Copper Queen Community Hospital

These charges represent the costs of individual services and supplies at Copper Queen Community Hospital.

Charges

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Charge Charge Type Standard Charge  
Service Code CPT 80365
Hospital Charge Code 23090937
Hospital Revenue Code 301
Min. Negotiated Rate $41.48
Max. Negotiated Rate $219.60
Rate for Payer: Aetna POS, PPO, HMO $219.60
Rate for Payer: Aetna Medicare $68.32
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $41.48
Rate for Payer: Amerigroup Medicare $41.48
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $91.13
Rate for Payer: Arizona Complete Care Health Medicare Advantage $41.48
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $41.48
Rate for Payer: City of Bisbee Police Bisbee Police $63.44
Rate for Payer: Cigna All Products $170.80
Rate for Payer: Copperpoint $68.44
Rate for Payer: HealthNet Commercial $146.40
Rate for Payer: HealthNet Medicare $68.32
Rate for Payer: Humana Medicare $41.48
Rate for Payer: Veterans (Triwest) $41.48
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $147.86
Rate for Payer: United Healthcare Medicare $41.48
Service Code CPT 76700
Hospital Charge Code 2214209
Hospital Revenue Code 402
Min. Negotiated Rate $190.23
Max. Negotiated Rate $1,007.10
Rate for Payer: Aetna POS, PPO, HMO $1,007.10
Rate for Payer: Aetna Medicare $313.32
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $190.23
Rate for Payer: Amerigroup Medicare $190.23
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $417.95
Rate for Payer: Arizona Complete Care Health Medicare Advantage $190.23
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $190.23
Rate for Payer: Blue Cross Blue Shield AZ PPO $833.87
Rate for Payer: City of Bisbee Police Bisbee Police $290.94
Rate for Payer: Cigna All Products $783.30
Rate for Payer: Copperpoint $313.88
Rate for Payer: HealthNet Commercial $671.40
Rate for Payer: HealthNet Medicare $313.32
Rate for Payer: Humana Medicare $190.23
Rate for Payer: Veterans (Triwest) $190.23
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $678.11
Rate for Payer: United Healthcare Medicare $190.23
Rate for Payer: UMR - Non-Contracted Commercial $849.76
Hospital Charge Code 22354974
Hospital Revenue Code 270
Min. Negotiated Rate $17.17
Max. Negotiated Rate $90.90
Rate for Payer: Aetna POS, PPO, HMO $90.90
Rate for Payer: Aetna Medicare $28.28
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $17.17
Rate for Payer: Amerigroup Medicare $17.17
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $37.72
Rate for Payer: Arizona Complete Care Health Medicare Advantage $17.17
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $17.17
Rate for Payer: City of Bisbee Police Bisbee Police $26.26
Rate for Payer: Cigna All Products $70.70
Rate for Payer: Copperpoint $28.33
Rate for Payer: HealthNet Commercial $60.60
Rate for Payer: HealthNet Medicare $28.28
Rate for Payer: Humana Medicare $17.17
Rate for Payer: Veterans (Triwest) $17.17
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $61.21
Rate for Payer: United Healthcare Medicare $17.17
Service Code CPT 27605
Hospital Charge Code 24043323
Hospital Revenue Code 360
Min. Negotiated Rate $141.95
Max. Negotiated Rate $751.50
Rate for Payer: Aetna POS, PPO, HMO $751.50
Rate for Payer: Aetna Medicare $233.80
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $141.95
Rate for Payer: Amerigroup Medicare $141.95
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $311.87
Rate for Payer: Arizona Complete Care Health Medicare Advantage $141.95
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $141.95
Rate for Payer: City of Bisbee Police Bisbee Police $217.10
Rate for Payer: Cigna All Products $584.50
Rate for Payer: Copperpoint $234.22
Rate for Payer: HealthNet Commercial $501.00
Rate for Payer: HealthNet Medicare $233.80
Rate for Payer: Humana Medicare $141.95
Rate for Payer: Veterans (Triwest) $141.95
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $506.01
Rate for Payer: United Healthcare Medicare $141.95
Service Code CPT 27605
Hospital Charge Code 24043323
Hospital Revenue Code 360
Min. Negotiated Rate $141.95
Max. Negotiated Rate $2,999.00
Rate for Payer: Aetna POS, PPO, HMO $751.50
Rate for Payer: Aetna Medicare $233.80
Rate for Payer: AHCCCS Medicaid $1,009.24
Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid $1,009.24
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $141.95
Rate for Payer: Amerigroup Medicare $141.95
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $311.87
Rate for Payer: Arizona Complete Care Health Medicaid $1,009.24
Rate for Payer: Arizona Complete Care Health Medicare Advantage $141.95
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $141.95
Rate for Payer: Banner University Family Care Medicaid $1,009.24
