Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$9,499.76

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG2273
Min. Negotiated Rate	$9,499.76
Max. Negotiated Rate	$9,499.76
Rate for Payer: AHCCCS Medicaid	$9,499.76
Rate for Payer: Allwell Medicaid	$9,499.76
Rate for Payer: AZCH Complete Medicaid	$9,499.76
Rate for Payer: Banner UC Health Medicaid	$9,499.76
Rate for Payer: Mercy Care Medicaid	$9,499.76

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$9,499.76

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG2271
Min. Negotiated Rate	$9,499.76
Max. Negotiated Rate	$9,499.76
Rate for Payer: AHCCCS Medicaid	$9,499.76
Rate for Payer: Allwell Medicaid	$9,499.76
Rate for Payer: AZCH Complete Medicaid	$9,499.76
Rate for Payer: Banner UC Health Medicaid	$9,499.76
Rate for Payer: Mercy Care Medicaid	$9,499.76

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$9,499.76

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG2272
Min. Negotiated Rate	$9,499.76
Max. Negotiated Rate	$9,499.76
Rate for Payer: AHCCCS Medicaid	$9,499.76
Rate for Payer: Allwell Medicaid	$9,499.76
Rate for Payer: AZCH Complete Medicaid	$9,499.76
Rate for Payer: Banner UC Health Medicaid	$9,499.76
Rate for Payer: Mercy Care Medicaid	$9,499.76

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$14,697.84

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG2272
Min. Negotiated Rate	$14,697.84
Max. Negotiated Rate	$14,697.84
Rate for Payer: AHCCCS Medicaid	$14,697.84
Rate for Payer: Allwell Medicaid	$14,697.84
Rate for Payer: AZCH Complete Medicaid	$14,697.84
Rate for Payer: Banner UC Health Medicaid	$14,697.84
Rate for Payer: Mercy Care Medicaid	$14,697.84

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$26,146.09

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG2274
Min. Negotiated Rate	$26,146.09
Max. Negotiated Rate	$26,146.09
Rate for Payer: AHCCCS Medicaid	$26,146.09
Rate for Payer: Allwell Medicaid	$26,146.09
Rate for Payer: AZCH Complete Medicaid	$26,146.09
Rate for Payer: Banner UC Health Medicaid	$26,146.09
Rate for Payer: Mercy Care Medicaid	$26,146.09

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$14,697.84

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG2271
Min. Negotiated Rate	$14,697.84
Max. Negotiated Rate	$14,697.84
Rate for Payer: AHCCCS Medicaid	$14,697.84
Rate for Payer: Allwell Medicaid	$14,697.84
Rate for Payer: AZCH Complete Medicaid	$14,697.84
Rate for Payer: Banner UC Health Medicaid	$14,697.84
Rate for Payer: Mercy Care Medicaid	$14,697.84

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$26,146.09

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG2271
Min. Negotiated Rate	$26,146.09
Max. Negotiated Rate	$26,146.09
Rate for Payer: AHCCCS Medicaid	$26,146.09
Rate for Payer: Allwell Medicaid	$26,146.09
Rate for Payer: AZCH Complete Medicaid	$26,146.09
Rate for Payer: Banner UC Health Medicaid	$26,146.09
Rate for Payer: Mercy Care Medicaid	$26,146.09

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$26,146.09

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG2272
Min. Negotiated Rate	$26,146.09
Max. Negotiated Rate	$26,146.09
Rate for Payer: AHCCCS Medicaid	$26,146.09
Rate for Payer: Allwell Medicaid	$26,146.09
Rate for Payer: AZCH Complete Medicaid	$26,146.09
Rate for Payer: Banner UC Health Medicaid	$26,146.09
Rate for Payer: Mercy Care Medicaid	$26,146.09

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$7,520.41

Service Code	APR-DRG 2271
Hospital Charge Code	APRDRG2272
Min. Negotiated Rate	$7,520.41
Max. Negotiated Rate	$7,520.41
Rate for Payer: AHCCCS Medicaid	$7,520.41
Rate for Payer: Allwell Medicaid	$7,520.41
Rate for Payer: AZCH Complete Medicaid	$7,520.41
Rate for Payer: Banner UC Health Medicaid	$7,520.41
Rate for Payer: Mercy Care Medicaid	$7,520.41

