Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Extensive Third Degree Burns With Skin Graft

Facility

IP

$57,269.31

Service Code	APR-DRG 8413
Hospital Charge Code	APRDRG8412
Min. Negotiated Rate	$57,269.31
Max. Negotiated Rate	$57,269.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$57,269.31
Rate for Payer: Mercy Care Medicaid	$57,269.31
Rate for Payer: NaphCare Correctional Healthcare	$57,269.31

Extensive Third Degree Burns With Skin Graft

Facility

IP

$37,216.28

Service Code	APR-DRG 8411
Hospital Charge Code	APRDRG8412
Min. Negotiated Rate	$37,216.28
Max. Negotiated Rate	$37,216.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,216.28
Rate for Payer: Mercy Care Medicaid	$37,216.28
Rate for Payer: NaphCare Correctional Healthcare	$37,216.28

Extensive Third Degree Burns With Skin Graft

Facility

IP

$144,168.56

Service Code	APR-DRG 8414
Hospital Charge Code	APRDRG8411
Min. Negotiated Rate	$144,168.56
Max. Negotiated Rate	$144,168.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$144,168.56
Rate for Payer: Mercy Care Medicaid	$144,168.56
Rate for Payer: NaphCare Correctional Healthcare	$144,168.56

Extensive Third Degree Burns With Skin Graft

Facility

IP

$37,216.28

Service Code	APR-DRG 8412
Hospital Charge Code	APRDRG8413
Min. Negotiated Rate	$37,216.28
Max. Negotiated Rate	$37,216.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,216.28
Rate for Payer: Mercy Care Medicaid	$37,216.28
Rate for Payer: NaphCare Correctional Healthcare	$37,216.28

Extensive Third Degree Burns With Skin Graft

Facility

IP

$144,168.56

Service Code	APR-DRG 8414
Hospital Charge Code	APRDRG8414
Min. Negotiated Rate	$144,168.56
Max. Negotiated Rate	$144,168.56
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$144,168.56
Rate for Payer: Mercy Care Medicaid	$144,168.56
Rate for Payer: NaphCare Correctional Healthcare	$144,168.56

Extensive Third Degree Burns With Skin Graft

Facility

IP

$37,216.28

Service Code	APR-DRG 8411
Hospital Charge Code	APRDRG8414
Min. Negotiated Rate	$37,216.28
Max. Negotiated Rate	$37,216.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,216.28
Rate for Payer: Mercy Care Medicaid	$37,216.28
Rate for Payer: NaphCare Correctional Healthcare	$37,216.28

Extensive Third Degree Burns With Skin Graft

Facility

IP

$57,269.31

Service Code	APR-DRG 8413
Hospital Charge Code	APRDRG8411
Min. Negotiated Rate	$57,269.31
Max. Negotiated Rate	$57,269.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$57,269.31
Rate for Payer: Mercy Care Medicaid	$57,269.31
Rate for Payer: NaphCare Correctional Healthcare	$57,269.31

Extensive Third Degree Burns With Skin Graft

Facility

IP

$37,216.28

Service Code	APR-DRG 8412
Hospital Charge Code	APRDRG8414
Min. Negotiated Rate	$37,216.28
Max. Negotiated Rate	$37,216.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,216.28
Rate for Payer: Mercy Care Medicaid	$37,216.28
Rate for Payer: NaphCare Correctional Healthcare	$37,216.28

Extensive Third Degree Burns With Skin Graft

Facility

IP

$37,216.28

Service Code	APR-DRG 8412
Hospital Charge Code	APRDRG8412
Min. Negotiated Rate	$37,216.28
Max. Negotiated Rate	$37,216.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,216.28
Rate for Payer: Mercy Care Medicaid	$37,216.28
Rate for Payer: NaphCare Correctional Healthcare	$37,216.28

External electrocardiographic recording for more than 48 hou

Facility

IP

$101.00

Service Code	CPT 93241
Hospital Charge Code	24275814
Hospital Revenue Code	521
Min. Negotiated Rate	$90.90
Max. Negotiated Rate	$90.90
Rate for Payer: Aetna of AZ Commercial	$90.90
Rate for Payer: Cash Price	$80.80

