Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

CT 3D Reconstruction

Facility

$1,166.00

Service Code	CPT 76377
Hospital Charge Code	1005104
Hospital Revenue Code	350
Min. Negotiated Rate	$303.16
Max. Negotiated Rate	$1,049.40
Rate for Payer: Aetna of AZ Commercial	$1,049.40
Rate for Payer: Bisbee Police All Plans	$303.16
Rate for Payer: Cash Price	$932.80
Rate for Payer: Self Pay Self Pay	$932.80

CT 3D Reconstruction

Facility

$1,166.00

Service Code	CPT 76377
Hospital Charge Code	1005104
Hospital Revenue Code	350
Min. Negotiated Rate	$186.56
Max. Negotiated Rate	$1,049.40
Rate for Payer: Aetna of AZ Commercial	$1,049.40
Rate for Payer: Aetna of AZ Medicare	$326.48
Rate for Payer: Allwell Medicare	$186.56
Rate for Payer: Amerigroup Medicare	$186.56
Rate for Payer: APIPA Medicare/Medicaid	$435.50
Rate for Payer: AZCH Complete Medicare	$186.56
Rate for Payer: Banner UC Health Medicare	$186.56
Rate for Payer: Bisbee Police All Plans	$303.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$792.88
Rate for Payer: Cash Price	$932.80
Rate for Payer: Cigna of AZ Commercial	$757.90
Rate for Payer: Copperpoint Commercial	$288.58
Rate for Payer: Health Net of AZ Commercial	$699.60
Rate for Payer: Health Net of AZ Medicare	$326.48
Rate for Payer: Humana of AZ Medicare	$186.56
Rate for Payer: Self Pay Self Pay	$932.80
Rate for Payer: TriWest Medicare	$186.56
Rate for Payer: UnitedHealth Group of AZ Commercial	$679.78
Rate for Payer: UnitedHealth Group of AZ Medicare	$209.88

CT Abdomen/Pelvis w/ Contrast

Facility

$4,585.00

Service Code	CPT 74177
Hospital Charge Code	1005109
Hospital Revenue Code	350
Min. Negotiated Rate	$733.60
Max. Negotiated Rate	$4,126.50
Rate for Payer: Aetna of AZ Commercial	$4,126.50
Rate for Payer: Aetna of AZ Medicare	$1,283.80
Rate for Payer: Allwell Medicare	$733.60
Rate for Payer: Amerigroup Medicare	$733.60
Rate for Payer: APIPA Medicare/Medicaid	$1,712.50
Rate for Payer: AZCH Complete Medicare	$733.60
Rate for Payer: Banner UC Health Medicare	$733.60
Rate for Payer: Bisbee Police All Plans	$1,192.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,117.80
Rate for Payer: Cash Price	$3,668.00
Rate for Payer: Cigna of AZ Commercial	$2,980.25
Rate for Payer: Copperpoint Commercial	$1,134.79
Rate for Payer: Health Net of AZ Commercial	$2,751.00
Rate for Payer: Health Net of AZ Medicare	$1,283.80
Rate for Payer: Humana of AZ Medicare	$733.60
Rate for Payer: Self Pay Self Pay	$3,668.00
Rate for Payer: TriWest Medicare	$733.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,673.05
Rate for Payer: UnitedHealth Group of AZ Medicare	$825.30

CT Abdomen/Pelvis w/ Contrast

Facility

$4,585.00

Service Code	CPT 74177
Hospital Charge Code	1005109
Hospital Revenue Code	350
Min. Negotiated Rate	$1,192.10
Max. Negotiated Rate	$4,126.50
Rate for Payer: Aetna of AZ Commercial	$4,126.50
Rate for Payer: Bisbee Police All Plans	$1,192.10
Rate for Payer: Cash Price	$3,668.00
Rate for Payer: Self Pay Self Pay	$3,668.00

