|
PT CONTRAST BATH @ 15 MIN
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 97034 GP
|
| Hospital Charge Code |
8865467
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$64.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Cigna All Products |
$120.40
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: HealthNet Commercial |
$103.20
|
| Rate for Payer: HealthNet Medicare |
$48.16
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$30.96
|
|
|
PT ELEC STIM MANUAL @ 15 MIN
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 97032 GP
|
| Hospital Charge Code |
692259
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$64.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Cigna All Products |
$120.40
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: HealthNet Commercial |
$103.20
|
| Rate for Payer: HealthNet Medicare |
$48.16
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$30.96
|
|
|
PT ELEC STIM MANUAL @ 15 MIN
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 97032 GP
|
| Hospital Charge Code |
692259
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
|
|
PT E-STIM UNATT 1 OR MORE
|
Facility
OP
|
$148.00
|
|
|
Service Code
|
CPT 97014 GP
|
| Hospital Charge Code |
1230068
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.16 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$133.20
|
| Rate for Payer: Aetna Medicare |
$41.44
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$25.16
|
| Rate for Payer: Amerigroup Medicare |
$25.16
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$55.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$25.16
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$25.16
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$96.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$38.48
|
| Rate for Payer: Cigna All Products |
$103.60
|
| Rate for Payer: Copperpoint |
$41.51
|
| Rate for Payer: HealthNet Commercial |
$88.80
|
| Rate for Payer: HealthNet Medicare |
$41.44
|
| Rate for Payer: Humana Medicare |
$25.16
|
| Rate for Payer: SELF PAY |
$118.40
|
| Rate for Payer: Veterans (Triwest) |
$25.16
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$86.28
|
| Rate for Payer: United Healthcare Medicare |
$26.64
|
|
|
PT E-STIM UNATT 1 OR MORE
|
Facility
IP
|
$148.00
|
|
|
Service Code
|
CPT 97014 GP
|
| Hospital Charge Code |
1230068
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.16 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$133.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$25.16
|
| Rate for Payer: Amerigroup Medicare |
$25.16
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$25.16
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$25.16
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$96.56
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$38.48
|
| Rate for Payer: Copperpoint |
$41.51
|
| Rate for Payer: Humana Medicare |
$25.16
|
| Rate for Payer: SELF PAY |
$118.40
|
| Rate for Payer: Veterans (Triwest) |
$25.16
|
|
|
PT E-STIM W US EACH 15
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 97035 GP
|
| Hospital Charge Code |
2619719
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$64.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$85.27
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Cigna All Products |
$120.40
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: HealthNet Commercial |
$103.20
|
| Rate for Payer: HealthNet Medicare |
$48.16
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$30.96
|
|
|
PT E-STIM W US EACH 15
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 97035 GP
|
| Hospital Charge Code |
2619719
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$85.27
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
|
|
PT EVAL 45 MIN
|
Facility
OP
|
$511.00
|
|
| Hospital Charge Code |
1230396
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$86.87 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$459.90
|
| Rate for Payer: Aetna Medicare |
$143.08
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$86.87
|
| Rate for Payer: Amerigroup Medicare |
$86.87
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$190.86
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$86.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$86.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$132.86
|
| Rate for Payer: Cigna All Products |
$357.70
|
| Rate for Payer: Copperpoint |
$143.34
|
| Rate for Payer: HealthNet Commercial |
$306.60
|
| Rate for Payer: HealthNet Medicare |
$143.08
|
| Rate for Payer: Humana Medicare |
$86.87
|
| Rate for Payer: SELF PAY |
$408.80
|
| Rate for Payer: Veterans (Triwest) |
$86.87
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$297.91
|
| Rate for Payer: United Healthcare Medicare |
$91.98
|
|
|
PT EVAL 45 MIN
|
Facility
IP
|
$511.00
|
|
| Hospital Charge Code |
1230396
