Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

.IMMUNO INFAB

Facility

IP

$73.00

Service Code	CPT 86317
Hospital Charge Code	22481446
Hospital Revenue Code	302
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$65.70
Rate for Payer: Aetna of AZ Commercial	$65.70
Rate for Payer: Bisbee Police All Plans	$18.98
Rate for Payer: Cash Price	$58.40
Rate for Payer: Self Pay Self Pay	$58.40

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: AHCCCS Medicaid	$160,146.45
Rate for Payer: Allwell Medicaid	$160,146.45
Rate for Payer: AZCH Complete Medicaid	$160,146.45
Rate for Payer: Banner UC Health Medicaid	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: AHCCCS Medicaid	$160,146.45
Rate for Payer: Allwell Medicaid	$160,146.45
Rate for Payer: AZCH Complete Medicaid	$160,146.45
Rate for Payer: Banner UC Health Medicaid	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: AHCCCS Medicaid	$111,650.96
Rate for Payer: Allwell Medicaid	$111,650.96
Rate for Payer: AZCH Complete Medicaid	$111,650.96
Rate for Payer: Banner UC Health Medicaid	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: AHCCCS Medicaid	$111,650.96
Rate for Payer: Allwell Medicaid	$111,650.96
Rate for Payer: AZCH Complete Medicaid	$111,650.96
Rate for Payer: Banner UC Health Medicaid	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: AHCCCS Medicaid	$160,146.45
Rate for Payer: Allwell Medicaid	$160,146.45
Rate for Payer: AZCH Complete Medicaid	$160,146.45
Rate for Payer: Banner UC Health Medicaid	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: AHCCCS Medicaid	$78,199.79
Rate for Payer: Allwell Medicaid	$78,199.79
Rate for Payer: AZCH Complete Medicaid	$78,199.79
Rate for Payer: Banner UC Health Medicaid	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: AHCCCS Medicaid	$160,146.45
Rate for Payer: Allwell Medicaid	$160,146.45
Rate for Payer: AZCH Complete Medicaid	$160,146.45
Rate for Payer: Banner UC Health Medicaid	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: AHCCCS Medicaid	$111,650.96
Rate for Payer: Allwell Medicaid	$111,650.96
Rate for Payer: AZCH Complete Medicaid	$111,650.96
Rate for Payer: Banner UC Health Medicaid	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: AHCCCS Medicaid	$111,650.96
Rate for Payer: Allwell Medicaid	$111,650.96
Rate for Payer: AZCH Complete Medicaid	$111,650.96
Rate for Payer: Banner UC Health Medicaid	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96

IMUNNOHISTOCHEMIST 1ST

Facility

IP

$308.00

Service Code	CPT G0461
Hospital Charge Code	22545749
Hospital Revenue Code	310
Min. Negotiated Rate	$80.08
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Bisbee Police All Plans	$80.08
Rate for Payer: Cash Price	$246.40
Rate for Payer: Self Pay Self Pay	$246.40

IMUNNOHISTOCHEMIST 1ST

Facility

OP

$308.00

Service Code	CPT G0461
Hospital Charge Code	22545749
Hospital Revenue Code	310
Min. Negotiated Rate	$49.28
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Aetna of AZ Medicare	$86.24
Rate for Payer: Allwell Medicare	$49.28
Rate for Payer: Amerigroup Medicare	$49.28
Rate for Payer: APIPA Medicare/Medicaid	$115.04
Rate for Payer: AZCH Complete Medicare	$49.28
Rate for Payer: Banner UC Health Medicare	$49.28
Rate for Payer: Bisbee Police All Plans	$80.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$209.44
Rate for Payer: Cash Price	$246.40
Rate for Payer: Cigna of AZ Commercial	$200.20
Rate for Payer: Copperpoint Commercial	$76.23
Rate for Payer: Health Net of AZ Commercial	$184.80
Rate for Payer: Health Net of AZ Medicare	$86.24
Rate for Payer: Humana of AZ Medicare	$49.28
Rate for Payer: Self Pay Self Pay	$246.40
Rate for Payer: TriWest Medicare	$49.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$179.56
Rate for Payer: UnitedHealth Group of AZ Medicare	$55.44

