Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

LEOS 01.6MM SMOOTH K WIRE

Facility

$630.00

Hospital Charge Code	27595625
Hospital Revenue Code	270
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$567.00
Rate for Payer: Aetna of AZ Commercial	$567.00
Rate for Payer: Aetna of AZ Medicare	$176.40
Rate for Payer: Allwell Medicare	$94.50
Rate for Payer: Amerigroup Medicare	$94.50
Rate for Payer: APIPA Medicare/Medicaid	$235.30
Rate for Payer: AZCH Complete Medicare	$94.50
Rate for Payer: Banner UC Health Medicare	$94.50
Rate for Payer: Bisbee Police All Plans	$163.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$428.40
Rate for Payer: Cash Price	$504.00
Rate for Payer: Cigna of AZ Commercial	$441.00
Rate for Payer: Copperpoint Commercial	$155.92
Rate for Payer: Health Net of AZ Commercial	$378.00
Rate for Payer: Health Net of AZ Medicare	$176.40
Rate for Payer: Humana of AZ Medicare	$94.50
Rate for Payer: Self Pay Self Pay	$504.00
Rate for Payer: TriWest Medicare	$94.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$367.29
Rate for Payer: UnitedHealth Group of AZ Medicare	$113.40

LEOS 1.6MM THREADED K WIRE

Facility

$656.00

Hospital Charge Code	27663811
Hospital Revenue Code	270
Min. Negotiated Rate	$170.56
Max. Negotiated Rate	$590.40
Rate for Payer: Aetna of AZ Commercial	$590.40
Rate for Payer: Bisbee Police All Plans	$170.56
Rate for Payer: Cash Price	$524.80
Rate for Payer: Self Pay Self Pay	$524.80

LEOS 1.6MM THREADED K WIRE

Facility

$656.00

Hospital Charge Code	27663811
Hospital Revenue Code	270
Min. Negotiated Rate	$98.40
Max. Negotiated Rate	$590.40
Rate for Payer: Aetna of AZ Commercial	$590.40
Rate for Payer: Aetna of AZ Medicare	$183.68
Rate for Payer: Allwell Medicare	$98.40
Rate for Payer: Amerigroup Medicare	$98.40
Rate for Payer: APIPA Medicare/Medicaid	$245.02
Rate for Payer: AZCH Complete Medicare	$98.40
Rate for Payer: Banner UC Health Medicare	$98.40
Rate for Payer: Bisbee Police All Plans	$170.56
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$446.08
Rate for Payer: Cash Price	$524.80
Rate for Payer: Cigna of AZ Commercial	$459.20
Rate for Payer: Copperpoint Commercial	$162.36
Rate for Payer: Health Net of AZ Commercial	$393.60
Rate for Payer: Health Net of AZ Medicare	$183.68
Rate for Payer: Humana of AZ Medicare	$98.40
Rate for Payer: Self Pay Self Pay	$524.80
Rate for Payer: TriWest Medicare	$98.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$382.45
Rate for Payer: UnitedHealth Group of AZ Medicare	$118.08

LEOS 2.0MM K WIRE

Facility

$788.00

Hospital Charge Code	27595620
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

LEOS 2.0MM K WIRE

Facility

$788.00

Hospital Charge Code	27595620
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

LEOS 2.7MM LOCKING SCREW 12MM

Facility

$2,510.00

Hospital Charge Code	27690542
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.7MM LOCKING SCREW 12MM

Facility

$2,510.00

Hospital Charge Code	27690542
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2.7MM LOCKING SCREW 14MM

Facility

$2,510.00

Hospital Charge Code	27663812
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.7MM LOCKING SCREW 14MM

Facility

$2,510.00

Hospital Charge Code	27663812
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2.7MM LOCKING SCREW 16MM

Facility

$2,510.00

Hospital Charge Code	27663806
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2.7MM LOCKING SCREW 16MM

Facility

$2,510.00

Hospital Charge Code	27663806
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.7MM LOCKING SCREW 18MM

Facility

$2,510.00

Hospital Charge Code	27663807
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.7MM LOCKING SCREW 18MM

Facility

$2,510.00

Hospital Charge Code	27663807
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2.7MM LOCKING SCREW 26MM

Facility

$2,510.00

Hospital Charge Code	27663813
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.7MM LOCKING SCREW 26MM

Facility

$2,510.00

Hospital Charge Code	27663813
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2.7MM NO LOCKING SCREW 18MM

Facility

$1,853.00

Hospital Charge Code	27663804
Hospital Revenue Code	270
Min. Negotiated Rate	$481.78
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Self Pay Self Pay	$1,482.40

LEOS 2.7MM NO LOCKING SCREW 18MM

Facility

$1,853.00

Hospital Charge Code	27663804
Hospital Revenue Code	270
Min. Negotiated Rate	$277.95
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Aetna of AZ Medicare	$518.84
Rate for Payer: Allwell Medicare	$277.95
Rate for Payer: Amerigroup Medicare	$277.95
Rate for Payer: APIPA Medicare/Medicaid	$692.10
Rate for Payer: AZCH Complete Medicare	$277.95
Rate for Payer: Banner UC Health Medicare	$277.95
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,260.04
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Copperpoint Commercial	$458.62
Rate for Payer: Health Net of AZ Commercial	$1,111.80
Rate for Payer: Health Net of AZ Medicare	$518.84
Rate for Payer: Humana of AZ Medicare	$277.95
Rate for Payer: Self Pay Self Pay	$1,482.40
Rate for Payer: TriWest Medicare	$277.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,080.30
Rate for Payer: UnitedHealth Group of AZ Medicare	$333.54

