Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Gastric Fundoplication

Facility

IP

$13,458.46

Service Code	APR-DRG 2323
Hospital Charge Code	APRDRG2323
Min. Negotiated Rate	$13,458.46
Max. Negotiated Rate	$13,458.46
Rate for Payer: AHCCCS Medicaid	$13,458.46
Rate for Payer: Allwell Medicaid	$13,458.46
Rate for Payer: AZCH Complete Medicaid	$13,458.46
Rate for Payer: Banner UC Health Medicaid	$13,458.46
Rate for Payer: Mercy Care Medicaid	$13,458.46

Gastric Fundoplication

Facility

IP

$8,538.84

Service Code	APR-DRG 2322
Hospital Charge Code	APRDRG2322
Min. Negotiated Rate	$8,538.84
Max. Negotiated Rate	$8,538.84
Rate for Payer: AHCCCS Medicaid	$8,538.84
Rate for Payer: Allwell Medicaid	$8,538.84
Rate for Payer: AZCH Complete Medicaid	$8,538.84
Rate for Payer: Banner UC Health Medicaid	$8,538.84
Rate for Payer: Mercy Care Medicaid	$8,538.84

Gastric Fundoplication

Facility

IP

$46,303.62

Service Code	APR-DRG 2324
Hospital Charge Code	APRDRG2324
Min. Negotiated Rate	$46,303.62
Max. Negotiated Rate	$46,303.62
Rate for Payer: AHCCCS Medicaid	$46,303.62
Rate for Payer: Allwell Medicaid	$46,303.62
Rate for Payer: AZCH Complete Medicaid	$46,303.62
Rate for Payer: Banner UC Health Medicaid	$46,303.62
Rate for Payer: Mercy Care Medicaid	$46,303.62

Gastrointestinal Panel Filmarray PCR

Facility

IP

$2,084.00

Service Code	CPT 87507
Hospital Charge Code	22961678
Hospital Revenue Code	301
Min. Negotiated Rate	$541.84
Max. Negotiated Rate	$1,875.60
Rate for Payer: Aetna of AZ Commercial	$1,875.60
Rate for Payer: Bisbee Police All Plans	$541.84
Rate for Payer: Cash Price	$1,667.20
Rate for Payer: Self Pay Self Pay	$1,667.20

Gastrointestinal Panel Filmarray PCR

Facility

OP

$2,084.00

Service Code	CPT 87507
Hospital Charge Code	22961678
Hospital Revenue Code	301
Min. Negotiated Rate	$312.60
Max. Negotiated Rate	$1,875.60
Rate for Payer: Aetna of AZ Commercial	$1,875.60
Rate for Payer: Aetna of AZ Medicare	$583.52
Rate for Payer: AHCCCS Medicaid	$416.78
Rate for Payer: Allwell Medicaid	$416.78
Rate for Payer: Allwell Medicare	$312.60
Rate for Payer: Amerigroup Medicare	$312.60
Rate for Payer: APIPA Medicare/Medicaid	$778.37
Rate for Payer: AZCH Complete Medicaid	$416.78
Rate for Payer: AZCH Complete Medicare	$312.60
Rate for Payer: Banner UC Health Medicaid	$416.78
Rate for Payer: Banner UC Health Medicare	$312.60
Rate for Payer: Bisbee Police All Plans	$541.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,417.12
Rate for Payer: Cash Price	$1,667.20
Rate for Payer: Cash Price	$1,667.20
Rate for Payer: Cigna of AZ Commercial	$1,354.60
Rate for Payer: Copperpoint Commercial	$515.79
Rate for Payer: Health Net of AZ Commercial	$1,250.40
Rate for Payer: Health Net of AZ Medicare	$583.52
Rate for Payer: Humana of AZ Medicare	$312.60
Rate for Payer: Mercy Care Medicaid	$416.78
Rate for Payer: Self Pay Self Pay	$1,667.20
Rate for Payer: TriWest Medicare	$312.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,214.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$375.12

