medicare |
$798.28
|
| Rate for Payer: AHCCCS Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicare |
$427.65
|
| Rate for Payer: Amerigroup Medicare |
$427.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$1,064.85
|
| Rate for Payer: AZCH Complete Medicaid |
$9,084.18
|
| Rate for Payer: AZCH Complete Medicare |
$427.65
|
| Rate for Payer: Banner UC Health Medicaid |
$9,084.18
|
| Rate for Payer: Banner UC Health Medicare |
$427.65
|
| Rate for Payer: Bisbee Police All Plans |
$741.26
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,938.68
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Cigna of AZ Commercial |
$1,425.50
|
| Rate for Payer: Copperpoint Commercial |
$705.62
|
| Rate for Payer: Health Net of AZ Commercial |
$1,710.60
|
| Rate for Payer: Health Net of AZ Medicare |
$798.28
|
| Rate for Payer: Humana of AZ Medicare |
$427.65
|
| Rate for Payer: Mercy Care Medicaid |
$9,084.18
|
| Rate for Payer: Self Pay Self Pay |
$2,280.80
|
| Rate for Payer: TriWest Medicare |
$427.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$513.18
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; BY DOUBLE
|
Facility
|
IP
|
$2,851.00
|
|
|
Service Code
|
CPT 28299
|
| Hospital Charge Code |
24043262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$741.26 |
| Max. Negotiated Rate |
$2,565.90 |
| Rate for Payer: Aetna of AZ Commercial |
$2,565.90
|
| Rate for Payer: Bisbee Police All Plans |
$741.26
|
| Rate for Payer: Cash Price |
$2,280.80
|
| Rate for Payer: Self Pay Self Pay |
$2,280.80
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; BY PHALANX - Tech
|
Facility
|
OP
|
$2,430.00
|
|
|
Service Code
|
CPT 28298
|
| Hospital Charge Code |
24043298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$364.50 |
| Max. Negotiated Rate |
$9,084.18 |
| Rate for Payer: Aetna of AZ Commercial |
$2,187.00
|
| Rate for Payer: Aetna of AZ Medicare |
$680.40
|
| Rate for Payer: AHCCCS Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicare |
$364.50
|
| Rate for Payer: Amerigroup Medicare |
$364.50
|
| Rate for Payer: APIPA Medicare/Medicaid |
$907.60
|
| Rate for Payer: AZCH Complete Medicaid |
$9,084.18
|
| Rate for Payer: AZCH Complete Medicare |
$364.50
|
| Rate for Payer: Banner UC Health Medicaid |
$9,084.18
|
| Rate for Payer: Banner UC Health Medicare |
$364.50
|
| Rate for Payer: Bisbee Police All Plans |
$631.80
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,652.40
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,215.00
|
| Rate for Payer: Copperpoint Commercial |
$601.42
|
| Rate for Payer: Health Net of AZ Commercial |
$1,458.00
|
| Rate for Payer: Health Net of AZ Medicare |
$680.40
|
| Rate for Payer: Humana of AZ Medicare |
$364.50
|
| Rate for Payer: Mercy Care Medicaid |
$9,084.18
|
| Rate for Payer: Self Pay Self Pay |
$1,944.00
|
| Rate for Payer: TriWest Medicare |
$364.50
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$437.40
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; BY PHALANX - Tech
|
Facility
|
IP
|
$2,430.00
|
|
|
Service Code
|
CPT 28298
|
| Hospital Charge Code |
24043298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$631.80 |
| Max. Negotiated Rate |
$2,187.00 |
| Rate for Payer: Aetna of AZ Commercial |
$2,187.00
|
| Rate for Payer: Bisbee Police All Plans |
$631.80
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Self Pay Self Pay |
$1,944.00
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; KELLER
|
Facility
|
IP
|
$2,375.00
|
|
|
Service Code
|
CPT 28292
|
| Hospital Charge Code |
24043308
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$617.50 |
| Max. Negotiated Rate |
$2,137.50 |
| Rate for Payer: Aetna of AZ Commercial |
$2,137.50
|
| Rate for Payer: Bisbee Police All Plans |
$617.50
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Self Pay Self Pay |
$1,900.00
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; KELLER
|
Facility
|
OP
|
$2,375.00
|
|
|
Service Code
|
CPT 28292
|
| Hospital Charge Code |
24043308
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$356.25 |
| Max. Negotiated Rate |
$4,104.08 |
| Rate for Payer: Aetna of AZ Commercial |
$2,137.50
|
| Rate for Payer: Aetna of AZ Medicare |
$665.00
|
| Rate for Payer: AHCCCS Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicare |
$356.25
|
| Rate for Payer: Amerigroup Medicare |
$356.25
|
| Rate for Payer: APIPA Medicare/Medicaid |
$887.06
|
| Rate for Payer: AZCH Complete Medicaid |
$4,104.08
|
| Rate for Payer: AZCH Complete Medicare |
$356.25
|
| Rate for Payer: Banner UC Health Medicaid |
$4,104.08
|
| Rate for Payer: Banner UC Health Medicare |
$356.25
