Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$12,648.35

Service Code	APR-DRG 3424
Hospital Charge Code	APRDRG3421
Min. Negotiated Rate	$12,648.35
Max. Negotiated Rate	$12,648.35
Rate for Payer: AHCCCS Medicaid	$12,648.35
Rate for Payer: Allwell Medicaid	$12,648.35
Rate for Payer: AZCH Complete Medicaid	$12,648.35
Rate for Payer: Banner UC Health Medicaid	$12,648.35
Rate for Payer: Mercy Care Medicaid	$12,648.35

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$4,588.56

Service Code	APR-DRG 3422
Hospital Charge Code	APRDRG3421
Min. Negotiated Rate	$4,588.56
Max. Negotiated Rate	$4,588.56
Rate for Payer: AHCCCS Medicaid	$4,588.56
Rate for Payer: Allwell Medicaid	$4,588.56
Rate for Payer: AZCH Complete Medicaid	$4,588.56
Rate for Payer: Banner UC Health Medicaid	$4,588.56
Rate for Payer: Mercy Care Medicaid	$4,588.56

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$3,642.37

Service Code	APR-DRG 3421
Hospital Charge Code	APRDRG3421
Min. Negotiated Rate	$3,642.37
Max. Negotiated Rate	$3,642.37
Rate for Payer: AHCCCS Medicaid	$3,642.37
Rate for Payer: Allwell Medicaid	$3,642.37
Rate for Payer: AZCH Complete Medicaid	$3,642.37
Rate for Payer: Banner UC Health Medicaid	$3,642.37
Rate for Payer: Mercy Care Medicaid	$3,642.37

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$12,648.35

Service Code	APR-DRG 3424
Hospital Charge Code	APRDRG3423
Min. Negotiated Rate	$12,648.35
Max. Negotiated Rate	$12,648.35
Rate for Payer: AHCCCS Medicaid	$12,648.35
Rate for Payer: Allwell Medicaid	$12,648.35
Rate for Payer: AZCH Complete Medicaid	$12,648.35
Rate for Payer: Banner UC Health Medicaid	$12,648.35
Rate for Payer: Mercy Care Medicaid	$12,648.35

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$4,588.56

Service Code	APR-DRG 3422
Hospital Charge Code	APRDRG3423
Min. Negotiated Rate	$4,588.56
Max. Negotiated Rate	$4,588.56
Rate for Payer: AHCCCS Medicaid	$4,588.56
Rate for Payer: Allwell Medicaid	$4,588.56
Rate for Payer: AZCH Complete Medicaid	$4,588.56
Rate for Payer: Banner UC Health Medicaid	$4,588.56
Rate for Payer: Mercy Care Medicaid	$4,588.56

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$3,642.37

Service Code	APR-DRG 3421
Hospital Charge Code	APRDRG3423
Min. Negotiated Rate	$3,642.37
Max. Negotiated Rate	$3,642.37
Rate for Payer: AHCCCS Medicaid	$3,642.37
Rate for Payer: Allwell Medicaid	$3,642.37
Rate for Payer: AZCH Complete Medicaid	$3,642.37
Rate for Payer: Banner UC Health Medicaid	$3,642.37
Rate for Payer: Mercy Care Medicaid	$3,642.37

Free and Total Insulin LC

Facility

IP

$195.00

Service Code	CPT 83527
Hospital Charge Code	22201725
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna of AZ Commercial	$175.50
Rate for Payer: Bisbee Police All Plans	$50.70
Rate for Payer: Cash Price	$156.00
Rate for Payer: Self Pay Self Pay	$156.00