Gastrointestinal Vascular Insufficiency

Facility

IP

$3,840.17

Service Code	APR-DRG 2461
Hospital Charge Code	APRDRG2461
Min. Negotiated Rate	$3,840.17
Max. Negotiated Rate	$3,840.17
Rate for Payer: AHCCCS Medicaid	$3,840.17
Rate for Payer: Allwell Medicaid	$3,840.17
Rate for Payer: AZCH Complete Medicaid	$3,840.17
Rate for Payer: Banner UC Health Medicaid	$3,840.17
Rate for Payer: Mercy Care Medicaid	$3,840.17

Gastrointestinal Vascular Insufficiency

Facility

IP

$12,765.48

Service Code	APR-DRG 2464
Hospital Charge Code	APRDRG2461
Min. Negotiated Rate	$12,765.48
Max. Negotiated Rate	$12,765.48
Rate for Payer: AHCCCS Medicaid	$12,765.48
Rate for Payer: Allwell Medicaid	$12,765.48
Rate for Payer: AZCH Complete Medicaid	$12,765.48
Rate for Payer: Banner UC Health Medicaid	$12,765.48
Rate for Payer: Mercy Care Medicaid	$12,765.48

Gastrointestinal Vascular Insufficiency

Facility

IP

$7,315.60

Service Code	APR-DRG 2463
Hospital Charge Code	APRDRG2462
Min. Negotiated Rate	$7,315.60
Max. Negotiated Rate	$7,315.60
Rate for Payer: AHCCCS Medicaid	$7,315.60
Rate for Payer: Allwell Medicaid	$7,315.60
Rate for Payer: AZCH Complete Medicaid	$7,315.60
Rate for Payer: Banner UC Health Medicaid	$7,315.60
Rate for Payer: Mercy Care Medicaid	$7,315.60

Gastrointestinal Vascular Insufficiency

Facility

IP

$3,840.17

Service Code	APR-DRG 2461
Hospital Charge Code	APRDRG2464
Min. Negotiated Rate	$3,840.17
Max. Negotiated Rate	$3,840.17
Rate for Payer: AHCCCS Medicaid	$3,840.17
Rate for Payer: Allwell Medicaid	$3,840.17
Rate for Payer: AZCH Complete Medicaid	$3,840.17
Rate for Payer: Banner UC Health Medicaid	$3,840.17
Rate for Payer: Mercy Care Medicaid	$3,840.17

Gastrointestinal Vascular Insufficiency

Facility

IP

$12,765.48

Service Code	APR-DRG 2464
Hospital Charge Code	APRDRG2464
Min. Negotiated Rate	$12,765.48
Max. Negotiated Rate	$12,765.48
Rate for Payer: AHCCCS Medicaid	$12,765.48
Rate for Payer: Allwell Medicaid	$12,765.48
Rate for Payer: AZCH Complete Medicaid	$12,765.48
Rate for Payer: Banner UC Health Medicaid	$12,765.48
Rate for Payer: Mercy Care Medicaid	$12,765.48

Gastrointestinal Vascular Insufficiency

Facility

IP

$7,315.60

Service Code	APR-DRG 2463
Hospital Charge Code	APRDRG2461
Min. Negotiated Rate	$7,315.60
Max. Negotiated Rate	$7,315.60
Rate for Payer: AHCCCS Medicaid	$7,315.60
Rate for Payer: Allwell Medicaid	$7,315.60
Rate for Payer: AZCH Complete Medicaid	$7,315.60
Rate for Payer: Banner UC Health Medicaid	$7,315.60
Rate for Payer: Mercy Care Medicaid	$7,315.60

Gastrointestinal Vascular Insufficiency

Facility

IP

$7,315.60

Service Code	APR-DRG 2463
Hospital Charge Code	APRDRG2463
Min. Negotiated Rate	$7,315.60
Max. Negotiated Rate	$7,315.60
Rate for Payer: AHCCCS Medicaid	$7,315.60
Rate for Payer: Allwell Medicaid	$7,315.60
Rate for Payer: AZCH Complete Medicaid	$7,315.60
Rate for Payer: Banner UC Health Medicaid	$7,315.60
Rate for Payer: Mercy Care Medicaid	$7,315.60

