|
Renal Function Panel Standard
|
Facility
IP
|
$159.00
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
22141046
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.03 |
| Max. Negotiated Rate |
$143.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$143.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$27.03
|
| Rate for Payer: Amerigroup Medicare |
$27.03
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$27.03
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$103.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$41.34
|
| Rate for Payer: Copperpoint |
$44.60
|
| Rate for Payer: Humana Medicare |
$27.03
|
| Rate for Payer: SELF PAY |
$127.20
|
| Rate for Payer: Veterans (Triwest) |
$27.03
|
|
|
Renal Function Panel Standard
|
Facility
OP
|
$159.00
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
22141046
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$143.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$143.10
|
| Rate for Payer: Aetna Medicare |
$44.52
|
| Rate for Payer: AHCCCS Medicaid |
$8.68
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$8.68
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$27.03
|
| Rate for Payer: Amerigroup Medicare |
$27.03
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$59.39
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$8.68
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$27.03
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$27.03
|
| Rate for Payer: Banner University Family Care Medicaid |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$103.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$41.34
|
| Rate for Payer: Cigna All Products |
$103.35
|
| Rate for Payer: Copperpoint |
$44.60
|
| Rate for Payer: HealthNet Commercial |
$95.40
|
| Rate for Payer: HealthNet Medicare |
$44.52
|
| Rate for Payer: Humana Medicare |
$27.03
|
| Rate for Payer: Mercy Care Medicaid |
$8.68
|
| Rate for Payer: SELF PAY |
$127.20
|
| Rate for Payer: Veterans (Triwest) |
$27.03
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$92.70
|
| Rate for Payer: United Healthcare Medicare |
$28.62
|
|
|
Renin Activity, Plasma LC
|
Facility
IP
|
$275.00
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
1905527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.75 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$247.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$46.75
|
| Rate for Payer: Amerigroup Medicare |
$46.75
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$46.75
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$46.75
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$71.50
|
| Rate for Payer: Copperpoint |
$77.14
|
| Rate for Payer: Humana Medicare |
$46.75
|
| Rate for Payer: SELF PAY |
$220.00
|
| Rate for Payer: Veterans (Triwest) |
$46.75
|
|
|
Renin Activity, Plasma LC
|
Facility
OP
|
$275.00
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
1905527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$247.50
|
| Rate for Payer: Aetna Medicare |
$77.00
|
| Rate for Payer: AHCCCS Medicaid |
$21.99
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$21.99
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$46.75
|
| Rate for Payer: Amerigroup Medicare |
$46.75
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$102.71
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$21.99
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$46.75
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$46.75
|
| Rate for Payer: Banner University Family Care Medicaid |
$21.99
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$71.50
|
| Rate for Payer: Cigna All Products |
$178.75
|
| Rate for Payer: Copperpoint |
$77.14
|
| Rate for Payer: HealthNet Commercial |
$165.00
|
| Rate for Payer: HealthNet Medicare |
$77.00
|
| Rate for Payer: Humana Medicare |
$46.75
|
| Rate for Payer: Mercy Care Medicaid |
$21.99
|
| Rate for Payer: SELF PAY |
$220.00
|
| Rate for Payer: Veterans (Triwest) |
$46.75
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$160.32
|
| Rate for Payer: United Healthcare Medicare |
$49.50
|
|
|
REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC
|
Facility
OP
|
$4,240.00
|
|
|
Service Code
|
CPT 23410
|
| Hospital Charge Code |
27371853
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$720.80 |
| Max. Negotiated Rate |
$9,084.18 |
| Rate for Payer: SELF PAY |
$3,392.00
|
| Rate for Payer: Aetna POS, PPO, HMO |
$3,816.00
|
| Rate for Payer: Aetna Medicare |
$1,187.20
|
| Rate for Payer: AHCCCS Medicaid |
$9,084.18
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$9,084.18
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$720.80
|
| Rate for Payer: Amerigroup Medicare |
$720.80
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1,583.64
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$9,084.18
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$720.80