IMUNNOHISTOCHEMIST 2ND

Facility

OP

$312.00

Service Code	CPT G0462
Hospital Charge Code	22545750
Hospital Revenue Code	310
Min. Negotiated Rate	$49.92
Max. Negotiated Rate	$280.80
Rate for Payer: Aetna of AZ Commercial	$280.80
Rate for Payer: Aetna of AZ Medicare	$87.36
Rate for Payer: Allwell Medicare	$49.92
Rate for Payer: Amerigroup Medicare	$49.92
Rate for Payer: APIPA Medicare/Medicaid	$116.53
Rate for Payer: AZCH Complete Medicare	$49.92
Rate for Payer: Banner UC Health Medicare	$49.92
Rate for Payer: Bisbee Police All Plans	$81.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$212.16
Rate for Payer: Cash Price	$249.60
Rate for Payer: Cigna of AZ Commercial	$202.80
Rate for Payer: Copperpoint Commercial	$77.22
Rate for Payer: Health Net of AZ Commercial	$187.20
Rate for Payer: Health Net of AZ Medicare	$87.36
Rate for Payer: Humana of AZ Medicare	$49.92
Rate for Payer: Self Pay Self Pay	$249.60
Rate for Payer: TriWest Medicare	$49.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$181.90
Rate for Payer: UnitedHealth Group of AZ Medicare	$56.16

IMUNNOHISTOCHEMIST 2ND

Facility

IP

$312.00

Service Code	CPT G0462
Hospital Charge Code	22545750
Hospital Revenue Code	310
Min. Negotiated Rate	$81.12
Max. Negotiated Rate	$280.80
Rate for Payer: Aetna of AZ Commercial	$280.80
Rate for Payer: Bisbee Police All Plans	$81.12
Rate for Payer: Cash Price	$249.60
Rate for Payer: Self Pay Self Pay	$249.60

Inborn Errors Of Metabolism

Facility

IP

$8,634.23

Service Code	APR-DRG 4233
Hospital Charge Code	APRDRG4231
Min. Negotiated Rate	$8,634.23
Max. Negotiated Rate	$8,634.23
Rate for Payer: AHCCCS Medicaid	$8,634.23
Rate for Payer: Allwell Medicaid	$8,634.23
Rate for Payer: AZCH Complete Medicaid	$8,634.23
Rate for Payer: Banner UC Health Medicaid	$8,634.23
Rate for Payer: Mercy Care Medicaid	$8,634.23

Inborn Errors Of Metabolism

Facility

IP

$3,920.83

Service Code	APR-DRG 4231
Hospital Charge Code	APRDRG4233
Min. Negotiated Rate	$3,920.83
Max. Negotiated Rate	$3,920.83
Rate for Payer: AHCCCS Medicaid	$3,920.83
Rate for Payer: Allwell Medicaid	$3,920.83
Rate for Payer: AZCH Complete Medicaid	$3,920.83
Rate for Payer: Banner UC Health Medicaid	$3,920.83
Rate for Payer: Mercy Care Medicaid	$3,920.83

Inborn Errors Of Metabolism

Facility

IP

$20,239.60

Service Code	APR-DRG 4234
Hospital Charge Code	APRDRG4233
Min. Negotiated Rate	$20,239.60
Max. Negotiated Rate	$20,239.60
Rate for Payer: AHCCCS Medicaid	$20,239.60
Rate for Payer: Allwell Medicaid	$20,239.60
Rate for Payer: AZCH Complete Medicaid	$20,239.60
Rate for Payer: Banner UC Health Medicaid	$20,239.60
Rate for Payer: Mercy Care Medicaid	$20,239.60

Inborn Errors Of Metabolism

Facility

IP

$5,705.19

Service Code	APR-DRG 4232
Hospital Charge Code	APRDRG4232
Min. Negotiated Rate	$5,705.19
Max. Negotiated Rate	$5,705.19
Rate for Payer: AHCCCS Medicaid	$5,705.19
Rate for Payer: Allwell Medicaid	$5,705.19
Rate for Payer: AZCH Complete Medicaid	$5,705.19
Rate for Payer: Banner UC Health Medicaid	$5,705.19
Rate for Payer: Mercy Care Medicaid	$5,705.19

<<
<
222
223
224
225
226
227
228
229
230
231
>
>>