Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Creatinine

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	22525233
Hospital Revenue Code	301
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Cash Price	$64.00
Rate for Payer: Self Pay Self Pay	$64.00

Creatinine

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	22525233
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Aetna of AZ Medicare	$22.40
Rate for Payer: AHCCCS Medicaid	$5.12
Rate for Payer: Allwell Medicaid	$5.12
Rate for Payer: Allwell Medicare	$12.00
Rate for Payer: Amerigroup Medicare	$12.00
Rate for Payer: APIPA Medicare/Medicaid	$29.88
Rate for Payer: AZCH Complete Medicaid	$5.12
Rate for Payer: AZCH Complete Medicare	$12.00
Rate for Payer: Banner UC Health Medicaid	$5.12
Rate for Payer: Banner UC Health Medicare	$12.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$54.40
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cigna of AZ Commercial	$52.00
Rate for Payer: Copperpoint Commercial	$19.80
Rate for Payer: Health Net of AZ Commercial	$48.00
Rate for Payer: Health Net of AZ Medicare	$22.40
Rate for Payer: Humana of AZ Medicare	$12.00
Rate for Payer: Mercy Care Medicaid	$5.12
Rate for Payer: Self Pay Self Pay	$64.00
Rate for Payer: TriWest Medicare	$12.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$46.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.40

Creatinine

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	633606
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Aetna of AZ Medicare	$22.40
Rate for Payer: AHCCCS Medicaid	$5.12
Rate for Payer: Allwell Medicaid	$5.12
Rate for Payer: Allwell Medicare	$12.00
Rate for Payer: Amerigroup Medicare	$12.00
Rate for Payer: APIPA Medicare/Medicaid	$29.88
Rate for Payer: AZCH Complete Medicaid	$5.12
Rate for Payer: AZCH Complete Medicare	$12.00
Rate for Payer: Banner UC Health Medicaid	$5.12
Rate for Payer: Banner UC Health Medicare	$12.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$54.40
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cigna of AZ Commercial	$52.00
Rate for Payer: Copperpoint Commercial	$19.80
Rate for Payer: Health Net of AZ Commercial	$48.00
Rate for Payer: Health Net of AZ Medicare	$22.40
Rate for Payer: Humana of AZ Medicare	$12.00
Rate for Payer: Mercy Care Medicaid	$5.12
Rate for Payer: Self Pay Self Pay	$64.00
Rate for Payer: TriWest Medicare	$12.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$46.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.40

Creatinine Clearance Standard

Facility

$159.00

Service Code	CPT 82575
Hospital Charge Code	22141049
Hospital Revenue Code	301
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Cash Price	$127.20
Rate for Payer: Self Pay Self Pay	$127.20

Creatinine Clearance Standard

Facility

$159.00

Service Code	CPT 82575
Hospital Charge Code	22141049
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Aetna of AZ Medicare	$44.52
Rate for Payer: AHCCCS Medicaid	$9.46
Rate for Payer: Allwell Medicaid	$9.46
Rate for Payer: Allwell Medicare	$23.85
Rate for Payer: Amerigroup Medicare	$23.85
Rate for Payer: APIPA Medicare/Medicaid	$59.39
Rate for Payer: AZCH Complete Medicaid	$9.46
Rate for Payer: AZCH Complete Medicare	$23.85
Rate for Payer: Banner UC Health Medicaid	$9.46
Rate for Payer: Banner UC Health Medicare	$23.85
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$108.12
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cigna of AZ Commercial	$103.35
Rate for Payer: Copperpoint Commercial	$39.35
Rate for Payer: Health Net of AZ Commercial	$95.40
Rate for Payer: Health Net of AZ Medicare	$44.52
Rate for Payer: Humana of AZ Medicare	$23.85
Rate for Payer: Mercy Care Medicaid	$9.46
Rate for Payer: Self Pay Self Pay	$127.20
Rate for Payer: TriWest Medicare	$23.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$92.70
Rate for Payer: UnitedHealth Group of AZ Medicare	$28.62

