|
00790 ANES INTRAPER UPPER ABDOMEN ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00790
|
| Hospital Charge Code |
22406094
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00790 ANES INTRAPER UPPER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00790
|
| Hospital Charge Code |
22406103
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00790 ANES INTRAPER UPPER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00790
|
| Hospital Charge Code |
22406103
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00800 ANES LOWER ANTER ABDMN WAL ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00800
|
| Hospital Charge Code |
22406106
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00800 ANES LOWER ANTER ABDMN WAL ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00800
|
| Hospital Charge Code |
22406106
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00800 ANES LOWER ANTER ABDOMINAL WALL ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00800
|
| Hospital Charge Code |
22406105
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00800 ANES LOWER ANTER ABDOMINAL WALL ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00800
|
| Hospital Charge Code |
22406105
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00811 ANES LOWER INSTESTINAL ENDO ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00812
|
| Hospital Charge Code |
22406130
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00811 ANES LOWER INSTESTINAL ENDO ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00812
|
| Hospital Charge Code |
22406130
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00811 ANES LOWER INSTESTINAL ENDO ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00811
|
| Hospital Charge Code |
22406131
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00811 ANES LOWER INSTESTINAL ENDO ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00811
|
| Hospital Charge Code |
22406131
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00830 ANES HERNIA REPAIR LOWER ABD ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00830
|
| Hospital Charge Code |
22406134
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00830 ANES HERNIA REPAIR LOWER ABD ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00830
|
| Hospital Charge Code |
22406134
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00830 ANES HERNIA REPAIR LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00830
|
| Hospital Charge Code |
22406133
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00830 ANES HERNIA REPAIR LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00830
|
| Hospital Charge Code |
22406133
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIA 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406137
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIA 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406137
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIA ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406136
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIA ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406136
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIAS BASE CHG AND 1ST MIN
|
Facility
IP
|
$723.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406135
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$187.98 |
| Max. Negotiated Rate |
$650.70 |
| Rate for Payer: Aetna of AZ Commercial |
$650.70
|
| Rate for Payer: Bisbee Police All Plans |
$187.98
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Self Pay Self Pay |
$578.40
|
|
|
00832 ANES VENTRAL INCISIONAL HERNIAS BASE CHG AND 1ST MIN
|
Facility
OP
|
$723.00
|
|
|
Service Code
|
CPT 00832
|
| Hospital Charge Code |
22406135
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$650.70 |
| Rate for Payer: Aetna of AZ Commercial |
$650.70
|
| Rate for Payer: Aetna of AZ Medicare |
$202.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$108.45
|
| Rate for Payer: Amerigroup Medicare |
$108.45
|
| Rate for Payer: APIPA Medicare/Medicaid |
$270.04
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$108.45
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$108.45
|
| Rate for Payer: Bisbee Police All Plans |
$187.98
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$491.64
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cigna of AZ Commercial |
$506.10
|
| Rate for Payer: Copperpoint Commercial |
$178.94
|
| Rate for Payer: Health Net of AZ Commercial |
$433.80
|
| Rate for Payer: Health Net of AZ Medicare |
$202.44
|
| Rate for Payer: Humana of AZ Medicare |
$108.45
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$578.40
|
| Rate for Payer: TriWest Medicare |
$108.45
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$421.51
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$130.14
|
|
|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN 0:30 CHARGE
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406140
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna of AZ Commercial |
$7.20
|
| Rate for Payer: Aetna of AZ Medicare |
$2.24
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.20
|
| Rate for Payer: Amerigroup Medicare |
$1.20
|
| Rate for Payer: APIPA Medicare/Medicaid |
$2.99
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.20
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.20
|
| Rate for Payer: Bisbee Police All Plans |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$5.44
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cigna of AZ Commercial |
$5.20
|
| Rate for Payer: Copperpoint Commercial |
$1.98
|
| Rate for Payer: Health Net of AZ Commercial |
$4.80
|
| Rate for Payer: Health Net of AZ Medicare |
$2.24
|
| Rate for Payer: Humana of AZ Medicare |
$1.20
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$6.40
|
| Rate for Payer: TriWest Medicare |
$1.20
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$4.66
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.44
|
|
|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN 0:30 CHARGE
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406140
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna of AZ Commercial |
$7.20
|
| Rate for Payer: Bisbee Police All Plans |
$2.08
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Self Pay Self Pay |
$6.40
|
|
|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406139
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406139
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
