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

$4,588.56

Service Code	APR-DRG 3422
Hospital Charge Code	APRDRG3422
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	APRDRG3422
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

$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

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

$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

$6,444.46

Service Code	APR-DRG 3423
Hospital Charge Code	APRDRG3424
Min. Negotiated Rate	$6,444.46
Max. Negotiated Rate	$6,444.46
Rate for Payer: AHCCCS Medicaid	$6,444.46
Rate for Payer: Allwell Medicaid	$6,444.46
Rate for Payer: AZCH Complete Medicaid	$6,444.46
Rate for Payer: Banner UC Health Medicaid	$6,444.46
Rate for Payer: Mercy Care Medicaid	$6,444.46

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$3,642.37

Service Code	APR-DRG 3421
Hospital Charge Code	APRDRG3424
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

$6,444.46

Service Code	APR-DRG 3423
Hospital Charge Code	APRDRG3421
Min. Negotiated Rate	$6,444.46
Max. Negotiated Rate	$6,444.46
Rate for Payer: AHCCCS Medicaid	$6,444.46
Rate for Payer: Allwell Medicaid	$6,444.46
Rate for Payer: AZCH Complete Medicaid	$6,444.46
Rate for Payer: Banner UC Health Medicaid	$6,444.46
Rate for Payer: Mercy Care Medicaid	$6,444.46

Fractures And Dislocations Except Femur, Pelvis And Back

Facility

IP

$12,648.35

Service Code	APR-DRG 3424
Hospital Charge Code	APRDRG3424
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

Free and Total Insulin LC

Facility

IP

$185.00

Service Code	CPT 83527
Hospital Charge Code	22201725
Hospital Revenue Code	301
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Cash Price	$148.00
Rate for Payer: Self Pay Self Pay	$148.00

Free and Total Insulin LC

Facility

OP

$185.00

Service Code	CPT 83527
Hospital Charge Code	22201725
Hospital Revenue Code	301
Min. Negotiated Rate	$29.60
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Aetna of AZ Medicare	$51.80
Rate for Payer: Allwell Medicare	$29.60
Rate for Payer: Amerigroup Medicare	$29.60
Rate for Payer: APIPA Medicare/Medicaid	$69.10
Rate for Payer: AZCH Complete Medicare	$29.60
Rate for Payer: Banner UC Health Medicare	$29.60
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$125.80
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cigna of AZ Commercial	$120.25
Rate for Payer: Copperpoint Commercial	$45.79
Rate for Payer: Health Net of AZ Commercial	$111.00
Rate for Payer: Health Net of AZ Medicare	$51.80
Rate for Payer: Humana of AZ Medicare	$29.60
Rate for Payer: Self Pay Self Pay	$148.00
Rate for Payer: TriWest Medicare	$29.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$107.86
Rate for Payer: UnitedHealth Group of AZ Medicare	$33.30

Free K+L Lt Chains,Qn,S LC

Facility

IP

$260.00

Service Code	CPT 83883
Hospital Charge Code	2029245
Hospital Revenue Code	301
Min. Negotiated Rate	$67.60
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna of AZ Commercial	$234.00
Rate for Payer: Bisbee Police All Plans	$67.60
Rate for Payer: Cash Price	$208.00
Rate for Payer: Self Pay Self Pay	$208.00

Free K+L Lt Chains,Qn,S LC

Facility

OP

$260.00

Service Code	CPT 83883
Hospital Charge Code	2029245
Hospital Revenue Code	301
Min. Negotiated Rate	$41.60
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna of AZ Commercial	$234.00
Rate for Payer: Aetna of AZ Medicare	$72.80
Rate for Payer: Allwell Medicare	$41.60
Rate for Payer: Amerigroup Medicare	$41.60
Rate for Payer: APIPA Medicare/Medicaid	$97.11
Rate for Payer: AZCH Complete Medicare	$41.60
Rate for Payer: Banner UC Health Medicare	$41.60
Rate for Payer: Bisbee Police All Plans	$67.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$176.80
Rate for Payer: Cash Price	$208.00
Rate for Payer: Cigna of AZ Commercial	$169.00
Rate for Payer: Copperpoint Commercial	$64.35
Rate for Payer: Health Net of AZ Commercial	$156.00
Rate for Payer: Health Net of AZ Medicare	$72.80
Rate for Payer: Humana of AZ Medicare	$41.60
Rate for Payer: Self Pay Self Pay	$208.00
Rate for Payer: TriWest Medicare	$41.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$151.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$46.80

