Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Fever And Inflammatory Conditions

Facility

IP

$8,982.13

Service Code	APR-DRG 7224
Hospital Charge Code	APRDRG7223
Min. Negotiated Rate	$8,982.13
Max. Negotiated Rate	$8,982.13
Rate for Payer: AHCCCS Medicaid	$8,982.13
Rate for Payer: Allwell Medicaid	$8,982.13
Rate for Payer: AZCH Complete Medicaid	$8,982.13
Rate for Payer: Banner UC Health Medicaid	$8,982.13
Rate for Payer: Mercy Care Medicaid	$8,982.13

Fever And Inflammatory Conditions

Facility

IP

$5,346.07

Service Code	APR-DRG 7223
Hospital Charge Code	APRDRG7222
Min. Negotiated Rate	$5,346.07
Max. Negotiated Rate	$5,346.07
Rate for Payer: AHCCCS Medicaid	$5,346.07
Rate for Payer: Allwell Medicaid	$5,346.07
Rate for Payer: AZCH Complete Medicaid	$5,346.07
Rate for Payer: Banner UC Health Medicaid	$5,346.07
Rate for Payer: Mercy Care Medicaid	$5,346.07

Fever And Inflammatory Conditions

Facility

IP

$8,982.13

Service Code	APR-DRG 7224
Hospital Charge Code	APRDRG7224
Min. Negotiated Rate	$8,982.13
Max. Negotiated Rate	$8,982.13
Rate for Payer: AHCCCS Medicaid	$8,982.13
Rate for Payer: Allwell Medicaid	$8,982.13
Rate for Payer: AZCH Complete Medicaid	$8,982.13
Rate for Payer: Banner UC Health Medicaid	$8,982.13
Rate for Payer: Mercy Care Medicaid	$8,982.13

Fever And Inflammatory Conditions

Facility

IP

$5,346.07

Service Code	APR-DRG 7223
Hospital Charge Code	APRDRG7224
Min. Negotiated Rate	$5,346.07
Max. Negotiated Rate	$5,346.07
Rate for Payer: AHCCCS Medicaid	$5,346.07
Rate for Payer: Allwell Medicaid	$5,346.07
Rate for Payer: AZCH Complete Medicaid	$5,346.07
Rate for Payer: Banner UC Health Medicaid	$5,346.07
Rate for Payer: Mercy Care Medicaid	$5,346.07

Fever And Inflammatory Conditions

Facility

IP

$2,771.93

Service Code	APR-DRG 7221
Hospital Charge Code	APRDRG7221
Min. Negotiated Rate	$2,771.93
Max. Negotiated Rate	$2,771.93
Rate for Payer: AHCCCS Medicaid	$2,771.93
Rate for Payer: Allwell Medicaid	$2,771.93
Rate for Payer: AZCH Complete Medicaid	$2,771.93
Rate for Payer: Banner UC Health Medicaid	$2,771.93
Rate for Payer: Mercy Care Medicaid	$2,771.93

Fever And Inflammatory Conditions

Facility

IP

$8,982.13

Service Code	APR-DRG 7224
Hospital Charge Code	APRDRG7221
Min. Negotiated Rate	$8,982.13
Max. Negotiated Rate	$8,982.13
Rate for Payer: AHCCCS Medicaid	$8,982.13
Rate for Payer: Allwell Medicaid	$8,982.13
Rate for Payer: AZCH Complete Medicaid	$8,982.13
Rate for Payer: Banner UC Health Medicaid	$8,982.13
Rate for Payer: Mercy Care Medicaid	$8,982.13

FFP CPD

Facility

IP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857708
Hospital Revenue Code	390
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Cash Price	$141.60
Rate for Payer: Self Pay Self Pay	$141.60

FFP CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857708
Hospital Revenue Code	390
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Aetna of AZ Medicare	$49.56
Rate for Payer: AHCCCS Medicaid	$119.86
Rate for Payer: Allwell Medicaid	$119.86
Rate for Payer: Allwell Medicare	$26.55
Rate for Payer: Amerigroup Medicare	$26.55
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicaid	$119.86
Rate for Payer: AZCH Complete Medicare	$26.55
Rate for Payer: Banner UC Health Medicaid	$119.86
Rate for Payer: Banner UC Health Medicare	$26.55
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$120.36
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cigna of AZ Commercial	$115.05
Rate for Payer: Copperpoint Commercial	$43.81
Rate for Payer: Health Net of AZ Commercial	$106.20
Rate for Payer: Health Net of AZ Medicare	$49.56
Rate for Payer: Humana of AZ Medicare	$26.55
Rate for Payer: Mercy Care Medicaid	$119.86
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$26.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

FFP Thawed CPD

Facility

IP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857624
Hospital Revenue Code	390
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Cash Price	$141.60
Rate for Payer: Self Pay Self Pay	$141.60

