|
STENT FILIFORM DOUBLE PIGTAIL 6.0FR/24CM
|
Facility
IP
|
$517.00
|
|
| Hospital Charge Code |
22354214
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$87.89 |
| Max. Negotiated Rate |
$465.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$465.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$87.89
|
| Rate for Payer: Amerigroup Medicare |
$87.89
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$87.89
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$87.89
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$134.42
|
| Rate for Payer: Copperpoint |
$145.02
|
| Rate for Payer: Humana Medicare |
$87.89
|
| Rate for Payer: SELF PAY |
$413.60
|
| Rate for Payer: Veterans (Triwest) |
$87.89
|
|
|
STENT FILIFORM DOUBLE PIGTAIL 6.0FR/24CM
|
Facility
OP
|
$517.00
|
|
| Hospital Charge Code |
22354214
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$87.89 |
| Max. Negotiated Rate |
$465.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$465.30
|
| Rate for Payer: Aetna Medicare |
$144.76
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$87.89
|
| Rate for Payer: Amerigroup Medicare |
$87.89
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$193.10
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$87.89
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$87.89
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$134.42
|
| Rate for Payer: Cigna All Products |
$361.90
|
| Rate for Payer: Copperpoint |
$145.02
|
| Rate for Payer: HealthNet Commercial |
$310.20
|
| Rate for Payer: HealthNet Medicare |
$144.76
|
| Rate for Payer: Humana Medicare |
$87.89
|
| Rate for Payer: SELF PAY |
$413.60
|
| Rate for Payer: Veterans (Triwest) |
$87.89
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$301.41
|
| Rate for Payer: United Healthcare Medicare |
$93.06
|
|
|
STENT FILIFORM DOUBLE PIGTAIL 6.0FR/26CM
|
Facility
OP
|
$456.00
|
|
| Hospital Charge Code |
22354215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.52 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$410.40
|
| Rate for Payer: Aetna Medicare |
$127.68
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.52
|
| Rate for Payer: Amerigroup Medicare |
$77.52
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$170.32
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.52
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.52
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.56
|
| Rate for Payer: Cigna All Products |
$319.20
|
| Rate for Payer: Copperpoint |
$127.91
|
| Rate for Payer: HealthNet Commercial |
$273.60
|
| Rate for Payer: HealthNet Medicare |
$127.68
|
| Rate for Payer: Humana Medicare |
$77.52
|
| Rate for Payer: SELF PAY |
$364.80
|
| Rate for Payer: Veterans (Triwest) |
$77.52
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.85
|
| Rate for Payer: United Healthcare Medicare |
$82.08
|
|
|
STENT FILIFORM DOUBLE PIGTAIL 6.0FR/26CM
|
Facility
IP
|
$456.00
|
|
| Hospital Charge Code |
22354215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.52 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$410.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.52
|
| Rate for Payer: Amerigroup Medicare |
$77.52
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.52
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.52
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.56
|
| Rate for Payer: Copperpoint |
$127.91
|
| Rate for Payer: Humana Medicare |
$77.52
|
| Rate for Payer: SELF PAY |
$364.80
|
| Rate for Payer: Veterans (Triwest) |
$77.52
|
|
|
STENT OPTIMA 24F
|
Facility
OP
|
$629.00
|
|
| Hospital Charge Code |
22354159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$566.10
|
| Rate for Payer: Aetna Medicare |
$176.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$106.93
|
| Rate for Payer: Amerigroup Medicare |
$106.93
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$234.93
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$106.93
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$106.93
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$163.54
|
| Rate for Payer: Cigna All Products |
$440.30
|
| Rate for Payer: Copperpoint |
$176.43
|
| Rate for Payer: HealthNet Commercial |
$377.40
|
| Rate for Payer: HealthNet Medicare |
$176.12
|
| Rate for Payer: Humana Medicare |
$106.93
|
| Rate for Payer: SELF PAY |
$503.20
|
| Rate for Payer: Veterans (Triwest) |
$106.93
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$366.71
|
| Rate for Payer: United Healthcare Medicare |
$113.22
|
|
|
STENT OPTIMA 24F
|
Facility
IP
|
$629.00
|
|
| Hospital Charge Code |
22354159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$566.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$106.93
|
| Rate for Payer: Amerigroup Medicare |
$106.93
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$106.93
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$106.93
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$163.54
|
| Rate for Payer: Copperpoint |
$176.43
|
| Rate for Payer: Humana Medicare |
$106.93
|
| Rate for Payer: SELF PAY |
$503.20
|
| Rate for Payer: Veterans (Triwest) |
$106.93
|
|
|
STENT OPTIMA 26F
|
Facility
OP
|
$629.00
|
|
| Hospital Charge Code |
22354160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$566.10
|
| Rate for Payer: Aetna Medicare |
$176.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$106.93
|
| Rate for Payer: Amerigroup Medicare |
$106.93
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$234.93
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$106.93
