Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$4,557.00

Service Code	APR-DRG 8102
Hospital Charge Code	APRDRG8101
Min. Negotiated Rate	$4,557.00
Max. Negotiated Rate	$4,557.00
Rate for Payer: AHCCCS Medicaid	$4,557.00
Rate for Payer: Allwell Medicaid	$4,557.00
Rate for Payer: AZCH Complete Medicaid	$4,557.00
Rate for Payer: Banner UC Health Medicaid	$4,557.00
Rate for Payer: Mercy Care Medicaid	$4,557.00

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$3,444.58

Service Code	APR-DRG 8101
Hospital Charge Code	APRDRG8104
Min. Negotiated Rate	$3,444.58
Max. Negotiated Rate	$3,444.58
Rate for Payer: AHCCCS Medicaid	$3,444.58
Rate for Payer: Allwell Medicaid	$3,444.58
Rate for Payer: AZCH Complete Medicaid	$3,444.58
Rate for Payer: Banner UC Health Medicaid	$3,444.58
Rate for Payer: Mercy Care Medicaid	$3,444.58

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$7,208.99

Service Code	APR-DRG 8103
Hospital Charge Code	APRDRG8103
Min. Negotiated Rate	$7,208.99
Max. Negotiated Rate	$7,208.99
Rate for Payer: AHCCCS Medicaid	$7,208.99
Rate for Payer: Allwell Medicaid	$7,208.99
Rate for Payer: AZCH Complete Medicaid	$7,208.99
Rate for Payer: Banner UC Health Medicaid	$7,208.99
Rate for Payer: Mercy Care Medicaid	$7,208.99

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$4,557.00

Service Code	APR-DRG 8102
Hospital Charge Code	APRDRG8104
Min. Negotiated Rate	$4,557.00
Max. Negotiated Rate	$4,557.00
Rate for Payer: AHCCCS Medicaid	$4,557.00
Rate for Payer: Allwell Medicaid	$4,557.00
Rate for Payer: AZCH Complete Medicaid	$4,557.00
Rate for Payer: Banner UC Health Medicaid	$4,557.00
Rate for Payer: Mercy Care Medicaid	$4,557.00

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$4,557.00

Service Code	APR-DRG 8102
Hospital Charge Code	APRDRG8103
Min. Negotiated Rate	$4,557.00
Max. Negotiated Rate	$4,557.00
Rate for Payer: AHCCCS Medicaid	$4,557.00
Rate for Payer: Allwell Medicaid	$4,557.00
Rate for Payer: AZCH Complete Medicaid	$4,557.00
Rate for Payer: Banner UC Health Medicaid	$4,557.00
Rate for Payer: Mercy Care Medicaid	$4,557.00

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$3,444.58

Service Code	APR-DRG 8101
Hospital Charge Code	APRDRG8103
Min. Negotiated Rate	$3,444.58
Max. Negotiated Rate	$3,444.58
Rate for Payer: AHCCCS Medicaid	$3,444.58
Rate for Payer: Allwell Medicaid	$3,444.58
Rate for Payer: AZCH Complete Medicaid	$3,444.58
Rate for Payer: Banner UC Health Medicaid	$3,444.58
Rate for Payer: Mercy Care Medicaid	$3,444.58

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$3,444.58

Service Code	APR-DRG 8101
Hospital Charge Code	APRDRG8102
Min. Negotiated Rate	$3,444.58
Max. Negotiated Rate	$3,444.58
Rate for Payer: AHCCCS Medicaid	$3,444.58
Rate for Payer: Allwell Medicaid	$3,444.58
Rate for Payer: AZCH Complete Medicaid	$3,444.58
Rate for Payer: Banner UC Health Medicaid	$3,444.58
Rate for Payer: Mercy Care Medicaid	$3,444.58

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$7,208.99

Service Code	APR-DRG 8103
Hospital Charge Code	APRDRG8104
Min. Negotiated Rate	$7,208.99
Max. Negotiated Rate	$7,208.99
Rate for Payer: AHCCCS Medicaid	$7,208.99
Rate for Payer: Allwell Medicaid	$7,208.99
Rate for Payer: AZCH Complete Medicaid	$7,208.99
Rate for Payer: Banner UC Health Medicaid	$7,208.99
Rate for Payer: Mercy Care Medicaid	$7,208.99

