Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Hand And Wrist Procedures

Facility

$12,369.19

Service Code	APR-DRG 3163
Hospital Charge Code	APRDRG3161
Min. Negotiated Rate	$12,369.19
Max. Negotiated Rate	$12,369.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,369.19
Rate for Payer: Mercy Care Medicaid	$12,369.19
Rate for Payer: NaphCare Correctional Healthcare	$12,369.19

Hand And Wrist Procedures

Facility

$7,741.35

Service Code	APR-DRG 3162
Hospital Charge Code	APRDRG3162
Min. Negotiated Rate	$7,741.35
Max. Negotiated Rate	$7,741.35
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,741.35
Rate for Payer: Mercy Care Medicaid	$7,741.35
Rate for Payer: NaphCare Correctional Healthcare	$7,741.35

Hand And Wrist Procedures

Facility

$5,813.20

Service Code	APR-DRG 3161
Hospital Charge Code	APRDRG3164
Min. Negotiated Rate	$5,813.20
Max. Negotiated Rate	$5,813.20
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,813.20
Rate for Payer: Mercy Care Medicaid	$5,813.20
Rate for Payer: NaphCare Correctional Healthcare	$5,813.20

Hand And Wrist Procedures

Facility

$12,369.19

Service Code	APR-DRG 3163
Hospital Charge Code	APRDRG3162
Min. Negotiated Rate	$12,369.19
Max. Negotiated Rate	$12,369.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,369.19
Rate for Payer: Mercy Care Medicaid	$12,369.19
Rate for Payer: NaphCare Correctional Healthcare	$12,369.19

Hand And Wrist Procedures

Facility

$5,813.20

Service Code	APR-DRG 3161
Hospital Charge Code	APRDRG3163
Min. Negotiated Rate	$5,813.20
Max. Negotiated Rate	$5,813.20
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,813.20
Rate for Payer: Mercy Care Medicaid	$5,813.20
Rate for Payer: NaphCare Correctional Healthcare	$5,813.20

Hand And Wrist Procedures

Facility

$7,741.35

Service Code	APR-DRG 3162
Hospital Charge Code	APRDRG3164
Min. Negotiated Rate	$7,741.35
Max. Negotiated Rate	$7,741.35
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,741.35
Rate for Payer: Mercy Care Medicaid	$7,741.35
Rate for Payer: NaphCare Correctional Healthcare	$7,741.35

Hand And Wrist Procedures

Facility

$5,813.20

Service Code	APR-DRG 3161
Hospital Charge Code	APRDRG3162
Min. Negotiated Rate	$5,813.20
Max. Negotiated Rate	$5,813.20
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,813.20
Rate for Payer: Mercy Care Medicaid	$5,813.20
Rate for Payer: NaphCare Correctional Healthcare	$5,813.20

Hand And Wrist Procedures

Facility

$23,327.16

Service Code	APR-DRG 3164
Hospital Charge Code	APRDRG3161
Min. Negotiated Rate	$23,327.16
Max. Negotiated Rate	$23,327.16
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$23,327.16
Rate for Payer: Mercy Care Medicaid	$23,327.16
Rate for Payer: NaphCare Correctional Healthcare	$23,327.16

Hand And Wrist Procedures

Facility

$23,327.16

Service Code	APR-DRG 3164
Hospital Charge Code	APRDRG3162
Min. Negotiated Rate	$23,327.16
Max. Negotiated Rate	$23,327.16
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$23,327.16
Rate for Payer: Mercy Care Medicaid	$23,327.16
Rate for Payer: NaphCare Correctional Healthcare	$23,327.16

Hand And Wrist Procedures

Facility

$23,327.16

Service Code	APR-DRG 3164
Hospital Charge Code	APRDRG3163
Min. Negotiated Rate	$23,327.16
Max. Negotiated Rate	$23,327.16
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$23,327.16
Rate for Payer: Mercy Care Medicaid	$23,327.16
Rate for Payer: NaphCare Correctional Healthcare	$23,327.16

Hand And Wrist Procedures

Facility

$7,741.35

Service Code	APR-DRG 3162
Hospital Charge Code	APRDRG3161
Min. Negotiated Rate	$7,741.35
Max. Negotiated Rate	$7,741.35
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,741.35
Rate for Payer: Mercy Care Medicaid	$7,741.35
Rate for Payer: NaphCare Correctional Healthcare	$7,741.35

HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC

Facility

$20,346.49

Service Code	MSDRG 513
Min. Negotiated Rate	$20,346.49
Max. Negotiated Rate	$20,346.49
Rate for Payer: Seven Corners Travel Insurance	$20,346.49

HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$13,309.19

Service Code	MSDRG 514
Min. Negotiated Rate	$13,309.19
Max. Negotiated Rate	$13,309.19
Rate for Payer: Seven Corners Travel Insurance	$13,309.19

HAND PROCEDURES FOR INJURIES

Facility

$25,386.90

Service Code	MSDRG 906
Min. Negotiated Rate	$25,386.90
Max. Negotiated Rate	$25,386.90
Rate for Payer: Seven Corners Travel Insurance	$25,386.90

HAPTOGLOBIN

Facility

$205.00

Service Code	CPT 83010
Hospital Charge Code	22481476
Hospital Revenue Code	301
Min. Negotiated Rate	$184.50
Max. Negotiated Rate	$184.50
Rate for Payer: Aetna of AZ Commercial	$184.50
Rate for Payer: Cash Price	$164.00

HAPTOGLOBIN

Facility

$205.00

Service Code	CPT 83010
Hospital Charge Code	22481476
Hospital Revenue Code	301
Min. Negotiated Rate	$18.24
Max. Negotiated Rate	$184.50
Rate for Payer: Aetna of AZ Commercial	$184.50
Rate for Payer: Arizona Complete Health Allwell	$32.80
Rate for Payer: Banner UC Health Medicare	$32.80
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$139.40
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$32.80
Rate for Payer: Care1st Health Plan Arizona Medicare	$32.80
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cigna of AZ Commercial	$133.25
Rate for Payer: Devoted Health Medicare	$36.90
Rate for Payer: Humana of AZ Medicare	$32.80
Rate for Payer: Seven Corners Travel Insurance	$18.24
Rate for Payer: Southwest Service Administrators UFCW	$139.40
Rate for Payer: TriWest Medicare	$32.80
Rate for Payer: United Healthcare Commercial	$117.26
Rate for Payer: United Healthcare Medicare	$32.80
Rate for Payer: Veterans Affairs TRICARE	$32.47

Haptoglobin LC

Facility

$195.00

Service Code	CPT 83010
Hospital Charge Code	1906874
Hospital Revenue Code	301
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna of AZ Commercial	$175.50
Rate for Payer: Cash Price	$156.00

Haptoglobin LC

Facility

$195.00

Service Code	CPT 83010
Hospital Charge Code	1906874
Hospital Revenue Code	301
Min. Negotiated Rate	$18.24
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna of AZ Commercial	$175.50
Rate for Payer: Arizona Complete Health Allwell	$31.20
Rate for Payer: Banner UC Health Medicare	$31.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$132.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$31.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$31.20
Rate for Payer: Cash Price	$156.00
Rate for Payer: Cash Price	$156.00
Rate for Payer: Cigna of AZ Commercial	$126.75
Rate for Payer: Devoted Health Medicare	$35.10
Rate for Payer: Humana of AZ Medicare	$31.20
Rate for Payer: Seven Corners Travel Insurance	$18.24
Rate for Payer: Southwest Service Administrators UFCW	$132.60
Rate for Payer: TriWest Medicare	$31.20
Rate for Payer: United Healthcare Commercial	$111.54
Rate for Payer: United Healthcare Medicare	$31.20
Rate for Payer: Veterans Affairs TRICARE	$30.89

.HBsAg Confirmation LC

Facility

$293.00

Service Code	CPT 87340
Hospital Charge Code	1285756
Hospital Revenue Code	306
Min. Negotiated Rate	$263.70
Max. Negotiated Rate	$263.70
Rate for Payer: Aetna of AZ Commercial	$263.70
Rate for Payer: Cash Price	$234.40

.HBsAg Confirmation LC

Facility

$293.00

Service Code	CPT 87340
Hospital Charge Code	1285756
Hospital Revenue Code	306
Min. Negotiated Rate	$14.98
Max. Negotiated Rate	$263.70
Rate for Payer: Aetna of AZ Commercial	$263.70
Rate for Payer: Arizona Complete Health Allwell	$46.88
Rate for Payer: Banner UC Health Medicare	$46.88
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$199.24
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$46.88
Rate for Payer: Care1st Health Plan Arizona Medicare	$46.88
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cash Price	$234.40
Rate for Payer: Cigna of AZ Commercial	$190.45
Rate for Payer: Devoted Health Medicare	$52.74
Rate for Payer: Humana of AZ Medicare	$46.88
Rate for Payer: Seven Corners Travel Insurance	$14.98
Rate for Payer: Southwest Service Administrators UFCW	$199.24
Rate for Payer: TriWest Medicare	$46.88
Rate for Payer: United Healthcare Commercial	$167.60
Rate for Payer: United Healthcare Medicare	$46.88
Rate for Payer: Veterans Affairs TRICARE	$46.41