Creatinine Kinase

Facility

$321.00

Service Code	CPT 82553
Hospital Charge Code	22525239
Hospital Revenue Code	301
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$288.90
Rate for Payer: Aetna of AZ Commercial	$288.90
Rate for Payer: Aetna of AZ Medicare	$89.88
Rate for Payer: AHCCCS Medicaid	$11.55
Rate for Payer: Allwell Medicaid	$11.55
Rate for Payer: Allwell Medicare	$48.15
Rate for Payer: Amerigroup Medicare	$48.15
Rate for Payer: APIPA Medicare/Medicaid	$119.89
Rate for Payer: AZCH Complete Medicaid	$11.55
Rate for Payer: AZCH Complete Medicare	$48.15
Rate for Payer: Banner UC Health Medicaid	$11.55
Rate for Payer: Banner UC Health Medicare	$48.15
Rate for Payer: Bisbee Police All Plans	$83.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$218.28
Rate for Payer: Cash Price	$256.80
Rate for Payer: Cash Price	$256.80
Rate for Payer: Cigna of AZ Commercial	$208.65
Rate for Payer: Copperpoint Commercial	$79.45
Rate for Payer: Health Net of AZ Commercial	$192.60
Rate for Payer: Health Net of AZ Medicare	$89.88
Rate for Payer: Humana of AZ Medicare	$48.15
Rate for Payer: Mercy Care Medicaid	$11.55
Rate for Payer: Self Pay Self Pay	$256.80
Rate for Payer: TriWest Medicare	$48.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$187.14
Rate for Payer: UnitedHealth Group of AZ Medicare	$57.78

Creatinine Kinase

Facility

$321.00

Service Code	CPT 82553
Hospital Charge Code	22525239
Hospital Revenue Code	301
Min. Negotiated Rate	$83.46
Max. Negotiated Rate	$288.90
Rate for Payer: Aetna of AZ Commercial	$288.90
Rate for Payer: Bisbee Police All Plans	$83.46
Rate for Payer: Cash Price	$256.80
Rate for Payer: Self Pay Self Pay	$256.80

Creatinine Level Urine

Facility

$80.00

Service Code	CPT 82570
Hospital Charge Code	633607
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Aetna of AZ Medicare	$22.40
Rate for Payer: AHCCCS Medicaid	$5.18
Rate for Payer: Allwell Medicaid	$5.18
Rate for Payer: Allwell Medicare	$12.00
Rate for Payer: Amerigroup Medicare	$12.00
Rate for Payer: APIPA Medicare/Medicaid	$29.88
Rate for Payer: AZCH Complete Medicaid	$5.18
Rate for Payer: AZCH Complete Medicare	$12.00
Rate for Payer: Banner UC Health Medicaid	$5.18
Rate for Payer: Banner UC Health Medicare	$12.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$54.40
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cigna of AZ Commercial	$52.00
Rate for Payer: Copperpoint Commercial	$19.80
Rate for Payer: Health Net of AZ Commercial	$48.00
Rate for Payer: Health Net of AZ Medicare	$22.40
Rate for Payer: Humana of AZ Medicare	$12.00
Rate for Payer: Mercy Care Medicaid	$5.18
Rate for Payer: Self Pay Self Pay	$64.00
Rate for Payer: TriWest Medicare	$12.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$46.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.40

Creatinine Level Urine

Facility

$80.00

Service Code	CPT 82570
Hospital Charge Code	633607
Hospital Revenue Code	301
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Cash Price	$64.00
Rate for Payer: Self Pay Self Pay	$64.00

CREATININE S

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	22481470
Hospital Revenue Code	301
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Cash Price	$64.00
Rate for Payer: Self Pay Self Pay	$64.00