CT Abdomen/Pelvis w/o Contrast

Facility

$4,535.00

Service Code	CPT 74176
Hospital Charge Code	1005112
Hospital Revenue Code	350
Min. Negotiated Rate	$725.60
Max. Negotiated Rate	$4,081.50
Rate for Payer: Aetna of AZ Commercial	$4,081.50
Rate for Payer: Aetna of AZ Medicare	$1,269.80
Rate for Payer: Allwell Medicare	$725.60
Rate for Payer: Amerigroup Medicare	$725.60
Rate for Payer: APIPA Medicare/Medicaid	$1,693.82
Rate for Payer: AZCH Complete Medicare	$725.60
Rate for Payer: Banner UC Health Medicare	$725.60
Rate for Payer: Bisbee Police All Plans	$1,179.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,083.80
Rate for Payer: Cash Price	$3,628.00
Rate for Payer: Cigna of AZ Commercial	$2,947.75
Rate for Payer: Copperpoint Commercial	$1,122.41
Rate for Payer: Health Net of AZ Commercial	$2,721.00
Rate for Payer: Health Net of AZ Medicare	$1,269.80
Rate for Payer: Humana of AZ Medicare	$725.60
Rate for Payer: Self Pay Self Pay	$3,628.00
Rate for Payer: TriWest Medicare	$725.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,643.91
Rate for Payer: UnitedHealth Group of AZ Medicare	$816.30

CT Abdomen/Pelvis w/o Contrast

Facility

$4,535.00

Service Code	CPT 74176
Hospital Charge Code	1005112
Hospital Revenue Code	350
Min. Negotiated Rate	$1,179.10
Max. Negotiated Rate	$4,081.50
Rate for Payer: Aetna of AZ Commercial	$4,081.50
Rate for Payer: Bisbee Police All Plans	$1,179.10
Rate for Payer: Cash Price	$3,628.00
Rate for Payer: Self Pay Self Pay	$3,628.00

CT Abdomen/Pelvis w + w/o Contrast

Facility

$5,174.00

Service Code	CPT 74178
Hospital Charge Code	1005106
Hospital Revenue Code	350
Min. Negotiated Rate	$1,345.24
Max. Negotiated Rate	$4,656.60
Rate for Payer: Aetna of AZ Commercial	$4,656.60
Rate for Payer: Bisbee Police All Plans	$1,345.24
Rate for Payer: Cash Price	$4,139.20
Rate for Payer: Self Pay Self Pay	$4,139.20

CT Abdomen/Pelvis w + w/o Contrast

Facility

$5,174.00

Service Code	CPT 74178
Hospital Charge Code	1005106
Hospital Revenue Code	350
Min. Negotiated Rate	$827.84
Max. Negotiated Rate	$4,656.60
Rate for Payer: Aetna of AZ Commercial	$4,656.60
Rate for Payer: Aetna of AZ Medicare	$1,448.72
Rate for Payer: Allwell Medicare	$827.84
Rate for Payer: Amerigroup Medicare	$827.84
Rate for Payer: APIPA Medicare/Medicaid	$1,932.49
Rate for Payer: AZCH Complete Medicare	$827.84
Rate for Payer: Banner UC Health Medicare	$827.84
Rate for Payer: Bisbee Police All Plans	$1,345.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,518.32
Rate for Payer: Cash Price	$4,139.20
Rate for Payer: Cigna of AZ Commercial	$3,363.10
Rate for Payer: Copperpoint Commercial	$1,280.57
Rate for Payer: Health Net of AZ Commercial	$3,104.40
Rate for Payer: Health Net of AZ Medicare	$1,448.72
Rate for Payer: Humana of AZ Medicare	$827.84
Rate for Payer: Self Pay Self Pay	$4,139.20
Rate for Payer: TriWest Medicare	$827.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,016.44
Rate for Payer: UnitedHealth Group of AZ Medicare	$931.32

CT Abdomen w/ Contrast

Facility

$3,627.00

Service Code	CPT 74160
Hospital Charge Code	821328
Hospital Revenue Code	352
Min. Negotiated Rate	$943.02
Max. Negotiated Rate	$3,264.30
Rate for Payer: Aetna of AZ Commercial	$3,264.30
Rate for Payer: Bisbee Police All Plans	$943.02
Rate for Payer: Cash Price	$2,901.60
Rate for Payer: Self Pay Self Pay	$2,901.60

