Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Head Trauma With Coma > 1 Hour Or Hemorrhage

Facility

$9,925.51

Service Code	APR-DRG 0553
Hospital Charge Code	APRDRG0553
Min. Negotiated Rate	$9,925.51
Max. Negotiated Rate	$9,925.51
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,925.51
Rate for Payer: Mercy Care Medicaid	$9,925.51
Rate for Payer: NaphCare Correctional Healthcare	$9,925.51

Hearing Test POC

Facility

$51.00

Service Code	CPT 92551
Hospital Charge Code	22380956
Hospital Revenue Code	521
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Arizona Complete Health Allwell	$8.16
Rate for Payer: Banner UC Health Medicare	$8.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$34.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$8.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$8.16
Rate for Payer: Cash Price	$40.80
Rate for Payer: Cigna of AZ Commercial	$35.70
Rate for Payer: Devoted Health Medicare	$9.18
Rate for Payer: Humana of AZ Medicare	$8.16
Rate for Payer: Southwest Service Administrators UFCW	$34.68
Rate for Payer: TriWest Medicare	$8.16
Rate for Payer: United Healthcare Commercial	$29.17
Rate for Payer: United Healthcare Medicare	$8.16
Rate for Payer: Veterans Affairs TRICARE	$8.08

Hearing Test POC

Facility

$51.00

Service Code	CPT 92551
Hospital Charge Code	22380956
Hospital Revenue Code	521
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Aetna of AZ Commercial	$45.90
Rate for Payer: Cash Price	$40.80

Heart And/Or Lung Transplant

Facility

$181,701.18

Service Code	APR-DRG 0024
Hospital Charge Code	APRDRG0022
Min. Negotiated Rate	$181,701.18
Max. Negotiated Rate	$181,701.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$181,701.18
Rate for Payer: Mercy Care Medicaid	$181,701.18
Rate for Payer: NaphCare Correctional Healthcare	$181,701.18

Heart And/Or Lung Transplant

Facility

$181,701.18

Service Code	APR-DRG 0024
Hospital Charge Code	APRDRG0023
Min. Negotiated Rate	$181,701.18
Max. Negotiated Rate	$181,701.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$181,701.18
Rate for Payer: Mercy Care Medicaid	$181,701.18
Rate for Payer: NaphCare Correctional Healthcare	$181,701.18

Heart And/Or Lung Transplant

Facility

$181,701.18

Service Code	APR-DRG 0024
Hospital Charge Code	APRDRG0024
Min. Negotiated Rate	$181,701.18
Max. Negotiated Rate	$181,701.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$181,701.18
Rate for Payer: Mercy Care Medicaid	$181,701.18
Rate for Payer: NaphCare Correctional Healthcare	$181,701.18

Heart And/Or Lung Transplant

Facility

$61,900.65

Service Code	APR-DRG 0021
Hospital Charge Code	APRDRG0024
Min. Negotiated Rate	$61,900.65
Max. Negotiated Rate	$61,900.65
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$61,900.65
Rate for Payer: Mercy Care Medicaid	$61,900.65
Rate for Payer: NaphCare Correctional Healthcare	$61,900.65

Heart And/Or Lung Transplant

Facility

$80,073.23

Service Code	APR-DRG 0022
Hospital Charge Code	APRDRG0022
Min. Negotiated Rate	$80,073.23
Max. Negotiated Rate	$80,073.23
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$80,073.23
Rate for Payer: Mercy Care Medicaid	$80,073.23
Rate for Payer: NaphCare Correctional Healthcare	$80,073.23

Heart And/Or Lung Transplant

Facility

$95,511.04

Service Code	APR-DRG 0023
Hospital Charge Code	APRDRG0022
Min. Negotiated Rate	$95,511.04
Max. Negotiated Rate	$95,511.04
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$95,511.04
Rate for Payer: Mercy Care Medicaid	$95,511.04
Rate for Payer: NaphCare Correctional Healthcare	$95,511.04

Heart And/Or Lung Transplant

Facility

$95,511.04

Service Code	APR-DRG 0023
Hospital Charge Code	APRDRG0024
Min. Negotiated Rate	$95,511.04
Max. Negotiated Rate	$95,511.04
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$95,511.04
Rate for Payer: Mercy Care Medicaid	$95,511.04
Rate for Payer: NaphCare Correctional Healthcare	$95,511.04

Heart And/Or Lung Transplant

Facility

$181,701.18

Service Code	APR-DRG 0024
Hospital Charge Code	APRDRG0021
Min. Negotiated Rate	$181,701.18
Max. Negotiated Rate	$181,701.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$181,701.18
Rate for Payer: Mercy Care Medicaid	$181,701.18
Rate for Payer: NaphCare Correctional Healthcare	$181,701.18

Heart And/Or Lung Transplant

Facility

$61,900.65

Service Code	APR-DRG 0021
Hospital Charge Code	APRDRG0021
Min. Negotiated Rate	$61,900.65
Max. Negotiated Rate	$61,900.65
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$61,900.65
Rate for Payer: Mercy Care Medicaid	$61,900.65
Rate for Payer: NaphCare Correctional Healthcare	$61,900.65