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$7,208.99

Service Code	APR-DRG 8103
Hospital Charge Code	APRDRG8101
Min. Negotiated Rate	$7,208.99
Max. Negotiated Rate	$7,208.99
Rate for Payer: AHCCCS Medicaid	$7,208.99
Rate for Payer: Allwell Medicaid	$7,208.99
Rate for Payer: AZCH Complete Medicaid	$7,208.99
Rate for Payer: Banner UC Health Medicaid	$7,208.99
Rate for Payer: Mercy Care Medicaid	$7,208.99

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$14,389.22

Service Code	APR-DRG 8104
Hospital Charge Code	APRDRG8103
Min. Negotiated Rate	$14,389.22
Max. Negotiated Rate	$14,389.22
Rate for Payer: AHCCCS Medicaid	$14,389.22
Rate for Payer: Allwell Medicaid	$14,389.22
Rate for Payer: AZCH Complete Medicaid	$14,389.22
Rate for Payer: Banner UC Health Medicaid	$14,389.22
Rate for Payer: Mercy Care Medicaid	$14,389.22

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$14,389.22

Service Code	APR-DRG 8104
Hospital Charge Code	APRDRG8104
Min. Negotiated Rate	$14,389.22
Max. Negotiated Rate	$14,389.22
Rate for Payer: AHCCCS Medicaid	$14,389.22
Rate for Payer: Allwell Medicaid	$14,389.22
Rate for Payer: AZCH Complete Medicaid	$14,389.22
Rate for Payer: Banner UC Health Medicaid	$14,389.22
Rate for Payer: Mercy Care Medicaid	$14,389.22

Hemorrhage Or Hematoma Due To Complication

Facility

IP

$3,444.58

Service Code	APR-DRG 8101
Hospital Charge Code	APRDRG8101
Min. Negotiated Rate	$3,444.58
Max. Negotiated Rate	$3,444.58
Rate for Payer: AHCCCS Medicaid	$3,444.58
Rate for Payer: Allwell Medicaid	$3,444.58
Rate for Payer: AZCH Complete Medicaid	$3,444.58
Rate for Payer: Banner UC Health Medicaid	$3,444.58
Rate for Payer: Mercy Care Medicaid	$3,444.58

HEMORRHOID BAND

Facility

OP

$405.00

Hospital Charge Code	22354833
Hospital Revenue Code	270
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$364.50
Rate for Payer: Aetna of AZ Commercial	$364.50
Rate for Payer: Aetna of AZ Medicare	$113.40
Rate for Payer: Allwell Medicare	$60.75
Rate for Payer: Amerigroup Medicare	$60.75
Rate for Payer: APIPA Medicare/Medicaid	$151.27
Rate for Payer: AZCH Complete Medicare	$60.75
Rate for Payer: Banner UC Health Medicare	$60.75
Rate for Payer: Bisbee Police All Plans	$105.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$275.40
Rate for Payer: Cash Price	$324.00
Rate for Payer: Cigna of AZ Commercial	$283.50
Rate for Payer: Copperpoint Commercial	$100.24
Rate for Payer: Health Net of AZ Commercial	$243.00
Rate for Payer: Health Net of AZ Medicare	$113.40
Rate for Payer: Humana of AZ Medicare	$60.75
Rate for Payer: Self Pay Self Pay	$324.00
Rate for Payer: TriWest Medicare	$60.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$236.12
Rate for Payer: UnitedHealth Group of AZ Medicare	$72.90

HEMORRHOID BAND

Facility

IP

$405.00

Hospital Charge Code	22354833
Hospital Revenue Code	270
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$364.50
Rate for Payer: Aetna of AZ Commercial	$364.50
Rate for Payer: Bisbee Police All Plans	$105.30
Rate for Payer: Cash Price	$324.00
Rate for Payer: Self Pay Self Pay	$324.00

