Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

enoxaparin 80 mg/0.8 mL SC [CQCH]

Facility

$5.63

Service Code	HCPCS J1650
Hospital Charge Code	105920432
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna of AZ Commercial	$5.07
Rate for Payer: Bisbee Police All Plans	$1.46
Rate for Payer: Cash Price	$4.50
Rate for Payer: Self Pay Self Pay	$4.50

enoxaparin 80 mg/0.8 mL SC [CQCH]

Facility

$5.63

Service Code	HCPCS J1650
Hospital Charge Code	105920432
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna of AZ Commercial	$5.07
Rate for Payer: Aetna of AZ Medicare	$1.58
Rate for Payer: Allwell Medicare	$0.90
Rate for Payer: Amerigroup Medicare	$0.90
Rate for Payer: APIPA Medicare/Medicaid	$2.10
Rate for Payer: AZCH Complete Medicare	$0.90
Rate for Payer: Banner UC Health Medicare	$0.90
Rate for Payer: Bisbee Police All Plans	$1.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3.83
Rate for Payer: Cash Price	$4.50
Rate for Payer: Cigna of AZ Commercial	$3.66
Rate for Payer: Copperpoint Commercial	$1.39
Rate for Payer: Health Net of AZ Commercial	$3.38
Rate for Payer: Health Net of AZ Medicare	$1.58
Rate for Payer: Humana of AZ Medicare	$0.90
Rate for Payer: Self Pay Self Pay	$4.50
Rate for Payer: TriWest Medicare	$0.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$3.28
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.01

ENSIZOR ENDOSCOPIC SCISSORS 235CM

Facility

$2,348.00

Hospital Charge Code	27758288
Hospital Revenue Code	270
Min. Negotiated Rate	$375.68
Max. Negotiated Rate	$2,113.20
Rate for Payer: Aetna of AZ Commercial	$2,113.20
Rate for Payer: Aetna of AZ Medicare	$657.44
Rate for Payer: Allwell Medicare	$375.68
Rate for Payer: Amerigroup Medicare	$375.68
Rate for Payer: APIPA Medicare/Medicaid	$876.98
Rate for Payer: AZCH Complete Medicare	$375.68
Rate for Payer: Banner UC Health Medicare	$375.68
Rate for Payer: Bisbee Police All Plans	$610.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,596.64
Rate for Payer: Cash Price	$1,878.40
Rate for Payer: Cigna of AZ Commercial	$1,643.60
Rate for Payer: Copperpoint Commercial	$581.13
Rate for Payer: Health Net of AZ Commercial	$1,408.80
Rate for Payer: Health Net of AZ Medicare	$657.44
Rate for Payer: Humana of AZ Medicare	$375.68
Rate for Payer: Self Pay Self Pay	$1,878.40
Rate for Payer: TriWest Medicare	$375.68
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,368.88
Rate for Payer: UnitedHealth Group of AZ Medicare	$422.64

ENSIZOR ENDOSCOPIC SCISSORS 235CM

Facility

$2,348.00

Hospital Charge Code	27758288
Hospital Revenue Code	270
Min. Negotiated Rate	$610.48
Max. Negotiated Rate	$2,113.20
Rate for Payer: Aetna of AZ Commercial	$2,113.20
Rate for Payer: Bisbee Police All Plans	$610.48
Rate for Payer: Cash Price	$1,878.40
Rate for Payer: Self Pay Self Pay	$1,878.40

entacapone 200 mg Tab [CQCH]

Facility

$2.42

Service Code	NDC 51079027303
Hospital Charge Code	105920659
Hospital Revenue Code	251
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$2.18
Rate for Payer: Aetna of AZ Commercial	$2.18
Rate for Payer: Aetna of AZ Medicare	$0.68
Rate for Payer: Allwell Medicare	$0.39
Rate for Payer: Amerigroup Medicare	$0.39
Rate for Payer: APIPA Medicare/Medicaid	$0.90
Rate for Payer: AZCH Complete Medicare	$0.39
Rate for Payer: Banner UC Health Medicare	$0.39
Rate for Payer: Bisbee Police All Plans	$0.63
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1.65
Rate for Payer: Cash Price	$1.94
Rate for Payer: Cigna of AZ Commercial	$1.57
Rate for Payer: Copperpoint Commercial	$0.60
Rate for Payer: Health Net of AZ Commercial	$1.45
Rate for Payer: Health Net of AZ Medicare	$0.68
Rate for Payer: Humana of AZ Medicare	$0.39
Rate for Payer: Self Pay Self Pay	$1.94
Rate for Payer: TriWest Medicare	$0.39
Rate for Payer: UnitedHealth Group of AZ Commercial	$1.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.44

entacapone 200 mg Tab [CQCH]