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$9,499.76

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG2274
Min. Negotiated Rate	$9,499.76
Max. Negotiated Rate	$9,499.76
Rate for Payer: AHCCCS Medicaid	$9,499.76
Rate for Payer: Allwell Medicaid	$9,499.76
Rate for Payer: AZCH Complete Medicaid	$9,499.76
Rate for Payer: Banner UC Health Medicaid	$9,499.76
Rate for Payer: Mercy Care Medicaid	$9,499.76

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$14,697.84

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG2274
Min. Negotiated Rate	$14,697.84
Max. Negotiated Rate	$14,697.84
Rate for Payer: AHCCCS Medicaid	$14,697.84
Rate for Payer: Allwell Medicaid	$14,697.84
Rate for Payer: AZCH Complete Medicaid	$14,697.84
Rate for Payer: Banner UC Health Medicaid	$14,697.84
Rate for Payer: Mercy Care Medicaid	$14,697.84

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$7,520.41

Service Code	APR-DRG 2271
Hospital Charge Code	APRDRG2273
Min. Negotiated Rate	$7,520.41
Max. Negotiated Rate	$7,520.41
Rate for Payer: AHCCCS Medicaid	$7,520.41
Rate for Payer: Allwell Medicaid	$7,520.41
Rate for Payer: AZCH Complete Medicaid	$7,520.41
Rate for Payer: Banner UC Health Medicaid	$7,520.41
Rate for Payer: Mercy Care Medicaid	$7,520.41

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$7,520.41

Service Code	APR-DRG 2271
Hospital Charge Code	APRDRG2271
Min. Negotiated Rate	$7,520.41
Max. Negotiated Rate	$7,520.41
Rate for Payer: AHCCCS Medicaid	$7,520.41
Rate for Payer: Allwell Medicaid	$7,520.41
Rate for Payer: AZCH Complete Medicaid	$7,520.41
Rate for Payer: Banner UC Health Medicaid	$7,520.41
Rate for Payer: Mercy Care Medicaid	$7,520.41

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$26,146.09

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG2273
Min. Negotiated Rate	$26,146.09
Max. Negotiated Rate	$26,146.09
Rate for Payer: AHCCCS Medicaid	$26,146.09
Rate for Payer: Allwell Medicaid	$26,146.09
Rate for Payer: AZCH Complete Medicaid	$26,146.09
Rate for Payer: Banner UC Health Medicaid	$26,146.09
Rate for Payer: Mercy Care Medicaid	$26,146.09

Hernia Procedures Except Inguinal, Femoral And Umbilical

Facility

IP

$14,697.84

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG2273
Min. Negotiated Rate	$14,697.84
Max. Negotiated Rate	$14,697.84
Rate for Payer: AHCCCS Medicaid	$14,697.84
Rate for Payer: Allwell Medicaid	$14,697.84
Rate for Payer: AZCH Complete Medicaid	$14,697.84
Rate for Payer: Banner UC Health Medicaid	$14,697.84
Rate for Payer: Mercy Care Medicaid	$14,697.84

Herpes Simplex (HSV) 1 2, NAA

Facility

OP

$603.00

Service Code	CPT 87529
Hospital Charge Code	22948345
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$542.70
Rate for Payer: Aetna of AZ Commercial	$542.70
Rate for Payer: Aetna of AZ Medicare	$168.84
Rate for Payer: AHCCCS Medicaid	$35.09
Rate for Payer: Allwell Medicaid	$35.09
Rate for Payer: Allwell Medicare	$90.45
Rate for Payer: Amerigroup Medicare	$90.45
Rate for Payer: APIPA Medicare/Medicaid	$225.22
Rate for Payer: AZCH Complete Medicaid	$35.09
Rate for Payer: AZCH Complete Medicare	$90.45
Rate for Payer: Banner UC Health Medicaid	$35.09
Rate for Payer: Banner UC Health Medicare	$90.45
Rate for Payer: Bisbee Police All Plans	$156.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$410.04
Rate for Payer: Cash Price	$482.40
Rate for Payer: Cash Price	$482.40
Rate for Payer: Cigna of AZ Commercial	$391.95
Rate for Payer: Copperpoint Commercial	$149.24
Rate for Payer: Health Net of AZ Commercial	$361.80
Rate for Payer: Health Net of AZ Medicare	$168.84
Rate for Payer: Humana of AZ Medicare	$90.45
Rate for Payer: Mercy Care Medicaid	$35.09
Rate for Payer: Self Pay Self Pay	$482.40
Rate for Payer: TriWest Medicare	$90.45
Rate for Payer: UnitedHealth Group of AZ Commercial	$351.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$108.54