FFP Thawed CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857624
Hospital Revenue Code	390
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna of AZ Commercial	$159.30
Rate for Payer: Aetna of AZ Medicare	$49.56
Rate for Payer: AHCCCS Medicaid	$119.86
Rate for Payer: Allwell Medicaid	$119.86
Rate for Payer: Allwell Medicare	$26.55
Rate for Payer: Amerigroup Medicare	$26.55
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicaid	$119.86
Rate for Payer: AZCH Complete Medicare	$26.55
Rate for Payer: Banner UC Health Medicaid	$119.86
Rate for Payer: Banner UC Health Medicare	$26.55
Rate for Payer: Bisbee Police All Plans	$46.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$120.36
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cash Price	$141.60
Rate for Payer: Cigna of AZ Commercial	$115.05
Rate for Payer: Copperpoint Commercial	$43.81
Rate for Payer: Health Net of AZ Commercial	$106.20
Rate for Payer: Health Net of AZ Medicare	$49.56
Rate for Payer: Humana of AZ Medicare	$26.55
Rate for Payer: Mercy Care Medicaid	$119.86
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$26.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

FIBER LASER 200 MIC HOLMIUM OLYMP

Facility

OP

$1,032.00

Hospital Charge Code	22773611
Hospital Revenue Code	272
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$928.80
Rate for Payer: Aetna of AZ Commercial	$928.80
Rate for Payer: Aetna of AZ Medicare	$288.96
Rate for Payer: Allwell Medicare	$154.80
Rate for Payer: Amerigroup Medicare	$154.80
Rate for Payer: APIPA Medicare/Medicaid	$385.45
Rate for Payer: AZCH Complete Medicare	$154.80
Rate for Payer: Banner UC Health Medicare	$154.80
Rate for Payer: Bisbee Police All Plans	$268.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$701.76
Rate for Payer: Cash Price	$825.60
Rate for Payer: Cigna of AZ Commercial	$722.40
Rate for Payer: Copperpoint Commercial	$255.42
Rate for Payer: Health Net of AZ Commercial	$619.20
Rate for Payer: Health Net of AZ Medicare	$288.96
Rate for Payer: Humana of AZ Medicare	$154.80
Rate for Payer: Self Pay Self Pay	$825.60
Rate for Payer: TriWest Medicare	$154.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$601.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$185.76

FIBER LASER 200 MIC HOLMIUM OLYMP

Facility

IP

$1,032.00

Hospital Charge Code	22773611
Hospital Revenue Code	272
Min. Negotiated Rate	$268.32
Max. Negotiated Rate	$928.80
Rate for Payer: Aetna of AZ Commercial	$928.80
Rate for Payer: Bisbee Police All Plans	$268.32
Rate for Payer: Cash Price	$825.60
Rate for Payer: Self Pay Self Pay	$825.60

FIBER LASER 273 MIC COOK

Facility

IP

$1,274.00

Hospital Charge Code	22354785
Hospital Revenue Code	270
Min. Negotiated Rate	$331.24
Max. Negotiated Rate	$1,146.60
Rate for Payer: Aetna of AZ Commercial	$1,146.60
Rate for Payer: Bisbee Police All Plans	$331.24
Rate for Payer: Cash Price	$1,019.20
Rate for Payer: Self Pay Self Pay	$1,019.20

FIBER LASER 273 MIC COOK

Facility

OP

$1,274.00

Hospital Charge Code	22354785
Hospital Revenue Code	270
Min. Negotiated Rate	$191.10
Max. Negotiated Rate	$1,146.60
Rate for Payer: Aetna of AZ Commercial	$1,146.60
Rate for Payer: Aetna of AZ Medicare	$356.72
Rate for Payer: Allwell Medicare	$191.10
Rate for Payer: Amerigroup Medicare	$191.10
Rate for Payer: APIPA Medicare/Medicaid	$475.84
Rate for Payer: AZCH Complete Medicare	$191.10
Rate for Payer: Banner UC Health Medicare	$191.10
Rate for Payer: Bisbee Police All Plans	$331.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$866.32
Rate for Payer: Cash Price	$1,019.20
Rate for Payer: Cigna of AZ Commercial	$891.80
Rate for Payer: Copperpoint Commercial	$315.32
Rate for Payer: Health Net of AZ Commercial	$764.40
Rate for Payer: Health Net of AZ Medicare	$356.72
Rate for Payer: Humana of AZ Medicare	$191.10
Rate for Payer: Self Pay Self Pay	$1,019.20
Rate for Payer: TriWest Medicare	$191.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$742.74
Rate for Payer: UnitedHealth Group of AZ Medicare	$229.32