Facility

$2.42

Service Code	NDC 51079027303
Hospital Charge Code	105920659
Hospital Revenue Code	251
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$2.18
Rate for Payer: Aetna of AZ Commercial	$2.18
Rate for Payer: Bisbee Police All Plans	$0.63
Rate for Payer: Cash Price	$1.94
Rate for Payer: Self Pay Self Pay	$1.94

Enterocele Repair vaginal

Facility

$2,615.00

Service Code	CPT 57268
Hospital Charge Code	27267822
Hospital Revenue Code	360
Min. Negotiated Rate	$679.90
Max. Negotiated Rate	$2,353.50
Rate for Payer: Aetna of AZ Commercial	$2,353.50
Rate for Payer: Bisbee Police All Plans	$679.90
Rate for Payer: Cash Price	$2,092.00
Rate for Payer: Self Pay Self Pay	$2,092.00

Enterocele Repair vaginal

Facility

$2,615.00

Service Code	CPT 57268
Hospital Charge Code	27267822
Hospital Revenue Code	360
Min. Negotiated Rate	$418.40
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$2,353.50
Rate for Payer: Aetna of AZ Medicare	$732.20
Rate for Payer: AHCCCS Medicaid	$3,196.92
Rate for Payer: Allwell Medicaid	$3,196.92
Rate for Payer: Allwell Medicare	$418.40
Rate for Payer: Amerigroup Medicare	$418.40
Rate for Payer: APIPA Medicare/Medicaid	$976.70
Rate for Payer: AZCH Complete Medicaid	$3,196.92
Rate for Payer: AZCH Complete Medicare	$418.40
Rate for Payer: Banner UC Health Medicaid	$3,196.92
Rate for Payer: Banner UC Health Medicare	$418.40
Rate for Payer: Bisbee Police All Plans	$679.90
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,778.20
Rate for Payer: Cash Price	$2,092.00
Rate for Payer: Cash Price	$2,092.00
Rate for Payer: Cigna of AZ Commercial	$1,307.50
Rate for Payer: Copperpoint Commercial	$647.21
Rate for Payer: Health Net of AZ Commercial	$1,569.00
Rate for Payer: Health Net of AZ Medicare	$732.20
Rate for Payer: Humana of AZ Medicare	$418.40
Rate for Payer: Mercy Care Medicaid	$3,196.92
Rate for Payer: Self Pay Self Pay	$2,092.00
Rate for Payer: TriWest Medicare	$418.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$470.70

ENTEROSCOPY SMALL BOWEL

Facility

$6,347.00

Service Code	CPT 44366
Hospital Charge Code	23598976
Hospital Revenue Code	750
Min. Negotiated Rate	$1,015.52
Max. Negotiated Rate	$5,712.30
Rate for Payer: Aetna of AZ Commercial	$5,712.30
Rate for Payer: Aetna of AZ Medicare	$1,777.16
Rate for Payer: AHCCCS Medicaid	$1,178.14
Rate for Payer: Allwell Medicaid	$1,178.14
Rate for Payer: Allwell Medicare	$1,015.52
Rate for Payer: Amerigroup Medicare	$1,015.52
Rate for Payer: APIPA Medicare/Medicaid	$2,370.60
Rate for Payer: AZCH Complete Medicaid	$1,178.14
Rate for Payer: AZCH Complete Medicare	$1,015.52
Rate for Payer: Banner UC Health Medicaid	$1,178.14
Rate for Payer: Banner UC Health Medicare	$1,015.52
Rate for Payer: Bisbee Police All Plans	$1,650.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$4,315.96
Rate for Payer: Cash Price	$5,077.60
Rate for Payer: Cash Price	$5,077.60
Rate for Payer: Cigna of AZ Commercial	$4,442.90
Rate for Payer: Copperpoint Commercial	$1,570.88
Rate for Payer: Health Net of AZ Commercial	$3,808.20
Rate for Payer: Health Net of AZ Medicare	$1,777.16
Rate for Payer: Humana of AZ Medicare	$1,015.52
Rate for Payer: Mercy Care Medicaid	$1,178.14
Rate for Payer: Self Pay Self Pay	$5,077.60
Rate for Payer: TriWest Medicare	$1,015.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$1,142.46

