|
Rubella Antibodies, IgG LC
|
Facility
OP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
2029257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Aetna Medicare |
$50.68
|
| Rate for Payer: AHCCCS Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$67.60
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Banner University Family Care Medicaid |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Cigna All Products |
$117.65
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: HealthNet Commercial |
$108.60
|
| Rate for Payer: HealthNet Medicare |
$50.68
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: Mercy Care Medicaid |
$14.39
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$105.52
|
| Rate for Payer: United Healthcare Medicare |
$32.58
|
|
|
Rubella Antibodies, IgG LC
|
Facility
IP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
2029257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
|
|
Rubella Antibody, IgM LC
|
Facility
IP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
2446665
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
|
|
Rubella Antibody, IgM LC
|
Facility
OP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
2446665
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Aetna Medicare |
$50.68
|
| Rate for Payer: AHCCCS Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$67.60
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Banner University Family Care Medicaid |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Cigna All Products |
$117.65
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: HealthNet Commercial |
$108.60
|
| Rate for Payer: HealthNet Medicare |
$50.68
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: Mercy Care Medicaid |
$14.39
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$105.52
|
| Rate for Payer: United Healthcare Medicare |
$32.58
|
|
|
RUBELLA IGG
|
Facility
OP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
22481502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Aetna Medicare |
$50.68
|
| Rate for Payer: AHCCCS Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$14.39
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$67.60
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$14.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Banner University Family Care Medicaid |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Cigna All Products |
$117.65
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: HealthNet Commercial |
$108.60
|
| Rate for Payer: HealthNet Medicare |
$50.68
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: Mercy Care Medicaid |
$14.39
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$105.52
|
| Rate for Payer: United Healthcare Medicare |
$32.58
|
|
|
RUBELLA IGG
|
Facility
IP
|
$181.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
22481502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.77
|
| Rate for Payer: Amerigroup Medicare |
$30.77
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.77
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$112.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$47.06
|
| Rate for Payer: Copperpoint |
$50.77
|
| Rate for Payer: Humana Medicare |
$30.77
|
| Rate for Payer: SELF PAY |
$144.80
|
| Rate for Payer: Veterans (Triwest) |
$30.77
|
|
|
Rubeola Antibodies, IgG LC
|
Facility
OP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
22201672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Aetna Medicare |
$64.40
|
| Rate for Payer: AHCCCS Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$85.91
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$12.88
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: Banner University Family Care Medicaid |
$12.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Cigna All Products |
$149.50
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: HealthNet Commercial |
$138.00
|
| Rate for Payer: HealthNet Medicare |
$64.40
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: Mercy Care Medicaid |
$12.88
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$134.09
|
| Rate for Payer: United Healthcare Medicare |
$41.40
|
|
|
Rubeola Antibodies, IgG LC
|
Facility
IP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
22201672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
|
|
RUBEOLA IGG
|
Facility
IP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
22481503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
|
|
RUBEOLA IGG
|
Facility
OP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
22481503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Aetna Medicare |
$64.40
|
| Rate for Payer: AHCCCS Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$85.91
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$12.88
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: Banner University Family Care Medicaid |
$12.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Cigna All Products |
$149.50
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: HealthNet Commercial |
$138.00
|
| Rate for Payer: HealthNet Medicare |
$64.40
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: Mercy Care Medicaid |
$12.88
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$134.09
|
| Rate for Payer: United Healthcare Medicare |
$41.40
|
|
|
Rubeola IgM LC
|
Facility
OP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
6780983
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Aetna Medicare |
$64.40
|
| Rate for Payer: AHCCCS Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$12.88
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$85.91
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$12.88
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: Banner University Family Care Medicaid |
$12.88
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Cigna All Products |
$149.50
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: HealthNet Commercial |
$138.00
|
| Rate for Payer: HealthNet Medicare |
