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Hospital Charge Code 24358101
Hospital Revenue Code 270
Min. Negotiated Rate $8,463.00
Max. Negotiated Rate $29,295.00
Rate for Payer: Aetna of AZ Commercial $29,295.00
Rate for Payer: Bisbee Police All Plans $8,463.00
Rate for Payer: Cash Price $26,040.00
Rate for Payer: Self Pay Self Pay $26,040.00
Hospital Charge Code 24358101
Hospital Revenue Code 270
Min. Negotiated Rate $4,882.50
Max. Negotiated Rate $29,295.00
Rate for Payer: Aetna of AZ Commercial $29,295.00
Rate for Payer: Aetna of AZ Medicare $9,114.00
Rate for Payer: Allwell Medicare $4,882.50
Rate for Payer: Amerigroup Medicare $4,882.50
Rate for Payer: APIPA Medicare/Medicaid $12,157.42
Rate for Payer: AZCH Complete Medicare $4,882.50
Rate for Payer: Banner UC Health Medicare $4,882.50
Rate for Payer: Bisbee Police All Plans $8,463.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $22,134.00
Rate for Payer: Cash Price $26,040.00
Rate for Payer: Cigna of AZ Commercial $22,785.00
Rate for Payer: Copperpoint Commercial $8,056.12
Rate for Payer: Health Net of AZ Commercial $19,530.00
Rate for Payer: Health Net of AZ Medicare $9,114.00
Rate for Payer: Humana of AZ Medicare $4,882.50
Rate for Payer: Self Pay Self Pay $26,040.00
Rate for Payer: TriWest Medicare $4,882.50
Rate for Payer: UnitedHealth Group of AZ Commercial $18,976.65
Rate for Payer: UnitedHealth Group of AZ Medicare $5,859.00
Hospital Charge Code 24358103
Hospital Revenue Code 270
Min. Negotiated Rate $118.20
Max. Negotiated Rate $709.20
Rate for Payer: Aetna of AZ Commercial $709.20
Rate for Payer: Aetna of AZ Medicare $220.64
Rate for Payer: Allwell Medicare $118.20
Rate for Payer: Amerigroup Medicare $118.20
Rate for Payer: APIPA Medicare/Medicaid $294.32
Rate for Payer: AZCH Complete Medicare $118.20
Rate for Payer: Banner UC Health Medicare $118.20
Rate for Payer: Bisbee Police All Plans $204.88
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $535.84
Rate for Payer: Cash Price $630.40
Rate for Payer: Cigna of AZ Commercial $551.60
Rate for Payer: Copperpoint Commercial $195.03
Rate for Payer: Health Net of AZ Commercial $472.80
Rate for Payer: Health Net of AZ Medicare $220.64
Rate for Payer: Humana of AZ Medicare $118.20
Rate for Payer: Self Pay Self Pay $630.40
Rate for Payer: TriWest Medicare $118.20
Rate for Payer: UnitedHealth Group of AZ Commercial $459.40
Rate for Payer: UnitedHealth Group of AZ Medicare $141.84
Hospital Charge Code 24358103
Hospital Revenue Code 270
Min. Negotiated Rate $204.88
Max. Negotiated Rate $709.20
Rate for Payer: Aetna of AZ Commercial $709.20
Rate for Payer: Bisbee Police All Plans $204.88
Rate for Payer: Cash Price $630.40
Rate for Payer: Self Pay Self Pay $630.40
Service Code CPT 31505
Hospital Charge Code 22209502
Hospital Revenue Code 450
Min. Negotiated Rate $104.70
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $628.20
Rate for Payer: Aetna of AZ Medicare $195.44
Rate for Payer: AHCCCS Medicaid $238.36
Rate for Payer: Allwell Medicaid $238.36
Rate for Payer: Allwell Medicare $104.70
