Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Disorders Of Personality And Impulse Control

Facility

IP

$2,166.62

Service Code	APR-DRG 7521
Hospital Charge Code	APRDRG7524
Min. Negotiated Rate	$2,166.62
Max. Negotiated Rate	$2,166.62
Rate for Payer: AHCCCS Medicaid	$2,166.62
Rate for Payer: Allwell Medicaid	$2,166.62
Rate for Payer: AZCH Complete Medicaid	$2,166.62
Rate for Payer: Banner UC Health Medicaid	$2,166.62
Rate for Payer: Mercy Care Medicaid	$2,166.62

Disorders Of Personality And Impulse Control

Facility

IP

$6,509.69

Service Code	APR-DRG 7523
Hospital Charge Code	APRDRG7523
Min. Negotiated Rate	$6,509.69
Max. Negotiated Rate	$6,509.69
Rate for Payer: AHCCCS Medicaid	$6,509.69
Rate for Payer: Allwell Medicaid	$6,509.69
Rate for Payer: AZCH Complete Medicaid	$6,509.69
Rate for Payer: Banner UC Health Medicaid	$6,509.69
Rate for Payer: Mercy Care Medicaid	$6,509.69

Disorders Of Personality And Impulse Control

Facility

IP

$2,166.62

Service Code	APR-DRG 7521
Hospital Charge Code	APRDRG7522
Min. Negotiated Rate	$2,166.62
Max. Negotiated Rate	$2,166.62
Rate for Payer: AHCCCS Medicaid	$2,166.62
Rate for Payer: Allwell Medicaid	$2,166.62
Rate for Payer: AZCH Complete Medicaid	$2,166.62
Rate for Payer: Banner UC Health Medicaid	$2,166.62
Rate for Payer: Mercy Care Medicaid	$2,166.62

Disorders Of Personality And Impulse Control

Facility

IP

$6,509.69

Service Code	APR-DRG 7524
Hospital Charge Code	APRDRG7521
Min. Negotiated Rate	$6,509.69
Max. Negotiated Rate	$6,509.69
Rate for Payer: AHCCCS Medicaid	$6,509.69
Rate for Payer: Allwell Medicaid	$6,509.69
Rate for Payer: AZCH Complete Medicaid	$6,509.69
Rate for Payer: Banner UC Health Medicaid	$6,509.69
Rate for Payer: Mercy Care Medicaid	$6,509.69

Disorders Of Personality And Impulse Control

Facility

IP

$2,814.02

Service Code	APR-DRG 7522
Hospital Charge Code	APRDRG7522
Min. Negotiated Rate	$2,814.02
Max. Negotiated Rate	$2,814.02
Rate for Payer: AHCCCS Medicaid	$2,814.02
Rate for Payer: Allwell Medicaid	$2,814.02
Rate for Payer: AZCH Complete Medicaid	$2,814.02
Rate for Payer: Banner UC Health Medicaid	$2,814.02
Rate for Payer: Mercy Care Medicaid	$2,814.02

Disorders Of Personality And Impulse Control

Facility

IP

$6,509.69

Service Code	APR-DRG 7524
Hospital Charge Code	APRDRG7523
Min. Negotiated Rate	$6,509.69
Max. Negotiated Rate	$6,509.69
Rate for Payer: AHCCCS Medicaid	$6,509.69
Rate for Payer: Allwell Medicaid	$6,509.69
Rate for Payer: AZCH Complete Medicaid	$6,509.69
Rate for Payer: Banner UC Health Medicaid	$6,509.69
Rate for Payer: Mercy Care Medicaid	$6,509.69

Disorders Of Personality And Impulse Control

Facility

IP

$2,166.62

Service Code	APR-DRG 7521
Hospital Charge Code	APRDRG7521
Min. Negotiated Rate	$2,166.62
Max. Negotiated Rate	$2,166.62
Rate for Payer: AHCCCS Medicaid	$2,166.62
Rate for Payer: Allwell Medicaid	$2,166.62
Rate for Payer: AZCH Complete Medicaid	$2,166.62
Rate for Payer: Banner UC Health Medicaid	$2,166.62
Rate for Payer: Mercy Care Medicaid	$2,166.62

