Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

EACH ADDITIONAL HOUR

Facility

OP

$97.00

Service Code	CPT 96361
Hospital Charge Code	22247980
Hospital Revenue Code	260
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Aetna of AZ Medicare	$27.16
Rate for Payer: AHCCCS Medicaid	$58.00
Rate for Payer: Allwell Medicaid	$58.00
Rate for Payer: Allwell Medicare	$14.55
Rate for Payer: Amerigroup Medicare	$14.55
Rate for Payer: APIPA Medicare/Medicaid	$36.23
Rate for Payer: AZCH Complete Medicaid	$58.00
Rate for Payer: AZCH Complete Medicare	$14.55
Rate for Payer: Banner UC Health Medicaid	$58.00
Rate for Payer: Banner UC Health Medicare	$14.55
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$65.96
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cigna of AZ Commercial	$67.90
Rate for Payer: Copperpoint Commercial	$24.01
Rate for Payer: Health Net of AZ Commercial	$58.20
Rate for Payer: Health Net of AZ Medicare	$27.16
Rate for Payer: Humana of AZ Medicare	$14.55
Rate for Payer: Mercy Care Medicaid	$58.00
Rate for Payer: Self Pay Self Pay	$77.60
Rate for Payer: TriWest Medicare	$14.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$56.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$17.46

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$5,968.21

Service Code	APR-DRG 1102
Hospital Charge Code	APRDRG1103
Min. Negotiated Rate	$5,968.21
Max. Negotiated Rate	$5,968.21
Rate for Payer: AHCCCS Medicaid	$5,968.21
Rate for Payer: Allwell Medicaid	$5,968.21
Rate for Payer: AZCH Complete Medicaid	$5,968.21
Rate for Payer: Banner UC Health Medicaid	$5,968.21
Rate for Payer: Mercy Care Medicaid	$5,968.21

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$4,909.80

Service Code	APR-DRG 1101
Hospital Charge Code	APRDRG1102
Min. Negotiated Rate	$4,909.80
Max. Negotiated Rate	$4,909.80
Rate for Payer: AHCCCS Medicaid	$4,909.80
Rate for Payer: Allwell Medicaid	$4,909.80
Rate for Payer: AZCH Complete Medicaid	$4,909.80
Rate for Payer: Banner UC Health Medicaid	$4,909.80
Rate for Payer: Mercy Care Medicaid	$4,909.80

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$9,130.12

Service Code	APR-DRG 1103
Hospital Charge Code	APRDRG1104
Min. Negotiated Rate	$9,130.12
Max. Negotiated Rate	$9,130.12
Rate for Payer: AHCCCS Medicaid	$9,130.12
Rate for Payer: Allwell Medicaid	$9,130.12
Rate for Payer: AZCH Complete Medicaid	$9,130.12
Rate for Payer: Banner UC Health Medicaid	$9,130.12
Rate for Payer: Mercy Care Medicaid	$9,130.12

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$5,968.21

Service Code	APR-DRG 1102
Hospital Charge Code	APRDRG1101
Min. Negotiated Rate	$5,968.21
Max. Negotiated Rate	$5,968.21
Rate for Payer: AHCCCS Medicaid	$5,968.21
Rate for Payer: Allwell Medicaid	$5,968.21
Rate for Payer: AZCH Complete Medicaid	$5,968.21
Rate for Payer: Banner UC Health Medicaid	$5,968.21
Rate for Payer: Mercy Care Medicaid	$5,968.21

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$15,546.53

Service Code	APR-DRG 1104
Hospital Charge Code	APRDRG1101
Min. Negotiated Rate	$15,546.53
Max. Negotiated Rate	$15,546.53
Rate for Payer: AHCCCS Medicaid	$15,546.53
Rate for Payer: Allwell Medicaid	$15,546.53
Rate for Payer: AZCH Complete Medicaid	$15,546.53
Rate for Payer: Banner UC Health Medicaid	$15,546.53
Rate for Payer: Mercy Care Medicaid	$15,546.53

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$15,546.53

Service Code	APR-DRG 1104
Hospital Charge Code	APRDRG1104
Min. Negotiated Rate	$15,546.53
Max. Negotiated Rate	$15,546.53
Rate for Payer: AHCCCS Medicaid	$15,546.53
Rate for Payer: Allwell Medicaid	$15,546.53
Rate for Payer: AZCH Complete Medicaid	$15,546.53
Rate for Payer: Banner UC Health Medicaid	$15,546.53
Rate for Payer: Mercy Care Medicaid	$15,546.53

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$9,130.12

Service Code	APR-DRG 1103
Hospital Charge Code	APRDRG1102
Min. Negotiated Rate	$9,130.12
Max. Negotiated Rate	$9,130.12
Rate for Payer: AHCCCS Medicaid	$9,130.12
Rate for Payer: Allwell Medicaid	$9,130.12
Rate for Payer: AZCH Complete Medicaid	$9,130.12
Rate for Payer: Banner UC Health Medicaid	$9,130.12
Rate for Payer: Mercy Care Medicaid	$9,130.12

