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Charge Type Setting Price  
Service Code CPT Q4282
Hospital Charge Code 27702637
Hospital Revenue Code 636
Min. Negotiated Rate $1,192.00
Max. Negotiated Rate $6,705.00
Rate for Payer: Aetna of AZ Commercial $6,705.00
Rate for Payer: Aetna of AZ Medicare $2,086.00
Rate for Payer: Allwell Medicare $1,192.00
Rate for Payer: Amerigroup Medicare $1,192.00
Rate for Payer: APIPA Medicare/Medicaid $2,782.57
Rate for Payer: AZCH Complete Medicare $1,192.00
Rate for Payer: Banner UC Health Medicare $1,192.00
Rate for Payer: Bisbee Police All Plans $1,937.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $5,066.00
Rate for Payer: Cash Price $5,960.00
Rate for Payer: Cigna of AZ Commercial $5,215.00
Rate for Payer: Copperpoint Commercial $1,843.88
Rate for Payer: Health Net of AZ Commercial $4,470.00
Rate for Payer: Health Net of AZ Medicare $2,086.00
Rate for Payer: Humana of AZ Medicare $1,192.00
Rate for Payer: Self Pay Self Pay $5,960.00
Rate for Payer: TriWest Medicare $1,192.00
Rate for Payer: UnitedHealth Group of AZ Commercial $4,343.35
Rate for Payer: UnitedHealth Group of AZ Medicare $1,341.00
Service Code CPT Q4282
Hospital Charge Code 27702637
Hospital Revenue Code 636
Min. Negotiated Rate $1,937.00
Max. Negotiated Rate $6,705.00
Rate for Payer: Aetna of AZ Commercial $6,705.00
Rate for Payer: Bisbee Police All Plans $1,937.00
Rate for Payer: Cash Price $5,960.00
Rate for Payer: Self Pay Self Pay $5,960.00
Service Code CPT Q4282
Hospital Charge Code 27694677
Hospital Revenue Code 636
Min. Negotiated Rate $1,189.33
Max. Negotiated Rate $6,690.00
Rate for Payer: Aetna of AZ Commercial $6,690.00
Rate for Payer: Aetna of AZ Medicare $2,081.33
Rate for Payer: Allwell Medicare $1,189.33
Rate for Payer: Amerigroup Medicare $1,189.33
Rate for Payer: APIPA Medicare/Medicaid $2,776.35
Rate for Payer: AZCH Complete Medicare $1,189.33
Rate for Payer: Banner UC Health Medicare $1,189.33
Rate for Payer: Bisbee Police All Plans $1,932.67
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $5,054.66
Rate for Payer: Cash Price $5,946.66
Rate for Payer: Cigna of AZ Commercial $5,203.33
Rate for Payer: Copperpoint Commercial $1,839.75
Rate for Payer: Health Net of AZ Commercial $4,460.00
Rate for Payer: Health Net of AZ Medicare $2,081.33
Rate for Payer: Humana of AZ Medicare $1,189.33
Rate for Payer: Self Pay Self Pay $5,946.66
Rate for Payer: TriWest Medicare $1,189.33
Rate for Payer: UnitedHealth Group of AZ Commercial $4,333.63
Rate for Payer: UnitedHealth Group of AZ Medicare $1,338.00
Service Code CPT Q4282
Hospital Charge Code 27694677
Hospital Revenue Code 636
Min. Negotiated Rate $1,932.67
Max. Negotiated Rate $6,690.00
Rate for Payer: Aetna of AZ Commercial $6,690.00
Rate for Payer: Bisbee Police All Plans $1,932.67
Rate for Payer: Cash Price $5,946.66
Rate for Payer: Self Pay Self Pay $5,946.66
Service Code CPT 82610
Hospital Charge Code 28010045
Hospital Revenue Code 302
Min. Negotiated Rate $23.92
Max. Negotiated Rate $82.80
Rate for Payer: Aetna of AZ Commercial $82.80
