Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)

Facility

OP

$104.00

Service Code	CPT 87635
Hospital Charge Code	23934513
Hospital Revenue Code	301
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of AZ Commercial	$93.60
Rate for Payer: Aetna of AZ Medicare	$29.12
Rate for Payer: Allwell Medicare	$16.64
Rate for Payer: Amerigroup Medicare	$16.64
Rate for Payer: APIPA Medicare/Medicaid	$38.84
Rate for Payer: AZCH Complete Medicare	$16.64
Rate for Payer: Banner UC Health Medicare	$16.64
Rate for Payer: Bisbee Police All Plans	$27.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$70.72
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cigna of AZ Commercial	$67.60
Rate for Payer: Copperpoint Commercial	$25.74
Rate for Payer: Health Net of AZ Commercial	$62.40
Rate for Payer: Health Net of AZ Medicare	$29.12
Rate for Payer: Humana of AZ Medicare	$16.64
Rate for Payer: Self Pay Self Pay	$83.20
Rate for Payer: TriWest Medicare	$16.64
Rate for Payer: UnitedHealth Group of AZ Commercial	$60.63
Rate for Payer: UnitedHealth Group of AZ Medicare	$18.72

INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)

Facility

IP

$104.00

Service Code	CPT 87635
Hospital Charge Code	23934513
Hospital Revenue Code	301
Min. Negotiated Rate	$27.04
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of AZ Commercial	$93.60
Rate for Payer: Bisbee Police All Plans	$27.04
Rate for Payer: Cash Price	$83.20
Rate for Payer: Self Pay Self Pay	$83.20

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$7,378.73

Service Code	APR-DRG 7101
Hospital Charge Code	APRDRG7103
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$17,367.37

Service Code	APR-DRG 7103
Hospital Charge Code	APRDRG7104
Min. Negotiated Rate	$17,367.37
Max. Negotiated Rate	$17,367.37
Rate for Payer: AHCCCS Medicaid	$17,367.37
Rate for Payer: Allwell Medicaid	$17,367.37
Rate for Payer: AZCH Complete Medicaid	$17,367.37
Rate for Payer: Banner UC Health Medicaid	$17,367.37
Rate for Payer: Mercy Care Medicaid	$17,367.37

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$10,647.95

Service Code	APR-DRG 7102
Hospital Charge Code	APRDRG7101
Min. Negotiated Rate	$10,647.95
Max. Negotiated Rate	$10,647.95
Rate for Payer: AHCCCS Medicaid	$10,647.95
Rate for Payer: Allwell Medicaid	$10,647.95
Rate for Payer: AZCH Complete Medicaid	$10,647.95
Rate for Payer: Banner UC Health Medicaid	$10,647.95
Rate for Payer: Mercy Care Medicaid	$10,647.95

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$10,647.95

Service Code	APR-DRG 7102
Hospital Charge Code	APRDRG7104
Min. Negotiated Rate	$10,647.95
Max. Negotiated Rate	$10,647.95
Rate for Payer: AHCCCS Medicaid	$10,647.95
Rate for Payer: Allwell Medicaid	$10,647.95
Rate for Payer: AZCH Complete Medicaid	$10,647.95
Rate for Payer: Banner UC Health Medicaid	$10,647.95
Rate for Payer: Mercy Care Medicaid	$10,647.95

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$10,647.95

Service Code	APR-DRG 7102
Hospital Charge Code	APRDRG7102
Min. Negotiated Rate	$10,647.95
Max. Negotiated Rate	$10,647.95
Rate for Payer: AHCCCS Medicaid	$10,647.95
Rate for Payer: Allwell Medicaid	$10,647.95
Rate for Payer: AZCH Complete Medicaid	$10,647.95
Rate for Payer: Banner UC Health Medicaid	$10,647.95
Rate for Payer: Mercy Care Medicaid	$10,647.95

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$33,463.79

Service Code	APR-DRG 7104
Hospital Charge Code	APRDRG7103
Min. Negotiated Rate	$33,463.79
Max. Negotiated Rate	$33,463.79
Rate for Payer: AHCCCS Medicaid	$33,463.79
Rate for Payer: Allwell Medicaid	$33,463.79
Rate for Payer: AZCH Complete Medicaid	$33,463.79
Rate for Payer: Banner UC Health Medicaid	$33,463.79
Rate for Payer: Mercy Care Medicaid	$33,463.79