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$86.87 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$459.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$86.87
|
| Rate for Payer: Amerigroup Medicare |
$86.87
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$86.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$86.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$132.86
|
| Rate for Payer: Copperpoint |
$143.34
|
| Rate for Payer: Humana Medicare |
$86.87
|
| Rate for Payer: SELF PAY |
$408.80
|
| Rate for Payer: Veterans (Triwest) |
$86.87
|
|
|
PT EVAL HIGH COMPLEX
|
Facility
IP
|
$664.00
|
|
|
Service Code
|
CPT 97163 GP
|
| Hospital Charge Code |
22528750
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$112.88 |
| Max. Negotiated Rate |
$597.60 |
| Rate for Payer: Copperpoint |
$186.25
|
| Rate for Payer: Humana Medicare |
$112.88
|
| Rate for Payer: SELF PAY |
$531.20
|
| Rate for Payer: Aetna POS, PPO, HMO |
$597.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$112.88
|
| Rate for Payer: Amerigroup Medicare |
$112.88
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$112.88
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$112.88
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$423.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$172.64
|
| Rate for Payer: Veterans (Triwest) |
$112.88
|
|
|
PT EVAL HIGH COMPLEX
|
Facility
OP
|
$664.00
|
|
|
Service Code
|
CPT 97163 GP
|
| Hospital Charge Code |
22528750
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$112.88 |
| Max. Negotiated Rate |
$597.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$597.60
|
| Rate for Payer: Aetna Medicare |
$185.92
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$112.88
|
| Rate for Payer: Amerigroup Medicare |
$112.88
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$248.00
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$112.88
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$112.88
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$423.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$172.64
|
| Rate for Payer: Cigna All Products |
$464.80
|
| Rate for Payer: Copperpoint |
$186.25
|
| Rate for Payer: HealthNet Commercial |
$398.40
|
| Rate for Payer: HealthNet Medicare |
$185.92
|
| Rate for Payer: Humana Medicare |
$112.88
|
| Rate for Payer: SELF PAY |
$531.20
|
| Rate for Payer: Veterans (Triwest) |
$112.88
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$387.11
|
| Rate for Payer: United Healthcare Medicare |
$119.52
|
|
|
PT EVAL LOW COMPLEX
|
Facility
OP
|
$341.00
|
|
|
Service Code
|
CPT 97161 GP
|
| Hospital Charge Code |
22528753
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$57.97 |
| Max. Negotiated Rate |
$306.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$306.90
|
| Rate for Payer: Aetna Medicare |
$95.48
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$57.97
|
| Rate for Payer: Amerigroup Medicare |
$57.97
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$127.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$57.97
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$57.97
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$221.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$88.66
|
| Rate for Payer: Cigna All Products |
$238.70
|
| Rate for Payer: Copperpoint |
$95.65
|
| Rate for Payer: HealthNet Commercial |
$204.60
|
| Rate for Payer: HealthNet Medicare |
$95.48
|
| Rate for Payer: Humana Medicare |
$57.97
|
| Rate for Payer: SELF PAY |
$272.80
|
| Rate for Payer: Veterans (Triwest) |
$57.97
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$198.80
|
| Rate for Payer: United Healthcare Medicare |
$61.38
|
|
|
PT EVAL LOW COMPLEX
|
Facility
IP
|
$341.00
|
|
|
Service Code
|
CPT 97161 GP
|
| Hospital Charge Code |
22528753
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$57.97 |
| Max. Negotiated Rate |
$306.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$306.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$57.97
|
| Rate for Payer: Amerigroup Medicare |
$57.97
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$57.97
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$57.97
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$221.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$88.66
|
| Rate for Payer: Copperpoint |
$95.65
|
| Rate for Payer: Humana Medicare |
$57.97
|
| Rate for Payer: SELF PAY |
$272.80
|
| Rate for Payer: Veterans (Triwest) |
$57.97
|
|
|
PT EVAL MOD COMPLEX
|
Facility
OP
|
$511.00
|
|
|
Service Code
|
CPT 97162 GP
|
| Hospital Charge Code |
22528754
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$86.87 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$459.90
|
| Rate for Payer: Aetna Medicare |
$143.08
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$86.87
|
| Rate for Payer: Amerigroup Medicare |
$86.87
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$190.86