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$720.80
|
| Rate for Payer: Banner University Family Care Medicaid |
$9,084.18
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,102.40
|
| Rate for Payer: Cigna All Products |
$2,120.00
|
| Rate for Payer: Copperpoint |
$1,189.32
|
| Rate for Payer: HealthNet Commercial |
$2,544.00
|
| Rate for Payer: HealthNet Medicare |
$1,187.20
|
| Rate for Payer: Humana Medicare |
$720.80
|
| Rate for Payer: Mercy Care Medicaid |
$9,084.18
|
| Rate for Payer: Veterans (Triwest) |
$720.80
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2,471.92
|
| Rate for Payer: United Healthcare Medicare |
$763.20
|
|
|
REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC
|
Facility
IP
|
$4,240.00
|
|
|
Service Code
|
CPT 23410
|
| Hospital Charge Code |
27371853
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$720.80 |
| Max. Negotiated Rate |
$3,816.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,816.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$720.80
|
| Rate for Payer: Amerigroup Medicare |
$720.80
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$720.80
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$720.80
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,102.40
|
| Rate for Payer: Copperpoint |
$1,189.32
|
| Rate for Payer: Humana Medicare |
$720.80
|
| Rate for Payer: SELF PAY |
$3,392.00
|
| Rate for Payer: Veterans (Triwest) |
$720.80
|
|
|
REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC
|
Facility
IP
|
$4,405.00
|
|
|
Service Code
|
CPT 23412
|
| Hospital Charge Code |
27368692
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$748.85 |
| Max. Negotiated Rate |
$3,964.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,964.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$748.85
|
| Rate for Payer: Amerigroup Medicare |
$748.85
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$748.85
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$748.85
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,145.30
|
| Rate for Payer: Copperpoint |
$1,235.60
|
| Rate for Payer: Humana Medicare |
$748.85
|
| Rate for Payer: SELF PAY |
$3,524.00
|
| Rate for Payer: Veterans (Triwest) |
$748.85
|
|
|
REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC
|
Facility
OP
|
$4,405.00
|
|
|
Service Code
|
CPT 23412
|
| Hospital Charge Code |
27368692
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$748.85 |
| Max. Negotiated Rate |
$9,084.18 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,964.50
|
| Rate for Payer: Aetna Medicare |
$1,233.40
|
| Rate for Payer: AHCCCS Medicaid |
$9,084.18
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$9,084.18
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$748.85
|
| Rate for Payer: Amerigroup Medicare |
$748.85
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1,645.27
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$9,084.18
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$748.85
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$748.85
|
| Rate for Payer: Banner University Family Care Medicaid |
$9,084.18
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,145.30
|
| Rate for Payer: Cigna All Products |
$2,202.50
|
| Rate for Payer: Copperpoint |
$1,235.60
|
| Rate for Payer: HealthNet Commercial |
$2,643.00
|
| Rate for Payer: HealthNet Medicare |
$1,233.40
|
| Rate for Payer: Humana Medicare |
$748.85
|
| Rate for Payer: Mercy Care Medicaid |
$9,084.18
|
| Rate for Payer: SELF PAY |
$3,524.00
|
| Rate for Payer: Veterans (Triwest) |
$748.85
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2,568.11
|
| Rate for Payer: United Healthcare Medicare |
$792.90
|
|
|
RESCUENET RETRIEVAL NET
|
Facility
IP
|
$332.50
|
|
| Hospital Charge Code |
23839570
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna POS, PPO, HMO |
$299.25
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$56.53
|
| Rate for Payer: Amerigroup Medicare |
$56.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$56.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$56.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$86.45
|
| Rate for Payer: Copperpoint |
$93.27
|
| Rate for Payer: Humana Medicare |
$56.53
|
| Rate for Payer: SELF PAY |
$266.00
|
| Rate for Payer: Veterans (Triwest) |
$56.53
|
|
|
RESCUENET RETRIEVAL NET
|
Facility
OP
|
$425.00
|
|
| Hospital Charge Code |
27497393
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.25 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$382.50
|
| Rate for Payer: Aetna Medicare |
$119.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$72.25
|
| Rate for Payer: Amerigroup Medicare |
$72.25
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$158.74
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$72.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$72.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$110.50
|
| Rate for Payer: Cigna All Products |