$64.40
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: Mercy Care Medicaid |
$12.88
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$134.09
|
| Rate for Payer: United Healthcare Medicare |
$41.40
|
|
|
Rubeola IgM LC
|
Facility
IP
|
$230.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
6780983
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$207.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$39.10
|
| Rate for Payer: Amerigroup Medicare |
$39.10
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$39.10
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$39.10
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$59.80
|
| Rate for Payer: Copperpoint |
$64.52
|
| Rate for Payer: Humana Medicare |
$39.10
|
| Rate for Payer: SELF PAY |
$184.00
|
| Rate for Payer: Veterans (Triwest) |
$39.10
|
|
|
Sacrospinous ligament fixaton
|
Facility
IP
|
$3,595.00
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
27267823
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$611.15 |
| Max. Negotiated Rate |
$3,235.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,235.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$611.15
|
| Rate for Payer: Amerigroup Medicare |
$611.15
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$611.15
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$611.15
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$934.70
|
| Rate for Payer: Copperpoint |
$1,008.40
|
| Rate for Payer: Humana Medicare |
$611.15
|
| Rate for Payer: SELF PAY |
$2,876.00
|
| Rate for Payer: Veterans (Triwest) |
$611.15
|
|
|
Sacrospinous ligament fixaton
|
Facility
OP
|
$3,595.00
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
27267823
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$611.15 |
| Max. Negotiated Rate |
$9,851.74 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,235.50
|
| Rate for Payer: Aetna Medicare |
$1,006.60
|
| Rate for Payer: AHCCCS Medicaid |
$9,851.74
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$9,851.74
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$611.15
|
| Rate for Payer: Amerigroup Medicare |
$611.15
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1,342.73
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$9,851.74
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$611.15
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$611.15
|
| Rate for Payer: Banner University Family Care Medicaid |
$9,851.74
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$934.70
|
| Rate for Payer: Cigna All Products |
$1,797.50
|
| Rate for Payer: Copperpoint |
$1,008.40
|
| Rate for Payer: HealthNet Commercial |
$2,157.00
|
| Rate for Payer: HealthNet Medicare |
$1,006.60
|
| Rate for Payer: Humana Medicare |
$611.15
|
| Rate for Payer: Mercy Care Medicaid |
$9,851.74
|
| Rate for Payer: SELF PAY |
$2,876.00
|
| Rate for Payer: Veterans (Triwest) |
$611.15
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2,095.88
|
| Rate for Payer: United Healthcare Medicare |
$647.10
|
|
|
Salicylate Level
|
Facility
IP
|
$180.00
|
|
|
Service Code
|
CPT G0480
|
| Hospital Charge Code |
633829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$208.37 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.60
|
| Rate for Payer: Amerigroup Medicare |
$30.60
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.60
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.60
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$208.37
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$46.80
|
| Rate for Payer: Copperpoint |
$50.49
|
| Rate for Payer: Humana Medicare |
$30.60
|
| Rate for Payer: SELF PAY |
$144.00
|
| Rate for Payer: Veterans (Triwest) |
$30.60
|
|
|
Salicylate Level
|
Facility
OP
|
$180.00
|
|
|
Service Code
|
CPT G0480
|
| Hospital Charge Code |
633829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$228.86 |
| Rate for Payer: Aetna POS, PPO, HMO |
$162.00
|
| Rate for Payer: Aetna Medicare |
$50.40
|
| Rate for Payer: AHCCCS Medicaid |
$228.86
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$228.86
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$30.60
|
| Rate for Payer: Amerigroup Medicare |
$30.60
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$67.23
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$228.86
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$30.60
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$30.60
|
| Rate for Payer: Banner University Family Care Medicaid |
$228.86
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$208.37
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$46.80
|
| Rate for Payer: Cigna All Products |
$117.00
|
| Rate for Payer: Copperpoint |
$50.49
|
| Rate for Payer: HealthNet Commercial |
$108.00
|
| Rate for Payer: HealthNet Medicare |
$50.40
|
| Rate for Payer: Humana Medicare |
$30.60
|
| Rate for Payer: Mercy Care Medicaid |
$228.86
|
| Rate for Payer: SELF PAY |
$144.00
|
| Rate for Payer: Veterans (Triwest) |
$30.60
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$104.94
|
| Rate for Payer: United Healthcare Medicare |
$32.40
|
|
|
SALINE FLUSH 10 ML
|
Facility
OP
|
$4.00
|
|
| Hospital Charge Code |
22354289
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3.60
|
| Rate for Payer: Aetna Medicare |
$1.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.68
|
| Rate for Payer: Amerigroup Medicare |
$0.68
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1.49
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.68
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.68
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.04
|
| Rate for Payer: Cigna All Products |
$2.80
|
| Rate for Payer: Copperpoint |
$1.12
|
| Rate for Payer: HealthNet Commercial |
$2.40
|
| Rate for Payer: HealthNet Medicare |
$1.12
|
| Rate for Payer: Humana Medicare |
$0.68
|
| Rate for Payer: SELF PAY |
$3.20
|
| Rate for Payer: Veterans (Triwest) |
$0.68
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2.33