External electrocardiographic recording for more than 48 hou

Facility

OP

$101.00

Service Code	CPT 93241
Hospital Charge Code	24275814
Hospital Revenue Code	521
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$90.90
Rate for Payer: Aetna of AZ Commercial	$90.90
Rate for Payer: Arizona Complete Health Allwell	$16.16
Rate for Payer: Banner UC Health Medicare	$16.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$68.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$16.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$16.16
Rate for Payer: Cash Price	$80.80
Rate for Payer: Cigna of AZ Commercial	$70.70
Rate for Payer: Devoted Health Medicare	$18.18
Rate for Payer: Humana of AZ Medicare	$16.16
Rate for Payer: Southwest Service Administrators UFCW	$68.68
Rate for Payer: TriWest Medicare	$16.16
Rate for Payer: United Healthcare Commercial	$57.77
Rate for Payer: United Healthcare Medicare	$16.16
Rate for Payer: Veterans Affairs TRICARE	$16.00

External electrocardiographic recording for more than 48 hou

Facility

OP

$76.00

Service Code	CPT 93244
Hospital Charge Code	24275817
Hospital Revenue Code	521
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Arizona Complete Health Allwell	$12.16
Rate for Payer: Banner UC Health Medicare	$12.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$51.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$12.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$12.16
Rate for Payer: Cash Price	$60.80
Rate for Payer: Cigna of AZ Commercial	$53.20
Rate for Payer: Devoted Health Medicare	$13.68
Rate for Payer: Humana of AZ Medicare	$12.16
Rate for Payer: Southwest Service Administrators UFCW	$51.68
Rate for Payer: TriWest Medicare	$12.16
Rate for Payer: United Healthcare Commercial	$43.47
Rate for Payer: United Healthcare Medicare	$12.16
Rate for Payer: Veterans Affairs TRICARE	$12.04

External electrocardiographic recording for more than 48 hou

Facility

IP

$51.00

Service Code	CPT 93243
Hospital Charge Code	24275816
Hospital Revenue Code	521
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Cash Price	$40.80

External electrocardiographic recording for more than 48 hou

Facility

OP

$47.00

Service Code	CPT 93242
Hospital Charge Code	24275815
Hospital Revenue Code	521
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$57.80
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Arizona Complete Health Allwell	$7.52
Rate for Payer: Banner UC Health Medicare	$7.52
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$31.96
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$7.52
Rate for Payer: Care1st Health Plan Arizona Medicare	$7.52
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cigna of AZ Commercial	$32.90
Rate for Payer: Devoted Health Medicare	$8.46
Rate for Payer: Humana of AZ Medicare	$7.52
Rate for Payer: Seven Corners Travel Insurance	$57.80
Rate for Payer: Southwest Service Administrators UFCW	$31.96
Rate for Payer: TriWest Medicare	$7.52
Rate for Payer: United Healthcare Commercial	$26.88
Rate for Payer: United Healthcare Medicare	$7.52
Rate for Payer: Veterans Affairs TRICARE	$7.44

External electrocardiographic recording for more than 48 hou

Facility

IP

$47.00

Service Code	CPT 93242
Hospital Charge Code	24275815
Hospital Revenue Code	521
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Cash Price	$37.60

External electrocardiographic recording for more than 48 hou

Facility

IP

$76.00

Service Code	CPT 93244
Hospital Charge Code	24275817
Hospital Revenue Code	521
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Cash Price	$60.80

External electrocardiographic recording for more than 48 hou

Facility

OP

$51.00

Service Code	CPT 93243
Hospital Charge Code	24275816
Hospital Revenue Code	521
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$205.86
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Arizona Complete Health Allwell	$8.16
Rate for Payer: Banner UC Health Medicare	$8.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$34.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$8.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$8.16
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cigna of AZ Commercial	$35.70
Rate for Payer: Devoted Health Medicare	$9.18
Rate for Payer: Humana of AZ Medicare	$8.16
Rate for Payer: Seven Corners Travel Insurance	$205.86
Rate for Payer: Southwest Service Administrators UFCW	$34.68
Rate for Payer: TriWest Medicare	$8.16
Rate for Payer: United Healthcare Commercial	$29.17
Rate for Payer: United Healthcare Medicare	$8.16
Rate for Payer: Veterans Affairs TRICARE	$8.08

External electrocardiographic recording for more than 7 days

Facility

IP

$51.00

Service Code	CPT 93247
Hospital Charge Code	24275820
Hospital Revenue Code	521
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Cash Price	$40.80