Rate for Payer: Bisbee Police All Plans $23.92
Rate for Payer: Cash Price $73.60
Rate for Payer: Self Pay Self Pay $73.60
Service Code CPT 82610
Hospital Charge Code 28010045
Hospital Revenue Code 302
Min. Negotiated Rate $14.72
Max. Negotiated Rate $82.80
Rate for Payer: Aetna of AZ Commercial $82.80
Rate for Payer: Aetna of AZ Medicare $25.76
Rate for Payer: Allwell Medicare $14.72
Rate for Payer: Amerigroup Medicare $14.72
Rate for Payer: APIPA Medicare/Medicaid $34.36
Rate for Payer: AZCH Complete Medicare $14.72
Rate for Payer: Banner UC Health Medicare $14.72
Rate for Payer: Bisbee Police All Plans $23.92
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $62.56
Rate for Payer: Cash Price $73.60
Rate for Payer: Cigna of AZ Commercial $59.80
Rate for Payer: Copperpoint Commercial $22.77
Rate for Payer: Health Net of AZ Commercial $55.20
Rate for Payer: Health Net of AZ Medicare $25.76
Rate for Payer: Humana of AZ Medicare $14.72
Rate for Payer: Self Pay Self Pay $73.60
Rate for Payer: TriWest Medicare $14.72
Rate for Payer: UnitedHealth Group of AZ Commercial $53.64
Rate for Payer: UnitedHealth Group of AZ Medicare $16.56
Service Code CPT 82610
Hospital Charge Code 22623884
Hospital Revenue Code 302
Min. Negotiated Rate $14.72
Max. Negotiated Rate $82.80
Rate for Payer: Aetna of AZ Commercial $82.80
Rate for Payer: Aetna of AZ Medicare $25.76
Rate for Payer: Allwell Medicare $14.72
Rate for Payer: Amerigroup Medicare $14.72
Rate for Payer: APIPA Medicare/Medicaid $34.36
Rate for Payer: AZCH Complete Medicare $14.72
Rate for Payer: Banner UC Health Medicare $14.72
Rate for Payer: Bisbee Police All Plans $23.92
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $62.56
Rate for Payer: Cash Price $73.60
Rate for Payer: Cigna of AZ Commercial $59.80
Rate for Payer: Copperpoint Commercial $22.77
Rate for Payer: Health Net of AZ Commercial $55.20
Rate for Payer: Health Net of AZ Medicare $25.76
Rate for Payer: Humana of AZ Medicare $14.72
Rate for Payer: Self Pay Self Pay $73.60
Rate for Payer: TriWest Medicare $14.72
Rate for Payer: UnitedHealth Group of AZ Commercial $53.64
Rate for Payer: UnitedHealth Group of AZ Medicare $16.56
Service Code CPT 82610
Hospital Charge Code 22623884
Hospital Revenue Code 302
Min. Negotiated Rate $23.92
Max. Negotiated Rate $82.80
Rate for Payer: Aetna of AZ Commercial $82.80
Rate for Payer: Bisbee Police All Plans $23.92
Rate for Payer: Cash Price $73.60
Rate for Payer: Self Pay Self Pay $73.60
Service Code APR-DRG 1312
Hospital Charge Code APRDRG1313
Min. Negotiated Rate $10,269.90
Max. Negotiated Rate $10,269.90
Rate for Payer: AHCCCS Medicaid $10,269.90
Rate for Payer: Allwell Medicaid $10,269.90
Rate for Payer: AZCH Complete Medicaid $10,269.90
Rate for Payer: Banner UC Health Medicaid $10,269.90
Rate for Payer: Mercy Care Medicaid $10,269.90
Service Code APR-DRG 1313
Hospital Charge Code APRDRG1311
Min. Negotiated Rate $13,952.95
Max. Negotiated Rate $13,952.95
Rate for Payer: AHCCCS Medicaid $13,952.95
Rate for Payer: Allwell Medicaid $13,952.95
Rate for Payer: AZCH Complete Medicaid $13,952.95
