Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Craniotomy For Multiple Significant Trauma

Facility

$22,777.26

Service Code	APR-DRG 9102
Hospital Charge Code	APRDRG9101
Min. Negotiated Rate	$22,777.26
Max. Negotiated Rate	$22,777.26
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,777.26
Rate for Payer: Mercy Care Medicaid	$22,777.26
Rate for Payer: NaphCare Correctional Healthcare	$22,777.26

Craniotomy For Multiple Significant Trauma

Facility

$22,777.26

Service Code	APR-DRG 9101
Hospital Charge Code	APRDRG9103
Min. Negotiated Rate	$22,777.26
Max. Negotiated Rate	$22,777.26
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,777.26
Rate for Payer: Mercy Care Medicaid	$22,777.26
Rate for Payer: NaphCare Correctional Healthcare	$22,777.26

Craniotomy For Multiple Significant Trauma

Facility

$22,777.26

Service Code	APR-DRG 9102
Hospital Charge Code	APRDRG9104
Min. Negotiated Rate	$22,777.26
Max. Negotiated Rate	$22,777.26
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,777.26
Rate for Payer: Mercy Care Medicaid	$22,777.26
Rate for Payer: NaphCare Correctional Healthcare	$22,777.26

Craniotomy For Multiple Significant Trauma

Facility

$50,111.52

Service Code	APR-DRG 9104
Hospital Charge Code	APRDRG9104
Min. Negotiated Rate	$50,111.52
Max. Negotiated Rate	$50,111.52
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$50,111.52
Rate for Payer: Mercy Care Medicaid	$50,111.52
Rate for Payer: NaphCare Correctional Healthcare	$50,111.52

CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$86,993.68

Service Code	MSDRG 955
Min. Negotiated Rate	$86,993.68
Max. Negotiated Rate	$86,993.68
Rate for Payer: Seven Corners Travel Insurance	$86,993.68

CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR

Facility

$74,059.20

Service Code	MSDRG 023
Min. Negotiated Rate	$74,059.20
Max. Negotiated Rate	$74,059.20
Rate for Payer: Seven Corners Travel Insurance	$74,059.20

CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC

Facility

$50,557.95

Service Code	MSDRG 024
Min. Negotiated Rate	$50,557.95
Max. Negotiated Rate	$50,557.95
Rate for Payer: Seven Corners Travel Insurance	$50,557.95

C-Reactive Protein

Facility

$157.00

Service Code	CPT 86141
Hospital Charge Code	633716
Hospital Revenue Code	302
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$141.30
Rate for Payer: Aetna of AZ Commercial	$141.30
Rate for Payer: Arizona Complete Health Allwell	$25.12
Rate for Payer: Banner UC Health Medicare	$25.12
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$106.76
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$25.12
Rate for Payer: Care1st Health Plan Arizona Medicare	$25.12
Rate for Payer: Cash Price	$125.60
Rate for Payer: Cash Price	$125.60
Rate for Payer: Cigna of AZ Commercial	$102.05
Rate for Payer: Devoted Health Medicare	$28.26
Rate for Payer: Humana of AZ Medicare	$25.12
Rate for Payer: Seven Corners Travel Insurance	$18.78
Rate for Payer: Southwest Service Administrators UFCW	$106.76
Rate for Payer: TriWest Medicare	$25.12
Rate for Payer: United Healthcare Commercial	$89.80
Rate for Payer: United Healthcare Medicare	$25.12
Rate for Payer: Veterans Affairs TRICARE	$24.87

C-Reactive Protein

Facility

$157.00

Service Code	CPT 86141
Hospital Charge Code	633716
Hospital Revenue Code	302
Min. Negotiated Rate	$141.30
Max. Negotiated Rate	$141.30
Rate for Payer: Aetna of AZ Commercial	$141.30
Rate for Payer: Cash Price	$125.60

C-Reactive Protein, Cardiac LC

Facility

$165.00

Service Code	CPT 86141
Hospital Charge Code	1285588
Hospital Revenue Code	302
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$148.50
Rate for Payer: Aetna of AZ Commercial	$148.50
Rate for Payer: Cash Price	$132.00