Hep A Ab, IgM LC

Facility

OP

$270.00

Service Code	CPT 86709
Hospital Charge Code	2087607
Hospital Revenue Code	302
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Aetna of AZ Medicare	$75.60
Rate for Payer: AHCCCS Medicaid	$11.26
Rate for Payer: Allwell Medicaid	$11.26
Rate for Payer: Allwell Medicare	$40.50
Rate for Payer: Amerigroup Medicare	$40.50
Rate for Payer: APIPA Medicare/Medicaid	$100.84
Rate for Payer: AZCH Complete Medicaid	$11.26
Rate for Payer: AZCH Complete Medicare	$40.50
Rate for Payer: Banner UC Health Medicaid	$11.26
Rate for Payer: Banner UC Health Medicare	$40.50
Rate for Payer: Bisbee Police All Plans	$70.20
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$183.60
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cigna of AZ Commercial	$175.50
Rate for Payer: Copperpoint Commercial	$66.82
Rate for Payer: Health Net of AZ Commercial	$162.00
Rate for Payer: Health Net of AZ Medicare	$75.60
Rate for Payer: Humana of AZ Medicare	$40.50
Rate for Payer: Mercy Care Medicaid	$11.26
Rate for Payer: Self Pay Self Pay	$216.00
Rate for Payer: TriWest Medicare	$40.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$157.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$48.60

Hep A Ab, IgM LC

Facility

IP

$270.00

Service Code	CPT 86709
Hospital Charge Code	2087607
Hospital Revenue Code	302
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Bisbee Police All Plans	$70.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Self Pay Self Pay	$216.00

Hep A Ab, Total LC

Facility

IP

$243.00

Service Code	CPT 86708
Hospital Charge Code	1906884
Hospital Revenue Code	302
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

Hep A Ab, Total LC

Facility

OP

$243.00

Service Code	CPT 86708
Hospital Charge Code	1906884
Hospital Revenue Code	302
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$218.70
Rate for Payer: Aetna of AZ Commercial	$218.70
Rate for Payer: Aetna of AZ Medicare	$68.04
Rate for Payer: AHCCCS Medicaid	$12.39
Rate for Payer: Allwell Medicaid	$12.39
Rate for Payer: Allwell Medicare	$36.45
Rate for Payer: Amerigroup Medicare	$36.45
Rate for Payer: APIPA Medicare/Medicaid	$90.76
Rate for Payer: AZCH Complete Medicaid	$12.39
Rate for Payer: AZCH Complete Medicare	$36.45
Rate for Payer: Banner UC Health Medicaid	$12.39
Rate for Payer: Banner UC Health Medicare	$36.45
Rate for Payer: Bisbee Police All Plans	$63.18
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$165.24
Rate for Payer: Cash Price	$194.40
Rate for Payer: Cash Price	$194.40
Rate for Payer: Cigna of AZ Commercial	$157.95
Rate for Payer: Copperpoint Commercial	$60.14
Rate for Payer: Health Net of AZ Commercial	$145.80
Rate for Payer: Health Net of AZ Medicare	$68.04
Rate for Payer: Humana of AZ Medicare	$36.45
Rate for Payer: Mercy Care Medicaid	$12.39
Rate for Payer: Self Pay Self Pay	$194.40
Rate for Payer: TriWest Medicare	$36.45
Rate for Payer: UnitedHealth Group of AZ Commercial	$141.67
Rate for Payer: UnitedHealth Group of AZ Medicare	$43.74

heparin 5000 units/mL Inj Sol [CQCH]

Facility

IP

$0.88

Service Code	HCPCS J1644
Hospital Charge Code	105925227
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.79
Rate for Payer: Aetna of AZ Commercial	$0.79
Rate for Payer: Bisbee Police All Plans	$0.23
Rate for Payer: Cash Price	$0.71
Rate for Payer: Self Pay Self Pay	$0.70

heparin 5000 units/mL Inj Sol [CQCH]