Herpes Simplex (HSV) 1 2, NAA

Facility

IP

$603.00

Service Code	CPT 87529
Hospital Charge Code	22587723
Hospital Revenue Code	306
Min. Negotiated Rate	$156.78
Max. Negotiated Rate	$542.70
Rate for Payer: Aetna of AZ Commercial	$542.70
Rate for Payer: Bisbee Police All Plans	$156.78
Rate for Payer: Cash Price	$482.40
Rate for Payer: Self Pay Self Pay	$482.40

Herpes Simplex (HSV) 1 2, NAA

Facility

OP

$603.00

Service Code	CPT 87529
Hospital Charge Code	22587723
Hospital Revenue Code	306
Min. Negotiated Rate	$35.09
Max. Negotiated Rate	$542.70
Rate for Payer: Aetna of AZ Commercial	$542.70
Rate for Payer: Aetna of AZ Medicare	$168.84
Rate for Payer: AHCCCS Medicaid	$35.09
Rate for Payer: Allwell Medicaid	$35.09
Rate for Payer: Allwell Medicare	$90.45
Rate for Payer: Amerigroup Medicare	$90.45
Rate for Payer: APIPA Medicare/Medicaid	$225.22
Rate for Payer: AZCH Complete Medicaid	$35.09
Rate for Payer: AZCH Complete Medicare	$90.45
Rate for Payer: Banner UC Health Medicaid	$35.09
Rate for Payer: Banner UC Health Medicare	$90.45
Rate for Payer: Bisbee Police All Plans	$156.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$410.04
Rate for Payer: Cash Price	$482.40
Rate for Payer: Cash Price	$482.40
Rate for Payer: Cigna of AZ Commercial	$391.95
Rate for Payer: Copperpoint Commercial	$149.24
Rate for Payer: Health Net of AZ Commercial	$361.80
Rate for Payer: Health Net of AZ Medicare	$168.84
Rate for Payer: Humana of AZ Medicare	$90.45
Rate for Payer: Mercy Care Medicaid	$35.09
Rate for Payer: Self Pay Self Pay	$482.40
Rate for Payer: TriWest Medicare	$90.45
Rate for Payer: UnitedHealth Group of AZ Commercial	$351.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$108.54

Herpes Simplex (HSV) 1 2, NAA

Facility

IP

$603.00

Service Code	CPT 87529
Hospital Charge Code	22948345
Hospital Revenue Code	306
Min. Negotiated Rate	$156.78
Max. Negotiated Rate	$542.70
Rate for Payer: Aetna of AZ Commercial	$542.70
Rate for Payer: Bisbee Police All Plans	$156.78
Rate for Payer: Cash Price	$482.40
Rate for Payer: Self Pay Self Pay	$482.40

HF LOOP LARGE .2W 12 DEG WA22503D

Facility

OP

$2,864.00

Hospital Charge Code	23278407
Hospital Revenue Code	272
Min. Negotiated Rate	$429.60
Max. Negotiated Rate	$2,577.60
Rate for Payer: Aetna of AZ Commercial	$2,577.60
Rate for Payer: Aetna of AZ Medicare	$801.92
Rate for Payer: Allwell Medicare	$429.60
Rate for Payer: Amerigroup Medicare	$429.60
Rate for Payer: APIPA Medicare/Medicaid	$1,069.70
Rate for Payer: AZCH Complete Medicare	$429.60
Rate for Payer: Banner UC Health Medicare	$429.60
Rate for Payer: Bisbee Police All Plans	$744.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,947.52
Rate for Payer: Cash Price	$2,291.20
Rate for Payer: Cigna of AZ Commercial	$2,004.80
Rate for Payer: Copperpoint Commercial	$708.84
Rate for Payer: Health Net of AZ Commercial	$1,718.40
Rate for Payer: Health Net of AZ Medicare	$801.92
Rate for Payer: Humana of AZ Medicare	$429.60
Rate for Payer: Self Pay Self Pay	$2,291.20
Rate for Payer: TriWest Medicare	$429.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,669.71
Rate for Payer: UnitedHealth Group of AZ Medicare	$515.52