ENTEROSCOPY SMALL BOWEL

Facility

$6,347.00

Service Code	CPT 44366
Hospital Charge Code	23598976
Hospital Revenue Code	750
Min. Negotiated Rate	$1,650.22
Max. Negotiated Rate	$5,712.30
Rate for Payer: Aetna of AZ Commercial	$5,712.30
Rate for Payer: Bisbee Police All Plans	$1,650.22
Rate for Payer: Cash Price	$5,077.60
Rate for Payer: Self Pay Self Pay	$5,077.60

Eosinophil Count- Nasal

Facility

$92.00

Service Code	CPT 89190
Hospital Charge Code	22360630
Hospital Revenue Code	305
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

Eosinophil Count- Nasal

Facility

$92.00

Service Code	CPT 89190
Hospital Charge Code	22360630
Hospital Revenue Code	305
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

ePHEDrine 50 mg/mL Inj Sol [CQCH]

Facility

$16.30

Service Code	NDC 17478051500
Hospital Charge Code	105920724
Hospital Revenue Code	251
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$14.67
Rate for Payer: Aetna of AZ Commercial	$14.67
Rate for Payer: Aetna of AZ Medicare	$4.56
Rate for Payer: Allwell Medicare	$2.61
Rate for Payer: Amerigroup Medicare	$2.61
Rate for Payer: APIPA Medicare/Medicaid	$6.09
Rate for Payer: AZCH Complete Medicare	$2.61
Rate for Payer: Banner UC Health Medicare	$2.61
Rate for Payer: Bisbee Police All Plans	$4.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$11.08
Rate for Payer: Cash Price	$13.04
Rate for Payer: Cigna of AZ Commercial	$10.60
Rate for Payer: Copperpoint Commercial	$4.03
Rate for Payer: Health Net of AZ Commercial	$9.78
Rate for Payer: Health Net of AZ Medicare	$4.56
Rate for Payer: Humana of AZ Medicare	$2.61
Rate for Payer: Self Pay Self Pay	$13.04
Rate for Payer: TriWest Medicare	$2.61
Rate for Payer: UnitedHealth Group of AZ Commercial	$9.50
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.93

ePHEDrine 50 mg/mL Inj Sol [CQCH]

Facility

$16.30

Service Code	NDC 17478051500
Hospital Charge Code	105920724
Hospital Revenue Code	251
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$14.67
Rate for Payer: Aetna of AZ Commercial	$14.67
Rate for Payer: Bisbee Police All Plans	$4.24
Rate for Payer: Cash Price	$13.04
Rate for Payer: Self Pay Self Pay	$13.04

EPICORD EXPANDABLE 2X3CM

Facility

$1,789.28

Service Code	CPT Q4187
Hospital Charge Code	24403651
Hospital Revenue Code	636
Min. Negotiated Rate	$465.21
Max. Negotiated Rate	$1,610.35
Rate for Payer: Aetna of AZ Commercial	$1,610.35
Rate for Payer: Bisbee Police All Plans	$465.21
Rate for Payer: Cash Price	$1,431.42
Rate for Payer: Self Pay Self Pay	$1,431.42

EPICORD EXPANDABLE 2X3CM

Facility

$1,789.28

Service Code	CPT Q4187
Hospital Charge Code	24403651
Hospital Revenue Code	636
Min. Negotiated Rate	$286.28
Max. Negotiated Rate	$1,610.35
Rate for Payer: Aetna of AZ Commercial	$1,610.35
Rate for Payer: Aetna of AZ Medicare	$501.00
Rate for Payer: Allwell Medicare	$286.28
Rate for Payer: Amerigroup Medicare	$286.28
Rate for Payer: APIPA Medicare/Medicaid	$668.30
Rate for Payer: AZCH Complete Medicare	$286.28
Rate for Payer: Banner UC Health Medicare	$286.28
Rate for Payer: Bisbee Police All Plans	$465.21
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,216.71
Rate for Payer: Cash Price	$1,431.42
Rate for Payer: Cigna of AZ Commercial	$1,252.50
Rate for Payer: Copperpoint Commercial	$442.85
Rate for Payer: Health Net of AZ Commercial	$1,073.57
Rate for Payer: Health Net of AZ Medicare	$501.00
Rate for Payer: Humana of AZ Medicare	$286.28
Rate for Payer: Self Pay Self Pay	$1,431.42
Rate for Payer: TriWest Medicare	$286.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,043.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$322.07