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$33,463.79

Service Code	APR-DRG 7104
Hospital Charge Code	APRDRG7101
Min. Negotiated Rate	$33,463.79
Max. Negotiated Rate	$33,463.79
Rate for Payer: AHCCCS Medicaid	$33,463.79
Rate for Payer: Allwell Medicaid	$33,463.79
Rate for Payer: AZCH Complete Medicaid	$33,463.79
Rate for Payer: Banner UC Health Medicaid	$33,463.79
Rate for Payer: Mercy Care Medicaid	$33,463.79

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$7,378.73

Service Code	APR-DRG 7101
Hospital Charge Code	APRDRG7101
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$7,378.73

Service Code	APR-DRG 7101
Hospital Charge Code	APRDRG7102
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$7,378.73

Service Code	APR-DRG 7101
Hospital Charge Code	APRDRG7104
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$10,647.95

Service Code	APR-DRG 7102
Hospital Charge Code	APRDRG7103
Min. Negotiated Rate	$10,647.95
Max. Negotiated Rate	$10,647.95
Rate for Payer: AHCCCS Medicaid	$10,647.95
Rate for Payer: Allwell Medicaid	$10,647.95
Rate for Payer: AZCH Complete Medicaid	$10,647.95
Rate for Payer: Banner UC Health Medicaid	$10,647.95
Rate for Payer: Mercy Care Medicaid	$10,647.95

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$17,367.37

Service Code	APR-DRG 7103
Hospital Charge Code	APRDRG7103
Min. Negotiated Rate	$17,367.37
Max. Negotiated Rate	$17,367.37
Rate for Payer: AHCCCS Medicaid	$17,367.37
Rate for Payer: Allwell Medicaid	$17,367.37
Rate for Payer: AZCH Complete Medicaid	$17,367.37
Rate for Payer: Banner UC Health Medicaid	$17,367.37
Rate for Payer: Mercy Care Medicaid	$17,367.37

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$33,463.79

Service Code	APR-DRG 7104
Hospital Charge Code	APRDRG7104
Min. Negotiated Rate	$33,463.79
Max. Negotiated Rate	$33,463.79
Rate for Payer: AHCCCS Medicaid	$33,463.79
Rate for Payer: Allwell Medicaid	$33,463.79
Rate for Payer: AZCH Complete Medicaid	$33,463.79
Rate for Payer: Banner UC Health Medicaid	$33,463.79
Rate for Payer: Mercy Care Medicaid	$33,463.79

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$17,367.37

Service Code	APR-DRG 7103
Hospital Charge Code	APRDRG7102
Min. Negotiated Rate	$17,367.37
Max. Negotiated Rate	$17,367.37
Rate for Payer: AHCCCS Medicaid	$17,367.37
Rate for Payer: Allwell Medicaid	$17,367.37
Rate for Payer: AZCH Complete Medicaid	$17,367.37
Rate for Payer: Banner UC Health Medicaid	$17,367.37
Rate for Payer: Mercy Care Medicaid	$17,367.37

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$33,463.79

Service Code	APR-DRG 7104
Hospital Charge Code	APRDRG7102
Min. Negotiated Rate	$33,463.79
Max. Negotiated Rate	$33,463.79
Rate for Payer: AHCCCS Medicaid	$33,463.79
Rate for Payer: Allwell Medicaid	$33,463.79
Rate for Payer: AZCH Complete Medicaid	$33,463.79
Rate for Payer: Banner UC Health Medicaid	$33,463.79
Rate for Payer: Mercy Care Medicaid	$33,463.79

Infectious And Parasitic Diseases Including Hiv With O.R. Procedure

Facility

IP

$17,367.37

Service Code	APR-DRG 7103
Hospital Charge Code	APRDRG7101
Min. Negotiated Rate	$17,367.37
Max. Negotiated Rate	$17,367.37
Rate for Payer: AHCCCS Medicaid	$17,367.37
Rate for Payer: Allwell Medicaid	$17,367.37
Rate for Payer: AZCH Complete Medicaid	$17,367.37
Rate for Payer: Banner UC Health Medicaid	$17,367.37
Rate for Payer: Mercy Care Medicaid	$17,367.37