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$86.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$86.87
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$333.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$132.86
|
| Rate for Payer: Cigna All Products |
$357.70
|
| Rate for Payer: Copperpoint |
$143.34
|
| Rate for Payer: HealthNet Commercial |
$306.60
|
| Rate for Payer: HealthNet Medicare |
$143.08
|
| Rate for Payer: Humana Medicare |
$86.87
|
| Rate for Payer: SELF PAY |
$408.80
|
| Rate for Payer: Veterans (Triwest) |
$86.87
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$297.91
|
| Rate for Payer: United Healthcare Medicare |
$91.98
|
|
|
PT EVAL MOD COMPLEX
|
Facility
IP
|
$511.00
|
|
|
Service Code
|
CPT 97162 GP
|
| Hospital Charge Code |
22528754
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$86.87 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$459.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$86.87
|
| Rate for Payer: Amerigroup Medicare |
$86.87
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$86.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$86.87
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$333.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$132.86
|
| Rate for Payer: Copperpoint |
$143.34
|
| Rate for Payer: Humana Medicare |
$86.87
|
| Rate for Payer: SELF PAY |
$408.80
|
| Rate for Payer: Veterans (Triwest) |
$86.87
|
|
|
PT FUNCTIONAL ACTIVITIES 15 MIN
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 97530 GP
|
| Hospital Charge Code |
5543179
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$95.37
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
|
|
PT FUNCTIONAL ACTIVITIES 15 MIN
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 97530 GP
|
| Hospital Charge Code |
5543179
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$64.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$95.37
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Cigna All Products |
$120.40
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: HealthNet Commercial |
$103.20
|
| Rate for Payer: HealthNet Medicare |
$48.16
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$30.96
|
|
|
PT GAIT TRAINING @ 15 MIN
|
Facility
IP
|
$172.00
|
|
|
Service Code
|
CPT 97116 GP
|
| Hospital Charge Code |
692247
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$86.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
|
|
PT GAIT TRAINING @ 15 MIN
|
Facility
OP
|
$172.00
|
|
|
Service Code
|
CPT 97116 GP
|
| Hospital Charge Code |
692247
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$154.80
|
| Rate for Payer: Aetna Medicare |
$48.16
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$29.24
|
| Rate for Payer: Amerigroup Medicare |
$29.24
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$64.24
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$29.24
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$29.24
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$86.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$44.72
|
| Rate for Payer: Cigna All Products |
$120.40
|
| Rate for Payer: Copperpoint |
$48.25
|
| Rate for Payer: HealthNet Commercial |
$103.20
|
| Rate for Payer: HealthNet Medicare |
$48.16
|
| Rate for Payer: Humana Medicare |
$29.24
|
| Rate for Payer: SELF PAY |
$137.60
|
| Rate for Payer: Veterans (Triwest) |
$29.24
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$100.28
|
| Rate for Payer: United Healthcare Medicare |
$30.96
|
|
|
PTH
|
Facility
IP
|
$334.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
22481499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.78 |
| Max. Negotiated Rate |
$300.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$300.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$56.78
|
| Rate for Payer: Amerigroup Medicare |
$56.78
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$56.78
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$56.78
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$218.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$86.84
|
| Rate for Payer: Copperpoint |
$93.69
|
| Rate for Payer: Humana Medicare |
$56.78
|
| Rate for Payer: SELF PAY |
$267.20
|
| Rate for Payer: Veterans (Triwest) |
$56.78
|
|
|
PTH
|
Facility
OP
|
$334.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
22481499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$300.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$300.60
|
| Rate for Payer: Aetna Medicare |
$93.52
|
| Rate for Payer: AHCCCS Medicaid |
$41.28
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$41.28
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$56.78
|
| Rate for Payer: Amerigroup Medicare |
$56.78
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$124.75
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$41.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$56.78