HBsAg Screen LC

Facility

$395.00

Service Code	CPT 87340
Hospital Charge Code	1902150
Hospital Revenue Code	306
Min. Negotiated Rate	$14.98
Max. Negotiated Rate	$355.50
Rate for Payer: Aetna of AZ Commercial	$355.50
Rate for Payer: Arizona Complete Health Allwell	$63.20
Rate for Payer: Banner UC Health Medicare	$63.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$268.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$63.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$63.20
Rate for Payer: Cash Price	$316.00
Rate for Payer: Cash Price	$316.00
Rate for Payer: Cigna of AZ Commercial	$256.75
Rate for Payer: Devoted Health Medicare	$71.10
Rate for Payer: Humana of AZ Medicare	$63.20
Rate for Payer: Seven Corners Travel Insurance	$14.98
Rate for Payer: Southwest Service Administrators UFCW	$268.60
Rate for Payer: TriWest Medicare	$63.20
Rate for Payer: United Healthcare Commercial	$225.94
Rate for Payer: United Healthcare Medicare	$63.20
Rate for Payer: Veterans Affairs TRICARE	$62.57

HBsAg Screen LC

Facility

$395.00

Service Code	CPT 87340
Hospital Charge Code	1902150
Hospital Revenue Code	306
Min. Negotiated Rate	$355.50
Max. Negotiated Rate	$355.50
Rate for Payer: Aetna of AZ Commercial	$355.50
Rate for Payer: Cash Price	$316.00

HBV Real-Time PCR Qn LC

Facility

$982.00

Service Code	CPT 87517
Hospital Charge Code	6782273
Hospital Revenue Code	306
Min. Negotiated Rate	$62.12
Max. Negotiated Rate	$883.80
Rate for Payer: Aetna of AZ Commercial	$883.80
Rate for Payer: Arizona Complete Health Allwell	$157.12
Rate for Payer: Banner UC Health Medicare	$157.12
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$667.76
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$157.12
Rate for Payer: Care1st Health Plan Arizona Medicare	$157.12
Rate for Payer: Cash Price	$785.60
Rate for Payer: Cash Price	$785.60
Rate for Payer: Cigna of AZ Commercial	$638.30
Rate for Payer: Devoted Health Medicare	$176.76
Rate for Payer: Humana of AZ Medicare	$157.12
Rate for Payer: Seven Corners Travel Insurance	$62.12
Rate for Payer: Southwest Service Administrators UFCW	$667.76
Rate for Payer: TriWest Medicare	$157.12
Rate for Payer: United Healthcare Commercial	$561.70
Rate for Payer: United Healthcare Medicare	$157.12
Rate for Payer: Veterans Affairs TRICARE	$155.55

HBV Real-Time PCR Qn LC

Facility

$982.00

Service Code	CPT 87517
Hospital Charge Code	6782273
Hospital Revenue Code	306
Min. Negotiated Rate	$883.80
Max. Negotiated Rate	$883.80
Rate for Payer: Aetna of AZ Commercial	$883.80
Rate for Payer: Cash Price	$785.60

hCG,Beta Subunit, Qnt, Serum LC

Facility

$207.00

Service Code	CPT 84702
Hospital Charge Code	1285573
Hospital Revenue Code	301
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$186.30
Rate for Payer: Aetna of AZ Commercial	$186.30
Rate for Payer: Arizona Complete Health Allwell	$33.12
Rate for Payer: Banner UC Health Medicare	$33.12
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$140.76
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$33.12
Rate for Payer: Care1st Health Plan Arizona Medicare	$33.12
Rate for Payer: Cash Price	$165.60
Rate for Payer: Cash Price	$165.60
Rate for Payer: Cigna of AZ Commercial	$134.55
Rate for Payer: Devoted Health Medicare	$37.26
Rate for Payer: Humana of AZ Medicare	$33.12
Rate for Payer: Seven Corners Travel Insurance	$21.82
Rate for Payer: Southwest Service Administrators UFCW	$140.76
Rate for Payer: TriWest Medicare	$33.12
Rate for Payer: United Healthcare Commercial	$118.40
Rate for Payer: United Healthcare Medicare	$33.12
Rate for Payer: Veterans Affairs TRICARE	$32.79

Know your out-of-pocket cost for care.

All Charges