CT Abdomen w/ Contrast

Facility

$3,627.00

Service Code	CPT 74160
Hospital Charge Code	821328
Hospital Revenue Code	352
Min. Negotiated Rate	$580.32
Max. Negotiated Rate	$3,264.30
Rate for Payer: Aetna of AZ Commercial	$3,264.30
Rate for Payer: Aetna of AZ Medicare	$1,015.56
Rate for Payer: Allwell Medicare	$580.32
Rate for Payer: Amerigroup Medicare	$580.32
Rate for Payer: APIPA Medicare/Medicaid	$1,354.68
Rate for Payer: AZCH Complete Medicare	$580.32
Rate for Payer: Banner UC Health Medicare	$580.32
Rate for Payer: Bisbee Police All Plans	$943.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,466.36
Rate for Payer: Cash Price	$2,901.60
Rate for Payer: Cigna of AZ Commercial	$2,357.55
Rate for Payer: Copperpoint Commercial	$897.68
Rate for Payer: Health Net of AZ Commercial	$2,176.20
Rate for Payer: Health Net of AZ Medicare	$1,015.56
Rate for Payer: Humana of AZ Medicare	$580.32
Rate for Payer: Self Pay Self Pay	$2,901.60
Rate for Payer: TriWest Medicare	$580.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,114.54
Rate for Payer: UnitedHealth Group of AZ Medicare	$652.86

CT Abdomen w/o Contrast

Facility

$2,395.00

Service Code	CPT 74150
Hospital Charge Code	821330
Hospital Revenue Code	352
Min. Negotiated Rate	$622.70
Max. Negotiated Rate	$2,155.50
Rate for Payer: Aetna of AZ Commercial	$2,155.50
Rate for Payer: Bisbee Police All Plans	$622.70
Rate for Payer: Cash Price	$1,916.00
Rate for Payer: Self Pay Self Pay	$1,916.00

CT Abdomen w/o Contrast

Facility

$2,395.00

Service Code	CPT 74150
Hospital Charge Code	821330
Hospital Revenue Code	352
Min. Negotiated Rate	$383.20
Max. Negotiated Rate	$2,155.50
Rate for Payer: Aetna of AZ Commercial	$2,155.50
Rate for Payer: Aetna of AZ Medicare	$670.60
Rate for Payer: Allwell Medicare	$383.20
Rate for Payer: Amerigroup Medicare	$383.20
Rate for Payer: APIPA Medicare/Medicaid	$894.53
Rate for Payer: AZCH Complete Medicare	$383.20
Rate for Payer: Banner UC Health Medicare	$383.20
Rate for Payer: Bisbee Police All Plans	$622.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,628.60
Rate for Payer: Cash Price	$1,916.00
Rate for Payer: Cigna of AZ Commercial	$1,556.75
Rate for Payer: Copperpoint Commercial	$592.76
Rate for Payer: Health Net of AZ Commercial	$1,437.00
Rate for Payer: Health Net of AZ Medicare	$670.60
Rate for Payer: Humana of AZ Medicare	$383.20
Rate for Payer: Self Pay Self Pay	$1,916.00
Rate for Payer: TriWest Medicare	$383.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,396.29
Rate for Payer: UnitedHealth Group of AZ Medicare	$431.10

CT Abdomen w/ + w/o Contrast

Facility

$4,113.00

Service Code	CPT 74170
Hospital Charge Code	821326
Hospital Revenue Code	352
Min. Negotiated Rate	$658.08
Max. Negotiated Rate	$3,701.70
Rate for Payer: Aetna of AZ Commercial	$3,701.70
Rate for Payer: Aetna of AZ Medicare	$1,151.64
Rate for Payer: Allwell Medicare	$658.08
Rate for Payer: Amerigroup Medicare	$658.08
Rate for Payer: APIPA Medicare/Medicaid	$1,536.21
Rate for Payer: AZCH Complete Medicare	$658.08
Rate for Payer: Banner UC Health Medicare	$658.08
Rate for Payer: Bisbee Police All Plans	$1,069.38
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,796.84
Rate for Payer: Cash Price	$3,290.40
Rate for Payer: Cigna of AZ Commercial	$2,673.45
Rate for Payer: Copperpoint Commercial	$1,017.97
Rate for Payer: Health Net of AZ Commercial	$2,467.80
Rate for Payer: Health Net of AZ Medicare	$1,151.64
Rate for Payer: Humana of AZ Medicare	$658.08
Rate for Payer: Self Pay Self Pay	$3,290.40
Rate for Payer: TriWest Medicare	$658.08
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,397.88
Rate for Payer: UnitedHealth Group of AZ Medicare	$740.34

