Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

heparin flush 10 units/mL Sol[CQCH]

Facility

OP

$0.59

Service Code	HCPCS J1642
Hospital Charge Code	153607645
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.53
Rate for Payer: Aetna of AZ Commercial	$0.53
Rate for Payer: Aetna of AZ Medicare	$0.17
Rate for Payer: AHCCCS Medicaid	$0.04
Rate for Payer: Allwell Medicaid	$0.04
Rate for Payer: Allwell Medicare	$0.09
Rate for Payer: Amerigroup Medicare	$0.09
Rate for Payer: APIPA Medicare/Medicaid	$0.22
Rate for Payer: AZCH Complete Medicaid	$0.04
Rate for Payer: AZCH Complete Medicare	$0.09
Rate for Payer: Banner UC Health Medicaid	$0.04
Rate for Payer: Banner UC Health Medicare	$0.09
Rate for Payer: Bisbee Police All Plans	$0.15
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.40
Rate for Payer: Cash Price	$0.47
Rate for Payer: Cash Price	$0.47
Rate for Payer: Cigna of AZ Commercial	$0.38
Rate for Payer: Copperpoint Commercial	$0.15
Rate for Payer: Health Net of AZ Commercial	$0.35
Rate for Payer: Health Net of AZ Medicare	$0.17
Rate for Payer: Humana of AZ Medicare	$0.09
Rate for Payer: Mercy Care Medicaid	$0.04
Rate for Payer: Self Pay Self Pay	$0.47
Rate for Payer: TriWest Medicare	$0.09
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.11

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$16,093.62

Service Code	APR-DRG 2794
Hospital Charge Code	APRDRG2792
Min. Negotiated Rate	$16,093.62
Max. Negotiated Rate	$16,093.62
Rate for Payer: AHCCCS Medicaid	$16,093.62
Rate for Payer: Allwell Medicaid	$16,093.62
Rate for Payer: AZCH Complete Medicaid	$16,093.62
Rate for Payer: Banner UC Health Medicaid	$16,093.62
Rate for Payer: Mercy Care Medicaid	$16,093.62

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$16,093.62

Service Code	APR-DRG 2794
Hospital Charge Code	APRDRG2794
Min. Negotiated Rate	$16,093.62
Max. Negotiated Rate	$16,093.62
Rate for Payer: AHCCCS Medicaid	$16,093.62
Rate for Payer: Allwell Medicaid	$16,093.62
Rate for Payer: AZCH Complete Medicaid	$16,093.62
Rate for Payer: Banner UC Health Medicaid	$16,093.62
Rate for Payer: Mercy Care Medicaid	$16,093.62

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$6,830.93

Service Code	APR-DRG 2793
Hospital Charge Code	APRDRG2794
Min. Negotiated Rate	$6,830.93
Max. Negotiated Rate	$6,830.93
Rate for Payer: AHCCCS Medicaid	$6,830.93
Rate for Payer: Allwell Medicaid	$6,830.93
Rate for Payer: AZCH Complete Medicaid	$6,830.93
Rate for Payer: Banner UC Health Medicaid	$6,830.93
Rate for Payer: Mercy Care Medicaid	$6,830.93

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$3,375.84

Service Code	APR-DRG 2791
Hospital Charge Code	APRDRG2791
Min. Negotiated Rate	$3,375.84
Max. Negotiated Rate	$3,375.84
Rate for Payer: AHCCCS Medicaid	$3,375.84
Rate for Payer: Allwell Medicaid	$3,375.84
Rate for Payer: AZCH Complete Medicaid	$3,375.84
Rate for Payer: Banner UC Health Medicaid	$3,375.84
Rate for Payer: Mercy Care Medicaid	$3,375.84

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$3,375.84

Service Code	APR-DRG 2791
Hospital Charge Code	APRDRG2794
Min. Negotiated Rate	$3,375.84
Max. Negotiated Rate	$3,375.84
Rate for Payer: AHCCCS Medicaid	$3,375.84
Rate for Payer: Allwell Medicaid	$3,375.84
Rate for Payer: AZCH Complete Medicaid	$3,375.84
Rate for Payer: Banner UC Health Medicaid	$3,375.84
Rate for Payer: Mercy Care Medicaid	$3,375.84

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$3,375.84

Service Code	APR-DRG 2791
Hospital Charge Code	APRDRG2793
Min. Negotiated Rate	$3,375.84
Max. Negotiated Rate	$3,375.84
Rate for Payer: AHCCCS Medicaid	$3,375.84
Rate for Payer: Allwell Medicaid	$3,375.84
Rate for Payer: AZCH Complete Medicaid	$3,375.84
Rate for Payer: Banner UC Health Medicaid	$3,375.84
Rate for Payer: Mercy Care Medicaid	$3,375.84