Free and Total Insulin LC

Facility

OP

$195.00

Service Code	CPT 83527
Hospital Charge Code	22201725
Hospital Revenue Code	301
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna of AZ Commercial	$175.50
Rate for Payer: Aetna of AZ Medicare	$54.60
Rate for Payer: AHCCCS Medicaid	$12.95
Rate for Payer: Allwell Medicaid	$12.95
Rate for Payer: Allwell Medicare	$29.25
Rate for Payer: Amerigroup Medicare	$29.25
Rate for Payer: APIPA Medicare/Medicaid	$72.83
Rate for Payer: AZCH Complete Medicaid	$12.95
Rate for Payer: AZCH Complete Medicare	$29.25
Rate for Payer: Banner UC Health Medicaid	$12.95
Rate for Payer: Banner UC Health Medicare	$29.25
Rate for Payer: Bisbee Police All Plans	$50.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$132.60
Rate for Payer: Cash Price	$156.00
Rate for Payer: Cash Price	$156.00
Rate for Payer: Cigna of AZ Commercial	$126.75
Rate for Payer: Copperpoint Commercial	$48.26
Rate for Payer: Health Net of AZ Commercial	$117.00
Rate for Payer: Health Net of AZ Medicare	$54.60
Rate for Payer: Humana of AZ Medicare	$29.25
Rate for Payer: Mercy Care Medicaid	$12.95
Rate for Payer: Self Pay Self Pay	$156.00
Rate for Payer: TriWest Medicare	$29.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$113.68
Rate for Payer: UnitedHealth Group of AZ Medicare	$35.10

Free K+L Lt Chains,Qn,S LC

Facility

IP

$274.00

Service Code	CPT 83883
Hospital Charge Code	2029245
Hospital Revenue Code	301
Min. Negotiated Rate	$71.24
Max. Negotiated Rate	$246.60
Rate for Payer: Aetna of AZ Commercial	$246.60
Rate for Payer: Bisbee Police All Plans	$71.24
Rate for Payer: Cash Price	$219.20
Rate for Payer: Self Pay Self Pay	$219.20

Free K+L Lt Chains,Qn,S LC

Facility

OP

$274.00

Service Code	CPT 83883
Hospital Charge Code	2029245
Hospital Revenue Code	301
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$246.60
Rate for Payer: Aetna of AZ Commercial	$246.60
Rate for Payer: Aetna of AZ Medicare	$76.72
Rate for Payer: AHCCCS Medicaid	$13.60
Rate for Payer: Allwell Medicaid	$13.60
Rate for Payer: Allwell Medicare	$41.10
Rate for Payer: Amerigroup Medicare	$41.10
Rate for Payer: APIPA Medicare/Medicaid	$102.34
Rate for Payer: AZCH Complete Medicaid	$13.60
Rate for Payer: AZCH Complete Medicare	$41.10
Rate for Payer: Banner UC Health Medicaid	$13.60
Rate for Payer: Banner UC Health Medicare	$41.10
Rate for Payer: Bisbee Police All Plans	$71.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$186.32
Rate for Payer: Cash Price	$219.20
Rate for Payer: Cash Price	$219.20
Rate for Payer: Cigna of AZ Commercial	$178.10
Rate for Payer: Copperpoint Commercial	$67.82
Rate for Payer: Health Net of AZ Commercial	$164.40
Rate for Payer: Health Net of AZ Medicare	$76.72
Rate for Payer: Humana of AZ Medicare	$41.10
Rate for Payer: Mercy Care Medicaid	$13.60
Rate for Payer: Self Pay Self Pay	$219.20
Rate for Payer: TriWest Medicare	$41.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$159.74
Rate for Payer: UnitedHealth Group of AZ Medicare	$49.32

Free K+L Lt Chains Ur Qn LC

Facility

IP

$168.00

Service Code	CPT 83883
Hospital Charge Code	6781685
Hospital Revenue Code	300
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna of AZ Commercial	$151.20
Rate for Payer: Bisbee Police All Plans	$43.68
Rate for Payer: Cash Price	$134.40
Rate for Payer: Self Pay Self Pay	$134.40