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$15,546.53

Service Code	APR-DRG 1104
Hospital Charge Code	APRDRG1102
Min. Negotiated Rate	$15,546.53
Max. Negotiated Rate	$15,546.53
Rate for Payer: AHCCCS Medicaid	$15,546.53
Rate for Payer: Allwell Medicaid	$15,546.53
Rate for Payer: AZCH Complete Medicaid	$15,546.53
Rate for Payer: Banner UC Health Medicaid	$15,546.53
Rate for Payer: Mercy Care Medicaid	$15,546.53

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$4,909.80

Service Code	APR-DRG 1101
Hospital Charge Code	APRDRG1103
Min. Negotiated Rate	$4,909.80
Max. Negotiated Rate	$4,909.80
Rate for Payer: AHCCCS Medicaid	$4,909.80
Rate for Payer: Allwell Medicaid	$4,909.80
Rate for Payer: AZCH Complete Medicaid	$4,909.80
Rate for Payer: Banner UC Health Medicaid	$4,909.80
Rate for Payer: Mercy Care Medicaid	$4,909.80

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$9,130.12

Service Code	APR-DRG 1103
Hospital Charge Code	APRDRG1101
Min. Negotiated Rate	$9,130.12
Max. Negotiated Rate	$9,130.12
Rate for Payer: AHCCCS Medicaid	$9,130.12
Rate for Payer: Allwell Medicaid	$9,130.12
Rate for Payer: AZCH Complete Medicaid	$9,130.12
Rate for Payer: Banner UC Health Medicaid	$9,130.12
Rate for Payer: Mercy Care Medicaid	$9,130.12

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$15,546.53

Service Code	APR-DRG 1104
Hospital Charge Code	APRDRG1103
Min. Negotiated Rate	$15,546.53
Max. Negotiated Rate	$15,546.53
Rate for Payer: AHCCCS Medicaid	$15,546.53
Rate for Payer: Allwell Medicaid	$15,546.53
Rate for Payer: AZCH Complete Medicaid	$15,546.53
Rate for Payer: Banner UC Health Medicaid	$15,546.53
Rate for Payer: Mercy Care Medicaid	$15,546.53

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$4,909.80

Service Code	APR-DRG 1101
Hospital Charge Code	APRDRG1104
Min. Negotiated Rate	$4,909.80
Max. Negotiated Rate	$4,909.80
Rate for Payer: AHCCCS Medicaid	$4,909.80
Rate for Payer: Allwell Medicaid	$4,909.80
Rate for Payer: AZCH Complete Medicaid	$4,909.80
Rate for Payer: Banner UC Health Medicaid	$4,909.80
Rate for Payer: Mercy Care Medicaid	$4,909.80

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$5,968.21

Service Code	APR-DRG 1102
Hospital Charge Code	APRDRG1104
Min. Negotiated Rate	$5,968.21
Max. Negotiated Rate	$5,968.21
Rate for Payer: AHCCCS Medicaid	$5,968.21
Rate for Payer: Allwell Medicaid	$5,968.21
Rate for Payer: AZCH Complete Medicaid	$5,968.21
Rate for Payer: Banner UC Health Medicaid	$5,968.21
Rate for Payer: Mercy Care Medicaid	$5,968.21

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$4,909.80

Service Code	APR-DRG 1101
Hospital Charge Code	APRDRG1101
Min. Negotiated Rate	$4,909.80
Max. Negotiated Rate	$4,909.80
Rate for Payer: AHCCCS Medicaid	$4,909.80
Rate for Payer: Allwell Medicaid	$4,909.80
Rate for Payer: AZCH Complete Medicaid	$4,909.80
Rate for Payer: Banner UC Health Medicaid	$4,909.80
Rate for Payer: Mercy Care Medicaid	$4,909.80

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$5,968.21

Service Code	APR-DRG 1102
Hospital Charge Code	APRDRG1102
Min. Negotiated Rate	$5,968.21
Max. Negotiated Rate	$5,968.21
Rate for Payer: AHCCCS Medicaid	$5,968.21
Rate for Payer: Allwell Medicaid	$5,968.21
Rate for Payer: AZCH Complete Medicaid	$5,968.21
Rate for Payer: Banner UC Health Medicaid	$5,968.21
Rate for Payer: Mercy Care Medicaid	$5,968.21

Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies

Facility

IP

$9,130.12

Service Code	APR-DRG 1103
Hospital Charge Code	APRDRG1103
Min. Negotiated Rate	$9,130.12
Max. Negotiated Rate	$9,130.12
Rate for Payer: AHCCCS Medicaid	$9,130.12
Rate for Payer: Allwell Medicaid	$9,130.12
Rate for Payer: AZCH Complete Medicaid	$9,130.12
Rate for Payer: Banner UC Health Medicaid	$9,130.12
Rate for Payer: Mercy Care Medicaid	$9,130.12