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$16,093.62

Service Code	APR-DRG 2794
Hospital Charge Code	APRDRG2791
Min. Negotiated Rate	$16,093.62
Max. Negotiated Rate	$16,093.62
Rate for Payer: AHCCCS Medicaid	$16,093.62
Rate for Payer: Allwell Medicaid	$16,093.62
Rate for Payer: AZCH Complete Medicaid	$16,093.62
Rate for Payer: Banner UC Health Medicaid	$16,093.62
Rate for Payer: Mercy Care Medicaid	$16,093.62

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$6,830.93

Service Code	APR-DRG 2793
Hospital Charge Code	APRDRG2791
Min. Negotiated Rate	$6,830.93
Max. Negotiated Rate	$6,830.93
Rate for Payer: AHCCCS Medicaid	$6,830.93
Rate for Payer: Allwell Medicaid	$6,830.93
Rate for Payer: AZCH Complete Medicaid	$6,830.93
Rate for Payer: Banner UC Health Medicaid	$6,830.93
Rate for Payer: Mercy Care Medicaid	$6,830.93

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$4,281.35

Service Code	APR-DRG 2792
Hospital Charge Code	APRDRG2794
Min. Negotiated Rate	$4,281.35
Max. Negotiated Rate	$4,281.35
Rate for Payer: AHCCCS Medicaid	$4,281.35
Rate for Payer: Allwell Medicaid	$4,281.35
Rate for Payer: AZCH Complete Medicaid	$4,281.35
Rate for Payer: Banner UC Health Medicaid	$4,281.35
Rate for Payer: Mercy Care Medicaid	$4,281.35

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$16,093.62

Service Code	APR-DRG 2794
Hospital Charge Code	APRDRG2793
Min. Negotiated Rate	$16,093.62
Max. Negotiated Rate	$16,093.62
Rate for Payer: AHCCCS Medicaid	$16,093.62
Rate for Payer: Allwell Medicaid	$16,093.62
Rate for Payer: AZCH Complete Medicaid	$16,093.62
Rate for Payer: Banner UC Health Medicaid	$16,093.62
Rate for Payer: Mercy Care Medicaid	$16,093.62

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$4,281.35

Service Code	APR-DRG 2792
Hospital Charge Code	APRDRG2792
Min. Negotiated Rate	$4,281.35
Max. Negotiated Rate	$4,281.35
Rate for Payer: AHCCCS Medicaid	$4,281.35
Rate for Payer: Allwell Medicaid	$4,281.35
Rate for Payer: AZCH Complete Medicaid	$4,281.35
Rate for Payer: Banner UC Health Medicaid	$4,281.35
Rate for Payer: Mercy Care Medicaid	$4,281.35

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$4,281.35

Service Code	APR-DRG 2792
Hospital Charge Code	APRDRG2791
Min. Negotiated Rate	$4,281.35
Max. Negotiated Rate	$4,281.35
Rate for Payer: AHCCCS Medicaid	$4,281.35
Rate for Payer: Allwell Medicaid	$4,281.35
Rate for Payer: AZCH Complete Medicaid	$4,281.35
Rate for Payer: Banner UC Health Medicaid	$4,281.35
Rate for Payer: Mercy Care Medicaid	$4,281.35

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$6,830.93

Service Code	APR-DRG 2793
Hospital Charge Code	APRDRG2793
Min. Negotiated Rate	$6,830.93
Max. Negotiated Rate	$6,830.93
Rate for Payer: AHCCCS Medicaid	$6,830.93
Rate for Payer: Allwell Medicaid	$6,830.93
Rate for Payer: AZCH Complete Medicaid	$6,830.93
Rate for Payer: Banner UC Health Medicaid	$6,830.93
Rate for Payer: Mercy Care Medicaid	$6,830.93

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$4,281.35

Service Code	APR-DRG 2792
Hospital Charge Code	APRDRG2793
Min. Negotiated Rate	$4,281.35
Max. Negotiated Rate	$4,281.35
Rate for Payer: AHCCCS Medicaid	$4,281.35
Rate for Payer: Allwell Medicaid	$4,281.35
Rate for Payer: AZCH Complete Medicaid	$4,281.35
Rate for Payer: Banner UC Health Medicaid	$4,281.35
Rate for Payer: Mercy Care Medicaid	$4,281.35

