|
SPLINT WRIST MEDIUM LEFT
|
Facility
OP
|
$45.00
|
|
| Hospital Charge Code |
22354252
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.81
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Cigna All Products |
$31.50
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: HealthNet Commercial |
$27.00
|
| Rate for Payer: HealthNet Medicare |
$12.60
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$26.23
|
| Rate for Payer: United Healthcare Medicare |
$8.10
|
|
|
SPLINT WRIST MEDIUM LEFT
|
Facility
IP
|
$45.00
|
|
| Hospital Charge Code |
22354252
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
|
|
SPLINT WRIST MEDIUM RIGHT
|
Facility
OP
|
$45.00
|
|
| Hospital Charge Code |
22354253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.81
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Cigna All Products |
$31.50
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: HealthNet Commercial |
$27.00
|
| Rate for Payer: HealthNet Medicare |
$12.60
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$26.23
|
| Rate for Payer: United Healthcare Medicare |
$8.10
|
|
|
SPLINT WRIST MEDIUM RIGHT
|
Facility
IP
|
$45.00
|
|
| Hospital Charge Code |
22354253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
|
|
SPLINT WRIST SMALL LEFT
|
Facility
IP
|
$45.00
|
|
| Hospital Charge Code |
22354250
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
|
|
SPLINT WRIST SMALL LEFT
|
Facility
OP
|
$45.00
|
|
| Hospital Charge Code |
22354250
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.81
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Cigna All Products |
$31.50
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: HealthNet Commercial |
$27.00
|
| Rate for Payer: HealthNet Medicare |
$12.60
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$26.23
|
| Rate for Payer: United Healthcare Medicare |
$8.10
|
|
|
SPLINT WRIST SMALL RIGHT
|
Facility
OP
|
$45.00
|
|
| Hospital Charge Code |
22354251
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$16.81
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Cigna All Products |
$31.50
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: HealthNet Commercial |
$27.00
|
| Rate for Payer: HealthNet Medicare |
$12.60
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$26.23
|
| Rate for Payer: United Healthcare Medicare |
$8.10
|
|
|
SPLINT WRIST SMALL RIGHT
|
Facility
IP
|
$45.00
|
|
| Hospital Charge Code |
22354251
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$40.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$7.65
|
| Rate for Payer: Amerigroup Medicare |
$7.65
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$7.65
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$7.65
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$11.70
|
| Rate for Payer: Copperpoint |
$12.62
|
| Rate for Payer: Humana Medicare |
$7.65
|
| Rate for Payer: SELF PAY |
$36.00
|
| Rate for Payer: Veterans (Triwest) |
$7.65
|
|
|
SPLINT WRIST XS PED LEFT
|
Facility
OP
|
$93.00
|
|
| Hospital Charge Code |
22354187
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$83.70
|
| Rate for Payer: Aetna Medicare |
$26.04
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$15.81
|
| Rate for Payer: Amerigroup Medicare |
$15.81
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$34.74
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$15.81
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$15.81
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$24.18
|
| Rate for Payer: Cigna All Products |
$65.10
|
| Rate for Payer: Copperpoint |
$26.09
|
| Rate for Payer: HealthNet Commercial |
$55.80
|
| Rate for Payer: HealthNet Medicare |
$26.04
|
| Rate for Payer: Humana Medicare |
$15.81
|
| Rate for Payer: SELF PAY |
$74.40
|
| Rate for Payer: Veterans (Triwest) |
$15.81
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$54.22
|
| Rate for Payer: United Healthcare Medicare |
$16.74
|
|
|
SPLINT WRIST XS PED LEFT
|
Facility
IP
|
$93.00
|
|
| Hospital Charge Code |
22354187
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$83.70
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$15.81
|
| Rate for Payer: Amerigroup Medicare |
$15.81
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$15.81
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$15.81
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$24.18
|
| Rate for Payer: Copperpoint |
$26.09
|
| Rate for Payer: Humana Medicare |
$15.81
|
| Rate for Payer: SELF PAY |
$74.40
|
| Rate for Payer: Veterans (Triwest) |
$15.81
|
|
|
SPONGE PEANUT
|
Facility
IP
|
$9.00
|
|
| Hospital Charge Code |
22355591
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
SPONGE PEANUT
|
Facility
OP
|
$9.00
|
|
| Hospital Charge Code |
22355591
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$6.30
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
SP PACU RECOVERY RM - SP RECOVERY RM > 360
|
Facility
OP
|
$450.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$76.50 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$405.00
|
| Rate for Payer: Aetna Medicare |
$126.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$76.50
|
| Rate for Payer: Amerigroup Medicare |
$76.50
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$168.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$76.50
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$76.50
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$117.00