C-Reactive Protein, Cardiac LC

Facility

$165.00

Service Code	CPT 86141
Hospital Charge Code	1285588
Hospital Revenue Code	302
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$148.50
Rate for Payer: Aetna of AZ Commercial	$148.50
Rate for Payer: Arizona Complete Health Allwell	$26.40
Rate for Payer: Banner UC Health Medicare	$26.40
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$112.20
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$26.40
Rate for Payer: Care1st Health Plan Arizona Medicare	$26.40
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cigna of AZ Commercial	$107.25
Rate for Payer: Devoted Health Medicare	$29.70
Rate for Payer: Humana of AZ Medicare	$26.40
Rate for Payer: Seven Corners Travel Insurance	$18.78
Rate for Payer: Southwest Service Administrators UFCW	$112.20
Rate for Payer: TriWest Medicare	$26.40
Rate for Payer: United Healthcare Commercial	$94.38
Rate for Payer: United Healthcare Medicare	$26.40
Rate for Payer: Veterans Affairs TRICARE	$26.14

C-Reactive Protein, Quant LC

Facility

$116.00

Service Code	CPT 86140
Hospital Charge Code	1285587
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna of AZ Commercial	$104.40
Rate for Payer: Arizona Complete Health Allwell	$18.56
Rate for Payer: Banner UC Health Medicare	$18.56
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$78.88
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$18.56
Rate for Payer: Care1st Health Plan Arizona Medicare	$18.56
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cash Price	$92.80
Rate for Payer: Cigna of AZ Commercial	$75.40
Rate for Payer: Devoted Health Medicare	$20.88
Rate for Payer: Humana of AZ Medicare	$18.56
Rate for Payer: Seven Corners Travel Insurance	$7.51
Rate for Payer: Southwest Service Administrators UFCW	$78.88
Rate for Payer: TriWest Medicare	$18.56
Rate for Payer: United Healthcare Commercial	$66.35
Rate for Payer: United Healthcare Medicare	$18.56
Rate for Payer: Veterans Affairs TRICARE	$18.37

C-Reactive Protein, Quant LC

Facility

$116.00

Service Code	CPT 86140
Hospital Charge Code	1285587
Hospital Revenue Code	302
Min. Negotiated Rate	$104.40
Max. Negotiated Rate	$104.40
Rate for Payer: Aetna of AZ Commercial	$104.40
Rate for Payer: Cash Price	$92.80

C-REACT PROT CARDIAC

Facility

$173.00

Service Code	CPT 86141
Hospital Charge Code	22334831
Hospital Revenue Code	302
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$155.70
Rate for Payer: Aetna of AZ Commercial	$155.70
Rate for Payer: Cash Price	$138.40

C-REACT PROT CARDIAC

Facility

$173.00

Service Code	CPT 86141
Hospital Charge Code	22334831
Hospital Revenue Code	302
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$155.70
Rate for Payer: Aetna of AZ Commercial	$155.70
Rate for Payer: Arizona Complete Health Allwell	$27.68
Rate for Payer: Banner UC Health Medicare	$27.68
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$117.64
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$27.68
Rate for Payer: Care1st Health Plan Arizona Medicare	$27.68
Rate for Payer: Cash Price	$138.40
Rate for Payer: Cash Price	$138.40
Rate for Payer: Cigna of AZ Commercial	$112.45
Rate for Payer: Devoted Health Medicare	$31.14
Rate for Payer: Humana of AZ Medicare	$27.68
Rate for Payer: Seven Corners Travel Insurance	$18.78
Rate for Payer: Southwest Service Administrators UFCW	$117.64
Rate for Payer: TriWest Medicare	$27.68
Rate for Payer: United Healthcare Commercial	$98.96
Rate for Payer: United Healthcare Medicare	$27.68
Rate for Payer: Veterans Affairs TRICARE	$27.40

CREAM SPECIAL CARE

Facility

$29.00

Hospital Charge Code	22355370
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$26.10
Rate for Payer: Aetna of AZ Commercial	$26.10
Rate for Payer: Arizona Complete Health Allwell	$4.64
Rate for Payer: Banner UC Health Medicare	$4.64
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$19.72
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$4.64
Rate for Payer: Care1st Health Plan Arizona Medicare	$4.64
Rate for Payer: Cash Price	$23.20
Rate for Payer: Cigna of AZ Commercial	$20.30
Rate for Payer: Devoted Health Medicare	$5.22
Rate for Payer: Humana of AZ Medicare	$4.64
Rate for Payer: Southwest Service Administrators UFCW	$19.72
Rate for Payer: TriWest Medicare	$4.64
Rate for Payer: United Healthcare Commercial	$16.59
Rate for Payer: United Healthcare Medicare	$4.64
Rate for Payer: Veterans Affairs TRICARE	$4.59