|
| Rate for Payer: United Healthcare Medicare |
$0.72
|
|
|
SALINE FLUSH 10 ML
|
Facility
IP
|
$4.00
|
|
| Hospital Charge Code |
22354289
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.68
|
| Rate for Payer: Amerigroup Medicare |
$0.68
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.68
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.68
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.04
|
| Rate for Payer: Copperpoint |
$1.12
|
| Rate for Payer: Humana Medicare |
$0.68
|
| Rate for Payer: SELF PAY |
$3.20
|
| Rate for Payer: Veterans (Triwest) |
$0.68
|
|
|
SALINE FLUSH 10 ML SYRINGE
|
Facility
OP
|
$4.00
|
|
| Hospital Charge Code |
27569984
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3.60
|
| Rate for Payer: Aetna Medicare |
$1.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.68
|
| Rate for Payer: Amerigroup Medicare |
$0.68
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1.49
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.68
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.68
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.04
|
| Rate for Payer: Cigna All Products |
$2.80
|
| Rate for Payer: Copperpoint |
$1.12
|
| Rate for Payer: HealthNet Commercial |
$2.40
|
| Rate for Payer: HealthNet Medicare |
$1.12
|
| Rate for Payer: Humana Medicare |
$0.68
|
| Rate for Payer: SELF PAY |
$3.20
|
| Rate for Payer: Veterans (Triwest) |
$0.68
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2.33
|
| Rate for Payer: United Healthcare Medicare |
$0.72
|
|
|
SALINE FLUSH 10 ML SYRINGE
|
Facility
IP
|
$4.00
|
|
| Hospital Charge Code |
27569984
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.68
|
| Rate for Payer: Amerigroup Medicare |
$0.68
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.68
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.68
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.04
|
| Rate for Payer: Copperpoint |
$1.12
|
| Rate for Payer: Humana Medicare |
$0.68
|
| Rate for Payer: SELF PAY |
$3.20
|
| Rate for Payer: Veterans (Triwest) |
$0.68
|
|
|
Salpingectomy complete/partial
|
Facility
IP
|
$4,120.00
|
|
|
Service Code
|
CPT 58700
|
| Hospital Charge Code |
27281891
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$700.40 |
| Max. Negotiated Rate |
$3,708.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,708.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$700.40
|
| Rate for Payer: Amerigroup Medicare |
$700.40
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$700.40
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$700.40
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,071.20
|
| Rate for Payer: Copperpoint |
$1,155.66
|
| Rate for Payer: Humana Medicare |
$700.40
|
| Rate for Payer: SELF PAY |
$3,296.00
|
| Rate for Payer: Veterans (Triwest) |
$700.40
|
|
|
Salpingectomy complete/partial
|
Facility
OP
|
$4,120.00
|
|
|
Service Code
|
CPT 58700
|
| Hospital Charge Code |
27281891
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$700.40 |
| Max. Negotiated Rate |
$3,708.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$3,708.00
|
| Rate for Payer: Aetna Medicare |
$1,153.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$700.40
|
| Rate for Payer: Amerigroup Medicare |
$700.40
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1,538.82
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$700.40
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$700.40
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1,071.20
|
| Rate for Payer: Cigna All Products |
$2,060.00
|
| Rate for Payer: Copperpoint |
$1,155.66
|
| Rate for Payer: HealthNet Commercial |
$2,472.00
|
| Rate for Payer: HealthNet Medicare |
$1,153.60
|
| Rate for Payer: Humana Medicare |
$700.40
|
| Rate for Payer: SELF PAY |
$3,296.00
|
| Rate for Payer: Veterans (Triwest) |
$700.40
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2,401.96
|
| Rate for Payer: United Healthcare Medicare |
$741.60
|
|
|
SCALPEL W/HANDLE #15 DISPOSABLE
|
Facility
OP
|
$4.55
|
|
| Hospital Charge Code |
22355086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna POS, PPO, HMO |
$4.09
|
| Rate for Payer: Aetna Medicare |
$1.27
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.77
|
| Rate for Payer: Amerigroup Medicare |
$0.77
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$1.70
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.77
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.18
|
| Rate for Payer: Cigna All Products |
$3.18
|
| Rate for Payer: Copperpoint |
$1.28
|
| Rate for Payer: HealthNet Commercial |
$2.73
|
| Rate for Payer: HealthNet Medicare |
$1.27
|
| Rate for Payer: Humana Medicare |
$0.77
|
| Rate for Payer: SELF PAY |
$3.64
|
| Rate for Payer: Veterans (Triwest) |
$0.77
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$2.65
|
| Rate for Payer: United Healthcare Medicare |
$0.82
|
|
|
SCALPEL W/HANDLE #15 DISPOSABLE
|
Facility
IP
|
$4.55
|
|
| Hospital Charge Code |
22355086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna POS, PPO, HMO |
$4.09
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$0.77
|
| Rate for Payer: Amerigroup Medicare |
$0.77
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$0.77
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$0.77
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$1.18
|
| Rate for Payer: Copperpoint |
$1.28
|
| Rate for Payer: Humana Medicare |
$0.77
|
| Rate for Payer: SELF PAY |
$3.64
|
| Rate for Payer: Veterans (Triwest) |
$0.77
|
|
|
Schizophrenia
|
Facility
IP
|
$17,732.79
|
|
|
Service Code
|
APRDRG 7504
|
| Hospital Charge Code |
APRDRG7504
|
| Min. Negotiated Rate |
$17,732.79 |
| Max. Negotiated Rate |
$17,732.79 |
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$17,732.79
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$17,732.79
|
| Rate for Payer: Banner University Family Care Medicaid |
$17,732.79
|
| Rate for Payer: Mercy Care Medicaid |
$17,732.79
|
|