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	$26.88
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: Allwell Medicare	$26.88
Rate for Payer: Amerigroup Medicare	$26.88
Rate for Payer: APIPA Medicare/Medicaid	$62.75
Rate for Payer: AZCH Complete Medicare	$26.88
Rate for Payer: Banner UC Health Medicare	$26.88
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: 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	$26.88
Rate for Payer: Self Pay Self Pay	$134.40
Rate for Payer: TriWest Medicare	$26.88
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	6781685
Hospital Revenue Code	300
Min. Negotiated Rate	$26.88
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: Allwell Medicare	$26.88
Rate for Payer: Amerigroup Medicare	$26.88
Rate for Payer: APIPA Medicare/Medicaid	$62.75
Rate for Payer: AZCH Complete Medicare	$26.88
Rate for Payer: Banner UC Health Medicare	$26.88
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: 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	$26.88
Rate for Payer: Self Pay Self Pay	$134.40
Rate for Payer: TriWest Medicare	$26.88
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	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

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

$355.00

Service Code	CPT 84439
Hospital Charge Code	857849
Hospital Revenue Code	301
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$319.50
Rate for Payer: Aetna of AZ Commercial	$319.50
Rate for Payer: Aetna of AZ Medicare	$99.40
Rate for Payer: Allwell Medicare	$56.80
Rate for Payer: Amerigroup Medicare	$56.80
Rate for Payer: APIPA Medicare/Medicaid	$132.59
Rate for Payer: AZCH Complete Medicare	$56.80
Rate for Payer: Banner UC Health Medicare	$56.80
Rate for Payer: Bisbee Police All Plans	$92.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$241.40
Rate for Payer: Cash Price	$284.00
Rate for Payer: Cigna of AZ Commercial	$230.75
Rate for Payer: Copperpoint Commercial	$87.86
Rate for Payer: Health Net of AZ Commercial	$213.00
Rate for Payer: Health Net of AZ Medicare	$99.40
Rate for Payer: Humana of AZ Medicare	$56.80
Rate for Payer: Self Pay Self Pay	$284.00
Rate for Payer: TriWest Medicare	$56.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$206.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$63.90

Free T4

Facility

IP

$355.00

Service Code	CPT 84439
Hospital Charge Code	857849
Hospital Revenue Code	301
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$319.50
Rate for Payer: Aetna of AZ Commercial	$319.50
Rate for Payer: Bisbee Police All Plans	$92.30
Rate for Payer: Cash Price	$284.00
Rate for Payer: Self Pay Self Pay	$284.00

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

FROZ SEC PREP

Facility

OP

$34.00

Service Code	CPT 88331
Hospital Charge Code	22545752
Hospital Revenue Code	310
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$30.60
Rate for Payer: Aetna of AZ Commercial	$30.60
Rate for Payer: Aetna of AZ Medicare	$9.52
Rate for Payer: Allwell Medicare	$5.44
Rate for Payer: Amerigroup Medicare	$5.44
Rate for Payer: APIPA Medicare/Medicaid	$12.70
Rate for Payer: AZCH Complete Medicare	$5.44
Rate for Payer: Banner UC Health Medicare	$5.44
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: Cigna of AZ Commercial	$22.10
Rate for Payer: Copperpoint Commercial	$8.41
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	$5.44
Rate for Payer: Self Pay Self Pay	$27.20
Rate for Payer: TriWest Medicare	$5.44
Rate for Payer: UnitedHealth Group of AZ Commercial	$19.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$6.12

Frz Plasma CPD

Facility

OP

$177.00

Service Code	CPT P9017
Hospital Charge Code	15493410
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

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

FSH and LH LC

Facility

IP

$419.00

Service Code	CPT 83001
Hospital Charge Code	1285571
Hospital Revenue Code	301
Min. Negotiated Rate	$108.94
Max. Negotiated Rate	$377.10
Rate for Payer: Aetna of AZ Commercial	$377.10
Rate for Payer: Bisbee Police All Plans	$108.94
Rate for Payer: Cash Price	$335.20
Rate for Payer: Self Pay Self Pay	$335.20

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