CREAM SPECIAL CARE

Facility

$29.00

Hospital Charge Code	22355370
Hospital Revenue Code	270
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Aetna of AZ Commercial	$26.10
Rate for Payer: Cash Price	$23.20

Creatine, 24-Hour Urine LC

Facility

$159.00

Service Code	CPT 82575
Hospital Charge Code	22311189
Hospital Revenue Code	301
Min. Negotiated Rate	$13.72
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Arizona Complete Health Allwell	$25.44
Rate for Payer: Banner UC Health Medicare	$25.44
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$108.12
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$25.44
Rate for Payer: Care1st Health Plan Arizona Medicare	$25.44
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: Devoted Health Medicare	$28.62
Rate for Payer: Humana of AZ Medicare	$25.44
Rate for Payer: Seven Corners Travel Insurance	$13.72
Rate for Payer: Southwest Service Administrators UFCW	$108.12
Rate for Payer: TriWest Medicare	$25.44
Rate for Payer: United Healthcare Commercial	$90.95
Rate for Payer: United Healthcare Medicare	$25.44
Rate for Payer: Veterans Affairs TRICARE	$25.19

Creatine, 24-Hour Urine LC

Facility

$159.00

Service Code	CPT 82575
Hospital Charge Code	22311189
Hospital Revenue Code	301
Min. Negotiated Rate	$143.10
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Cash Price	$127.20

Creatine Kinase

Facility

$78.00

Service Code	CPT 82550
Hospital Charge Code	633712
Hospital Revenue Code	301
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$70.20
Rate for Payer: Aetna of AZ Commercial	$70.20
Rate for Payer: Arizona Complete Health Allwell	$12.48
Rate for Payer: Banner UC Health Medicare	$12.48
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$53.04
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$12.48
Rate for Payer: Care1st Health Plan Arizona Medicare	$12.48
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cigna of AZ Commercial	$50.70
Rate for Payer: Devoted Health Medicare	$14.04
Rate for Payer: Humana of AZ Medicare	$12.48
Rate for Payer: Seven Corners Travel Insurance	$9.44
Rate for Payer: Southwest Service Administrators UFCW	$53.04
Rate for Payer: TriWest Medicare	$12.48
Rate for Payer: United Healthcare Commercial	$44.62
Rate for Payer: United Healthcare Medicare	$12.48
Rate for Payer: Veterans Affairs TRICARE	$12.36

Creatine Kinase

Facility

$78.00

Service Code	CPT 82550
Hospital Charge Code	633712
Hospital Revenue Code	301
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$70.20
Rate for Payer: Aetna of AZ Commercial	$70.20
Rate for Payer: Cash Price	$62.40

Creatine Kinase-MB

Facility

$308.00

Service Code	CPT 82553
Hospital Charge Code	785969
Hospital Revenue Code	301
Min. Negotiated Rate	$277.20
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Cash Price	$246.40

Creatine Kinase-MB

Facility

$308.00

Service Code	CPT 82553
Hospital Charge Code	785969
Hospital Revenue Code	301
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Arizona Complete Health Allwell	$49.28
Rate for Payer: Banner UC Health Medicare	$49.28
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$209.44
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$49.28
Rate for Payer: Care1st Health Plan Arizona Medicare	$49.28
Rate for Payer: Cash Price	$246.40
Rate for Payer: Cash Price	$246.40
Rate for Payer: Cigna of AZ Commercial	$200.20
Rate for Payer: Devoted Health Medicare	$55.44
Rate for Payer: Humana of AZ Medicare	$49.28
Rate for Payer: Seven Corners Travel Insurance	$16.75
Rate for Payer: Southwest Service Administrators UFCW	$209.44
Rate for Payer: TriWest Medicare	$49.28
Rate for Payer: United Healthcare Commercial	$176.18
Rate for Payer: United Healthcare Medicare	$49.28
Rate for Payer: Veterans Affairs TRICARE	$48.79

Creatinine

Facility

$76.00

Service Code	CPT 82565
Hospital Charge Code	633606
Hospital Revenue Code	301
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Cash Price	$60.80

Creatinine

Facility

$80.00

Service Code	CPT 82565
Hospital Charge Code	22525233
Hospital Revenue Code	301
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Cash Price	$64.00

Know your out-of-pocket cost for care.

All Charges