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$6,830.93

Service Code	APR-DRG 2793
Hospital Charge Code	APRDRG2792
Min. Negotiated Rate	$6,830.93
Max. Negotiated Rate	$6,830.93
Rate for Payer: AHCCCS Medicaid	$6,830.93
Rate for Payer: Allwell Medicaid	$6,830.93
Rate for Payer: AZCH Complete Medicaid	$6,830.93
Rate for Payer: Banner UC Health Medicaid	$6,830.93
Rate for Payer: Mercy Care Medicaid	$6,830.93

Hepatic Coma And Other Major Acute Liver Disorders

Facility

IP

$3,375.84

Service Code	APR-DRG 2791
Hospital Charge Code	APRDRG2792
Min. Negotiated Rate	$3,375.84
Max. Negotiated Rate	$3,375.84
Rate for Payer: AHCCCS Medicaid	$3,375.84
Rate for Payer: Allwell Medicaid	$3,375.84
Rate for Payer: AZCH Complete Medicaid	$3,375.84
Rate for Payer: Banner UC Health Medicaid	$3,375.84
Rate for Payer: Mercy Care Medicaid	$3,375.84

Hepatic Function Panel Standard

Facility

OP

$208.00

Service Code	CPT 80076
Hospital Charge Code	22141045
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$187.20
Rate for Payer: Aetna of AZ Commercial	$187.20
Rate for Payer: Aetna of AZ Medicare	$58.24
Rate for Payer: AHCCCS Medicaid	$8.17
Rate for Payer: Allwell Medicaid	$8.17
Rate for Payer: Allwell Medicare	$31.20
Rate for Payer: Amerigroup Medicare	$31.20
Rate for Payer: APIPA Medicare/Medicaid	$77.69
Rate for Payer: AZCH Complete Medicaid	$8.17
Rate for Payer: AZCH Complete Medicare	$31.20
Rate for Payer: Banner UC Health Medicaid	$8.17
Rate for Payer: Banner UC Health Medicare	$31.20
Rate for Payer: Bisbee Police All Plans	$54.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$141.44
Rate for Payer: Cash Price	$166.40
Rate for Payer: Cash Price	$166.40
Rate for Payer: Cigna of AZ Commercial	$135.20
Rate for Payer: Copperpoint Commercial	$51.48
Rate for Payer: Health Net of AZ Commercial	$124.80
Rate for Payer: Health Net of AZ Medicare	$58.24
Rate for Payer: Humana of AZ Medicare	$31.20
Rate for Payer: Mercy Care Medicaid	$8.17
Rate for Payer: Self Pay Self Pay	$166.40
Rate for Payer: TriWest Medicare	$31.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$121.26
Rate for Payer: UnitedHealth Group of AZ Medicare	$37.44

Hepatic Function Panel Standard

Facility

IP

$208.00

Service Code	CPT 80076
Hospital Charge Code	22141045
Hospital Revenue Code	301
Min. Negotiated Rate	$54.08
Max. Negotiated Rate	$187.20
Rate for Payer: Aetna of AZ Commercial	$187.20
Rate for Payer: Bisbee Police All Plans	$54.08
Rate for Payer: Cash Price	$166.40
Rate for Payer: Self Pay Self Pay	$166.40

hepatitis A adult vaccine 1440 units/mL preservative free Sus[CQCH]

Facility

IP

$63.32

Service Code	NDC 58160082652
Hospital Charge Code	147577806
Hospital Revenue Code	250
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$56.99
Rate for Payer: Aetna of AZ Commercial	$56.99
Rate for Payer: Bisbee Police All Plans	$16.46
Rate for Payer: Cash Price	$50.66
Rate for Payer: Self Pay Self Pay	$50.66

hepatitis A adult vaccine 1440 units/mL preservative free Sus[CQCH]

Facility

OP

$63.32

Service Code	NDC 58160082652
Hospital Charge Code	147577806
Hospital Revenue Code	250
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$56.99
Rate for Payer: Aetna of AZ Commercial	$56.99
Rate for Payer: Aetna of AZ Medicare	$17.73
Rate for Payer: Allwell Medicare	$9.50
Rate for Payer: Amerigroup Medicare	$9.50
Rate for Payer: APIPA Medicare/Medicaid	$23.65
Rate for Payer: AZCH Complete Medicare	$9.50
Rate for Payer: Banner UC Health Medicare	$9.50
Rate for Payer: Bisbee Police All Plans	$16.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$43.06
Rate for Payer: Cash Price	$50.66
Rate for Payer: Cigna of AZ Commercial	$41.16
Rate for Payer: Copperpoint Commercial	$15.67
Rate for Payer: Health Net of AZ Commercial	$37.99
Rate for Payer: Health Net of AZ Medicare	$17.73
Rate for Payer: Humana of AZ Medicare	$9.50
Rate for Payer: Self Pay Self Pay	$50.66
Rate for Payer: TriWest Medicare	$9.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$36.92
Rate for Payer: UnitedHealth Group of AZ Medicare	$11.40

hepatitis B adult vaccine 20 mcg [CQCH]