Rate for Payer: City of Bisbee Police Bisbee Police $217.10
Rate for Payer: Cigna All Products $584.50
Rate for Payer: Copperpoint $234.22
Rate for Payer: HealthNet Commercial $501.00
Rate for Payer: HealthNet Medicare $233.80
Rate for Payer: Humana Medicare $141.95
Rate for Payer: Mercy Care Medicaid $1,009.24
Rate for Payer: Veterans (Triwest) $141.95
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $2,999.00
Rate for Payer: United Healthcare Medicare $141.95
Service Code CPT 11719
Hospital Charge Code 24049505
Hospital Revenue Code 360
Min. Negotiated Rate $5.95
Max. Negotiated Rate $31.50
Rate for Payer: Aetna POS, PPO, HMO $31.50
Rate for Payer: Aetna Medicare $9.80
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $5.95
Rate for Payer: Amerigroup Medicare $5.95
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $13.07
Rate for Payer: Arizona Complete Care Health Medicare Advantage $5.95
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $5.95
Rate for Payer: City of Bisbee Police Bisbee Police $9.10
Rate for Payer: Cigna All Products $24.50
Rate for Payer: Copperpoint $9.82
Rate for Payer: HealthNet Commercial $21.00
Rate for Payer: HealthNet Medicare $9.80
Rate for Payer: Humana Medicare $5.95
Rate for Payer: Veterans (Triwest) $5.95
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $21.21
Rate for Payer: United Healthcare Medicare $5.95
Service Code CPT 11719
Hospital Charge Code 24049505
Hospital Revenue Code 360
Min. Negotiated Rate $5.95
Max. Negotiated Rate $1,922.00
Rate for Payer: Aetna POS, PPO, HMO $31.50
Rate for Payer: Aetna Medicare $9.80
Rate for Payer: AHCCCS Medicaid $45.22
Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid $45.22
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $5.95
Rate for Payer: Amerigroup Medicare $5.95
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $13.07
Rate for Payer: Arizona Complete Care Health Medicaid $45.22
Rate for Payer: Arizona Complete Care Health Medicare Advantage $5.95
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $5.95
Rate for Payer: Banner University Family Care Medicaid $45.22
Rate for Payer: City of Bisbee Police Bisbee Police $9.10
Rate for Payer: Cigna All Products $24.50
Rate for Payer: Copperpoint $9.82
Rate for Payer: HealthNet Commercial $21.00
Rate for Payer: HealthNet Medicare $9.80
Rate for Payer: Humana Medicare $5.95
Rate for Payer: Mercy Care Medicaid $45.22
Rate for Payer: Veterans (Triwest) $5.95
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $1,922.00
Rate for Payer: United Healthcare Medicare $5.95
Service Code CPT 36430
Hospital Charge Code 609598
Hospital Revenue Code 391
Min. Negotiated Rate $100.30
Max. Negotiated Rate $531.00
Rate for Payer: Aetna POS, PPO, HMO $531.00
Rate for Payer: Aetna Medicare $165.20
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $100.30
Rate for Payer: Amerigroup Medicare $100.30
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $220.37
Rate for Payer: Arizona Complete Care Health Medicare Advantage $100.30
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $100.30
Rate for Payer: City of Bisbee Police Bisbee Police $153.40
Rate for Payer: Cigna All Products $413.00
Rate for Payer: Copperpoint $165.50
Rate for Payer: HealthNet Commercial $354.00
Rate for Payer: HealthNet Medicare $165.20
Rate for Payer: Humana Medicare $100.30
Rate for Payer: Veterans (Triwest) $100.30
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $357.54
Rate for Payer: United Healthcare Medicare $100.30
Service Code CPT 83883
Hospital Charge Code 22720193
Hospital Revenue Code 302
Min. Negotiated Rate $13.60
Max. Negotiated Rate $222.30
Rate for Payer: Aetna POS, PPO, HMO $222.30
Rate for Payer: Aetna Medicare $69.16
Rate for Payer: AHCCCS Medicaid $13.60
Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid $13.60
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage $41.99
Rate for Payer: Amerigroup Medicare $41.99
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid $92.25
Rate for Payer: Arizona Complete Care Health Medicaid $13.60
Rate for Payer: Arizona Complete Care Health Medicare Advantage $41.99
Rate for Payer: Banner University Care Advantage Health Maintenance Organization $41.99
Rate for Payer: Banner University Family Care Medicaid $13.60
Rate for Payer: Blue Cross Blue Shield AZ PPO $178.84
Rate for Payer: City of Bisbee Police Bisbee Police $64.22
Rate for Payer: Cigna All Products $172.90
Rate for Payer: Copperpoint $69.28
Rate for Payer: HealthNet Commercial $148.20
Rate for Payer: HealthNet Medicare $69.16
Rate for Payer: Humana Medicare $41.99
Rate for Payer: Mercy Care Medicaid $13.60
Rate for Payer: Veterans (Triwest) $41.99
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) $149.68
Rate for Payer: United Healthcare Medicare $41.99
Rate for Payer: UMR - Non-Contracted Commercial $157.27