Free K+L Lt Chains Ur Qn LC

Facility

OP

$168.00

Service Code	CPT 83883
Hospital Charge Code	6781685
Hospital Revenue Code	300
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna of AZ Commercial	$151.20
Rate for Payer: Aetna of AZ Medicare	$47.04
Rate for Payer: AHCCCS Medicaid	$13.60
Rate for Payer: Allwell Medicaid	$13.60
Rate for Payer: Allwell Medicare	$25.20
Rate for Payer: Amerigroup Medicare	$25.20
Rate for Payer: APIPA Medicare/Medicaid	$62.75
Rate for Payer: AZCH Complete Medicaid	$13.60
Rate for Payer: AZCH Complete Medicare	$25.20
Rate for Payer: Banner UC Health Medicaid	$13.60
Rate for Payer: Banner UC Health Medicare	$25.20
Rate for Payer: Bisbee Police All Plans	$43.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$114.24
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cigna of AZ Commercial	$109.20
Rate for Payer: Copperpoint Commercial	$41.58
Rate for Payer: Health Net of AZ Commercial	$100.80
Rate for Payer: Health Net of AZ Medicare	$47.04
Rate for Payer: Humana of AZ Medicare	$25.20
Rate for Payer: Mercy Care Medicaid	$13.60
Rate for Payer: Self Pay Self Pay	$134.40
Rate for Payer: TriWest Medicare	$25.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$97.94
Rate for Payer: UnitedHealth Group of AZ Medicare	$30.24

Free K+L Lt Chains Ur Qn LC

Facility

OP

$168.00

Service Code	CPT 83883
Hospital Charge Code	23756988
Hospital Revenue Code	300
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna of AZ Commercial	$151.20
Rate for Payer: Aetna of AZ Medicare	$47.04
Rate for Payer: AHCCCS Medicaid	$13.60
Rate for Payer: Allwell Medicaid	$13.60
Rate for Payer: Allwell Medicare	$25.20
Rate for Payer: Amerigroup Medicare	$25.20
Rate for Payer: APIPA Medicare/Medicaid	$62.75
Rate for Payer: AZCH Complete Medicaid	$13.60
Rate for Payer: AZCH Complete Medicare	$25.20
Rate for Payer: Banner UC Health Medicaid	$13.60
Rate for Payer: Banner UC Health Medicare	$25.20
Rate for Payer: Bisbee Police All Plans	$43.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$114.24
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cash Price	$134.40
Rate for Payer: Cigna of AZ Commercial	$109.20
Rate for Payer: Copperpoint Commercial	$41.58
Rate for Payer: Health Net of AZ Commercial	$100.80
Rate for Payer: Health Net of AZ Medicare	$47.04
Rate for Payer: Humana of AZ Medicare	$25.20
Rate for Payer: Mercy Care Medicaid	$13.60
Rate for Payer: Self Pay Self Pay	$134.40
Rate for Payer: TriWest Medicare	$25.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$97.94
Rate for Payer: UnitedHealth Group of AZ Medicare	$30.24

Free K+L Lt Chains Ur Qn LC

Facility

IP

$168.00

Service Code	CPT 83883
Hospital Charge Code	23756988
Hospital Revenue Code	300
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna of AZ Commercial	$151.20
Rate for Payer: Bisbee Police All Plans	$43.68
Rate for Payer: Cash Price	$134.40
Rate for Payer: Self Pay Self Pay	$134.40