CT Abdomen w/ + w/o Contrast

Facility

$4,113.00

Service Code	CPT 74170
Hospital Charge Code	821326
Hospital Revenue Code	352
Min. Negotiated Rate	$1,069.38
Max. Negotiated Rate	$3,701.70
Rate for Payer: Aetna of AZ Commercial	$3,701.70
Rate for Payer: Bisbee Police All Plans	$1,069.38
Rate for Payer: Cash Price	$3,290.40
Rate for Payer: Self Pay Self Pay	$3,290.40

CTA EXTREMITY W/

Facility

$519.00

Service Code	CPT 73706
Hospital Charge Code	1185058
Hospital Revenue Code	351
Min. Negotiated Rate	$83.04
Max. Negotiated Rate	$467.10
Rate for Payer: Aetna of AZ Commercial	$467.10
Rate for Payer: Aetna of AZ Medicare	$145.32
Rate for Payer: Allwell Medicare	$83.04
Rate for Payer: Amerigroup Medicare	$83.04
Rate for Payer: APIPA Medicare/Medicaid	$193.85
Rate for Payer: AZCH Complete Medicare	$83.04
Rate for Payer: Banner UC Health Medicare	$83.04
Rate for Payer: Bisbee Police All Plans	$134.94
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$352.92
Rate for Payer: Cash Price	$415.20
Rate for Payer: Cigna of AZ Commercial	$337.35
Rate for Payer: Copperpoint Commercial	$128.45
Rate for Payer: Health Net of AZ Commercial	$311.40
Rate for Payer: Health Net of AZ Medicare	$145.32
Rate for Payer: Humana of AZ Medicare	$83.04
Rate for Payer: Self Pay Self Pay	$415.20
Rate for Payer: TriWest Medicare	$83.04
Rate for Payer: UnitedHealth Group of AZ Commercial	$302.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$93.42

CTA EXTREMITY W/

Facility

$519.00

Service Code	CPT 73706
Hospital Charge Code	1185058
Hospital Revenue Code	351
Min. Negotiated Rate	$134.94
Max. Negotiated Rate	$467.10
Rate for Payer: Aetna of AZ Commercial	$467.10
Rate for Payer: Bisbee Police All Plans	$134.94
Rate for Payer: Cash Price	$415.20
Rate for Payer: Self Pay Self Pay	$415.20

CTA LOWER EXTERMITY W/

Facility

$701.00

Service Code	CPT 75635
Hospital Charge Code	2213993
Hospital Revenue Code	351
Min. Negotiated Rate	$112.16
Max. Negotiated Rate	$630.90
Rate for Payer: Aetna of AZ Commercial	$630.90
Rate for Payer: Aetna of AZ Medicare	$196.28
Rate for Payer: Allwell Medicare	$112.16
Rate for Payer: Amerigroup Medicare	$112.16
Rate for Payer: APIPA Medicare/Medicaid	$261.82
Rate for Payer: AZCH Complete Medicare	$112.16
Rate for Payer: Banner UC Health Medicare	$112.16
Rate for Payer: Bisbee Police All Plans	$182.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$476.68
Rate for Payer: Cash Price	$560.80
Rate for Payer: Cigna of AZ Commercial	$455.65
Rate for Payer: Copperpoint Commercial	$173.50
Rate for Payer: Health Net of AZ Commercial	$420.60
Rate for Payer: Health Net of AZ Medicare	$196.28
Rate for Payer: Humana of AZ Medicare	$112.16
Rate for Payer: Self Pay Self Pay	$560.80
Rate for Payer: TriWest Medicare	$112.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$408.68
Rate for Payer: UnitedHealth Group of AZ Medicare	$126.18