Rate for Payer: Amerigroup Medicare $104.70
Rate for Payer: APIPA Medicare/Medicaid $260.70
Rate for Payer: AZCH Complete Medicaid $238.36
Rate for Payer: AZCH Complete Medicare $104.70
Rate for Payer: Banner UC Health Medicaid $238.36
Rate for Payer: Banner UC Health Medicare $104.70
Rate for Payer: Bisbee Police All Plans $181.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $474.64
Rate for Payer: Cash Price $558.40
Rate for Payer: Cash Price $558.40
Rate for Payer: Cigna of AZ Commercial $488.60
Rate for Payer: Copperpoint Commercial $172.76
Rate for Payer: Health Net of AZ Commercial $418.80
Rate for Payer: Health Net of AZ Medicare $195.44
Rate for Payer: Humana of AZ Medicare $104.70
Rate for Payer: Mercy Care Medicaid $238.36
Rate for Payer: Self Pay Self Pay $558.40
Rate for Payer: TriWest Medicare $104.70
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $125.64
Service Code CPT 31505
Hospital Charge Code 22209502
Hospital Revenue Code 450
Min. Negotiated Rate $181.48
Max. Negotiated Rate $628.20
Rate for Payer: Aetna of AZ Commercial $628.20
Rate for Payer: Bisbee Police All Plans $181.48
Rate for Payer: Cash Price $558.40
Rate for Payer: Self Pay Self Pay $558.40
Service Code NDC 17478062512
Hospital Charge Code 105927842
Hospital Revenue Code 251
Min. Negotiated Rate $0.33
Max. Negotiated Rate $1.98
Rate for Payer: Aetna of AZ Commercial $1.98
Rate for Payer: Aetna of AZ Medicare $0.62
Rate for Payer: Allwell Medicare $0.33
Rate for Payer: Amerigroup Medicare $0.33
Rate for Payer: APIPA Medicare/Medicaid $0.82
Rate for Payer: AZCH Complete Medicare $0.33
Rate for Payer: Banner UC Health Medicare $0.33
Rate for Payer: Bisbee Police All Plans $0.57
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1.50
Rate for Payer: Cash Price $1.76
Rate for Payer: Cigna of AZ Commercial $1.43
Rate for Payer: Copperpoint Commercial $0.54
Rate for Payer: Health Net of AZ Commercial $1.32
Rate for Payer: Health Net of AZ Medicare $0.62
Rate for Payer: Humana of AZ Medicare $0.33
Rate for Payer: Self Pay Self Pay $1.76
Rate for Payer: TriWest Medicare $0.33
Rate for Payer: UnitedHealth Group of AZ Commercial $1.28
Rate for Payer: UnitedHealth Group of AZ Medicare $0.40
Service Code NDC 17478062512
Hospital Charge Code 105927842
Hospital Revenue Code 251
Min. Negotiated Rate $0.57
Max. Negotiated Rate $1.98
Rate for Payer: Aetna of AZ Commercial $1.98
Rate for Payer: Bisbee Police All Plans $0.57
Rate for Payer: Cash Price $1.76
Rate for Payer: Self Pay Self Pay $1.76
Service Code CPT 83721
Hospital Charge Code 22311155
Hospital Revenue Code 301
Min. Negotiated Rate $41.08
Max. Negotiated Rate $142.20
Rate for Payer: Aetna of AZ Commercial $142.20
Rate for Payer: Bisbee Police All Plans $41.08
Rate for Payer: Cash Price $126.40
Rate for Payer: Self Pay Self Pay $126.40
Service Code CPT 83721
Hospital Charge Code 22311155
Hospital Revenue Code 301
Min. Negotiated Rate $10.50
Max. Negotiated Rate $142.20
Rate for Payer: Aetna of AZ Commercial $142.20
Rate for Payer: Aetna of AZ Medicare $44.24