Free T4

Facility

OP

$374.00

Service Code	CPT 84439
Hospital Charge Code	857849
Hospital Revenue Code	301
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$336.60
Rate for Payer: Aetna of AZ Commercial	$336.60
Rate for Payer: Aetna of AZ Medicare	$104.72
Rate for Payer: AHCCCS Medicaid	$9.02
Rate for Payer: Allwell Medicaid	$9.02
Rate for Payer: Allwell Medicare	$56.10
Rate for Payer: Amerigroup Medicare	$56.10
Rate for Payer: APIPA Medicare/Medicaid	$139.69
Rate for Payer: AZCH Complete Medicaid	$9.02
Rate for Payer: AZCH Complete Medicare	$56.10
Rate for Payer: Banner UC Health Medicaid	$9.02
Rate for Payer: Banner UC Health Medicare	$56.10
Rate for Payer: Bisbee Police All Plans	$97.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$254.32
Rate for Payer: Cash Price	$299.20
Rate for Payer: Cash Price	$299.20
Rate for Payer: Cigna of AZ Commercial	$243.10
Rate for Payer: Copperpoint Commercial	$92.56
Rate for Payer: Health Net of AZ Commercial	$224.40
Rate for Payer: Health Net of AZ Medicare	$104.72
Rate for Payer: Humana of AZ Medicare	$56.10
Rate for Payer: Mercy Care Medicaid	$9.02
Rate for Payer: Self Pay Self Pay	$299.20
Rate for Payer: TriWest Medicare	$56.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$218.04
Rate for Payer: UnitedHealth Group of AZ Medicare	$67.32

Free T4

Facility

IP

$374.00

Service Code	CPT 84439
Hospital Charge Code	857849
Hospital Revenue Code	301
Min. Negotiated Rate	$97.24
Max. Negotiated Rate	$336.60
Rate for Payer: Aetna of AZ Commercial	$336.60
Rate for Payer: Bisbee Police All Plans	$97.24
Rate for Payer: Cash Price	$299.20
Rate for Payer: Self Pay Self Pay	$299.20

FROZ SEC PREP

Facility

OP

$34.00

Service Code	CPT 88331
Hospital Charge Code	22545752
Hospital Revenue Code	310
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$108.14
Rate for Payer: Aetna of AZ Commercial	$30.60
Rate for Payer: Aetna of AZ Medicare	$9.52
Rate for Payer: AHCCCS Medicaid	$108.14
Rate for Payer: Allwell Medicaid	$108.14
Rate for Payer: Allwell Medicare	$5.10
Rate for Payer: Amerigroup Medicare	$5.10
Rate for Payer: APIPA Medicare/Medicaid	$12.70
Rate for Payer: AZCH Complete Medicaid	$108.14
Rate for Payer: AZCH Complete Medicare	$5.10
Rate for Payer: Banner UC Health Medicaid	$108.14
Rate for Payer: Banner UC Health Medicare	$5.10
Rate for Payer: Bisbee Police All Plans	$8.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$23.12
Rate for Payer: Cash Price	$27.20
Rate for Payer: Cash Price	$27.20
Rate for Payer: Cigna of AZ Commercial	$22.10
Rate for Payer: Copperpoint Commercial	$8.42
Rate for Payer: Health Net of AZ Commercial	$20.40
Rate for Payer: Health Net of AZ Medicare	$9.52
Rate for Payer: Humana of AZ Medicare	$5.10
Rate for Payer: Mercy Care Medicaid	$108.14
Rate for Payer: Self Pay Self Pay	$27.20
Rate for Payer: TriWest Medicare	$5.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$19.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$6.12

FROZ SEC PREP

Facility

IP

$34.00

Service Code	CPT 88331
Hospital Charge Code	22545752
Hospital Revenue Code	310
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$30.60
Rate for Payer: Aetna of AZ Commercial	$30.60
Rate for Payer: Bisbee Police All Plans	$8.84
Rate for Payer: Cash Price	$27.20
Rate for Payer: Self Pay Self Pay	$27.20

Frz Plasma CPD

Facility

IP

$177.00

Service Code	CPT P9017
Hospital Charge Code	15493410
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

Frz Plasma CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	15493410
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

FSH and LH LC

Facility

IP

$441.00

Service Code	CPT 83001
Hospital Charge Code	1285571
Hospital Revenue Code	301
Min. Negotiated Rate	$114.66
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna of AZ Commercial	$396.90
Rate for Payer: Bisbee Police All Plans	$114.66
Rate for Payer: Cash Price	$352.80
Rate for Payer: Self Pay Self Pay	$352.80