Facility

IP

$48.20

Service Code	HCPCS 90746
Hospital Charge Code	105925438
Hospital Revenue Code	250
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$43.38
Rate for Payer: Aetna of AZ Commercial	$43.38
Rate for Payer: Bisbee Police All Plans	$12.53
Rate for Payer: Cash Price	$38.56
Rate for Payer: Self Pay Self Pay	$38.56

hepatitis B adult vaccine 20 mcg [CQCH]

Facility

OP

$48.20

Service Code	HCPCS 90746
Hospital Charge Code	105925438
Hospital Revenue Code	250
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$133.72
Rate for Payer: Aetna of AZ Commercial	$43.38
Rate for Payer: Aetna of AZ Medicare	$13.50
Rate for Payer: AHCCCS Medicaid	$133.72
Rate for Payer: Allwell Medicaid	$133.72
Rate for Payer: Allwell Medicare	$7.23
Rate for Payer: Amerigroup Medicare	$7.23
Rate for Payer: APIPA Medicare/Medicaid	$18.00
Rate for Payer: AZCH Complete Medicaid	$133.72
Rate for Payer: AZCH Complete Medicare	$7.23
Rate for Payer: Banner UC Health Medicaid	$133.72
Rate for Payer: Banner UC Health Medicare	$7.23
Rate for Payer: Bisbee Police All Plans	$12.53
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$32.78
Rate for Payer: Cash Price	$38.56
Rate for Payer: Cash Price	$38.56
Rate for Payer: Cigna of AZ Commercial	$31.33
Rate for Payer: Copperpoint Commercial	$11.93
Rate for Payer: Health Net of AZ Commercial	$28.92
Rate for Payer: Health Net of AZ Medicare	$13.50
Rate for Payer: Humana of AZ Medicare	$7.23
Rate for Payer: Mercy Care Medicaid	$133.72
Rate for Payer: Self Pay Self Pay	$38.56
Rate for Payer: TriWest Medicare	$7.23
Rate for Payer: UnitedHealth Group of AZ Commercial	$28.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$8.68

Hepatitis Be Ag, LC

Facility

OP

$238.00

Service Code	CPT 87350
Hospital Charge Code	4976988
Hospital Revenue Code	302
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$214.20
Rate for Payer: Aetna of AZ Commercial	$214.20
Rate for Payer: Aetna of AZ Medicare	$66.64
Rate for Payer: AHCCCS Medicaid	$11.53
Rate for Payer: Allwell Medicaid	$11.53
Rate for Payer: Allwell Medicare	$35.70
Rate for Payer: Amerigroup Medicare	$35.70
Rate for Payer: APIPA Medicare/Medicaid	$88.89
Rate for Payer: AZCH Complete Medicaid	$11.53
Rate for Payer: AZCH Complete Medicare	$35.70
Rate for Payer: Banner UC Health Medicaid	$11.53
Rate for Payer: Banner UC Health Medicare	$35.70
Rate for Payer: Bisbee Police All Plans	$61.88
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$161.84
Rate for Payer: Cash Price	$190.40
Rate for Payer: Cash Price	$190.40
Rate for Payer: Cigna of AZ Commercial	$154.70
Rate for Payer: Copperpoint Commercial	$58.90
Rate for Payer: Health Net of AZ Commercial	$142.80
Rate for Payer: Health Net of AZ Medicare	$66.64
Rate for Payer: Humana of AZ Medicare	$35.70
Rate for Payer: Mercy Care Medicaid	$11.53
Rate for Payer: Self Pay Self Pay	$190.40
Rate for Payer: TriWest Medicare	$35.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$138.75
Rate for Payer: UnitedHealth Group of AZ Medicare	$42.84

Hepatitis Be Ag, LC

Facility

IP

$238.00

Service Code	CPT 87350
Hospital Charge Code	4976988
Hospital Revenue Code	302
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$214.20
Rate for Payer: Aetna of AZ Commercial	$214.20
Rate for Payer: Bisbee Police All Plans	$61.88
Rate for Payer: Cash Price	$190.40
Rate for Payer: Self Pay Self Pay	$190.40

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