Rate for Payer: AHCCCS Medicaid $10.50
Rate for Payer: Allwell Medicaid $10.50
Rate for Payer: Allwell Medicare $23.70
Rate for Payer: Amerigroup Medicare $23.70
Rate for Payer: APIPA Medicare/Medicaid $59.01
Rate for Payer: AZCH Complete Medicaid $10.50
Rate for Payer: AZCH Complete Medicare $23.70
Rate for Payer: Banner UC Health Medicaid $10.50
Rate for Payer: Banner UC Health Medicare $23.70
Rate for Payer: Bisbee Police All Plans $41.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $107.44
Rate for Payer: Cash Price $126.40
Rate for Payer: Cash Price $126.40
Rate for Payer: Cigna of AZ Commercial $102.70
Rate for Payer: Copperpoint Commercial $39.10
Rate for Payer: Health Net of AZ Commercial $94.80
Rate for Payer: Health Net of AZ Medicare $44.24
Rate for Payer: Humana of AZ Medicare $23.70
Rate for Payer: Mercy Care Medicaid $10.50
Rate for Payer: Self Pay Self Pay $126.40
Rate for Payer: TriWest Medicare $23.70
Rate for Payer: UnitedHealth Group of AZ Commercial $92.11
Rate for Payer: UnitedHealth Group of AZ Medicare $28.44
Service Code CPT C1778
Hospital Charge Code 22354567
Hospital Revenue Code 270
Min. Negotiated Rate $0.13
Max. Negotiated Rate $17,126.10
Rate for Payer: Aetna of AZ Commercial $17,126.10
Rate for Payer: Aetna of AZ Medicare $5,328.12
Rate for Payer: AHCCCS Medicaid $0.13
Rate for Payer: Allwell Medicaid $0.13
Rate for Payer: Allwell Medicare $2,854.35
Rate for Payer: Amerigroup Medicare $2,854.35
Rate for Payer: APIPA Medicare/Medicaid $7,107.33
Rate for Payer: AZCH Complete Medicaid $0.13
Rate for Payer: AZCH Complete Medicare $2,854.35
Rate for Payer: Banner UC Health Medicaid $0.13
Rate for Payer: Banner UC Health Medicare $2,854.35
Rate for Payer: Bisbee Police All Plans $4,947.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $12,939.72
Rate for Payer: Cash Price $15,223.20
Rate for Payer: Cash Price $15,223.20
Rate for Payer: Cigna of AZ Commercial $13,320.30
Rate for Payer: Copperpoint Commercial $4,709.68
Rate for Payer: Health Net of AZ Commercial $11,417.40
Rate for Payer: Health Net of AZ Medicare $5,328.12
Rate for Payer: Humana of AZ Medicare $2,854.35
Rate for Payer: Mercy Care Medicaid $0.13
Rate for Payer: Self Pay Self Pay $15,223.20
Rate for Payer: TriWest Medicare $2,854.35
Rate for Payer: UnitedHealth Group of AZ Commercial $11,093.91
Rate for Payer: UnitedHealth Group of AZ Medicare $3,425.22
Service Code CPT C1778
Hospital Charge Code 22354567
Hospital Revenue Code 270
Min. Negotiated Rate $4,947.54
Max. Negotiated Rate $17,126.10
Rate for Payer: Aetna of AZ Commercial $17,126.10
Rate for Payer: Bisbee Police All Plans $4,947.54
Rate for Payer: Cash Price $15,223.20
Rate for Payer: Self Pay Self Pay $15,223.20
Service Code CPT 83655
Hospital Charge Code 22481489
Hospital Revenue Code 301
Min. Negotiated Rate $12.11
Max. Negotiated Rate $266.40
Rate for Payer: Aetna of AZ Commercial $266.40
Rate for Payer: Aetna of AZ Medicare $82.88
Rate for Payer: AHCCCS Medicaid $12.11
Rate for Payer: Allwell Medicaid $12.11
Rate for Payer: Allwell Medicare $44.40