FIBER LASER OPTILITE HOLMIUM 273 COOK

Facility

IP

$1,423.00

Hospital Charge Code	22354786
Hospital Revenue Code	270
Min. Negotiated Rate	$369.98
Max. Negotiated Rate	$1,280.70
Rate for Payer: Aetna of AZ Commercial	$1,280.70
Rate for Payer: Bisbee Police All Plans	$369.98
Rate for Payer: Cash Price	$1,138.40
Rate for Payer: Self Pay Self Pay	$1,138.40

FIBER LASER OPTILITE HOLMIUM 273 COOK

Facility

OP

$1,423.00

Hospital Charge Code	22354786
Hospital Revenue Code	270
Min. Negotiated Rate	$213.45
Max. Negotiated Rate	$1,280.70
Rate for Payer: Aetna of AZ Commercial	$1,280.70
Rate for Payer: Aetna of AZ Medicare	$398.44
Rate for Payer: Allwell Medicare	$213.45
Rate for Payer: Amerigroup Medicare	$213.45
Rate for Payer: APIPA Medicare/Medicaid	$531.49
Rate for Payer: AZCH Complete Medicare	$213.45
Rate for Payer: Banner UC Health Medicare	$213.45
Rate for Payer: Bisbee Police All Plans	$369.98
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$967.64
Rate for Payer: Cash Price	$1,138.40
Rate for Payer: Cigna of AZ Commercial	$996.10
Rate for Payer: Copperpoint Commercial	$352.19
Rate for Payer: Health Net of AZ Commercial	$853.80
Rate for Payer: Health Net of AZ Medicare	$398.44
Rate for Payer: Humana of AZ Medicare	$213.45
Rate for Payer: Self Pay Self Pay	$1,138.40
Rate for Payer: TriWest Medicare	$213.45
Rate for Payer: UnitedHealth Group of AZ Commercial	$829.61
Rate for Payer: UnitedHealth Group of AZ Medicare	$256.14

Fibrinogen

Facility

IP

$146.00

Service Code	CPT 85384
Hospital Charge Code	633728
Hospital Revenue Code	305
Min. Negotiated Rate	$37.96
Max. Negotiated Rate	$131.40
Rate for Payer: Aetna of AZ Commercial	$131.40
Rate for Payer: Bisbee Police All Plans	$37.96
Rate for Payer: Cash Price	$116.80
Rate for Payer: Self Pay Self Pay	$116.80

Fibrinogen

Facility

OP

$146.00

Service Code	CPT 85384
Hospital Charge Code	633728
Hospital Revenue Code	305
Min. Negotiated Rate	$9.72
Max. Negotiated Rate	$131.40
Rate for Payer: Aetna of AZ Commercial	$131.40
Rate for Payer: Aetna of AZ Medicare	$40.88
Rate for Payer: AHCCCS Medicaid	$9.72
Rate for Payer: Allwell Medicaid	$9.72
Rate for Payer: Allwell Medicare	$21.90
Rate for Payer: Amerigroup Medicare	$21.90
Rate for Payer: APIPA Medicare/Medicaid	$54.53
Rate for Payer: AZCH Complete Medicaid	$9.72
Rate for Payer: AZCH Complete Medicare	$21.90
Rate for Payer: Banner UC Health Medicaid	$9.72
Rate for Payer: Banner UC Health Medicare	$21.90
Rate for Payer: Bisbee Police All Plans	$37.96
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$99.28
Rate for Payer: Cash Price	$116.80
Rate for Payer: Cash Price	$116.80
Rate for Payer: Cigna of AZ Commercial	$94.90
Rate for Payer: Copperpoint Commercial	$36.14
Rate for Payer: Health Net of AZ Commercial	$87.60
Rate for Payer: Health Net of AZ Medicare	$40.88
Rate for Payer: Humana of AZ Medicare	$21.90
Rate for Payer: Mercy Care Medicaid	$9.72
Rate for Payer: Self Pay Self Pay	$116.80
Rate for Payer: TriWest Medicare	$21.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$85.12
Rate for Payer: UnitedHealth Group of AZ Medicare	$26.28

FILTER BLOOD TRANSFUSION 120

Facility

OP

$111.00

Hospital Charge Code	22355515
Hospital Revenue Code	270
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$99.90
Rate for Payer: Aetna of AZ Commercial	$99.90
Rate for Payer: Aetna of AZ Medicare	$31.08
Rate for Payer: Allwell Medicare	$16.65
Rate for Payer: Amerigroup Medicare	$16.65
Rate for Payer: APIPA Medicare/Medicaid	$41.46
Rate for Payer: AZCH Complete Medicare	$16.65
Rate for Payer: Banner UC Health Medicare	$16.65
Rate for Payer: Bisbee Police All Plans	$28.86
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$75.48
Rate for Payer: Cash Price	$88.80
Rate for Payer: Cigna of AZ Commercial	$77.70
Rate for Payer: Copperpoint Commercial	$27.47
Rate for Payer: Health Net of AZ Commercial	$66.60
Rate for Payer: Health Net of AZ Medicare	$31.08
Rate for Payer: Humana of AZ Medicare	$16.65
Rate for Payer: Self Pay Self Pay	$88.80
Rate for Payer: TriWest Medicare	$16.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$64.71
Rate for Payer: UnitedHealth Group of AZ Medicare	$19.98