|
| Rate for Payer: Bisbee Police All Plans |
$617.50
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,615.00
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,187.50
|
| Rate for Payer: Copperpoint Commercial |
$587.81
|
| Rate for Payer: Health Net of AZ Commercial |
$1,425.00
|
| Rate for Payer: Health Net of AZ Medicare |
$665.00
|
| Rate for Payer: Humana of AZ Medicare |
$356.25
|
| Rate for Payer: Mercy Care Medicaid |
$4,104.08
|
| Rate for Payer: Self Pay Self Pay |
$1,900.00
|
| Rate for Payer: TriWest Medicare |
$356.25
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$427.50
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; LAPIDUS
|
Facility
|
IP
|
$2,938.00
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
24043296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$763.88 |
| Max. Negotiated Rate |
$2,644.20 |
| Rate for Payer: Aetna of AZ Commercial |
$2,644.20
|
| Rate for Payer: Bisbee Police All Plans |
$763.88
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Self Pay Self Pay |
$2,350.40
|
|
|
CORRECTION HALLUX VALGUS (BUNION) WITH OR WITHOUT SESAMOIDECTOMY; LAPIDUS
|
Facility
|
OP
|
$2,938.00
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
24043296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$440.70 |
| Max. Negotiated Rate |
$9,084.18 |
| Rate for Payer: Aetna of AZ Commercial |
$2,644.20
|
| Rate for Payer: Aetna of AZ Medicare |
$822.64
|
| Rate for Payer: AHCCCS Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicaid |
$9,084.18
|
| Rate for Payer: Allwell Medicare |
$440.70
|
| Rate for Payer: Amerigroup Medicare |
$440.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$1,097.34
|
| Rate for Payer: AZCH Complete Medicaid |
$9,084.18
|
| Rate for Payer: AZCH Complete Medicare |
$440.70
|
| Rate for Payer: Banner UC Health Medicaid |
$9,084.18
|
| Rate for Payer: Banner UC Health Medicare |
$440.70
|
| Rate for Payer: Bisbee Police All Plans |
$763.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,997.84
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cigna of AZ Commercial |
$1,469.00
|
| Rate for Payer: Copperpoint Commercial |
$727.16
|
| Rate for Payer: Health Net of AZ Commercial |
$1,762.80
|
| Rate for Payer: Health Net of AZ Medicare |
$822.64
|
| Rate for Payer: Humana of AZ Medicare |
$440.70
|
| Rate for Payer: Mercy Care Medicaid |
$9,084.18
|
| Rate for Payer: Self Pay Self Pay |
$2,350.40
|
| Rate for Payer: TriWest Medicare |
$440.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,914.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$528.84
|
|
|
CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
CPT 28285
|
| Hospital Charge Code |
24043260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$481.26 |
| Max. Negotiated Rate |
$1,665.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,665.90
|
| Rate for Payer: Bisbee Police All Plans |
$481.26
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Self Pay Self Pay |
$1,480.80
|
|
|
CORRECTION HAMMERTOE (EG INTERPHALANGEAL FUSION PARTIAL OR TOTAL
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
CPT 28285
|
| Hospital Charge Code |
24043260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$277.65 |
| Max. Negotiated Rate |
$4,104.08 |
| Rate for Payer: Aetna of AZ Commercial |
$1,665.90
|
| Rate for Payer: Aetna of AZ Medicare |
$518.28
|
| Rate for Payer: AHCCCS Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicaid |
$4,104.08
|
| Rate for Payer: Allwell Medicare |
$277.65
|
| Rate for Payer: Amerigroup Medicare |
$277.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$691.35
|
| Rate for Payer: AZCH Complete Medicaid |
$4,104.08
|
| Rate for Payer: AZCH Complete Medicare |
$277.65
|
| Rate for Payer: Banner UC Health Medicaid |
$4,104.08
|
| Rate for Payer: Banner UC Health Medicare |
$277.65
|
| Rate for Payer: Bisbee Police All Plans |
$481.26
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,258.68
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cigna of AZ Commercial |
$925.50
|
| Rate for Payer: Copperpoint Commercial |
$458.12
|
| Rate for Payer: Health Net of AZ Commercial |
$1,110.60
|
| Rate for Payer: Health Net of AZ Medicare |
$518.28
|
| Rate for Payer: Humana of AZ Medicare |
$277.65
|
| Rate for Payer: Mercy Care Medicaid |
$4,104.08
|
| Rate for Payer: Self Pay Self Pay |
$1,480.80
|
| Rate for Payer: TriWest Medicare |
$277.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$3,373.00
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$333.18
|
|
|
Cortisol LC
|
Facility
|
IP
|
$202.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