HF LOOP LARGE .2W 12 DEG WA22503D

Facility

IP

$2,864.00

Hospital Charge Code	23278407
Hospital Revenue Code	272
Min. Negotiated Rate	$744.64
Max. Negotiated Rate	$2,577.60
Rate for Payer: Aetna of AZ Commercial	$2,577.60
Rate for Payer: Bisbee Police All Plans	$744.64
Rate for Payer: Cash Price	$2,291.20
Rate for Payer: Self Pay Self Pay	$2,291.20

Hgb Frac. w/o Solubility LC

Facility

OP

$224.00

Service Code	CPT 83021
Hospital Charge Code	2087611
Hospital Revenue Code	301
Min. Negotiated Rate	$18.06
Max. Negotiated Rate	$201.60
Rate for Payer: Aetna of AZ Commercial	$201.60
Rate for Payer: Aetna of AZ Medicare	$62.72
Rate for Payer: AHCCCS Medicaid	$18.06
Rate for Payer: Allwell Medicaid	$18.06
Rate for Payer: Allwell Medicare	$33.60
Rate for Payer: Amerigroup Medicare	$33.60
Rate for Payer: APIPA Medicare/Medicaid	$83.66
Rate for Payer: AZCH Complete Medicaid	$18.06
Rate for Payer: AZCH Complete Medicare	$33.60
Rate for Payer: Banner UC Health Medicaid	$18.06
Rate for Payer: Banner UC Health Medicare	$33.60
Rate for Payer: Bisbee Police All Plans	$58.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$152.32
Rate for Payer: Cash Price	$179.20
Rate for Payer: Cash Price	$179.20
Rate for Payer: Cigna of AZ Commercial	$145.60
Rate for Payer: Copperpoint Commercial	$55.44
Rate for Payer: Health Net of AZ Commercial	$134.40
Rate for Payer: Health Net of AZ Medicare	$62.72
Rate for Payer: Humana of AZ Medicare	$33.60
Rate for Payer: Mercy Care Medicaid	$18.06
Rate for Payer: Self Pay Self Pay	$179.20
Rate for Payer: TriWest Medicare	$33.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$130.59
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.32

Hgb Frac. w/o Solubility LC

Facility

IP

$224.00

Service Code	CPT 83021
Hospital Charge Code	2087611
Hospital Revenue Code	301
Min. Negotiated Rate	$58.24
Max. Negotiated Rate	$201.60
Rate for Payer: Aetna of AZ Commercial	$201.60
Rate for Payer: Bisbee Police All Plans	$58.24
Rate for Payer: Cash Price	$179.20
Rate for Payer: Self Pay Self Pay	$179.20

HIFLO BUBBLE HUMIDIFIER EMPTY

Facility

OP

$148.00

Hospital Charge Code	24180129
Hospital Revenue Code	270
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$133.20
Rate for Payer: Aetna of AZ Commercial	$133.20
Rate for Payer: Aetna of AZ Medicare	$41.44
Rate for Payer: Allwell Medicare	$22.20
Rate for Payer: Amerigroup Medicare	$22.20
Rate for Payer: APIPA Medicare/Medicaid	$55.28
Rate for Payer: AZCH Complete Medicare	$22.20
Rate for Payer: Banner UC Health Medicare	$22.20
Rate for Payer: Bisbee Police All Plans	$38.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$100.64
Rate for Payer: Cash Price	$118.40
Rate for Payer: Cigna of AZ Commercial	$103.60
Rate for Payer: Copperpoint Commercial	$36.63
Rate for Payer: Health Net of AZ Commercial	$88.80
Rate for Payer: Health Net of AZ Medicare	$41.44
Rate for Payer: Humana of AZ Medicare	$22.20
Rate for Payer: Self Pay Self Pay	$118.40
Rate for Payer: TriWest Medicare	$22.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$86.28
Rate for Payer: UnitedHealth Group of AZ Medicare	$26.64

HIFLO BUBBLE HUMIDIFIER EMPTY

Facility

IP

$148.00

Hospital Charge Code	24180129
Hospital Revenue Code	270
Min. Negotiated Rate	$38.48
Max. Negotiated Rate	$133.20
Rate for Payer: Aetna of AZ Commercial	$133.20
Rate for Payer: Bisbee Police All Plans	$38.48
Rate for Payer: Cash Price	$118.40
Rate for Payer: Self Pay Self Pay	$118.40

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