CTA LOWER EXTERMITY W/

Facility

$701.00

Service Code	CPT 75635
Hospital Charge Code	2213993
Hospital Revenue Code	351
Min. Negotiated Rate	$182.26
Max. Negotiated Rate	$630.90
Rate for Payer: Aetna of AZ Commercial	$630.90
Rate for Payer: Bisbee Police All Plans	$182.26
Rate for Payer: Cash Price	$560.80
Rate for Payer: Self Pay Self Pay	$560.80

CT Angiography Abdomen

Facility

$2,367.00

Service Code	CPT 74175
Hospital Charge Code	1005124
Hospital Revenue Code	352
Min. Negotiated Rate	$615.42
Max. Negotiated Rate	$2,130.30
Rate for Payer: Aetna of AZ Commercial	$2,130.30
Rate for Payer: Bisbee Police All Plans	$615.42
Rate for Payer: Cash Price	$1,893.60
Rate for Payer: Self Pay Self Pay	$1,893.60

CT Angiography Abdomen

Facility

$2,367.00

Service Code	CPT 74175
Hospital Charge Code	1005124
Hospital Revenue Code	352
Min. Negotiated Rate	$378.72
Max. Negotiated Rate	$2,130.30
Rate for Payer: Aetna of AZ Commercial	$2,130.30
Rate for Payer: Aetna of AZ Medicare	$662.76
Rate for Payer: Allwell Medicare	$378.72
Rate for Payer: Amerigroup Medicare	$378.72
Rate for Payer: APIPA Medicare/Medicaid	$884.07
Rate for Payer: AZCH Complete Medicare	$378.72
Rate for Payer: Banner UC Health Medicare	$378.72
Rate for Payer: Bisbee Police All Plans	$615.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,609.56
Rate for Payer: Cash Price	$1,893.60
Rate for Payer: Cigna of AZ Commercial	$1,538.55
Rate for Payer: Copperpoint Commercial	$585.83
Rate for Payer: Health Net of AZ Commercial	$1,420.20
Rate for Payer: Health Net of AZ Medicare	$662.76
Rate for Payer: Humana of AZ Medicare	$378.72
Rate for Payer: Self Pay Self Pay	$1,893.60
Rate for Payer: TriWest Medicare	$378.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,379.96
Rate for Payer: UnitedHealth Group of AZ Medicare	$426.06

CT Angiography Abdomen/Pelvis

Facility

$5,874.00

Service Code	CPT 74174
Hospital Charge Code	4132928
Hospital Revenue Code	352
Min. Negotiated Rate	$241.82
Max. Negotiated Rate	$5,286.60
Rate for Payer: Aetna of AZ Commercial	$5,286.60
Rate for Payer: Aetna of AZ Medicare	$1,644.72
Rate for Payer: AHCCCS Medicaid	$241.82
Rate for Payer: Allwell Medicaid	$241.82
Rate for Payer: Allwell Medicare	$939.84
Rate for Payer: Amerigroup Medicare	$939.84
Rate for Payer: APIPA Medicare/Medicaid	$2,193.94
Rate for Payer: AZCH Complete Medicaid	$241.82
Rate for Payer: AZCH Complete Medicare	$939.84
Rate for Payer: Banner UC Health Medicaid	$241.82
Rate for Payer: Banner UC Health Medicare	$939.84
Rate for Payer: Bisbee Police All Plans	$1,527.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,994.32
Rate for Payer: Cash Price	$4,699.20
Rate for Payer: Cash Price	$4,699.20
Rate for Payer: Cigna of AZ Commercial	$3,818.10
Rate for Payer: Copperpoint Commercial	$1,453.82
Rate for Payer: Health Net of AZ Commercial	$3,524.40
Rate for Payer: Health Net of AZ Medicare	$1,644.72
Rate for Payer: Humana of AZ Medicare	$939.84
Rate for Payer: Mercy Care Medicaid	$241.82
Rate for Payer: Self Pay Self Pay	$4,699.20
Rate for Payer: TriWest Medicare	$939.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,424.54
Rate for Payer: UnitedHealth Group of AZ Medicare	$1,057.32