External electrocardiographic recording for more than 7 days

Facility

OP

$84.00

Service Code	CPT 93248
Hospital Charge Code	24275821
Hospital Revenue Code	521
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Arizona Complete Health Allwell	$13.44
Rate for Payer: Banner UC Health Medicare	$13.44
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$57.12
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$13.44
Rate for Payer: Care1st Health Plan Arizona Medicare	$13.44
Rate for Payer: Cash Price	$67.20
Rate for Payer: Cigna of AZ Commercial	$58.80
Rate for Payer: Devoted Health Medicare	$15.12
Rate for Payer: Humana of AZ Medicare	$13.44
Rate for Payer: Southwest Service Administrators UFCW	$57.12
Rate for Payer: TriWest Medicare	$13.44
Rate for Payer: United Healthcare Commercial	$48.05
Rate for Payer: United Healthcare Medicare	$13.44
Rate for Payer: Veterans Affairs TRICARE	$13.31

External electrocardiographic recording for more than 7 days

Facility

OP

$101.00

Service Code	CPT 93245
Hospital Charge Code	24275818
Hospital Revenue Code	521
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$90.90
Rate for Payer: Aetna of AZ Commercial	$90.90
Rate for Payer: Arizona Complete Health Allwell	$16.16
Rate for Payer: Banner UC Health Medicare	$16.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$68.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$16.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$16.16
Rate for Payer: Cash Price	$80.80
Rate for Payer: Cigna of AZ Commercial	$70.70
Rate for Payer: Devoted Health Medicare	$18.18
Rate for Payer: Humana of AZ Medicare	$16.16
Rate for Payer: Southwest Service Administrators UFCW	$68.68
Rate for Payer: TriWest Medicare	$16.16
Rate for Payer: United Healthcare Commercial	$57.77
Rate for Payer: United Healthcare Medicare	$16.16
Rate for Payer: Veterans Affairs TRICARE	$16.00

External electrocardiographic recording for more than 7 days

Facility

IP

$101.00

Service Code	CPT 93245
Hospital Charge Code	24275818
Hospital Revenue Code	521
Min. Negotiated Rate	$90.90
Max. Negotiated Rate	$90.90
Rate for Payer: Aetna of AZ Commercial	$90.90
Rate for Payer: Cash Price	$80.80

External electrocardiographic recording for more than 7 days

Facility

IP

$84.00

Service Code	CPT 93248
Hospital Charge Code	24275821
Hospital Revenue Code	521
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Cash Price	$67.20

External electrocardiographic recording for more than 7 days

Facility

OP

$47.00

Service Code	CPT 93246
Hospital Charge Code	24275819
Hospital Revenue Code	521
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$57.80
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Arizona Complete Health Allwell	$7.52
Rate for Payer: Banner UC Health Medicare	$7.52
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$31.96
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$7.52
Rate for Payer: Care1st Health Plan Arizona Medicare	$7.52
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cigna of AZ Commercial	$32.90
Rate for Payer: Devoted Health Medicare	$8.46
Rate for Payer: Humana of AZ Medicare	$7.52
Rate for Payer: Seven Corners Travel Insurance	$57.80
Rate for Payer: Southwest Service Administrators UFCW	$31.96
Rate for Payer: TriWest Medicare	$7.52
Rate for Payer: United Healthcare Commercial	$26.88
Rate for Payer: United Healthcare Medicare	$7.52
Rate for Payer: Veterans Affairs TRICARE	$7.44

External electrocardiographic recording for more than 7 days

Facility

IP

$47.00

Service Code	CPT 93246
Hospital Charge Code	24275819
Hospital Revenue Code	521
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Cash Price	$37.60

External electrocardiographic recording for more than 7 days

Facility

OP

$51.00

Service Code	CPT 93247
Hospital Charge Code	24275820
Hospital Revenue Code	521
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$205.86
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Arizona Complete Health Allwell	$8.16
Rate for Payer: Banner UC Health Medicare	$8.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$34.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$8.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$8.16
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cigna of AZ Commercial	$35.70
Rate for Payer: Devoted Health Medicare	$9.18
Rate for Payer: Humana of AZ Medicare	$8.16
Rate for Payer: Seven Corners Travel Insurance	$205.86
Rate for Payer: Southwest Service Administrators UFCW	$34.68
Rate for Payer: TriWest Medicare	$8.16
Rate for Payer: United Healthcare Commercial	$29.17
Rate for Payer: United Healthcare Medicare	$8.16
Rate for Payer: Veterans Affairs TRICARE	$8.08

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