Rate for Payer: Amerigroup Medicare $44.40
Rate for Payer: APIPA Medicare/Medicaid $110.56
Rate for Payer: AZCH Complete Medicaid $12.11
Rate for Payer: AZCH Complete Medicare $44.40
Rate for Payer: Banner UC Health Medicaid $12.11
Rate for Payer: Banner UC Health Medicare $44.40
Rate for Payer: Bisbee Police All Plans $76.96
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $201.28
Rate for Payer: Cash Price $236.80
Rate for Payer: Cash Price $236.80
Rate for Payer: Cigna of AZ Commercial $192.40
Rate for Payer: Copperpoint Commercial $73.26
Rate for Payer: Health Net of AZ Commercial $177.60
Rate for Payer: Health Net of AZ Medicare $82.88
Rate for Payer: Humana of AZ Medicare $44.40
Rate for Payer: Mercy Care Medicaid $12.11
Rate for Payer: Self Pay Self Pay $236.80
Rate for Payer: TriWest Medicare $44.40
Rate for Payer: UnitedHealth Group of AZ Commercial $172.57
Rate for Payer: UnitedHealth Group of AZ Medicare $53.28
Service Code CPT 83655
Hospital Charge Code 22481489
Hospital Revenue Code 301
Min. Negotiated Rate $76.96
Max. Negotiated Rate $266.40
Rate for Payer: Aetna of AZ Commercial $266.40
Rate for Payer: Bisbee Police All Plans $76.96
Rate for Payer: Cash Price $236.80
Rate for Payer: Self Pay Self Pay $236.80
Service Code CPT 83655
Hospital Charge Code 1285614
Hospital Revenue Code 301
Min. Negotiated Rate $73.32
Max. Negotiated Rate $253.80
Rate for Payer: Aetna of AZ Commercial $253.80
Rate for Payer: Bisbee Police All Plans $73.32
Rate for Payer: Cash Price $225.60
Rate for Payer: Self Pay Self Pay $225.60
Service Code CPT 83655
Hospital Charge Code 1285614
Hospital Revenue Code 301
Min. Negotiated Rate $12.11
Max. Negotiated Rate $253.80
Rate for Payer: Aetna of AZ Commercial $253.80
Rate for Payer: Aetna of AZ Medicare $78.96
Rate for Payer: AHCCCS Medicaid $12.11
Rate for Payer: Allwell Medicaid $12.11
Rate for Payer: Allwell Medicare $42.30
Rate for Payer: Amerigroup Medicare $42.30
Rate for Payer: APIPA Medicare/Medicaid $105.33
Rate for Payer: AZCH Complete Medicaid $12.11
Rate for Payer: AZCH Complete Medicare $42.30
Rate for Payer: Banner UC Health Medicaid $12.11
Rate for Payer: Banner UC Health Medicare $42.30
Rate for Payer: Bisbee Police All Plans $73.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $191.76
Rate for Payer: Cash Price $225.60
Rate for Payer: Cash Price $225.60
Rate for Payer: Cigna of AZ Commercial $183.30
Rate for Payer: Copperpoint Commercial $69.80
Rate for Payer: Health Net of AZ Commercial $169.20
Rate for Payer: Health Net of AZ Medicare $78.96
Rate for Payer: Humana of AZ Medicare $42.30
Rate for Payer: Mercy Care Medicaid $12.11
Rate for Payer: Self Pay Self Pay $225.60
Rate for Payer: TriWest Medicare $42.30
Rate for Payer: UnitedHealth Group of AZ Commercial $164.41
Rate for Payer: UnitedHealth Group of AZ Medicare $50.76
Service Code CPT 83655
Hospital Charge Code 1285615
Hospital Revenue Code 301
Min. Negotiated Rate $12.11
Max. Negotiated Rate $253.80
Rate for Payer: Aetna of AZ Commercial $253.80
Rate for Payer: Aetna of AZ Medicare $78.96