|
| Rate for Payer: Cigna All Products |
$315.00
|
| Rate for Payer: Copperpoint |
$126.23
|
| Rate for Payer: HealthNet Commercial |
$270.00
|
| Rate for Payer: HealthNet Medicare |
$126.00
|
| Rate for Payer: Humana Medicare |
$76.50
|
| Rate for Payer: SELF PAY |
$360.00
|
| Rate for Payer: Veterans (Triwest) |
$76.50
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$262.35
|
| Rate for Payer: United Healthcare Medicare |
$81.00
|
|
|
SP PACU RECOVERY RM - SP RECOVERY RM > 360
|
Facility
IP
|
$450.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$76.50 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$405.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$76.50
|
| Rate for Payer: Amerigroup Medicare |
$76.50
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$76.50
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$76.50
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$117.00
|
| Rate for Payer: Copperpoint |
$126.23
|
| Rate for Payer: Humana Medicare |
$76.50
|
| Rate for Payer: SELF PAY |
$360.00
|
| Rate for Payer: Veterans (Triwest) |
$76.50
|
|
|
SP PACU RECOVERY RM - SP RECOVRY 331-360MIN
|
Facility
IP
|
$486.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$82.62 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$437.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$82.62
|
| Rate for Payer: Amerigroup Medicare |
$82.62
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$82.62
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$82.62
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$126.36
|
| Rate for Payer: Copperpoint |
$136.32
|
| Rate for Payer: Humana Medicare |
$82.62
|
| Rate for Payer: SELF PAY |
$388.80
|
| Rate for Payer: Veterans (Triwest) |
$82.62
|
|
|
SP PACU RECOVERY RM - SP RECOVRY 331-360MIN
|
Facility
OP
|
$486.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$82.62 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$437.40
|
| Rate for Payer: Aetna Medicare |
$136.08
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$82.62
|
| Rate for Payer: Amerigroup Medicare |
$82.62
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$181.52
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$82.62
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$82.62
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$126.36
|
| Rate for Payer: Cigna All Products |
$340.20
|
| Rate for Payer: Copperpoint |
$136.32
|
| Rate for Payer: HealthNet Commercial |
$291.60
|
| Rate for Payer: HealthNet Medicare |
$136.08
|
| Rate for Payer: Humana Medicare |
$82.62
|
| Rate for Payer: SELF PAY |
$388.80
|
| Rate for Payer: Veterans (Triwest) |
$82.62
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$283.34
|
| Rate for Payer: United Healthcare Medicare |
$87.48
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 0-60 MIN
|
Facility
IP
|
$1,478.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$251.26 |
| Max. Negotiated Rate |
$1,330.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$1,330.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$251.26
|
| Rate for Payer: Amerigroup Medicare |
$251.26
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$251.26
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$251.26
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$384.28
|
| Rate for Payer: Copperpoint |
$414.58
|
| Rate for Payer: Humana Medicare |
$251.26
|
| Rate for Payer: SELF PAY |
$1,182.40
|
| Rate for Payer: Veterans (Triwest) |
$251.26
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 0-60 MIN
|
Facility
OP
|
$1,478.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$251.26 |
| Max. Negotiated Rate |
$1,330.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$1,330.20
|
| Rate for Payer: Aetna Medicare |
$413.84
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$251.26
|
| Rate for Payer: Amerigroup Medicare |
$251.26
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$552.03
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$251.26
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$251.26
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$384.28
|
| Rate for Payer: Cigna All Products |
$1,034.60
|
| Rate for Payer: Copperpoint |
$414.58
|
| Rate for Payer: HealthNet Commercial |
$886.80
|
| Rate for Payer: HealthNet Medicare |
$413.84
|
| Rate for Payer: Humana Medicare |
$251.26
|
| Rate for Payer: SELF PAY |
$1,182.40
|
| Rate for Payer: Veterans (Triwest) |
$251.26
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$861.67
|
| Rate for Payer: United Healthcare Medicare |
$266.04
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 121-180 MIN
|
Facility
OP
|
$707.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$120.19 |
| Max. Negotiated Rate |
$636.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$636.30
|
| Rate for Payer: Aetna Medicare |
$197.96
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$120.19
|
| Rate for Payer: Amerigroup Medicare |
$120.19
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$264.06
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$120.19
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$120.19
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$183.82
|
| Rate for Payer: Cigna All Products |
$494.90
|
| Rate for Payer: Copperpoint |
$198.31
|
| Rate for Payer: HealthNet Commercial |
$424.20
|
| Rate for Payer: HealthNet Medicare |
$197.96
|