LEOS 2.7MM NO LOCKING SCREW 20MM

Facility

$1,853.00

Hospital Charge Code	27663805
Hospital Revenue Code	270
Min. Negotiated Rate	$277.95
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Aetna of AZ Medicare	$518.84
Rate for Payer: Allwell Medicare	$277.95
Rate for Payer: Amerigroup Medicare	$277.95
Rate for Payer: APIPA Medicare/Medicaid	$692.10
Rate for Payer: AZCH Complete Medicare	$277.95
Rate for Payer: Banner UC Health Medicare	$277.95
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,260.04
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Copperpoint Commercial	$458.62
Rate for Payer: Health Net of AZ Commercial	$1,111.80
Rate for Payer: Health Net of AZ Medicare	$518.84
Rate for Payer: Humana of AZ Medicare	$277.95
Rate for Payer: Self Pay Self Pay	$1,482.40
Rate for Payer: TriWest Medicare	$277.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,080.30
Rate for Payer: UnitedHealth Group of AZ Medicare	$333.54

LEOS 2.7MM NO LOCKING SCREW 20MM

Facility

$1,853.00

Hospital Charge Code	27663805
Hospital Revenue Code	270
Min. Negotiated Rate	$481.78
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Self Pay Self Pay	$1,482.40

LEOS 2.7MM NON LOCKING SCREW 22MM

Facility

$1,853.00

Hospital Charge Code	27690541
Hospital Revenue Code	270
Min. Negotiated Rate	$277.95
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Aetna of AZ Medicare	$518.84
Rate for Payer: Allwell Medicare	$277.95
Rate for Payer: Amerigroup Medicare	$277.95
Rate for Payer: APIPA Medicare/Medicaid	$692.10
Rate for Payer: AZCH Complete Medicare	$277.95
Rate for Payer: Banner UC Health Medicare	$277.95
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,260.04
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Copperpoint Commercial	$458.62
Rate for Payer: Health Net of AZ Commercial	$1,111.80
Rate for Payer: Health Net of AZ Medicare	$518.84
Rate for Payer: Humana of AZ Medicare	$277.95
Rate for Payer: Self Pay Self Pay	$1,482.40
Rate for Payer: TriWest Medicare	$277.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,080.30
Rate for Payer: UnitedHealth Group of AZ Medicare	$333.54

LEOS 2.7MM NON LOCKING SCREW 22MM

Facility

$1,853.00

Hospital Charge Code	27690541
Hospital Revenue Code	270
Min. Negotiated Rate	$481.78
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Bisbee Police All Plans	$481.78
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Self Pay Self Pay	$1,482.40

LEOS 2.8MM LOCKING SCREW 10MM

Facility

$2,510.00

Hospital Charge Code	27690540
Hospital Revenue Code	270
Min. Negotiated Rate	$376.50
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,463.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

LEOS 2.8MM LOCKING SCREW 10MM

Facility

$2,510.00

Hospital Charge Code	27690540
Hospital Revenue Code	270
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

LEOS 2MM DRILL

Facility

$2,237.00

Hospital Charge Code	27663810
Hospital Revenue Code	270
Min. Negotiated Rate	$335.55
Max. Negotiated Rate	$2,013.30
Rate for Payer: Aetna of AZ Commercial	$2,013.30
Rate for Payer: Aetna of AZ Medicare	$626.36
Rate for Payer: Allwell Medicare	$335.55
Rate for Payer: Amerigroup Medicare	$335.55
Rate for Payer: APIPA Medicare/Medicaid	$835.52
Rate for Payer: AZCH Complete Medicare	$335.55
Rate for Payer: Banner UC Health Medicare	$335.55
Rate for Payer: Bisbee Police All Plans	$581.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,521.16
Rate for Payer: Cash Price	$1,789.60
Rate for Payer: Cigna of AZ Commercial	$1,565.90
Rate for Payer: Copperpoint Commercial	$553.66
Rate for Payer: Health Net of AZ Commercial	$1,342.20
Rate for Payer: Health Net of AZ Medicare	$626.36
Rate for Payer: Humana of AZ Medicare	$335.55
Rate for Payer: Self Pay Self Pay	$1,789.60
Rate for Payer: TriWest Medicare	$335.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,304.17
Rate for Payer: UnitedHealth Group of AZ Medicare	$402.66

LEOS 2MM DRILL

Facility

$2,237.00

Hospital Charge Code	27663810
Hospital Revenue Code	270
Min. Negotiated Rate	$581.62
Max. Negotiated Rate	$2,013.30
Rate for Payer: Aetna of AZ Commercial	$2,013.30
Rate for Payer: Bisbee Police All Plans	$581.62
Rate for Payer: Cash Price	$1,789.60
Rate for Payer: Self Pay Self Pay	$1,789.60

Know your out-of-pocket cost for care.

All Charges