Heart And/Or Lung Transplant

Facility

$95,511.04

Service Code	APR-DRG 0023
Hospital Charge Code	APRDRG0023
Min. Negotiated Rate	$95,511.04
Max. Negotiated Rate	$95,511.04
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$95,511.04
Rate for Payer: Mercy Care Medicaid	$95,511.04
Rate for Payer: NaphCare Correctional Healthcare	$95,511.04

Heart And/Or Lung Transplant

Facility

$80,073.23

Service Code	APR-DRG 0022
Hospital Charge Code	APRDRG0023
Min. Negotiated Rate	$80,073.23
Max. Negotiated Rate	$80,073.23
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$80,073.23
Rate for Payer: Mercy Care Medicaid	$80,073.23
Rate for Payer: NaphCare Correctional Healthcare	$80,073.23

Heart And/Or Lung Transplant

Facility

$80,073.23

Service Code	APR-DRG 0022
Hospital Charge Code	APRDRG0024
Min. Negotiated Rate	$80,073.23
Max. Negotiated Rate	$80,073.23
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$80,073.23
Rate for Payer: Mercy Care Medicaid	$80,073.23
Rate for Payer: NaphCare Correctional Healthcare	$80,073.23

Heart And/Or Lung Transplant

Facility

$95,511.04

Service Code	APR-DRG 0023
Hospital Charge Code	APRDRG0021
Min. Negotiated Rate	$95,511.04
Max. Negotiated Rate	$95,511.04
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$95,511.04
Rate for Payer: Mercy Care Medicaid	$95,511.04
Rate for Payer: NaphCare Correctional Healthcare	$95,511.04

Heart And/Or Lung Transplant

Facility

$61,900.65

Service Code	APR-DRG 0021
Hospital Charge Code	APRDRG0022
Min. Negotiated Rate	$61,900.65
Max. Negotiated Rate	$61,900.65
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$61,900.65
Rate for Payer: Mercy Care Medicaid	$61,900.65
Rate for Payer: NaphCare Correctional Healthcare	$61,900.65

Heart And/Or Lung Transplant

Facility

$80,073.23

Service Code	APR-DRG 0022
Hospital Charge Code	APRDRG0021
Min. Negotiated Rate	$80,073.23
Max. Negotiated Rate	$80,073.23
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$80,073.23
Rate for Payer: Mercy Care Medicaid	$80,073.23
Rate for Payer: NaphCare Correctional Healthcare	$80,073.23

Heart And/Or Lung Transplant

Facility

$61,900.65

Service Code	APR-DRG 0021
Hospital Charge Code	APRDRG0023
Min. Negotiated Rate	$61,900.65
Max. Negotiated Rate	$61,900.65
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$61,900.65
Rate for Payer: Mercy Care Medicaid	$61,900.65
Rate for Payer: NaphCare Correctional Healthcare	$61,900.65

Heart Failure

Facility

$6,358.19

Service Code	APR-DRG 1943
Hospital Charge Code	APRDRG1941
Min. Negotiated Rate	$6,358.19
Max. Negotiated Rate	$6,358.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,358.19
Rate for Payer: Mercy Care Medicaid	$6,358.19
Rate for Payer: NaphCare Correctional Healthcare	$6,358.19

Heart Failure

Facility

$6,358.19

Service Code	APR-DRG 1943
Hospital Charge Code	APRDRG1944
Min. Negotiated Rate	$6,358.19
Max. Negotiated Rate	$6,358.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,358.19
Rate for Payer: Mercy Care Medicaid	$6,358.19
Rate for Payer: NaphCare Correctional Healthcare	$6,358.19

Heart Failure

Facility

$10,411.58

Service Code	APR-DRG 1944
Hospital Charge Code	APRDRG1941
Min. Negotiated Rate	$10,411.58
Max. Negotiated Rate	$10,411.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,411.58
Rate for Payer: Mercy Care Medicaid	$10,411.58
Rate for Payer: NaphCare Correctional Healthcare	$10,411.58

Heart Failure

Facility

$6,358.19

Service Code	APR-DRG 1943
Hospital Charge Code	APRDRG1943
Min. Negotiated Rate	$6,358.19
Max. Negotiated Rate	$6,358.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,358.19
Rate for Payer: Mercy Care Medicaid	$6,358.19
Rate for Payer: NaphCare Correctional Healthcare	$6,358.19

Heart Failure

Facility

$4,503.69

Service Code	APR-DRG 1942
Hospital Charge Code	APRDRG1943
Min. Negotiated Rate	$4,503.69
Max. Negotiated Rate	$4,503.69
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,503.69
Rate for Payer: Mercy Care Medicaid	$4,503.69
Rate for Payer: NaphCare Correctional Healthcare	$4,503.69

Heart Failure

Facility

$3,331.65

Service Code	APR-DRG 1941
Hospital Charge Code	APRDRG1943
Min. Negotiated Rate	$3,331.65
Max. Negotiated Rate	$3,331.65
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,331.65
Rate for Payer: Mercy Care Medicaid	$3,331.65
Rate for Payer: NaphCare Correctional Healthcare	$3,331.65

Know your out-of-pocket cost for care.

All Charges