CREATININE S

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	22481470
Hospital Revenue Code	301
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Aetna of AZ Medicare	$22.40
Rate for Payer: AHCCCS Medicaid	$5.12
Rate for Payer: Allwell Medicaid	$5.12
Rate for Payer: Allwell Medicare	$12.00
Rate for Payer: Amerigroup Medicare	$12.00
Rate for Payer: APIPA Medicare/Medicaid	$29.88
Rate for Payer: AZCH Complete Medicaid	$5.12
Rate for Payer: AZCH Complete Medicare	$12.00
Rate for Payer: Banner UC Health Medicaid	$5.12
Rate for Payer: Banner UC Health Medicare	$12.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$54.40
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cigna of AZ Commercial	$52.00
Rate for Payer: Copperpoint Commercial	$19.80
Rate for Payer: Health Net of AZ Commercial	$48.00
Rate for Payer: Health Net of AZ Medicare	$22.40
Rate for Payer: Humana of AZ Medicare	$12.00
Rate for Payer: Mercy Care Medicaid	$5.12
Rate for Payer: Self Pay Self Pay	$64.00
Rate for Payer: TriWest Medicare	$12.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$46.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.40

CREATININE URINE 24

Facility

$99.00

Service Code	CPT 82570
Hospital Charge Code	22481471
Hospital Revenue Code	301
Min. Negotiated Rate	$25.74
Max. Negotiated Rate	$89.10
Rate for Payer: Aetna of AZ Commercial	$89.10
Rate for Payer: Bisbee Police All Plans	$25.74
Rate for Payer: Cash Price	$79.20
Rate for Payer: Self Pay Self Pay	$79.20

CREATININE URINE 24

Facility

$99.00

Service Code	CPT 82570
Hospital Charge Code	22481471
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$89.10
Rate for Payer: Aetna of AZ Commercial	$89.10
Rate for Payer: Aetna of AZ Medicare	$27.72
Rate for Payer: AHCCCS Medicaid	$5.18
Rate for Payer: Allwell Medicaid	$5.18
Rate for Payer: Allwell Medicare	$14.85
Rate for Payer: Amerigroup Medicare	$14.85
Rate for Payer: APIPA Medicare/Medicaid	$36.98
Rate for Payer: AZCH Complete Medicaid	$5.18
Rate for Payer: AZCH Complete Medicare	$14.85
Rate for Payer: Banner UC Health Medicaid	$5.18
Rate for Payer: Banner UC Health Medicare	$14.85
Rate for Payer: Bisbee Police All Plans	$25.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$67.32
Rate for Payer: Cash Price	$79.20
Rate for Payer: Cash Price	$79.20
Rate for Payer: Cigna of AZ Commercial	$64.35
Rate for Payer: Copperpoint Commercial	$24.50
Rate for Payer: Health Net of AZ Commercial	$59.40
Rate for Payer: Health Net of AZ Medicare	$27.72
Rate for Payer: Humana of AZ Medicare	$14.85
Rate for Payer: Mercy Care Medicaid	$5.18
Rate for Payer: Self Pay Self Pay	$79.20
Rate for Payer: TriWest Medicare	$14.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$57.72
Rate for Payer: UnitedHealth Group of AZ Medicare	$17.82

Creatinine, Urine LC

Facility

$84.00

Service Code	CPT 82570
Hospital Charge Code	1285619
Hospital Revenue Code	301
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

Creatinine, Urine LC

Facility

$84.00

Service Code	CPT 82570
Hospital Charge Code	1285619
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
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: AHCCCS Medicaid	$5.18
Rate for Payer: Allwell Medicaid	$5.18
Rate for Payer: Allwell Medicare	$12.60
Rate for Payer: Amerigroup Medicare	$12.60
Rate for Payer: APIPA Medicare/Medicaid	$31.37
Rate for Payer: AZCH Complete Medicaid	$5.18
Rate for Payer: AZCH Complete Medicare	$12.60
Rate for Payer: Banner UC Health Medicaid	$5.18
Rate for Payer: Banner UC Health Medicare	$12.60
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: Cash Price	$67.20
Rate for Payer: Cigna of AZ Commercial	$54.60
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	$12.60
Rate for Payer: Mercy Care Medicaid	$5.18
Rate for Payer: Self Pay Self Pay	$67.20
Rate for Payer: TriWest Medicare	$12.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$48.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$15.12