$297.50
|
| Rate for Payer: Copperpoint |
$119.21
|
| Rate for Payer: HealthNet Commercial |
$255.00
|
| Rate for Payer: HealthNet Medicare |
$119.00
|
| Rate for Payer: Humana Medicare |
$72.25
|
| Rate for Payer: SELF PAY |
$340.00
|
| Rate for Payer: Veterans (Triwest) |
$72.25
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$247.77
|
| Rate for Payer: United Healthcare Medicare |
$76.50
|
|
|
RESCUENET RETRIEVAL NET
|
Facility
IP
|
$425.00
|
|
| Hospital Charge Code |
27497393
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.25 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$382.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$72.25
|
| Rate for Payer: Amerigroup Medicare |
$72.25
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$72.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$72.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$110.50
|
| Rate for Payer: Copperpoint |
$119.21
|
| Rate for Payer: Humana Medicare |
$72.25
|
| Rate for Payer: SELF PAY |
$340.00
|
| Rate for Payer: Veterans (Triwest) |
$72.25
|
|
|
RESCUENET RETRIEVAL NET
|
Facility
OP
|
$332.50
|
|
| Hospital Charge Code |
23839570
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna POS, PPO, HMO |
$299.25
|
| Rate for Payer: Aetna Medicare |
$93.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$56.53
|
| Rate for Payer: Amerigroup Medicare |
$56.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$124.19
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$56.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$56.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$86.45
|
| Rate for Payer: Cigna All Products |
$232.75
|
| Rate for Payer: Copperpoint |
$93.27
|
| Rate for Payer: HealthNet Commercial |
$199.50
|
| Rate for Payer: HealthNet Medicare |
$93.10
|
| Rate for Payer: Humana Medicare |
$56.53
|
| Rate for Payer: SELF PAY |
$266.00
|
| Rate for Payer: Veterans (Triwest) |
$56.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$193.85
|
| Rate for Payer: United Healthcare Medicare |
$59.85
|
|
|
RESECTOR SHAVER BLADE 3MM
|
Facility
IP
|
$225.00
|
|
| Hospital Charge Code |
25519687
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$202.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$38.25
|
| Rate for Payer: Amerigroup Medicare |
$38.25
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$38.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$38.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$58.50
|
| Rate for Payer: Copperpoint |
$63.11
|
| Rate for Payer: Humana Medicare |
$38.25
|
| Rate for Payer: SELF PAY |
$180.00
|
| Rate for Payer: Veterans (Triwest) |
$38.25
|
|
|
RESECTOR SHAVER BLADE 3MM
|
Facility
OP
|
$225.00
|
|
| Hospital Charge Code |
25519687
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$202.50
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$38.25
|
| Rate for Payer: Amerigroup Medicare |
$38.25
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$84.04
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$38.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$38.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$58.50
|
| Rate for Payer: Cigna All Products |
$157.50
|
| Rate for Payer: Copperpoint |
$63.11
|
| Rate for Payer: HealthNet Commercial |
$135.00
|
| Rate for Payer: HealthNet Medicare |
$63.00
|
| Rate for Payer: Humana Medicare |
$38.25
|
| Rate for Payer: SELF PAY |
$180.00
|
| Rate for Payer: Veterans (Triwest) |
$38.25
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$131.17
|
| Rate for Payer: United Healthcare Medicare |
$40.50
|
|
|
RESECTOR SHAVER BLADE 4MM
|
Facility
IP
|
$225.00
|
|
| Hospital Charge Code |
25519688
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$202.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$38.25
|
| Rate for Payer: Amerigroup Medicare |
$38.25
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$38.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$38.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$58.50
|
| Rate for Payer: Copperpoint |
$63.11
|
| Rate for Payer: Humana Medicare |
$38.25
|
| Rate for Payer: SELF PAY |
$180.00
|
| Rate for Payer: Veterans (Triwest) |
$38.25
|
|
|
RESECTOR SHAVER BLADE 4MM
|
Facility
OP
|
$225.00
|
|
| Hospital Charge Code |
25519688
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$202.50
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$38.25
|
| Rate for Payer: Amerigroup Medicare |
$38.25
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$84.04
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$38.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$38.25
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$58.50
|
| Rate for Payer: Cigna All Products |
$157.50
|
| Rate for Payer: Copperpoint |
$63.11
|
| Rate for Payer: HealthNet Commercial |
$135.00
|
| Rate for Payer: HealthNet Medicare |
$63.00
|
| Rate for Payer: Humana Medicare |
$38.25