Disorders Of Personality And Impulse Control

Facility

IP

$6,509.69

Service Code	APR-DRG 7523
Hospital Charge Code	APRDRG7524
Min. Negotiated Rate	$6,509.69
Max. Negotiated Rate	$6,509.69
Rate for Payer: AHCCCS Medicaid	$6,509.69
Rate for Payer: Allwell Medicaid	$6,509.69
Rate for Payer: AZCH Complete Medicaid	$6,509.69
Rate for Payer: Banner UC Health Medicaid	$6,509.69
Rate for Payer: Mercy Care Medicaid	$6,509.69

Disorders Of Personality And Impulse Control

Facility

IP

$2,166.62

Service Code	APR-DRG 7521
Hospital Charge Code	APRDRG7523
Min. Negotiated Rate	$2,166.62
Max. Negotiated Rate	$2,166.62
Rate for Payer: AHCCCS Medicaid	$2,166.62
Rate for Payer: Allwell Medicaid	$2,166.62
Rate for Payer: AZCH Complete Medicaid	$2,166.62
Rate for Payer: Banner UC Health Medicaid	$2,166.62
Rate for Payer: Mercy Care Medicaid	$2,166.62

Disorders Of Personality And Impulse Control

Facility

IP

$2,814.02

Service Code	APR-DRG 7522
Hospital Charge Code	APRDRG7523
Min. Negotiated Rate	$2,814.02
Max. Negotiated Rate	$2,814.02
Rate for Payer: AHCCCS Medicaid	$2,814.02
Rate for Payer: Allwell Medicaid	$2,814.02
Rate for Payer: AZCH Complete Medicaid	$2,814.02
Rate for Payer: Banner UC Health Medicaid	$2,814.02
Rate for Payer: Mercy Care Medicaid	$2,814.02

Disorders Of Personality And Impulse Control

Facility

IP

$6,509.69

Service Code	APR-DRG 7523
Hospital Charge Code	APRDRG7521
Min. Negotiated Rate	$6,509.69
Max. Negotiated Rate	$6,509.69
Rate for Payer: AHCCCS Medicaid	$6,509.69
Rate for Payer: Allwell Medicaid	$6,509.69
Rate for Payer: AZCH Complete Medicaid	$6,509.69
Rate for Payer: Banner UC Health Medicaid	$6,509.69
Rate for Payer: Mercy Care Medicaid	$6,509.69

Disorders Of Personality And Impulse Control

Facility

IP

$2,814.02

Service Code	APR-DRG 7522
Hospital Charge Code	APRDRG7524
Min. Negotiated Rate	$2,814.02
Max. Negotiated Rate	$2,814.02
Rate for Payer: AHCCCS Medicaid	$2,814.02
Rate for Payer: Allwell Medicaid	$2,814.02
Rate for Payer: AZCH Complete Medicaid	$2,814.02
Rate for Payer: Banner UC Health Medicaid	$2,814.02
Rate for Payer: Mercy Care Medicaid	$2,814.02

DISP BIOPSY FORCEP 2.8MM

Facility

OP

$41.00

Hospital Charge Code	22355304
Hospital Revenue Code	270
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna of AZ Commercial	$36.90
Rate for Payer: Aetna of AZ Medicare	$11.48
Rate for Payer: Allwell Medicare	$6.15
Rate for Payer: Amerigroup Medicare	$6.15
Rate for Payer: APIPA Medicare/Medicaid	$15.31
Rate for Payer: AZCH Complete Medicare	$6.15
Rate for Payer: Banner UC Health Medicare	$6.15
Rate for Payer: Bisbee Police All Plans	$10.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$27.88
Rate for Payer: Cash Price	$32.80
Rate for Payer: Cigna of AZ Commercial	$28.70
Rate for Payer: Copperpoint Commercial	$10.15
Rate for Payer: Health Net of AZ Commercial	$24.60
Rate for Payer: Health Net of AZ Medicare	$11.48
Rate for Payer: Humana of AZ Medicare	$6.15
Rate for Payer: Self Pay Self Pay	$32.80
Rate for Payer: TriWest Medicare	$6.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$23.90
Rate for Payer: UnitedHealth Group of AZ Medicare	$7.38