Gastrointestinal Vascular Insufficiency

Facility

IP

$3,840.17

Service Code	APR-DRG 2461
Hospital Charge Code	APRDRG2463
Min. Negotiated Rate	$3,840.17
Max. Negotiated Rate	$3,840.17
Rate for Payer: AHCCCS Medicaid	$3,840.17
Rate for Payer: Allwell Medicaid	$3,840.17
Rate for Payer: AZCH Complete Medicaid	$3,840.17
Rate for Payer: Banner UC Health Medicaid	$3,840.17
Rate for Payer: Mercy Care Medicaid	$3,840.17

Gastrointestinal Vascular Insufficiency

Facility

IP

$7,315.60

Service Code	APR-DRG 2463
Hospital Charge Code	APRDRG2464
Min. Negotiated Rate	$7,315.60
Max. Negotiated Rate	$7,315.60
Rate for Payer: AHCCCS Medicaid	$7,315.60
Rate for Payer: Allwell Medicaid	$7,315.60
Rate for Payer: AZCH Complete Medicaid	$7,315.60
Rate for Payer: Banner UC Health Medicaid	$7,315.60
Rate for Payer: Mercy Care Medicaid	$7,315.60

Gastrointestinal Vascular Insufficiency

Facility

IP

$4,782.85

Service Code	APR-DRG 2462
Hospital Charge Code	APRDRG2463
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Gastrointestinal Vascular Insufficiency

Facility

IP

$4,782.85

Service Code	APR-DRG 2462
Hospital Charge Code	APRDRG2462
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Gastrointestinal Vascular Insufficiency

Facility

IP

$4,782.85

Service Code	APR-DRG 2462
Hospital Charge Code	APRDRG2464
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

Gastrointestinal Vascular Insufficiency

Facility

IP

$12,765.48

Service Code	APR-DRG 2464
Hospital Charge Code	APRDRG2462
Min. Negotiated Rate	$12,765.48
Max. Negotiated Rate	$12,765.48
Rate for Payer: AHCCCS Medicaid	$12,765.48
Rate for Payer: Allwell Medicaid	$12,765.48
Rate for Payer: AZCH Complete Medicaid	$12,765.48
Rate for Payer: Banner UC Health Medicaid	$12,765.48
Rate for Payer: Mercy Care Medicaid	$12,765.48

Gastrointestinal Vascular Insufficiency

Facility

IP

$12,765.48

Service Code	APR-DRG 2464
Hospital Charge Code	APRDRG2463
Min. Negotiated Rate	$12,765.48
Max. Negotiated Rate	$12,765.48
Rate for Payer: AHCCCS Medicaid	$12,765.48
Rate for Payer: Allwell Medicaid	$12,765.48
Rate for Payer: AZCH Complete Medicaid	$12,765.48
Rate for Payer: Banner UC Health Medicaid	$12,765.48
Rate for Payer: Mercy Care Medicaid	$12,765.48

Gastrointestinal Vascular Insufficiency

Facility

IP

$3,840.17

Service Code	APR-DRG 2461
Hospital Charge Code	APRDRG2462
Min. Negotiated Rate	$3,840.17
Max. Negotiated Rate	$3,840.17
Rate for Payer: AHCCCS Medicaid	$3,840.17
Rate for Payer: Allwell Medicaid	$3,840.17
Rate for Payer: AZCH Complete Medicaid	$3,840.17
Rate for Payer: Banner UC Health Medicaid	$3,840.17
Rate for Payer: Mercy Care Medicaid	$3,840.17

Gastrointestinal Vascular Insufficiency

Facility

IP

$4,782.85

Service Code	APR-DRG 2462
Hospital Charge Code	APRDRG2461
Min. Negotiated Rate	$4,782.85
Max. Negotiated Rate	$4,782.85
Rate for Payer: AHCCCS Medicaid	$4,782.85
Rate for Payer: Allwell Medicaid	$4,782.85
Rate for Payer: AZCH Complete Medicaid	$4,782.85
Rate for Payer: Banner UC Health Medicaid	$4,782.85
Rate for Payer: Mercy Care Medicaid	$4,782.85