Rate for Payer: AHCCCS Medicaid $12.11
Rate for Payer: Allwell Medicaid $12.11
Rate for Payer: Allwell Medicare $42.30
Rate for Payer: Amerigroup Medicare $42.30
Rate for Payer: APIPA Medicare/Medicaid $105.33
Rate for Payer: AZCH Complete Medicaid $12.11
Rate for Payer: AZCH Complete Medicare $42.30
Rate for Payer: Banner UC Health Medicaid $12.11
Rate for Payer: Banner UC Health Medicare $42.30
Rate for Payer: Bisbee Police All Plans $73.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $191.76
Rate for Payer: Cash Price $225.60
Rate for Payer: Cash Price $225.60
Rate for Payer: Cigna of AZ Commercial $183.30
Rate for Payer: Copperpoint Commercial $69.80
Rate for Payer: Health Net of AZ Commercial $169.20
Rate for Payer: Health Net of AZ Medicare $78.96
Rate for Payer: Humana of AZ Medicare $42.30
Rate for Payer: Mercy Care Medicaid $12.11
Rate for Payer: Self Pay Self Pay $225.60
Rate for Payer: TriWest Medicare $42.30
Rate for Payer: UnitedHealth Group of AZ Commercial $164.41
Rate for Payer: UnitedHealth Group of AZ Medicare $50.76
Service Code CPT 83655
Hospital Charge Code 1285615
Hospital Revenue Code 301
Min. Negotiated Rate $73.32
Max. Negotiated Rate $253.80
Rate for Payer: Aetna of AZ Commercial $253.80
Rate for Payer: Bisbee Police All Plans $73.32
Rate for Payer: Cash Price $225.60
Rate for Payer: Self Pay Self Pay $225.60
Service Code CPT C1894
Hospital Charge Code 22354566
Hospital Revenue Code 270
Min. Negotiated Rate $0.13
Max. Negotiated Rate $1,444.50
Rate for Payer: Aetna of AZ Commercial $1,444.50
Rate for Payer: Aetna of AZ Medicare $449.40
Rate for Payer: AHCCCS Medicaid $0.13
Rate for Payer: Allwell Medicaid $0.13
Rate for Payer: Allwell Medicare $240.75
Rate for Payer: Amerigroup Medicare $240.75
Rate for Payer: APIPA Medicare/Medicaid $599.47
Rate for Payer: AZCH Complete Medicaid $0.13
Rate for Payer: AZCH Complete Medicare $240.75
Rate for Payer: Banner UC Health Medicaid $0.13
Rate for Payer: Banner UC Health Medicare $240.75
Rate for Payer: Bisbee Police All Plans $417.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,091.40
Rate for Payer: Cash Price $1,284.00
Rate for Payer: Cash Price $1,284.00
Rate for Payer: Cigna of AZ Commercial $1,123.50
Rate for Payer: Copperpoint Commercial $397.24
Rate for Payer: Health Net of AZ Commercial $963.00
Rate for Payer: Health Net of AZ Medicare $449.40
Rate for Payer: Humana of AZ Medicare $240.75
Rate for Payer: Mercy Care Medicaid $0.13
Rate for Payer: Self Pay Self Pay $1,284.00
Rate for Payer: TriWest Medicare $240.75
Rate for Payer: UnitedHealth Group of AZ Commercial $935.72
Rate for Payer: UnitedHealth Group of AZ Medicare $288.90
Service Code CPT C1894
Hospital Charge Code 22354566
Hospital Revenue Code 270
Min. Negotiated Rate $417.30
Max. Negotiated Rate $1,444.50
Rate for Payer: Aetna of AZ Commercial $1,444.50
Rate for Payer: Bisbee Police All Plans $417.30
Rate for Payer: Cash Price $1,284.00
Rate for Payer: Self Pay Self Pay $1,284.00
Hospital Charge Code 2240047
Hospital Revenue Code 300
Min. Negotiated Rate $7.20