Rate for Payer: Banner UC Health Medicaid $13,952.95
Rate for Payer: Mercy Care Medicaid $13,952.95
Service Code APR-DRG 1312
Hospital Charge Code APRDRG1314
Min. Negotiated Rate $10,269.90
Max. Negotiated Rate $10,269.90
Rate for Payer: AHCCCS Medicaid $10,269.90
Rate for Payer: Allwell Medicaid $10,269.90
Rate for Payer: AZCH Complete Medicaid $10,269.90
Rate for Payer: Banner UC Health Medicaid $10,269.90
Rate for Payer: Mercy Care Medicaid $10,269.90
Service Code APR-DRG 1311
Hospital Charge Code APRDRG1314
Min. Negotiated Rate $8,339.65
Max. Negotiated Rate $8,339.65
Rate for Payer: AHCCCS Medicaid $8,339.65
Rate for Payer: Allwell Medicaid $8,339.65
Rate for Payer: AZCH Complete Medicaid $8,339.65
Rate for Payer: Banner UC Health Medicaid $8,339.65
Rate for Payer: Mercy Care Medicaid $8,339.65
Service Code APR-DRG 1313
Hospital Charge Code APRDRG1312
Min. Negotiated Rate $13,952.95
Max. Negotiated Rate $13,952.95
Rate for Payer: AHCCCS Medicaid $13,952.95
Rate for Payer: Allwell Medicaid $13,952.95
Rate for Payer: AZCH Complete Medicaid $13,952.95
Rate for Payer: Banner UC Health Medicaid $13,952.95
Rate for Payer: Mercy Care Medicaid $13,952.95
Service Code APR-DRG 1314
Hospital Charge Code APRDRG1312
Min. Negotiated Rate $18,516.96
Max. Negotiated Rate $18,516.96
Rate for Payer: AHCCCS Medicaid $18,516.96
Rate for Payer: Allwell Medicaid $18,516.96
Rate for Payer: AZCH Complete Medicaid $18,516.96
Rate for Payer: Banner UC Health Medicaid $18,516.96
Rate for Payer: Mercy Care Medicaid $18,516.96
Service Code APR-DRG 1311
Hospital Charge Code APRDRG1311
Min. Negotiated Rate $8,339.65
Max. Negotiated Rate $8,339.65
Rate for Payer: AHCCCS Medicaid $8,339.65
Rate for Payer: Allwell Medicaid $8,339.65
Rate for Payer: AZCH Complete Medicaid $8,339.65
Rate for Payer: Banner UC Health Medicaid $8,339.65
Rate for Payer: Mercy Care Medicaid $8,339.65
Service Code APR-DRG 1311
Hospital Charge Code APRDRG1313
Min. Negotiated Rate $8,339.65
Max. Negotiated Rate $8,339.65
Rate for Payer: AHCCCS Medicaid $8,339.65
Rate for Payer: Allwell Medicaid $8,339.65
Rate for Payer: AZCH Complete Medicaid $8,339.65
Rate for Payer: Banner UC Health Medicaid $8,339.65
Rate for Payer: Mercy Care Medicaid $8,339.65
Service Code APR-DRG 1314
Hospital Charge Code APRDRG1313
Min. Negotiated Rate $18,516.96
Max. Negotiated Rate $18,516.96
Rate for Payer: AHCCCS Medicaid $18,516.96
Rate for Payer: Allwell Medicaid $18,516.96
Rate for Payer: AZCH Complete Medicaid $18,516.96
Rate for Payer: Banner UC Health Medicaid $18,516.96
Rate for Payer: Mercy Care Medicaid $18,516.96
Service Code APR-DRG 1314
Hospital Charge Code APRDRG1311
Min. Negotiated Rate $18,516.96
Max. Negotiated Rate $18,516.96
Rate for Payer: AHCCCS Medicaid $18,516.96
Rate for Payer: Allwell Medicaid $18,516.96
Rate for Payer: AZCH Complete Medicaid $18,516.96
Rate for Payer: Banner UC Health Medicaid $18,516.96
Rate for Payer: Mercy Care Medicaid $18,516.96
Service Code APR-DRG 1314
Hospital Charge Code APRDRG1314
Min. Negotiated Rate $18,516.96