DISP BIOPSY FORCEP 2.8MM

Facility

IP

$41.00

Hospital Charge Code	22355304
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna of AZ Commercial	$36.90
Rate for Payer: Bisbee Police All Plans	$10.66
Rate for Payer: Cash Price	$32.80
Rate for Payer: Self Pay Self Pay	$32.80

DISP INJECTION NEEDLE

Facility

IP

$109.00

Hospital Charge Code	22354820
Hospital Revenue Code	270
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$98.10
Rate for Payer: Aetna of AZ Commercial	$98.10
Rate for Payer: Bisbee Police All Plans	$28.34
Rate for Payer: Cash Price	$87.20
Rate for Payer: Self Pay Self Pay	$87.20

DISP INJECTION NEEDLE

Facility

OP

$109.00

Hospital Charge Code	22354820
Hospital Revenue Code	270
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$98.10
Rate for Payer: Aetna of AZ Commercial	$98.10
Rate for Payer: Aetna of AZ Medicare	$30.52
Rate for Payer: Allwell Medicare	$16.35
Rate for Payer: Amerigroup Medicare	$16.35
Rate for Payer: APIPA Medicare/Medicaid	$40.71
Rate for Payer: AZCH Complete Medicare	$16.35
Rate for Payer: Banner UC Health Medicare	$16.35
Rate for Payer: Bisbee Police All Plans	$28.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$74.12
Rate for Payer: Cash Price	$87.20
Rate for Payer: Cigna of AZ Commercial	$76.30
Rate for Payer: Copperpoint Commercial	$26.98
Rate for Payer: Health Net of AZ Commercial	$65.40
Rate for Payer: Health Net of AZ Medicare	$30.52
Rate for Payer: Humana of AZ Medicare	$16.35
Rate for Payer: Self Pay Self Pay	$87.20
Rate for Payer: TriWest Medicare	$16.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$63.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$19.62

DISPOSABLE PIN

Facility

IP

$218.00

Hospital Charge Code	24129901
Hospital Revenue Code	270
Min. Negotiated Rate	$56.68
Max. Negotiated Rate	$196.20
Rate for Payer: Aetna of AZ Commercial	$196.20
Rate for Payer: Bisbee Police All Plans	$56.68
Rate for Payer: Cash Price	$174.40
Rate for Payer: Self Pay Self Pay	$174.40

DISPOSABLE PIN

Facility

OP

$218.00

Hospital Charge Code	24129901
Hospital Revenue Code	270
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$196.20
Rate for Payer: Aetna of AZ Commercial	$196.20
Rate for Payer: Aetna of AZ Medicare	$61.04
Rate for Payer: Allwell Medicare	$32.70
Rate for Payer: Amerigroup Medicare	$32.70
Rate for Payer: APIPA Medicare/Medicaid	$81.42
Rate for Payer: AZCH Complete Medicare	$32.70
Rate for Payer: Banner UC Health Medicare	$32.70
Rate for Payer: Bisbee Police All Plans	$56.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$148.24
Rate for Payer: Cash Price	$174.40
Rate for Payer: Cigna of AZ Commercial	$152.60
Rate for Payer: Copperpoint Commercial	$53.96
Rate for Payer: Health Net of AZ Commercial	$130.80
Rate for Payer: Health Net of AZ Medicare	$61.04
Rate for Payer: Humana of AZ Medicare	$32.70
Rate for Payer: Self Pay Self Pay	$174.40
Rate for Payer: TriWest Medicare	$32.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$127.09
Rate for Payer: UnitedHealth Group of AZ Medicare	$39.24