Crossmatch AHG Tube

Facility

$177.00

Service Code	CPT 86922
Hospital Charge Code	4662835
Hospital Revenue Code	302
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Cash Price	$141.60
Rate for Payer: Self Pay Self Pay	$141.60

Crossmatch AHG Tube

Facility

$177.00

Service Code	CPT 86922
Hospital Charge Code	1681878
Hospital Revenue Code	302
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Cash Price	$141.60
Rate for Payer: Self Pay Self Pay	$141.60

Crossmatch AHG Tube

Facility

$177.00

Service Code	CPT 86922
Hospital Charge Code	1681878
Hospital Revenue Code	302
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Aetna of AZ Medicare	$49.56
Rate for Payer: AHCCCS Medicaid	$108.14
Rate for Payer: Allwell Medicaid	$108.14
Rate for Payer: Allwell Medicare	$26.55
Rate for Payer: Amerigroup Medicare	$26.55
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicaid	$108.14
Rate for Payer: AZCH Complete Medicare	$26.55
Rate for Payer: Banner UC Health Medicaid	$108.14
Rate for Payer: Banner UC Health Medicare	$26.55
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$120.36
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cigna of AZ Commercial	$115.05
Rate for Payer: Copperpoint Commercial	$43.81
Rate for Payer: Health Net of AZ Commercial	$106.20
Rate for Payer: Health Net of AZ Medicare	$49.56
Rate for Payer: Humana of AZ Medicare	$26.55
Rate for Payer: Mercy Care Medicaid	$108.14
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$26.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

Crossmatch AHG Tube

Facility

$177.00

Service Code	CPT 86922
Hospital Charge Code	4662835
Hospital Revenue Code	302
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Aetna of AZ Medicare	$49.56
Rate for Payer: AHCCCS Medicaid	$108.14
Rate for Payer: Allwell Medicaid	$108.14
Rate for Payer: Allwell Medicare	$26.55
Rate for Payer: Amerigroup Medicare	$26.55
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicaid	$108.14
Rate for Payer: AZCH Complete Medicare	$26.55
Rate for Payer: Banner UC Health Medicaid	$108.14
Rate for Payer: Banner UC Health Medicare	$26.55
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$120.36
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cigna of AZ Commercial	$115.05
Rate for Payer: Copperpoint Commercial	$43.81
Rate for Payer: Health Net of AZ Commercial	$106.20
Rate for Payer: Health Net of AZ Medicare	$49.56
Rate for Payer: Humana of AZ Medicare	$26.55
Rate for Payer: Mercy Care Medicaid	$108.14
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$26.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

Crossmatch Immediate Spin

Facility

$177.00

Service Code	CPT 86920
Hospital Charge Code	22107850
Hospital Revenue Code	302
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Aetna of AZ Medicare	$49.56
Rate for Payer: AHCCCS Medicaid	$108.14
Rate for Payer: Allwell Medicaid	$108.14
Rate for Payer: Allwell Medicare	$26.55
Rate for Payer: Amerigroup Medicare	$26.55
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicaid	$108.14
Rate for Payer: AZCH Complete Medicare	$26.55
Rate for Payer: Banner UC Health Medicaid	$108.14
Rate for Payer: Banner UC Health Medicare	$26.55
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$120.36
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cigna of AZ Commercial	$115.05
Rate for Payer: Copperpoint Commercial	$43.81
Rate for Payer: Health Net of AZ Commercial	$106.20
Rate for Payer: Health Net of AZ Medicare	$49.56
Rate for Payer: Humana of AZ Medicare	$26.55
Rate for Payer: Mercy Care Medicaid	$108.14
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$26.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