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$56.78
|
| Rate for Payer: Banner University Family Care Medicaid |
$41.28
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$218.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$86.84
|
| Rate for Payer: Cigna All Products |
$217.10
|
| Rate for Payer: Copperpoint |
$93.69
|
| Rate for Payer: HealthNet Commercial |
$200.40
|
| Rate for Payer: HealthNet Medicare |
$93.52
|
| Rate for Payer: Humana Medicare |
$56.78
|
| Rate for Payer: Mercy Care Medicaid |
$41.28
|
| Rate for Payer: SELF PAY |
$267.20
|
| Rate for Payer: Veterans (Triwest) |
$56.78
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$194.72
|
| Rate for Payer: United Healthcare Medicare |
$60.12
|
|
|
PTH, Intact LC
|
Facility
IP
|
$512.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
1285622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.04 |
| Max. Negotiated Rate |
$460.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$460.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$87.04
|
| Rate for Payer: Amerigroup Medicare |
$87.04
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$87.04
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$87.04
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$218.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$133.12
|
| Rate for Payer: Copperpoint |
$143.62
|
| Rate for Payer: Humana Medicare |
$87.04
|
| Rate for Payer: SELF PAY |
$409.60
|
| Rate for Payer: Veterans (Triwest) |
$87.04
|
|
|
PTH, Intact LC
|
Facility
OP
|
$512.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
1285622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$460.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$460.80
|
| Rate for Payer: Aetna Medicare |
$143.36
|
| Rate for Payer: AHCCCS Medicaid |
$41.28
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$41.28
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$87.04
|
| Rate for Payer: Amerigroup Medicare |
$87.04
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$191.23
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$41.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$87.04
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$87.04
|
| Rate for Payer: Banner University Family Care Medicaid |
$41.28
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$218.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$133.12
|
| Rate for Payer: Cigna All Products |
$332.80
|
| Rate for Payer: Copperpoint |
$143.62
|
| Rate for Payer: HealthNet Commercial |
$307.20
|
| Rate for Payer: HealthNet Medicare |
$143.36
|
| Rate for Payer: Humana Medicare |
$87.04
|
| Rate for Payer: Mercy Care Medicaid |
$41.28
|
| Rate for Payer: SELF PAY |
$409.60
|
| Rate for Payer: Veterans (Triwest) |
$87.04
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$298.50
|
| Rate for Payer: United Healthcare Medicare |
$92.16
|
|
|
PTHrP (PTH-Related Peptide) LC
|
Facility
IP
|
$392.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
2087647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.64 |
| Max. Negotiated Rate |
$352.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$352.80
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$66.64
|
| Rate for Payer: Amerigroup Medicare |
$66.64
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$66.64
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$66.64
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$101.92
|
| Rate for Payer: Copperpoint |
$109.96
|
| Rate for Payer: Humana Medicare |
$66.64
|
| Rate for Payer: SELF PAY |
$313.60
|
| Rate for Payer: Veterans (Triwest) |
$66.64
|
|
|
PTHrP (PTH-Related Peptide) LC
|
Facility
OP
|
$392.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
2087647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$352.80 |
| Rate for Payer: Aetna POS, PPO, HMO |
$352.80
|
| Rate for Payer: Aetna Medicare |
$109.76
|
| Rate for Payer: AHCCCS Medicaid |
$14.12
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$66.64
|
| Rate for Payer: Amerigroup Medicare |
$66.64
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$146.41
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14.12
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$66.64
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$66.64
|
| Rate for Payer: Banner University Family Care Medicaid |
$14.12
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$101.92
|
| Rate for Payer: Cigna All Products |
$254.80
|
| Rate for Payer: Copperpoint |
$109.96
|
| Rate for Payer: HealthNet Commercial |
$235.20
|
| Rate for Payer: HealthNet Medicare |
$109.76
|
| Rate for Payer: Humana Medicare |
$66.64
|
| Rate for Payer: Mercy Care Medicaid |
$14.12
|
| Rate for Payer: SELF PAY |
$313.60
|
| Rate for Payer: Veterans (Triwest) |
$66.64
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$228.54
|
| Rate for Payer: United Healthcare Medicare |
$70.56
|
|