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$106.93
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$163.54
|
| Rate for Payer: Cigna All Products |
$440.30
|
| Rate for Payer: Copperpoint |
$176.43
|
| Rate for Payer: HealthNet Commercial |
$377.40
|
| Rate for Payer: HealthNet Medicare |
$176.12
|
| Rate for Payer: Humana Medicare |
$106.93
|
| Rate for Payer: SELF PAY |
$503.20
|
| Rate for Payer: Veterans (Triwest) |
$106.93
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$366.71
|
| Rate for Payer: United Healthcare Medicare |
$113.22
|
|
|
STENT OPTIMA 26F
|
Facility
IP
|
$629.00
|
|
| Hospital Charge Code |
22354160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$566.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$106.93
|
| Rate for Payer: Amerigroup Medicare |
$106.93
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$106.93
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$106.93
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$163.54
|
| Rate for Payer: Copperpoint |
$176.43
|
| Rate for Payer: Humana Medicare |
$106.93
|
| Rate for Payer: SELF PAY |
$503.20
|
| Rate for Payer: Veterans (Triwest) |
$106.93
|
|
|
STENT SOFT URETERAL 24F UNIVERSA COOK
|
Facility
OP
|
$455.00
|
|
| Hospital Charge Code |
22354230
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Aetna Medicare |
$127.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$169.94
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Cigna All Products |
$318.50
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: HealthNet Commercial |
$273.00
|
| Rate for Payer: HealthNet Medicare |
$127.40
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.26
|
| Rate for Payer: United Healthcare Medicare |
$81.90
|
|
|
STENT SOFT URETERAL 24F UNIVERSA COOK
|
Facility
IP
|
$455.00
|
|
| Hospital Charge Code |
22354230
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
|
|
STENT SOFT URETERAL 26F UNIVERSA COOK
|
Facility
OP
|
$455.00
|
|
| Hospital Charge Code |
22354231
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Aetna Medicare |
$127.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$169.94
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Cigna All Products |
$318.50
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: HealthNet Commercial |
$273.00
|
| Rate for Payer: HealthNet Medicare |
$127.40
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.26
|
| Rate for Payer: United Healthcare Medicare |
$81.90
|
|
|
STENT SOFT URETERAL 26F UNIVERSA COOK
|
Facility
IP
|
$455.00
|
|
| Hospital Charge Code |
22354231
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
|
|
STENT SOFT URETERAL 28F UNIVERSA COOK
|
Facility
OP
|
$455.00
|
|
| Hospital Charge Code |
22354232
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Aetna Medicare |
$127.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$169.94
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Cigna All Products |
$318.50
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: HealthNet Commercial |
$273.00
|
| Rate for Payer: HealthNet Medicare |
$127.40
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.26
|
| Rate for Payer: United Healthcare Medicare |
$81.90
|
|
|
STENT SOFT URETERAL 28F UNIVERSA COOK
|
Facility
IP
|
$455.00
|
|
| Hospital Charge Code |
22354232
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
|
|
STENT SOFT URETERAL 7X26 UNIVERSA COOK
|
Facility
OP
|
$311.00
|
|
| Hospital Charge Code |
22354234
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.87 |
| Max. Negotiated Rate |
$279.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$279.90
|
| Rate for Payer: Aetna Medicare |
$87.08
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$52.87
|
| Rate for Payer: Amerigroup Medicare |
$52.87
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$116.16
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$52.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$52.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$80.86
|
| Rate for Payer: Cigna All Products |
$217.70
|
| Rate for Payer: Copperpoint |
$87.24
|
| Rate for Payer: HealthNet Commercial |
$186.60
|
| Rate for Payer: HealthNet Medicare |
$87.08
|
| Rate for Payer: Humana Medicare |
$52.87
|
| Rate for Payer: SELF PAY |
$248.80
|
| Rate for Payer: Veterans (Triwest) |
$52.87
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$181.31
|
| Rate for Payer: United Healthcare Medicare |
$55.98
|
|
|
STENT SOFT URETERAL 7X26 UNIVERSA COOK
|
Facility
IP
|
$311.00
|
|
| Hospital Charge Code |
22354234
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.87 |
| Max. Negotiated Rate |
$279.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$279.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$52.87
|
| Rate for Payer: Amerigroup Medicare |
$52.87
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$52.87
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$52.87
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$80.86
|
| Rate for Payer: Copperpoint |
$87.24
|
| Rate for Payer: Humana Medicare |
$52.87
|
| Rate for Payer: SELF PAY |
$248.80
|
| Rate for Payer: Veterans (Triwest) |
$52.87
|
|
|
STENT SOFT URETERAL UNIVERSA 28F COOK
|
Facility
IP
|
$455.00
|
|
| Hospital Charge Code |
22354233
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
|
|
STENT SOFT URETERAL UNIVERSA 28F COOK
|
Facility
OP
|
$455.00
|
|
| Hospital Charge Code |
22354233
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Aetna Medicare |