1906812
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.52 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Aetna of AZ Commercial |
$181.80
|
| Rate for Payer: Bisbee Police All Plans |
$52.52
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Self Pay Self Pay |
$161.60
|
|
|
Cortisol LC
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
1906812
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Aetna of AZ Commercial |
$181.80
|
| Rate for Payer: Aetna of AZ Medicare |
$56.56
|
| Rate for Payer: AHCCCS Medicaid |
$16.30
|
| Rate for Payer: Allwell Medicaid |
$16.30
|
| Rate for Payer: Allwell Medicare |
$30.30
|
| Rate for Payer: Amerigroup Medicare |
$30.30
|
| Rate for Payer: APIPA Medicare/Medicaid |
$75.45
|
| Rate for Payer: AZCH Complete Medicaid |
$16.30
|
| Rate for Payer: AZCH Complete Medicare |
$30.30
|
| Rate for Payer: Banner UC Health Medicaid |
$16.30
|
| Rate for Payer: Banner UC Health Medicare |
$30.30
|
| Rate for Payer: Bisbee Police All Plans |
$52.52
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$137.36
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cigna of AZ Commercial |
$131.30
|
| Rate for Payer: Copperpoint Commercial |
$50.00
|
| Rate for Payer: Health Net of AZ Commercial |
$121.20
|
| Rate for Payer: Health Net of AZ Medicare |
$56.56
|
| Rate for Payer: Humana of AZ Medicare |
$30.30
|
| Rate for Payer: Mercy Care Medicaid |
$16.30
|
| Rate for Payer: Self Pay Self Pay |
$161.60
|
| Rate for Payer: TriWest Medicare |
$30.30
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$117.77
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$36.36
|
|
|
Cortisol, Urinary Free LC
|
Facility
|
OP
|
$271.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
1906820
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$243.90 |
| Rate for Payer: Aetna of AZ Commercial |
$243.90
|
| Rate for Payer: Aetna of AZ Medicare |
$75.88
|
| Rate for Payer: AHCCCS Medicaid |
$16.30
|
| Rate for Payer: Allwell Medicaid |
$16.30
|
| Rate for Payer: Allwell Medicare |
$40.65
|
| Rate for Payer: Amerigroup Medicare |
$40.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$101.22
|
| Rate for Payer: AZCH Complete Medicaid |
$16.30
|
| Rate for Payer: AZCH Complete Medicare |
$40.65
|
| Rate for Payer: Banner UC Health Medicaid |
$16.30
|
| Rate for Payer: Banner UC Health Medicare |
$40.65
|
| Rate for Payer: Bisbee Police All Plans |
$70.46
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$184.28
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cigna of AZ Commercial |
$176.15
|
| Rate for Payer: Copperpoint Commercial |
$67.07
|
| Rate for Payer: Health Net of AZ Commercial |
$162.60
|
| Rate for Payer: Health Net of AZ Medicare |
$75.88
|
| Rate for Payer: Humana of AZ Medicare |
$40.65
|
| Rate for Payer: Mercy Care Medicaid |
$16.30
|
| Rate for Payer: Self Pay Self Pay |
$216.80
|
| Rate for Payer: TriWest Medicare |
$40.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$157.99
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$48.78
|
|
|
Cortisol, Urinary Free LC
|
Facility
|
IP
|
$271.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
1906820
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.46 |
| Max. Negotiated Rate |
$243.90 |
| Rate for Payer: Aetna of AZ Commercial |
$243.90
|
| Rate for Payer: Bisbee Police All Plans |
$70.46
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Self Pay Self Pay |
$216.80
|
|
|
cortrosyn injection[CQCH]
|
Facility
|
OP
|
$18.52
|
|
|
Service Code
|
NDC 3.05486E+11
|
| Hospital Charge Code |
124449918
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$16.67 |
| Rate for Payer: Aetna of AZ Commercial |
$16.67
|
| Rate for Payer: Aetna of AZ Medicare |
$5.19
|
| Rate for Payer: Allwell Medicare |
$2.78
|
| Rate for Payer: Amerigroup Medicare |
$2.78
|
| Rate for Payer: APIPA Medicare/Medicaid |
$6.92
|
| Rate for Payer: AZCH Complete Medicare |
$2.78
|
| Rate for Payer: Banner UC Health Medicare |
$2.78
|
| Rate for Payer: Bisbee Police All Plans |
$4.82
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$12.59
|
| Rate for Payer: Cash Price |
$14.82
|
| Rate for Payer: Cigna of AZ Commercial |
$12.04
|
| Rate for Payer: Copperpoint Commercial |
$4.58
|
| Rate for Payer: Health Net of AZ Commercial |
$11.11
|
| Rate for Payer: Health Net of AZ Medicare |
$5.19
|
| Rate for Payer: Humana of AZ Medicare |
$2.78
|
| Rate for Payer: Self Pay Self Pay |
$14.82
|
| Rate for Payer: TriWest Medicare |
$2.78
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$10.80
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$3.33
|
|