Facility

OP

$0.88

Service Code	HCPCS J1644
Hospital Charge Code	105925227
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.79
Rate for Payer: Aetna of AZ Commercial	$0.79
Rate for Payer: Aetna of AZ Medicare	$0.25
Rate for Payer: AHCCCS Medicaid	$0.24
Rate for Payer: Allwell Medicaid	$0.24
Rate for Payer: Allwell Medicare	$0.13
Rate for Payer: Amerigroup Medicare	$0.13
Rate for Payer: APIPA Medicare/Medicaid	$0.33
Rate for Payer: AZCH Complete Medicaid	$0.24
Rate for Payer: AZCH Complete Medicare	$0.13
Rate for Payer: Banner UC Health Medicaid	$0.24
Rate for Payer: Banner UC Health Medicare	$0.13
Rate for Payer: Bisbee Police All Plans	$0.23
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.60
Rate for Payer: Cash Price	$0.71
Rate for Payer: Cash Price	$0.71
Rate for Payer: Cigna of AZ Commercial	$0.57
Rate for Payer: Copperpoint Commercial	$0.22
Rate for Payer: Health Net of AZ Commercial	$0.53
Rate for Payer: Health Net of AZ Medicare	$0.25
Rate for Payer: Humana of AZ Medicare	$0.13
Rate for Payer: Mercy Care Medicaid	$0.24
Rate for Payer: Self Pay Self Pay	$0.70
Rate for Payer: TriWest Medicare	$0.13
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.51
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.16

heparin drip 25000 units/ 250 mL IVPB [CQCH]

Facility

IP

$0.04

Service Code	HCPCS J1644
Hospital Charge Code	105925296
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
Rate for Payer: Aetna of AZ Commercial	$0.04
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Cash Price	$0.03
Rate for Payer: Self Pay Self Pay	$0.03

heparin drip 25000 units/ 250 mL IVPB [CQCH]

Facility

OP

$0.04

Service Code	HCPCS J1644
Hospital Charge Code	105925296
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.24
Rate for Payer: Aetna of AZ Commercial	$0.04
Rate for Payer: Aetna of AZ Medicare	$0.01
Rate for Payer: AHCCCS Medicaid	$0.24
Rate for Payer: Allwell Medicaid	$0.24
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.01
Rate for Payer: AZCH Complete Medicaid	$0.24
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicaid	$0.24
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.03
Rate for Payer: Cash Price	$0.03
Rate for Payer: Cash Price	$0.03
Rate for Payer: Cigna of AZ Commercial	$0.03
Rate for Payer: Copperpoint Commercial	$0.01
Rate for Payer: Health Net of AZ Commercial	$0.02
Rate for Payer: Health Net of AZ Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Mercy Care Medicaid	$0.24
Rate for Payer: Self Pay Self Pay	$0.03
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.02
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

heparin flush 100 units/mL Sol [CQCH]

Facility

OP

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	105925367
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.06
Rate for Payer: Aetna of AZ Commercial	$0.06
Rate for Payer: Aetna of AZ Medicare	$0.02
Rate for Payer: AHCCCS Medicaid	$0.04
Rate for Payer: Allwell Medicaid	$0.04
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.03
Rate for Payer: AZCH Complete Medicaid	$0.04
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicaid	$0.04
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.05
Rate for Payer: Cash Price	$0.06
Rate for Payer: Cash Price	$0.06
Rate for Payer: Cigna of AZ Commercial	$0.05
Rate for Payer: Copperpoint Commercial	$0.02
Rate for Payer: Health Net of AZ Commercial	$0.04
Rate for Payer: Health Net of AZ Medicare	$0.02
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Mercy Care Medicaid	$0.04
Rate for Payer: Self Pay Self Pay	$0.06
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.04
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

heparin flush 100 units/mL Sol [CQCH]

Facility

IP

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	105925367
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.06
Rate for Payer: Aetna of AZ Commercial	$0.06
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Cash Price	$0.06
Rate for Payer: Self Pay Self Pay	$0.06

heparin flush 10 units/mL Sol[CQCH]

Facility

IP

$0.59

Service Code	HCPCS J1642
Hospital Charge Code	153607645
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.53
Rate for Payer: Aetna of AZ Commercial	$0.53
Rate for Payer: Bisbee Police All Plans	$0.15
Rate for Payer: Cash Price	$0.47
Rate for Payer: Self Pay Self Pay	$0.47

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