DISP SOFT SNARE

Facility

IP

$49.00

Hospital Charge Code	22354920
Hospital Revenue Code	270
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$44.10
Rate for Payer: Aetna of AZ Commercial	$44.10
Rate for Payer: Bisbee Police All Plans	$12.74
Rate for Payer: Cash Price	$39.20
Rate for Payer: Self Pay Self Pay	$39.20

DISP SOFT SNARE

Facility

OP

$49.00

Hospital Charge Code	22354920
Hospital Revenue Code	270
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$44.10
Rate for Payer: Aetna of AZ Commercial	$44.10
Rate for Payer: Aetna of AZ Medicare	$13.72
Rate for Payer: Allwell Medicare	$7.35
Rate for Payer: Amerigroup Medicare	$7.35
Rate for Payer: APIPA Medicare/Medicaid	$18.30
Rate for Payer: AZCH Complete Medicare	$7.35
Rate for Payer: Banner UC Health Medicare	$7.35
Rate for Payer: Bisbee Police All Plans	$12.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$33.32
Rate for Payer: Cash Price	$39.20
Rate for Payer: Cigna of AZ Commercial	$34.30
Rate for Payer: Copperpoint Commercial	$12.13
Rate for Payer: Health Net of AZ Commercial	$29.40
Rate for Payer: Health Net of AZ Medicare	$13.72
Rate for Payer: Humana of AZ Medicare	$7.35
Rate for Payer: Self Pay Self Pay	$39.20
Rate for Payer: TriWest Medicare	$7.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$28.57
Rate for Payer: UnitedHealth Group of AZ Medicare	$8.82

divalproex sodium 125 mg DR Tablet[CQCH]

Facility

IP

$0.05

Service Code	NDC 62756079688
Hospital Charge Code	130345400
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Cash Price	$0.04
Rate for Payer: Self Pay Self Pay	$0.04

divalproex sodium 125 mg DR Tablet[CQCH]

Facility

OP

$0.05

Service Code	NDC 62756079688
Hospital Charge Code	130345400
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Aetna of AZ Medicare	$0.01
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.02
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.03
Rate for Payer: Cash Price	$0.04
Rate for Payer: Cigna of AZ Commercial	$0.03
Rate for Payer: Copperpoint Commercial	$0.01
Rate for Payer: Health Net of AZ Commercial	$0.03
Rate for Payer: Health Net of AZ Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Self Pay Self Pay	$0.04
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

divalproex sodium 250 mg Oral DR Tab [CQCH]

Facility

IP

$0.17

Service Code	NDC 68084077601
Hospital Charge Code	105919506
Hospital Revenue Code	251
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.15
Rate for Payer: Aetna of AZ Commercial	$0.15
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Cash Price	$0.14
Rate for Payer: Self Pay Self Pay	$0.14

divalproex sodium 250 mg Oral DR Tab [CQCH]

Facility

OP

$0.17

Service Code	NDC 68084077601
Hospital Charge Code	105919506
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.15
Rate for Payer: Aetna of AZ Commercial	$0.15
Rate for Payer: Aetna of AZ Medicare	$0.05
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.06
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.12
Rate for Payer: Cash Price	$0.14
Rate for Payer: Cigna of AZ Commercial	$0.11
Rate for Payer: Copperpoint Commercial	$0.04
Rate for Payer: Health Net of AZ Commercial	$0.10
Rate for Payer: Health Net of AZ Medicare	$0.05
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.14
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.03

Diverticulitis And Diverticulosis

Facility

IP

$13,498.44

Service Code	APR-DRG 2444
Hospital Charge Code	APRDRG2443
Min. Negotiated Rate	$13,498.44
Max. Negotiated Rate	$13,498.44
Rate for Payer: AHCCCS Medicaid	$13,498.44
Rate for Payer: Allwell Medicaid	$13,498.44
Rate for Payer: AZCH Complete Medicaid	$13,498.44
Rate for Payer: Banner UC Health Medicaid	$13,498.44
Rate for Payer: Mercy Care Medicaid	$13,498.44

<<
<
152
153
154
155
156
157
158
159
160
161
>
>>