Max. Negotiated Rate $43.20
Rate for Payer: Aetna of AZ Commercial $43.20
Rate for Payer: Aetna of AZ Medicare $13.44
Rate for Payer: Allwell Medicare $7.20
Rate for Payer: Amerigroup Medicare $7.20
Rate for Payer: APIPA Medicare/Medicaid $17.93
Rate for Payer: AZCH Complete Medicare $7.20
Rate for Payer: Banner UC Health Medicare $7.20
Rate for Payer: Bisbee Police All Plans $12.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $32.64
Rate for Payer: Cash Price $38.40
Rate for Payer: Cigna of AZ Commercial $31.20
Rate for Payer: Copperpoint Commercial $11.88
Rate for Payer: Health Net of AZ Commercial $28.80
Rate for Payer: Health Net of AZ Medicare $13.44
Rate for Payer: Humana of AZ Medicare $7.20
Rate for Payer: Self Pay Self Pay $38.40
Rate for Payer: TriWest Medicare $7.20
Rate for Payer: UnitedHealth Group of AZ Commercial $27.98
Rate for Payer: UnitedHealth Group of AZ Medicare $8.64
Hospital Charge Code 2240047
Hospital Revenue Code 300
Min. Negotiated Rate $12.48
Max. Negotiated Rate $43.20
Rate for Payer: Aetna of AZ Commercial $43.20
Rate for Payer: Bisbee Police All Plans $12.48
Rate for Payer: Cash Price $38.40
Rate for Payer: Self Pay Self Pay $38.40
Service Code CPT 86713
Hospital Charge Code 22201718
Hospital Revenue Code 302
Min. Negotiated Rate $13.65
Max. Negotiated Rate $81.90
Rate for Payer: Aetna of AZ Commercial $81.90
Rate for Payer: Aetna of AZ Medicare $25.48
Rate for Payer: AHCCCS Medicaid $15.30
Rate for Payer: Allwell Medicaid $15.30
Rate for Payer: Allwell Medicare $13.65
Rate for Payer: Amerigroup Medicare $13.65
Rate for Payer: APIPA Medicare/Medicaid $33.99
Rate for Payer: AZCH Complete Medicaid $15.30
Rate for Payer: AZCH Complete Medicare $13.65
Rate for Payer: Banner UC Health Medicaid $15.30
Rate for Payer: Banner UC Health Medicare $13.65
Rate for Payer: Bisbee Police All Plans $23.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $61.88
Rate for Payer: Cash Price $72.80
Rate for Payer: Cash Price $72.80
Rate for Payer: Cigna of AZ Commercial $59.15
Rate for Payer: Copperpoint Commercial $22.52
Rate for Payer: Health Net of AZ Commercial $54.60
Rate for Payer: Health Net of AZ Medicare $25.48
Rate for Payer: Humana of AZ Medicare $13.65
Rate for Payer: Mercy Care Medicaid $15.30
Rate for Payer: Self Pay Self Pay $72.80
Rate for Payer: TriWest Medicare $13.65
Rate for Payer: UnitedHealth Group of AZ Commercial $53.05
Rate for Payer: UnitedHealth Group of AZ Medicare $16.38
Service Code CPT 86713
Hospital Charge Code 22201718
Hospital Revenue Code 302
Min. Negotiated Rate $23.66
Max. Negotiated Rate $81.90
Rate for Payer: Aetna of AZ Commercial $81.90
Rate for Payer: Bisbee Police All Plans $23.66
Rate for Payer: Cash Price $72.80
Rate for Payer: Self Pay Self Pay $72.80
Hospital Charge Code 27595625
Hospital Revenue Code 270
Min. Negotiated Rate $163.80
Max. Negotiated Rate $567.00
Rate for Payer: Aetna of AZ Commercial $567.00
Rate for Payer: Bisbee Police All Plans $163.80
Rate for Payer: Cash Price $504.00
Rate for Payer: Self Pay Self Pay $504.00