Infectious disease, chronic hepatitis C virus (HCV) infectio

Facility

OP

$1,736.00

Service Code	CPT 81596
Hospital Charge Code	23599256
Hospital Revenue Code	301
Min. Negotiated Rate	$277.76
Max. Negotiated Rate	$1,562.40
Rate for Payer: Aetna of AZ Commercial	$1,562.40
Rate for Payer: Aetna of AZ Medicare	$486.08
Rate for Payer: Allwell Medicare	$277.76
Rate for Payer: Amerigroup Medicare	$277.76
Rate for Payer: APIPA Medicare/Medicaid	$648.40
Rate for Payer: AZCH Complete Medicare	$277.76
Rate for Payer: Banner UC Health Medicare	$277.76
Rate for Payer: Bisbee Police All Plans	$451.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,180.48
Rate for Payer: Cash Price	$1,388.80
Rate for Payer: Cigna of AZ Commercial	$1,128.40
Rate for Payer: Copperpoint Commercial	$429.66
Rate for Payer: Health Net of AZ Commercial	$1,041.60
Rate for Payer: Health Net of AZ Medicare	$486.08
Rate for Payer: Humana of AZ Medicare	$277.76
Rate for Payer: Self Pay Self Pay	$1,388.80
Rate for Payer: TriWest Medicare	$277.76
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,012.09
Rate for Payer: UnitedHealth Group of AZ Medicare	$312.48

Infectious disease, chronic hepatitis C virus (HCV) infectio

Facility

IP

$1,736.00

Service Code	CPT 81596
Hospital Charge Code	23599256
Hospital Revenue Code	301
Min. Negotiated Rate	$451.36
Max. Negotiated Rate	$1,562.40
Rate for Payer: Aetna of AZ Commercial	$1,562.40
Rate for Payer: Bisbee Police All Plans	$451.36
Rate for Payer: Cash Price	$1,388.80
Rate for Payer: Self Pay Self Pay	$1,388.80

Inflammatory Bowel Disease

Facility

IP

$4,831.94

Service Code	APR-DRG 2452
Hospital Charge Code	APRDRG2453
Min. Negotiated Rate	$4,831.94
Max. Negotiated Rate	$4,831.94
Rate for Payer: AHCCCS Medicaid	$4,831.94
Rate for Payer: Allwell Medicaid	$4,831.94
Rate for Payer: AZCH Complete Medicaid	$4,831.94
Rate for Payer: Banner UC Health Medicaid	$4,831.94
Rate for Payer: Mercy Care Medicaid	$4,831.94

Inflammatory Bowel Disease

Facility

IP

$4,831.94

Service Code	APR-DRG 2452
Hospital Charge Code	APRDRG2454
Min. Negotiated Rate	$4,831.94
Max. Negotiated Rate	$4,831.94
Rate for Payer: AHCCCS Medicaid	$4,831.94
Rate for Payer: Allwell Medicaid	$4,831.94
Rate for Payer: AZCH Complete Medicaid	$4,831.94
Rate for Payer: Banner UC Health Medicaid	$4,831.94
Rate for Payer: Mercy Care Medicaid	$4,831.94

Inflammatory Bowel Disease

Facility

IP

$3,807.20

Service Code	APR-DRG 2451
Hospital Charge Code	APRDRG2451
Min. Negotiated Rate	$3,807.20
Max. Negotiated Rate	$3,807.20
Rate for Payer: AHCCCS Medicaid	$3,807.20
Rate for Payer: Allwell Medicaid	$3,807.20
Rate for Payer: AZCH Complete Medicaid	$3,807.20
Rate for Payer: Banner UC Health Medicaid	$3,807.20
Rate for Payer: Mercy Care Medicaid	$3,807.20

Inflammatory Bowel Disease

Facility

IP

$4,831.94

Service Code	APR-DRG 2452
Hospital Charge Code	APRDRG2451
Min. Negotiated Rate	$4,831.94
Max. Negotiated Rate	$4,831.94
Rate for Payer: AHCCCS Medicaid	$4,831.94
Rate for Payer: Allwell Medicaid	$4,831.94
Rate for Payer: AZCH Complete Medicaid	$4,831.94
Rate for Payer: Banner UC Health Medicaid	$4,831.94
Rate for Payer: Mercy Care Medicaid	$4,831.94

Inflammatory Bowel Disease

Facility

IP

$3,807.20

Service Code	APR-DRG 2451
Hospital Charge Code	APRDRG2454
Min. Negotiated Rate	$3,807.20
Max. Negotiated Rate	$3,807.20
Rate for Payer: AHCCCS Medicaid	$3,807.20
Rate for Payer: Allwell Medicaid	$3,807.20
Rate for Payer: AZCH Complete Medicaid	$3,807.20
Rate for Payer: Banner UC Health Medicaid	$3,807.20
Rate for Payer: Mercy Care Medicaid	$3,807.20

<<
<
225
226
227
228
229
230
231
232
233
234
>
>>