Eating Disorders

Facility

IP

$28,590.47

Service Code	APR-DRG 7594
Hospital Charge Code	APRDRG7592
Min. Negotiated Rate	$28,590.47
Max. Negotiated Rate	$28,590.47
Rate for Payer: AHCCCS Medicaid	$28,590.47
Rate for Payer: Allwell Medicaid	$28,590.47
Rate for Payer: AZCH Complete Medicaid	$28,590.47
Rate for Payer: Banner UC Health Medicaid	$28,590.47
Rate for Payer: Mercy Care Medicaid	$28,590.47

Eating Disorders

Facility

IP

$8,143.96

Service Code	APR-DRG 7592
Hospital Charge Code	APRDRG7594
Min. Negotiated Rate	$8,143.96
Max. Negotiated Rate	$8,143.96
Rate for Payer: AHCCCS Medicaid	$8,143.96
Rate for Payer: Allwell Medicaid	$8,143.96
Rate for Payer: AZCH Complete Medicaid	$8,143.96
Rate for Payer: Banner UC Health Medicaid	$8,143.96
Rate for Payer: Mercy Care Medicaid	$8,143.96

Eating Disorders

Facility

IP

$7,972.81

Service Code	APR-DRG 7591
Hospital Charge Code	APRDRG7594
Min. Negotiated Rate	$7,972.81
Max. Negotiated Rate	$7,972.81
Rate for Payer: AHCCCS Medicaid	$7,972.81
Rate for Payer: Allwell Medicaid	$7,972.81
Rate for Payer: AZCH Complete Medicaid	$7,972.81
Rate for Payer: Banner UC Health Medicaid	$7,972.81
Rate for Payer: Mercy Care Medicaid	$7,972.81

Eating Disorders

Facility

IP

$11,545.04

Service Code	APR-DRG 7593
Hospital Charge Code	APRDRG7594
Min. Negotiated Rate	$11,545.04
Max. Negotiated Rate	$11,545.04
Rate for Payer: AHCCCS Medicaid	$11,545.04
Rate for Payer: Allwell Medicaid	$11,545.04
Rate for Payer: AZCH Complete Medicaid	$11,545.04
Rate for Payer: Banner UC Health Medicaid	$11,545.04
Rate for Payer: Mercy Care Medicaid	$11,545.04

Eating Disorders

Facility

IP

$7,972.81

Service Code	APR-DRG 7591
Hospital Charge Code	APRDRG7591
Min. Negotiated Rate	$7,972.81
Max. Negotiated Rate	$7,972.81
Rate for Payer: AHCCCS Medicaid	$7,972.81
Rate for Payer: Allwell Medicaid	$7,972.81
Rate for Payer: AZCH Complete Medicaid	$7,972.81
Rate for Payer: Banner UC Health Medicaid	$7,972.81
Rate for Payer: Mercy Care Medicaid	$7,972.81

Eating Disorders

Facility

IP

$7,972.81

Service Code	APR-DRG 7591
Hospital Charge Code	APRDRG7593
Min. Negotiated Rate	$7,972.81
Max. Negotiated Rate	$7,972.81
Rate for Payer: AHCCCS Medicaid	$7,972.81
Rate for Payer: Allwell Medicaid	$7,972.81
Rate for Payer: AZCH Complete Medicaid	$7,972.81
Rate for Payer: Banner UC Health Medicaid	$7,972.81
Rate for Payer: Mercy Care Medicaid	$7,972.81

Eating Disorders

Facility

IP

$28,590.47

Service Code	APR-DRG 7594
Hospital Charge Code	APRDRG7594
Min. Negotiated Rate	$28,590.47
Max. Negotiated Rate	$28,590.47
Rate for Payer: AHCCCS Medicaid	$28,590.47
Rate for Payer: Allwell Medicaid	$28,590.47
Rate for Payer: AZCH Complete Medicaid	$28,590.47
Rate for Payer: Banner UC Health Medicaid	$28,590.47
Rate for Payer: Mercy Care Medicaid	$28,590.47

Eating Disorders

Facility

IP

$11,545.04

Service Code	APR-DRG 7593
Hospital Charge Code	APRDRG7591
Min. Negotiated Rate	$11,545.04
Max. Negotiated Rate	$11,545.04
Rate for Payer: AHCCCS Medicaid	$11,545.04
Rate for Payer: Allwell Medicaid	$11,545.04
Rate for Payer: AZCH Complete Medicaid	$11,545.04
Rate for Payer: Banner UC Health Medicaid	$11,545.04
Rate for Payer: Mercy Care Medicaid	$11,545.04

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