Epidural Blood Patch

Facility

$309.00

Hospital Charge Code	9310198
Hospital Revenue Code	360
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$278.10
Rate for Payer: Aetna of AZ Commercial	$278.10
Rate for Payer: Bisbee Police All Plans	$80.34
Rate for Payer: Cash Price	$247.20
Rate for Payer: Self Pay Self Pay	$247.20

Epidural Blood Patch

Facility

$309.00

Hospital Charge Code	9310198
Hospital Revenue Code	360
Min. Negotiated Rate	$49.44
Max. Negotiated Rate	$278.10
Rate for Payer: Aetna of AZ Commercial	$278.10
Rate for Payer: Aetna of AZ Medicare	$86.52
Rate for Payer: Allwell Medicare	$49.44
Rate for Payer: Amerigroup Medicare	$49.44
Rate for Payer: APIPA Medicare/Medicaid	$115.41
Rate for Payer: AZCH Complete Medicare	$49.44
Rate for Payer: Banner UC Health Medicare	$49.44
Rate for Payer: Bisbee Police All Plans	$80.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$210.12
Rate for Payer: Cash Price	$247.20
Rate for Payer: Cigna of AZ Commercial	$154.50
Rate for Payer: Copperpoint Commercial	$76.48
Rate for Payer: Health Net of AZ Commercial	$185.40
Rate for Payer: Health Net of AZ Medicare	$86.52
Rate for Payer: Humana of AZ Medicare	$49.44
Rate for Payer: Self Pay Self Pay	$247.20
Rate for Payer: TriWest Medicare	$49.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$180.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$55.62

EPIEFFECT 2CMX3CM

Facility

$4,240.00

Service Code	CPT Q4278
Hospital Charge Code	27651348
Hospital Revenue Code	636
Min. Negotiated Rate	$678.40
Max. Negotiated Rate	$3,816.00
Rate for Payer: Aetna of AZ Commercial	$3,816.00
Rate for Payer: Aetna of AZ Medicare	$1,187.20
Rate for Payer: Allwell Medicare	$678.40
Rate for Payer: Amerigroup Medicare	$678.40
Rate for Payer: APIPA Medicare/Medicaid	$1,583.64
Rate for Payer: AZCH Complete Medicare	$678.40
Rate for Payer: Banner UC Health Medicare	$678.40
Rate for Payer: Bisbee Police All Plans	$1,102.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,883.20
Rate for Payer: Cash Price	$3,392.00
Rate for Payer: Cigna of AZ Commercial	$2,968.00
Rate for Payer: Copperpoint Commercial	$1,049.40
Rate for Payer: Health Net of AZ Commercial	$2,544.00
Rate for Payer: Health Net of AZ Medicare	$1,187.20
Rate for Payer: Humana of AZ Medicare	$678.40
Rate for Payer: Self Pay Self Pay	$3,392.00
Rate for Payer: TriWest Medicare	$678.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,471.92
Rate for Payer: UnitedHealth Group of AZ Medicare	$763.20

EPIEFFECT 2CMX3CM

Facility

$4,240.00

Service Code	CPT Q4278
Hospital Charge Code	27651348
Hospital Revenue Code	636
Min. Negotiated Rate	$1,102.40
Max. Negotiated Rate	$3,816.00
Rate for Payer: Aetna of AZ Commercial	$3,816.00
Rate for Payer: Bisbee Police All Plans	$1,102.40
Rate for Payer: Cash Price	$3,392.00
Rate for Payer: Self Pay Self Pay	$3,392.00

EPIEFFECT 3CMX5CM

Facility

$4,240.00

Service Code	CPT Q4278
Hospital Charge Code	27651349
Hospital Revenue Code	636
Min. Negotiated Rate	$678.40
Max. Negotiated Rate	$3,816.00
Rate for Payer: Aetna of AZ Commercial	$3,816.00
Rate for Payer: Aetna of AZ Medicare	$1,187.20
Rate for Payer: Allwell Medicare	$678.40
Rate for Payer: Amerigroup Medicare	$678.40
Rate for Payer: APIPA Medicare/Medicaid	$1,583.64
Rate for Payer: AZCH Complete Medicare	$678.40
Rate for Payer: Banner UC Health Medicare	$678.40
Rate for Payer: Bisbee Police All Plans	$1,102.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,883.20
Rate for Payer: Cash Price	$3,392.00
Rate for Payer: Cigna of AZ Commercial	$2,968.00
Rate for Payer: Copperpoint Commercial	$1,049.40
Rate for Payer: Health Net of AZ Commercial	$2,544.00
Rate for Payer: Health Net of AZ Medicare	$1,187.20
Rate for Payer: Humana of AZ Medicare	$678.40
Rate for Payer: Self Pay Self Pay	$3,392.00
Rate for Payer: TriWest Medicare	$678.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,471.92
Rate for Payer: UnitedHealth Group of AZ Medicare	$763.20