FILTER BLOOD TRANSFUSION 120

Facility

IP

$111.00

Hospital Charge Code	22355515
Hospital Revenue Code	270
Min. Negotiated Rate	$28.86
Max. Negotiated Rate	$99.90
Rate for Payer: Aetna of AZ Commercial	$99.90
Rate for Payer: Bisbee Police All Plans	$28.86
Rate for Payer: Cash Price	$88.80
Rate for Payer: Self Pay Self Pay	$88.80

FILTER HME

Facility

OP

$14.00

Hospital Charge Code	22355679
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Aetna of AZ Medicare	$3.92
Rate for Payer: Allwell Medicare	$2.10
Rate for Payer: Amerigroup Medicare	$2.10
Rate for Payer: APIPA Medicare/Medicaid	$5.23
Rate for Payer: AZCH Complete Medicare	$2.10
Rate for Payer: Banner UC Health Medicare	$2.10
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$9.52
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cigna of AZ Commercial	$9.80
Rate for Payer: Copperpoint Commercial	$3.46
Rate for Payer: Health Net of AZ Commercial	$8.40
Rate for Payer: Health Net of AZ Medicare	$3.92
Rate for Payer: Humana of AZ Medicare	$2.10
Rate for Payer: Self Pay Self Pay	$11.20
Rate for Payer: TriWest Medicare	$2.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$8.16
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.52

FILTER HME

Facility

IP

$14.00

Hospital Charge Code	22355679
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Cash Price	$11.20
Rate for Payer: Self Pay Self Pay	$11.20

finasteride 5 mg Tab [CQCH]

Facility

OP

$0.13

Service Code	HCPCS S0138
Hospital Charge Code	105922782
Hospital Revenue Code	251
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna of AZ Commercial	$0.12
Rate for Payer: Aetna of AZ Medicare	$0.04
Rate for Payer: Allwell Medicare	$0.02
Rate for Payer: Amerigroup Medicare	$0.02
Rate for Payer: APIPA Medicare/Medicaid	$0.05
Rate for Payer: AZCH Complete Medicare	$0.02
Rate for Payer: Banner UC Health Medicare	$0.02
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.09
Rate for Payer: Cash Price	$0.11
Rate for Payer: Cigna of AZ Commercial	$0.08
Rate for Payer: Copperpoint Commercial	$0.03
Rate for Payer: Health Net of AZ Commercial	$0.08
Rate for Payer: Health Net of AZ Medicare	$0.04
Rate for Payer: Humana of AZ Medicare	$0.02
Rate for Payer: Self Pay Self Pay	$0.10
Rate for Payer: TriWest Medicare	$0.02
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.08
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.02

finasteride 5 mg Tab [CQCH]

Facility

IP

$0.13

Service Code	HCPCS S0138
Hospital Charge Code	105922782
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna of AZ Commercial	$0.12
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Cash Price	$0.11
Rate for Payer: Self Pay Self Pay	$0.10

FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE

Facility

OP

$1,433.00

Service Code	CPT 10021
Hospital Charge Code	22209352
Hospital Revenue Code	450
Min. Negotiated Rate	$214.95
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$1,289.70
Rate for Payer: Aetna of AZ Medicare	$401.24
Rate for Payer: AHCCCS Medicaid	$501.46
Rate for Payer: Allwell Medicaid	$501.46
Rate for Payer: Allwell Medicare	$214.95
Rate for Payer: Amerigroup Medicare	$214.95
Rate for Payer: APIPA Medicare/Medicaid	$535.23
Rate for Payer: AZCH Complete Medicaid	$501.46
Rate for Payer: AZCH Complete Medicare	$214.95
Rate for Payer: Banner UC Health Medicaid	$501.46
Rate for Payer: Banner UC Health Medicare	$214.95
Rate for Payer: Bisbee Police All Plans	$372.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$974.44
Rate for Payer: Cash Price	$1,146.40
Rate for Payer: Cash Price	$1,146.40
Rate for Payer: Cigna of AZ Commercial	$1,003.10
Rate for Payer: Copperpoint Commercial	$354.67
Rate for Payer: Health Net of AZ Commercial	$859.80
Rate for Payer: Health Net of AZ Medicare	$401.24
Rate for Payer: Humana of AZ Medicare	$214.95
Rate for Payer: Mercy Care Medicaid	$501.46
Rate for Payer: Self Pay Self Pay	$1,146.40
Rate for Payer: TriWest Medicare	$214.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$257.94

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