$127.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$169.94
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Cigna All Products |
$318.50
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: HealthNet Commercial |
$273.00
|
| Rate for Payer: HealthNet Medicare |
$127.40
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.26
|
| Rate for Payer: United Healthcare Medicare |
$81.90
|
|
|
STENT URETERAL SOFT 22F UNIVERSA COOK
|
Facility
IP
|
$455.00
|
|
| Hospital Charge Code |
22354229
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
|
|
STENT URETERAL SOFT 22F UNIVERSA COOK
|
Facility
OP
|
$455.00
|
|
| Hospital Charge Code |
22354229
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$409.50
|
| Rate for Payer: Aetna Medicare |
$127.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$77.35
|
| Rate for Payer: Amerigroup Medicare |
$77.35
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$169.94
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$77.35
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$77.35
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$118.30
|
| Rate for Payer: Cigna All Products |
$318.50
|
| Rate for Payer: Copperpoint |
$127.63
|
| Rate for Payer: HealthNet Commercial |
$273.00
|
| Rate for Payer: HealthNet Medicare |
$127.40
|
| Rate for Payer: Humana Medicare |
$77.35
|
| Rate for Payer: SELF PAY |
$364.00
|
| Rate for Payer: Veterans (Triwest) |
$77.35
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$265.26
|
| Rate for Payer: United Healthcare Medicare |
$81.90
|
|
|
STERIS PAPER ROLL
|
Facility
IP
|
$15.69
|
|
| Hospital Charge Code |
27456000
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna POS, PPO, HMO |
$14.12
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$2.67
|
| Rate for Payer: Amerigroup Medicare |
$2.67
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$2.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$2.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$4.08
|
| Rate for Payer: Copperpoint |
$4.40
|
| Rate for Payer: Humana Medicare |
$2.67
|
| Rate for Payer: SELF PAY |
$12.55
|
| Rate for Payer: Veterans (Triwest) |
$2.67
|
|
|
STERIS PAPER ROLL
|
Facility
OP
|
$15.69
|
|
| Hospital Charge Code |
27456000
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$14.12 |
| Rate for Payer: Aetna POS, PPO, HMO |
$14.12
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$2.67
|
| Rate for Payer: Amerigroup Medicare |
$2.67
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$5.86
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$2.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$2.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$4.08
|
| Rate for Payer: Cigna All Products |
$10.98
|
| Rate for Payer: Copperpoint |
$4.40
|
| Rate for Payer: HealthNet Commercial |
$9.41
|
| Rate for Payer: HealthNet Medicare |
$4.39
|
| Rate for Payer: Humana Medicare |
$2.67
|
| Rate for Payer: SELF PAY |
$12.55
|
| Rate for Payer: Veterans (Triwest) |
$2.67
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$9.15
|
| Rate for Payer: United Healthcare Medicare |
$2.82
|
|
|
STERI STRIPS 1/2 X 4
|
Facility
OP
|
$8.00
|
|
| Hospital Charge Code |
22355671
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$7.20
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.36
|
| Rate for Payer: Amerigroup Medicare |
$1.36
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$2.99
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.36
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.08
|
| Rate for Payer: Cigna All Products |
$5.60
|
| Rate for Payer: Copperpoint |
$2.24
|
| Rate for Payer: HealthNet Commercial |
$4.80
|
| Rate for Payer: HealthNet Medicare |
$2.24
|
| Rate for Payer: Humana Medicare |
$1.36
|
| Rate for Payer: SELF PAY |
$6.40
|
| Rate for Payer: Veterans (Triwest) |
$1.36
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$4.66
|
| Rate for Payer: United Healthcare Medicare |
$1.44
|
|
|
STERI STRIPS 1/2 X 4
|
Facility
IP
|
$8.00
|
|
| Hospital Charge Code |
22355671
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$7.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.36
|
| Rate for Payer: Amerigroup Medicare |
$1.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.36
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.08
|
| Rate for Payer: Copperpoint |
$2.24
|
| Rate for Payer: Humana Medicare |
$1.36
|
| Rate for Payer: SELF PAY |
$6.40
|
| Rate for Payer: Veterans (Triwest) |
$1.36
|
|
|
STIRRUP ANKLE AIRCAST UNIVERSAL
|
Facility
OP
|
$67.68
|
|
| Hospital Charge Code |
22354887
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$60.91 |
| Rate for Payer: Aetna POS, PPO, HMO |
$60.91
|
| Rate for Payer: Aetna Medicare |
$18.95
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$11.51
|
| Rate for Payer: Amerigroup Medicare |
$11.51
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$25.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$11.51
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$11.51
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$17.60
|
| Rate for Payer: Cigna All Products |
$47.38
|
| Rate for Payer: Copperpoint |
$18.98
|
| Rate for Payer: HealthNet Commercial |
$40.61
|
| Rate for Payer: HealthNet Medicare |
$18.95
|
| Rate for Payer: Humana Medicare |
$11.51
|
| Rate for Payer: SELF PAY |
$54.14
|
| Rate for Payer: Veterans (Triwest) |
$11.51
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$39.46
|
| Rate for Payer: United Healthcare Medicare |
$12.18
|
|