FSH and LH LC

Facility

OP

$441.00

Service Code	CPT 83001
Hospital Charge Code	1285571
Hospital Revenue Code	301
Min. Negotiated Rate	$18.58
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna of AZ Commercial	$396.90
Rate for Payer: Aetna of AZ Medicare	$123.48
Rate for Payer: AHCCCS Medicaid	$18.58
Rate for Payer: Allwell Medicaid	$18.58
Rate for Payer: Allwell Medicare	$66.15
Rate for Payer: Amerigroup Medicare	$66.15
Rate for Payer: APIPA Medicare/Medicaid	$164.71
Rate for Payer: AZCH Complete Medicaid	$18.58
Rate for Payer: AZCH Complete Medicare	$66.15
Rate for Payer: Banner UC Health Medicaid	$18.58
Rate for Payer: Banner UC Health Medicare	$66.15
Rate for Payer: Bisbee Police All Plans	$114.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$299.88
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cigna of AZ Commercial	$286.65
Rate for Payer: Copperpoint Commercial	$109.15
Rate for Payer: Health Net of AZ Commercial	$264.60
Rate for Payer: Health Net of AZ Medicare	$123.48
Rate for Payer: Humana of AZ Medicare	$66.15
Rate for Payer: Mercy Care Medicaid	$18.58
Rate for Payer: Self Pay Self Pay	$352.80
Rate for Payer: TriWest Medicare	$66.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$257.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$79.38

FSH, Serum LC

Facility

IP

$441.00

Service Code	CPT 83001
Hospital Charge Code	1285570
Hospital Revenue Code	301
Min. Negotiated Rate	$114.66
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna of AZ Commercial	$396.90
Rate for Payer: Bisbee Police All Plans	$114.66
Rate for Payer: Cash Price	$352.80
Rate for Payer: Self Pay Self Pay	$352.80

FSH, Serum LC

Facility

OP

$441.00

Service Code	CPT 83001
Hospital Charge Code	1285570
Hospital Revenue Code	301
Min. Negotiated Rate	$18.58
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna of AZ Commercial	$396.90
Rate for Payer: Aetna of AZ Medicare	$123.48
Rate for Payer: AHCCCS Medicaid	$18.58
Rate for Payer: Allwell Medicaid	$18.58
Rate for Payer: Allwell Medicare	$66.15
Rate for Payer: Amerigroup Medicare	$66.15
Rate for Payer: APIPA Medicare/Medicaid	$164.71
Rate for Payer: AZCH Complete Medicaid	$18.58
Rate for Payer: AZCH Complete Medicare	$66.15
Rate for Payer: Banner UC Health Medicaid	$18.58
Rate for Payer: Banner UC Health Medicare	$66.15
Rate for Payer: Bisbee Police All Plans	$114.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$299.88
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cigna of AZ Commercial	$286.65
Rate for Payer: Copperpoint Commercial	$109.15
Rate for Payer: Health Net of AZ Commercial	$264.60
Rate for Payer: Health Net of AZ Medicare	$123.48
Rate for Payer: Humana of AZ Medicare	$66.15
Rate for Payer: Mercy Care Medicaid	$18.58
Rate for Payer: Self Pay Self Pay	$352.80
Rate for Payer: TriWest Medicare	$66.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$257.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$79.38

.Fungal Cult LC

Facility

IP

$243.00

Service Code	CPT 87101
Hospital Charge Code	9228407
Hospital Revenue Code	301
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$218.70
Rate for Payer: Aetna of AZ Commercial	$218.70
Rate for Payer: Bisbee Police All Plans	$63.18
Rate for Payer: Cash Price	$194.40
Rate for Payer: Self Pay Self Pay	$194.40

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