Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

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

$3,953.09

Service Code	APR-DRG 7222
Hospital Charge Code	APRDRG7224
Min. Negotiated Rate	$3,953.09
Max. Negotiated Rate	$3,953.09
Rate for Payer: AHCCCS Medicaid	$3,953.09
Rate for Payer: Allwell Medicaid	$3,953.09
Rate for Payer: AZCH Complete Medicaid	$3,953.09
Rate for Payer: Banner UC Health Medicaid	$3,953.09
Rate for Payer: Mercy Care Medicaid	$3,953.09

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

$5,346.07

Service Code	APR-DRG 7223
Hospital Charge Code	APRDRG7223
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

$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

$5,346.07

Service Code	APR-DRG 7223
Hospital Charge Code	APRDRG7221
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

$3,953.09

Service Code	APR-DRG 7222
Hospital Charge Code	APRDRG7221
Min. Negotiated Rate	$3,953.09
Max. Negotiated Rate	$3,953.09
Rate for Payer: AHCCCS Medicaid	$3,953.09
Rate for Payer: Allwell Medicaid	$3,953.09
Rate for Payer: AZCH Complete Medicaid	$3,953.09
Rate for Payer: Banner UC Health Medicaid	$3,953.09
Rate for Payer: Mercy Care Medicaid	$3,953.09

FFP CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857708
Hospital Revenue Code	390
Min. Negotiated Rate	$28.32
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: Allwell Medicare	$28.32
Rate for Payer: Amerigroup Medicare	$28.32
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicare	$28.32
Rate for Payer: Banner UC Health Medicare	$28.32
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: 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	$28.32
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$28.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$103.19
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.86

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 Thawed CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	857624
Hospital Revenue Code	390
Min. Negotiated Rate	$28.32
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: Allwell Medicare	$28.32
Rate for Payer: Amerigroup Medicare	$28.32
Rate for Payer: APIPA Medicare/Medicaid	$66.11
Rate for Payer: AZCH Complete Medicare	$28.32
Rate for Payer: Banner UC Health Medicare	$28.32
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: 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	$28.32
Rate for Payer: Self Pay Self Pay	$141.60
Rate for Payer: TriWest Medicare	$28.32
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

FIBER LASER 200 MIC HOLMIUM OLYMP

Facility

OP

$1,032.00

Hospital Charge Code	22773611
Hospital Revenue Code	272
Min. Negotiated Rate	$165.12
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	$165.12
Rate for Payer: Amerigroup Medicare	$165.12
Rate for Payer: APIPA Medicare/Medicaid	$385.45
Rate for Payer: AZCH Complete Medicare	$165.12
Rate for Payer: Banner UC Health Medicare	$165.12
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	$165.12
Rate for Payer: Self Pay Self Pay	$825.60
Rate for Payer: TriWest Medicare	$165.12
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	$203.84
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	$203.84
Rate for Payer: Amerigroup Medicare	$203.84
Rate for Payer: APIPA Medicare/Medicaid	$475.84
Rate for Payer: AZCH Complete Medicare	$203.84
Rate for Payer: Banner UC Health Medicare	$203.84
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	$315.31
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	$203.84
Rate for Payer: Self Pay Self Pay	$1,019.20
Rate for Payer: TriWest Medicare	$203.84
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	$227.68
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	$227.68
Rate for Payer: Amerigroup Medicare	$227.68
Rate for Payer: APIPA Medicare/Medicaid	$531.49
Rate for Payer: AZCH Complete Medicare	$227.68
Rate for Payer: Banner UC Health Medicare	$227.68
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	$227.68
Rate for Payer: Self Pay Self Pay	$1,138.40
Rate for Payer: TriWest Medicare	$227.68
Rate for Payer: UnitedHealth Group of AZ Commercial	$829.61
Rate for Payer: UnitedHealth Group of AZ Medicare	$256.14

Fibrinogen

Facility

IP

$139.00

Service Code	CPT 85384
Hospital Charge Code	633728
Hospital Revenue Code	305
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$125.10
Rate for Payer: Aetna of AZ Commercial	$125.10
Rate for Payer: Bisbee Police All Plans	$36.14
Rate for Payer: Cash Price	$111.20
Rate for Payer: Self Pay Self Pay	$111.20

Fibrinogen

Facility

OP

$139.00

Service Code	CPT 85384
Hospital Charge Code	633728
Hospital Revenue Code	305
Min. Negotiated Rate	$22.24
Max. Negotiated Rate	$125.10
Rate for Payer: Aetna of AZ Commercial	$125.10
Rate for Payer: Aetna of AZ Medicare	$38.92
Rate for Payer: Allwell Medicare	$22.24
Rate for Payer: Amerigroup Medicare	$22.24
Rate for Payer: APIPA Medicare/Medicaid	$51.92
Rate for Payer: AZCH Complete Medicare	$22.24
Rate for Payer: Banner UC Health Medicare	$22.24
Rate for Payer: Bisbee Police All Plans	$36.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$94.52
Rate for Payer: Cash Price	$111.20
Rate for Payer: Cigna of AZ Commercial	$90.35
Rate for Payer: Copperpoint Commercial	$34.40
Rate for Payer: Health Net of AZ Commercial	$83.40
Rate for Payer: Health Net of AZ Medicare	$38.92
Rate for Payer: Humana of AZ Medicare	$22.24
Rate for Payer: Self Pay Self Pay	$111.20
Rate for Payer: TriWest Medicare	$22.24
Rate for Payer: UnitedHealth Group of AZ Commercial	$81.04
Rate for Payer: UnitedHealth Group of AZ Medicare	$25.02

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 BLOOD TRANSFUSION 120

Facility

OP

$111.00

Hospital Charge Code	22355515
Hospital Revenue Code	270
Min. Negotiated Rate	$17.76
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	$17.76
Rate for Payer: Amerigroup Medicare	$17.76
Rate for Payer: APIPA Medicare/Medicaid	$41.46
Rate for Payer: AZCH Complete Medicare	$17.76
Rate for Payer: Banner UC Health Medicare	$17.76
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	$17.76
Rate for Payer: Self Pay Self Pay	$88.80
Rate for Payer: TriWest Medicare	$17.76
Rate for Payer: UnitedHealth Group of AZ Commercial	$64.71
Rate for Payer: UnitedHealth Group of AZ Medicare	$19.98

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

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

FISTULA PLUG COOK

Facility

IP

$2,854.00

Hospital Charge Code	22921514
Hospital Revenue Code	272
Min. Negotiated Rate	$742.04
Max. Negotiated Rate	$2,568.60
Rate for Payer: Aetna of AZ Commercial	$2,568.60
Rate for Payer: Bisbee Police All Plans	$742.04
Rate for Payer: Cash Price	$2,283.20
Rate for Payer: Self Pay Self Pay	$2,283.20

<<
<
185
186
187
188
189
190
191
192
193
194
>
>>