Crossmatch Immediate Spin

Facility

$177.00

Service Code	CPT 86920
Hospital Charge Code	22107850
Hospital Revenue Code	302
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Cash Price	$141.60
Rate for Payer: Self Pay Self Pay	$141.60

CRUTCH ADULT

Facility

$60.00

Service Code	CPT E0113
Hospital Charge Code	22354909
Hospital Revenue Code	270
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna of AZ Commercial	$54.00
Rate for Payer: Bisbee Police All Plans	$15.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Self Pay Self Pay	$48.00

CRUTCH ADULT

Facility

$60.00

Service Code	CPT E0113
Hospital Charge Code	22354909
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna of AZ Commercial	$54.00
Rate for Payer: Aetna of AZ Medicare	$16.80
Rate for Payer: AHCCCS Medicaid	$32.36
Rate for Payer: Allwell Medicaid	$32.36
Rate for Payer: Allwell Medicare	$9.00
Rate for Payer: Amerigroup Medicare	$9.00
Rate for Payer: APIPA Medicare/Medicaid	$22.41
Rate for Payer: AZCH Complete Medicaid	$32.36
Rate for Payer: AZCH Complete Medicare	$9.00
Rate for Payer: Banner UC Health Medicaid	$32.36
Rate for Payer: Banner UC Health Medicare	$9.00
Rate for Payer: Bisbee Police All Plans	$15.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$40.80
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cigna of AZ Commercial	$42.00
Rate for Payer: Copperpoint Commercial	$14.85
Rate for Payer: Health Net of AZ Commercial	$36.00
Rate for Payer: Health Net of AZ Medicare	$16.80
Rate for Payer: Humana of AZ Medicare	$9.00
Rate for Payer: Mercy Care Medicaid	$32.36
Rate for Payer: Self Pay Self Pay	$48.00
Rate for Payer: TriWest Medicare	$9.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$34.98
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.80

CRUTCH ADULT TALL

Facility

$60.00

Service Code	CPT E0113
Hospital Charge Code	22354907
Hospital Revenue Code	270
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna of AZ Commercial	$54.00
Rate for Payer: Bisbee Police All Plans	$15.60
Rate for Payer: Cash Price	$48.00
Rate for Payer: Self Pay Self Pay	$48.00

CRUTCH ADULT TALL

Facility

$60.00

Service Code	CPT E0113
Hospital Charge Code	22354907
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna of AZ Commercial	$54.00
Rate for Payer: Aetna of AZ Medicare	$16.80
Rate for Payer: AHCCCS Medicaid	$32.36
Rate for Payer: Allwell Medicaid	$32.36
Rate for Payer: Allwell Medicare	$9.00
Rate for Payer: Amerigroup Medicare	$9.00
Rate for Payer: APIPA Medicare/Medicaid	$22.41
Rate for Payer: AZCH Complete Medicaid	$32.36
Rate for Payer: AZCH Complete Medicare	$9.00
Rate for Payer: Banner UC Health Medicaid	$32.36
Rate for Payer: Banner UC Health Medicare	$9.00
Rate for Payer: Bisbee Police All Plans	$15.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$40.80
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cigna of AZ Commercial	$42.00
Rate for Payer: Copperpoint Commercial	$14.85
Rate for Payer: Health Net of AZ Commercial	$36.00
Rate for Payer: Health Net of AZ Medicare	$16.80
Rate for Payer: Humana of AZ Medicare	$9.00
Rate for Payer: Mercy Care Medicaid	$32.36
Rate for Payer: Self Pay Self Pay	$48.00
Rate for Payer: TriWest Medicare	$9.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$34.98
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.80

Know your out-of-pocket cost for care.

All Charges