CT Angiography Abdomen/Pelvis

Facility

$5,874.00

Service Code	CPT 74174
Hospital Charge Code	4132928
Hospital Revenue Code	352
Min. Negotiated Rate	$1,527.24
Max. Negotiated Rate	$5,286.60
Rate for Payer: Aetna of AZ Commercial	$5,286.60
Rate for Payer: Bisbee Police All Plans	$1,527.24
Rate for Payer: Cash Price	$4,699.20
Rate for Payer: Self Pay Self Pay	$4,699.20

CT Angiography Chest w/ Contrast

Facility

$4,175.00

Service Code	CPT 71275
Hospital Charge Code	1165683
Hospital Revenue Code	350
Min. Negotiated Rate	$668.00
Max. Negotiated Rate	$3,757.50
Rate for Payer: Aetna of AZ Commercial	$3,757.50
Rate for Payer: Aetna of AZ Medicare	$1,169.00
Rate for Payer: Allwell Medicare	$668.00
Rate for Payer: Amerigroup Medicare	$668.00
Rate for Payer: APIPA Medicare/Medicaid	$1,559.36
Rate for Payer: AZCH Complete Medicare	$668.00
Rate for Payer: Banner UC Health Medicare	$668.00
Rate for Payer: Bisbee Police All Plans	$1,085.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,839.00
Rate for Payer: Cash Price	$3,340.00
Rate for Payer: Cigna of AZ Commercial	$2,713.75
Rate for Payer: Copperpoint Commercial	$1,033.31
Rate for Payer: Health Net of AZ Commercial	$2,505.00
Rate for Payer: Health Net of AZ Medicare	$1,169.00
Rate for Payer: Humana of AZ Medicare	$668.00
Rate for Payer: Self Pay Self Pay	$3,340.00
Rate for Payer: TriWest Medicare	$668.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,434.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$751.50

CT Angiography Chest w/ Contrast

Facility

$4,175.00

Service Code	CPT 71275
Hospital Charge Code	1165683
Hospital Revenue Code	350
Min. Negotiated Rate	$1,085.50
Max. Negotiated Rate	$3,757.50
Rate for Payer: Aetna of AZ Commercial	$3,757.50
Rate for Payer: Bisbee Police All Plans	$1,085.50
Rate for Payer: Cash Price	$3,340.00
Rate for Payer: Self Pay Self Pay	$3,340.00

CT Angiography Head w/ Contrast

Facility

$4,326.00

Service Code	CPT 70496
Hospital Charge Code	22035134
Hospital Revenue Code	350
Min. Negotiated Rate	$692.16
Max. Negotiated Rate	$3,893.40
Rate for Payer: Aetna of AZ Commercial	$3,893.40
Rate for Payer: Aetna of AZ Medicare	$1,211.28
Rate for Payer: Allwell Medicare	$692.16
Rate for Payer: Amerigroup Medicare	$692.16
Rate for Payer: APIPA Medicare/Medicaid	$1,615.76
Rate for Payer: AZCH Complete Medicare	$692.16
Rate for Payer: Banner UC Health Medicare	$692.16
Rate for Payer: Bisbee Police All Plans	$1,124.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,941.68
Rate for Payer: Cash Price	$3,460.80
Rate for Payer: Cigna of AZ Commercial	$2,811.90
Rate for Payer: Copperpoint Commercial	$1,070.68
Rate for Payer: Health Net of AZ Commercial	$2,595.60
Rate for Payer: Health Net of AZ Medicare	$1,211.28
Rate for Payer: Humana of AZ Medicare	$692.16
Rate for Payer: Self Pay Self Pay	$3,460.80
Rate for Payer: TriWest Medicare	$692.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,522.06
Rate for Payer: UnitedHealth Group of AZ Medicare	$778.68

Know your out-of-pocket cost for care.

All Charges