| Rate for Payer: Humana Medicare |
$120.19
|
| Rate for Payer: SELF PAY |
$565.60
|
| Rate for Payer: Veterans (Triwest) |
$120.19
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$412.18
|
| Rate for Payer: United Healthcare Medicare |
$127.26
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 121-180 MIN
|
Facility
IP
|
$707.00
|
|
| Hospital Charge Code |
22297673
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$120.19 |
| Max. Negotiated Rate |
$636.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$636.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$120.19
|
| Rate for Payer: Amerigroup Medicare |
$120.19
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$120.19
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$120.19
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$183.82
|
| Rate for Payer: Copperpoint |
$198.31
|
| Rate for Payer: Humana Medicare |
$120.19
|
| Rate for Payer: SELF PAY |
$565.60
|
| Rate for Payer: Veterans (Triwest) |
$120.19
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 181-240 MIN
|
Facility
IP
|
$554.00
|
|
| Hospital Charge Code |
22297674
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$94.18 |
| Max. Negotiated Rate |
$498.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$498.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$94.18
|
| Rate for Payer: Amerigroup Medicare |
$94.18
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$94.18
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$94.18
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$144.04
|
| Rate for Payer: Copperpoint |
$155.40
|
| Rate for Payer: Humana Medicare |
$94.18
|
| Rate for Payer: SELF PAY |
$443.20
|
| Rate for Payer: Veterans (Triwest) |
$94.18
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 181-240 MIN
|
Facility
OP
|
$554.00
|
|
| Hospital Charge Code |
22297674
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$94.18 |
| Max. Negotiated Rate |
$498.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$498.60
|
| Rate for Payer: Aetna Medicare |
$155.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$94.18
|
| Rate for Payer: Amerigroup Medicare |
$94.18
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$206.92
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$94.18
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$94.18
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$144.04
|
| Rate for Payer: Cigna All Products |
$387.80
|
| Rate for Payer: Copperpoint |
$155.40
|
| Rate for Payer: HealthNet Commercial |
$332.40
|
| Rate for Payer: HealthNet Medicare |
$155.12
|
| Rate for Payer: Humana Medicare |
$94.18
|
| Rate for Payer: SELF PAY |
$443.20
|
| Rate for Payer: Veterans (Triwest) |
$94.18
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$322.98
|
| Rate for Payer: United Healthcare Medicare |
$99.72
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 241-270MIN
|
Facility
OP
|
$1,109.00
|
|
| Hospital Charge Code |
22297674
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$188.53 |
| Max. Negotiated Rate |
$998.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$998.10
|
| Rate for Payer: Aetna Medicare |
$310.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$188.53
|
| Rate for Payer: Amerigroup Medicare |
$188.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$414.21
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$188.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$188.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$288.34
|
| Rate for Payer: Cigna All Products |
$776.30
|
| Rate for Payer: Copperpoint |
$311.07
|
| Rate for Payer: HealthNet Commercial |
$665.40
|
| Rate for Payer: HealthNet Medicare |
$310.52
|
| Rate for Payer: Humana Medicare |
$188.53
|
| Rate for Payer: SELF PAY |
$887.20
|
| Rate for Payer: Veterans (Triwest) |
$188.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$646.55
|
| Rate for Payer: United Healthcare Medicare |
$199.62
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 241-270MIN
|
Facility
IP
|
$1,109.00
|
|
| Hospital Charge Code |
22297674
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$188.53 |
| Max. Negotiated Rate |
$998.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$998.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$188.53
|
| Rate for Payer: Amerigroup Medicare |
$188.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$188.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$188.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$288.34
|
| Rate for Payer: Copperpoint |
$311.07
|
| Rate for Payer: Humana Medicare |
$188.53
|
| Rate for Payer: SELF PAY |
$887.20
|
| Rate for Payer: Veterans (Triwest) |
$188.53
|
|
|
SP PACU RECOVERY RM - SP RECOVRY RM 271-300MIN
|
Facility
IP
|
$474.00
|
|
| Hospital Charge Code |
22297674
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$80.58 |
| Max. Negotiated Rate |
$426.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$426.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$80.58
|
| Rate for Payer: Amerigroup Medicare |
$80.58
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$80.58
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$80.58
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$123.24
|
| Rate for Payer: Copperpoint |
$132.96
|
| Rate for Payer: Humana Medicare |
$80.58
|
| Rate for Payer: SELF PAY |
$379.20
|
| Rate for Payer: Veterans (Triwest) |
$80.58
|
|