|
| Rate for Payer: SELF PAY |
$180.00
|
| Rate for Payer: Veterans (Triwest) |
$38.25
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$131.17
|
| Rate for Payer: United Healthcare Medicare |
$40.50
|
|
|
Resolution Clip
|
Facility
IP
|
$838.00
|
|
| Hospital Charge Code |
22926472
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$754.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$142.46
|
| Rate for Payer: Amerigroup Medicare |
$142.46
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$142.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$142.46
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$217.88
|
| Rate for Payer: Copperpoint |
$235.06
|
| Rate for Payer: Humana Medicare |
$142.46
|
| Rate for Payer: SELF PAY |
$670.40
|
| Rate for Payer: Veterans (Triwest) |
$142.46
|
|
|
Resolution Clip
|
Facility
OP
|
$838.00
|
|
| Hospital Charge Code |
22926472
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$754.20
|
| Rate for Payer: Aetna Medicare |
$234.64
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$142.46
|
| Rate for Payer: Amerigroup Medicare |
$142.46
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$312.99
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$142.46
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$142.46
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$217.88
|
| Rate for Payer: Cigna All Products |
$586.60
|
| Rate for Payer: Copperpoint |
$235.06
|
| Rate for Payer: HealthNet Commercial |
$502.80
|
| Rate for Payer: HealthNet Medicare |
$234.64
|
| Rate for Payer: Humana Medicare |
$142.46
|
| Rate for Payer: SELF PAY |
$670.40
|
| Rate for Payer: Veterans (Triwest) |
$142.46
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$488.55
|
| Rate for Payer: United Healthcare Medicare |
$150.84
|
|
|
Respiratory Failure
|
Facility
IP
|
$4,633.45
|
|
|
Service Code
|
APRDRG 1332
|
| Hospital Charge Code |
APRDRG1332
|
| Min. Negotiated Rate |
$4,633.45 |
| Max. Negotiated Rate |
$4,633.45 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,633.45
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,633.45
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,633.45
|
| Rate for Payer: Mercy Care Medicaid |
$4,633.45
|
|
|
Respiratory Failure
|
Facility
IP
|
$7,082.04
|
|
|
Service Code
|
APRDRG 1333
|
| Hospital Charge Code |
APRDRG1333
|
| Min. Negotiated Rate |
$7,082.04 |
| Max. Negotiated Rate |
$7,082.04 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$7,082.04
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$7,082.04
|
| Rate for Payer: Banner University Family Care Medicaid |
$7,082.04
|
| Rate for Payer: Mercy Care Medicaid |
$7,082.04
|
|
|
Respiratory Failure
|
Facility
IP
|
$2,807.70
|
|
|
Service Code
|
APRDRG 1331
|
| Hospital Charge Code |
APRDRG1331
|
| Min. Negotiated Rate |
$2,807.70 |
| Max. Negotiated Rate |
$2,807.70 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$2,807.70
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$2,807.70
|
| Rate for Payer: Banner University Family Care Medicaid |
$2,807.70
|
| Rate for Payer: Mercy Care Medicaid |
$2,807.70
|
|
|
Respiratory Failure
|
Facility
IP
|
$12,428.81
|
|
|
Service Code
|
APRDRG 1334
|
| Hospital Charge Code |
APRDRG1334
|
| Min. Negotiated Rate |
$12,428.81 |
| Max. Negotiated Rate |
$12,428.81 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$12,428.81
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$12,428.81
|
| Rate for Payer: Banner University Family Care Medicaid |
$12,428.81
|
| Rate for Payer: Mercy Care Medicaid |
$12,428.81
|
|
|
Respiratory Malignancy
|
Facility
IP
|
$12,962.57
|
|
|
Service Code
|
APRDRG 1364
|
| Hospital Charge Code |
APRDRG1364
|
| Min. Negotiated Rate |
$12,962.57 |
| Max. Negotiated Rate |
$12,962.57 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$12,962.57
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$12,962.57
|
| Rate for Payer: Banner University Family Care Medicaid |
$12,962.57
|
| Rate for Payer: Mercy Care Medicaid |
$12,962.57
|
|
|
Respiratory Malignancy
|
Facility
IP
|
$8,765.40
|
|
|
Service Code
|
APRDRG 1363
|
| Hospital Charge Code |
APRDRG1363
|
| Min. Negotiated Rate |
$8,765.40 |
| Max. Negotiated Rate |
$8,765.40 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$8,765.40
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$8,765.40
|
| Rate for Payer: Banner University Family Care Medicaid |
$8,765.40
|
| Rate for Payer: Mercy Care Medicaid |
$8,765.40
|
|
|
Respiratory Malignancy
|
Facility
IP
|
$4,724.63
|
|
|
Service Code
|
APRDRG 1361
|
| Hospital Charge Code |
APRDRG1361
|
| Min. Negotiated Rate |
$4,724.63 |
| Max. Negotiated Rate |
$4,724.63 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$4,724.63
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$4,724.63
|
| Rate for Payer: Banner University Family Care Medicaid |
$4,724.63
|
| Rate for Payer: Mercy Care Medicaid |
$4,724.63
|
|