Max. Negotiated Rate $18,516.96
Rate for Payer: AHCCCS Medicaid $18,516.96
Rate for Payer: Allwell Medicaid $18,516.96
Rate for Payer: AZCH Complete Medicaid $18,516.96
Rate for Payer: Banner UC Health Medicaid $18,516.96
Rate for Payer: Mercy Care Medicaid $18,516.96
Service Code APR-DRG 1312
Hospital Charge Code APRDRG1312
Min. Negotiated Rate $10,269.90
Max. Negotiated Rate $10,269.90
Rate for Payer: AHCCCS Medicaid $10,269.90
Rate for Payer: Allwell Medicaid $10,269.90
Rate for Payer: AZCH Complete Medicaid $10,269.90
Rate for Payer: Banner UC Health Medicaid $10,269.90
Rate for Payer: Mercy Care Medicaid $10,269.90
Service Code APR-DRG 1313
Hospital Charge Code APRDRG1313
Min. Negotiated Rate $13,952.95
Max. Negotiated Rate $13,952.95
Rate for Payer: AHCCCS Medicaid $13,952.95
Rate for Payer: Allwell Medicaid $13,952.95
Rate for Payer: AZCH Complete Medicaid $13,952.95
Rate for Payer: Banner UC Health Medicaid $13,952.95
Rate for Payer: Mercy Care Medicaid $13,952.95
Service Code APR-DRG 1312
Hospital Charge Code APRDRG1311
Min. Negotiated Rate $10,269.90
Max. Negotiated Rate $10,269.90
Rate for Payer: AHCCCS Medicaid $10,269.90
Rate for Payer: Allwell Medicaid $10,269.90
Rate for Payer: AZCH Complete Medicaid $10,269.90
Rate for Payer: Banner UC Health Medicaid $10,269.90
Rate for Payer: Mercy Care Medicaid $10,269.90
Service Code APR-DRG 1313
Hospital Charge Code APRDRG1314
Min. Negotiated Rate $13,952.95
Max. Negotiated Rate $13,952.95
Rate for Payer: AHCCCS Medicaid $13,952.95
Rate for Payer: Allwell Medicaid $13,952.95
Rate for Payer: AZCH Complete Medicaid $13,952.95
Rate for Payer: Banner UC Health Medicaid $13,952.95
Rate for Payer: Mercy Care Medicaid $13,952.95
Service Code APR-DRG 1311
Hospital Charge Code APRDRG1312
Min. Negotiated Rate $8,339.65
Max. Negotiated Rate $8,339.65
Rate for Payer: AHCCCS Medicaid $8,339.65
Rate for Payer: Allwell Medicaid $8,339.65
Rate for Payer: AZCH Complete Medicaid $8,339.65
Rate for Payer: Banner UC Health Medicaid $8,339.65
Rate for Payer: Mercy Care Medicaid $8,339.65
Service Code CPT 82131
Hospital Charge Code 22481472
Hospital Revenue Code 301
Min. Negotiated Rate $45.28
Max. Negotiated Rate $254.70
Rate for Payer: Aetna of AZ Commercial $254.70
Rate for Payer: Aetna of AZ Medicare $79.24
Rate for Payer: Allwell Medicare $45.28
Rate for Payer: Amerigroup Medicare $45.28
Rate for Payer: APIPA Medicare/Medicaid $105.70
Rate for Payer: AZCH Complete Medicare $45.28
Rate for Payer: Banner UC Health Medicare $45.28
Rate for Payer: Bisbee Police All Plans $73.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $192.44
Rate for Payer: Cash Price $226.40
Rate for Payer: Cigna of AZ Commercial $183.95
Rate for Payer: Copperpoint Commercial $70.04
Rate for Payer: Health Net of AZ Commercial $169.80
Rate for Payer: Health Net of AZ Medicare $79.24
Rate for Payer: Humana of AZ Medicare $45.28
Rate for Payer: Self Pay Self Pay $226.40
Rate for Payer: TriWest Medicare $45.28
Rate for Payer: UnitedHealth Group of AZ Commercial $164.99
Rate for Payer: UnitedHealth Group of AZ Medicare $50.94