EPIEFFECT 3CMX5CM

Facility

$4,240.00

Service Code	CPT Q4278
Hospital Charge Code	27651349
Hospital Revenue Code	636
Min. Negotiated Rate	$1,102.40
Max. Negotiated Rate	$3,816.00
Rate for Payer: Aetna of AZ Commercial	$3,816.00
Rate for Payer: Bisbee Police All Plans	$1,102.40
Rate for Payer: Cash Price	$3,392.00
Rate for Payer: Self Pay Self Pay	$3,392.00

EPIEFFECT 7CMX7CM

Facility

$2,938.80

Hospital Charge Code	27660335
Hospital Revenue Code	636
Min. Negotiated Rate	$764.09
Max. Negotiated Rate	$2,644.92
Rate for Payer: Aetna of AZ Commercial	$2,644.92
Rate for Payer: Bisbee Police All Plans	$764.09
Rate for Payer: Cash Price	$2,351.04
Rate for Payer: Self Pay Self Pay	$2,351.04

EPIEFFECT 7CMX7CM

Facility

$2,938.80

Hospital Charge Code	27660335
Hospital Revenue Code	636
Min. Negotiated Rate	$470.21
Max. Negotiated Rate	$2,644.92
Rate for Payer: Aetna of AZ Commercial	$2,644.92
Rate for Payer: Aetna of AZ Medicare	$822.86
Rate for Payer: Allwell Medicare	$470.21
Rate for Payer: Amerigroup Medicare	$470.21
Rate for Payer: APIPA Medicare/Medicaid	$1,097.64
Rate for Payer: AZCH Complete Medicare	$470.21
Rate for Payer: Banner UC Health Medicare	$470.21
Rate for Payer: Bisbee Police All Plans	$764.09
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,998.38
Rate for Payer: Cash Price	$2,351.04
Rate for Payer: Cigna of AZ Commercial	$2,057.16
Rate for Payer: Copperpoint Commercial	$727.35
Rate for Payer: Health Net of AZ Commercial	$1,763.28
Rate for Payer: Health Net of AZ Medicare	$822.86
Rate for Payer: Humana of AZ Medicare	$470.21
Rate for Payer: Self Pay Self Pay	$2,351.04
Rate for Payer: TriWest Medicare	$470.21
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,713.32
Rate for Payer: UnitedHealth Group of AZ Medicare	$528.98

EPIFIX 18MM DISK

Facility

$1,096.80

Service Code	CPT Q4186
Hospital Charge Code	27592022
Hospital Revenue Code	636
Min. Negotiated Rate	$175.49
Max. Negotiated Rate	$987.12
Rate for Payer: Aetna of AZ Commercial	$987.12
Rate for Payer: Aetna of AZ Medicare	$307.10
Rate for Payer: Allwell Medicare	$175.49
Rate for Payer: Amerigroup Medicare	$175.49
Rate for Payer: APIPA Medicare/Medicaid	$409.65
Rate for Payer: AZCH Complete Medicare	$175.49
Rate for Payer: Banner UC Health Medicare	$175.49
Rate for Payer: Bisbee Police All Plans	$285.17
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$745.82
Rate for Payer: Cash Price	$877.44
Rate for Payer: Cigna of AZ Commercial	$767.76
Rate for Payer: Copperpoint Commercial	$271.46
Rate for Payer: Health Net of AZ Commercial	$658.08
Rate for Payer: Health Net of AZ Medicare	$307.10
Rate for Payer: Humana of AZ Medicare	$175.49
Rate for Payer: Self Pay Self Pay	$877.44
Rate for Payer: TriWest Medicare	$175.49
Rate for Payer: UnitedHealth Group of AZ Commercial	$639.43
Rate for Payer: UnitedHealth Group of AZ Medicare	$197.42

Know your out-of-pocket cost for care.

All Charges