GC AMPLIFICTN

Facility

IP

$434.00

Service Code	CPT 87591
Hospital Charge Code	22481475
Hospital Revenue Code	306
Min. Negotiated Rate	$112.84
Max. Negotiated Rate	$390.60
Rate for Payer: Aetna of AZ Commercial	$390.60
Rate for Payer: Bisbee Police All Plans	$112.84
Rate for Payer: Cash Price	$347.20
Rate for Payer: Self Pay Self Pay	$347.20

GC AMPLIFICTN

Facility

OP

$434.00

Service Code	CPT 87591
Hospital Charge Code	22481475
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$390.60
Rate for Payer: Aetna of AZ Commercial	$390.60
Rate for Payer: Aetna of AZ Medicare	$121.52
Rate for Payer: AHCCCS Medicaid	$35.09
Rate for Payer: Allwell Medicaid	$35.09
Rate for Payer: Allwell Medicare	$65.10
Rate for Payer: Amerigroup Medicare	$65.10
Rate for Payer: APIPA Medicare/Medicaid	$162.10
Rate for Payer: AZCH Complete Medicaid	$35.09
Rate for Payer: AZCH Complete Medicare	$65.10
Rate for Payer: Banner UC Health Medicaid	$35.09
Rate for Payer: Banner UC Health Medicare	$65.10
Rate for Payer: Bisbee Police All Plans	$112.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$295.12
Rate for Payer: Cash Price	$347.20
Rate for Payer: Cash Price	$347.20
Rate for Payer: Cigna of AZ Commercial	$282.10
Rate for Payer: Copperpoint Commercial	$107.42
Rate for Payer: Health Net of AZ Commercial	$260.40
Rate for Payer: Health Net of AZ Medicare	$121.52
Rate for Payer: Humana of AZ Medicare	$65.10
Rate for Payer: Mercy Care Medicaid	$35.09
Rate for Payer: Self Pay Self Pay	$347.20
Rate for Payer: TriWest Medicare	$65.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$253.02
Rate for Payer: UnitedHealth Group of AZ Medicare	$78.12

GC ANTIBODY

Facility

IP

$353.00

Service Code	CPT 86609
Hospital Charge Code	23092679
Hospital Revenue Code	302
Min. Negotiated Rate	$91.78
Max. Negotiated Rate	$317.70
Rate for Payer: Aetna of AZ Commercial	$317.70
Rate for Payer: Bisbee Police All Plans	$91.78
Rate for Payer: Cash Price	$282.40
Rate for Payer: Self Pay Self Pay	$282.40

GC ANTIBODY

Facility

OP

$353.00

Service Code	CPT 86609
Hospital Charge Code	23092679
Hospital Revenue Code	302
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$317.70
Rate for Payer: Aetna of AZ Commercial	$317.70
Rate for Payer: Aetna of AZ Medicare	$98.84
Rate for Payer: AHCCCS Medicaid	$12.88
Rate for Payer: Allwell Medicaid	$12.88
Rate for Payer: Allwell Medicare	$52.95
Rate for Payer: Amerigroup Medicare	$52.95
Rate for Payer: APIPA Medicare/Medicaid	$131.85
Rate for Payer: AZCH Complete Medicaid	$12.88
Rate for Payer: AZCH Complete Medicare	$52.95
Rate for Payer: Banner UC Health Medicaid	$12.88
Rate for Payer: Banner UC Health Medicare	$52.95
Rate for Payer: Bisbee Police All Plans	$91.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$240.04
Rate for Payer: Cash Price	$282.40
Rate for Payer: Cash Price	$282.40
Rate for Payer: Cigna of AZ Commercial	$229.45
Rate for Payer: Copperpoint Commercial	$87.37
Rate for Payer: Health Net of AZ Commercial	$211.80
Rate for Payer: Health Net of AZ Medicare	$98.84
Rate for Payer: Humana of AZ Medicare	$52.95
Rate for Payer: Mercy Care Medicaid	$12.88
Rate for Payer: Self Pay Self Pay	$282.40
Rate for Payer: TriWest Medicare	$52.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$205.80
Rate for Payer: UnitedHealth Group of AZ Medicare	$63.54

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