Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Heart Failure

Facility

$6,358.19

Service Code	APR-DRG 1943
Hospital Charge Code	APRDRG1942
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

$3,331.65

Service Code	APR-DRG 1941
Hospital Charge Code	APRDRG1941
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

Heart Failure

Facility

$3,331.65

Service Code	APR-DRG 1941
Hospital Charge Code	APRDRG1942
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

Heart Failure

Facility

$3,331.65

Service Code	APR-DRG 1941
Hospital Charge Code	APRDRG1944
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

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

$4,503.69

Service Code	APR-DRG 1942
Hospital Charge Code	APRDRG1944
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

$10,411.58

Service Code	APR-DRG 1944
Hospital Charge Code	APRDRG1943
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

$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

$4,503.69

Service Code	APR-DRG 1942
Hospital Charge Code	APRDRG1942
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

$10,411.58

Service Code	APR-DRG 1944
Hospital Charge Code	APRDRG1944
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 AND SHOCK WITH CC

Facility

$11,113.26

Service Code	MSDRG 292
Min. Negotiated Rate	$11,113.26
Max. Negotiated Rate	$11,113.26
Rate for Payer: Seven Corners Travel Insurance	$11,113.26

HEART FAILURE AND SHOCK WITH MCC

Facility

$16,622.71

Service Code	MSDRG 291
Min. Negotiated Rate	$16,622.71
Max. Negotiated Rate	$16,622.71
Rate for Payer: Seven Corners Travel Insurance	$16,622.71

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$7,527.31

Service Code	MSDRG 293
Min. Negotiated Rate	$7,527.31
Max. Negotiated Rate	$7,527.31
Rate for Payer: Seven Corners Travel Insurance	$7,527.31

HEART RHYTHM TRACING, ANALYSIS, AND INTERPRETATION OF 48-HOU

Facility

$225.00

Service Code	CPT 93224
Hospital Charge Code	24275813
Hospital Revenue Code	521
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna of AZ Commercial	$202.50
Rate for Payer: Arizona Complete Health Allwell	$36.00
Rate for Payer: Banner UC Health Medicare	$36.00
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$153.00
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$36.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$36.00
Rate for Payer: Cash Price	$180.00
Rate for Payer: Cigna of AZ Commercial	$157.50
Rate for Payer: Devoted Health Medicare	$40.50
Rate for Payer: Humana of AZ Medicare	$36.00
Rate for Payer: Southwest Service Administrators UFCW	$153.00
Rate for Payer: TriWest Medicare	$36.00
Rate for Payer: United Healthcare Commercial	$128.70
Rate for Payer: United Healthcare Medicare	$36.00
Rate for Payer: Veterans Affairs TRICARE	$35.64

HEART RHYTHM TRACING, ANALYSIS, AND INTERPRETATION OF 48-HOU

Facility

$225.00

Service Code	CPT 93224
Hospital Charge Code	24275813
Hospital Revenue Code	521
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna of AZ Commercial	$202.50
Rate for Payer: Cash Price	$180.00

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$362,184.84

Service Code	MSDRG 001
Min. Negotiated Rate	$362,184.84
Max. Negotiated Rate	$362,184.84
Rate for Payer: Seven Corners Travel Insurance	$362,184.84

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$146,453.77

Service Code	MSDRG 002
Min. Negotiated Rate	$146,453.77
Max. Negotiated Rate	$146,453.77
Rate for Payer: Seven Corners Travel Insurance	$146,453.77

Heavy Metal Profile II, LC

Facility

$463.00

Service Code	CPT 82300
Hospital Charge Code	4976987
Hospital Revenue Code	301
Min. Negotiated Rate	$34.28
Max. Negotiated Rate	$416.70
Rate for Payer: Aetna of AZ Commercial	$416.70
Rate for Payer: Arizona Complete Health Allwell	$74.08
Rate for Payer: Banner UC Health Medicare	$74.08
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$314.84
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$74.08
Rate for Payer: Care1st Health Plan Arizona Medicare	$74.08
Rate for Payer: Cash Price	$370.40
Rate for Payer: Cash Price	$370.40
Rate for Payer: Cigna of AZ Commercial	$300.95
Rate for Payer: Devoted Health Medicare	$83.34
Rate for Payer: Humana of AZ Medicare	$74.08
Rate for Payer: Seven Corners Travel Insurance	$34.28
Rate for Payer: Southwest Service Administrators UFCW	$314.84
Rate for Payer: TriWest Medicare	$74.08
Rate for Payer: United Healthcare Commercial	$264.84
Rate for Payer: United Healthcare Medicare	$74.08
Rate for Payer: Veterans Affairs TRICARE	$73.34

Heavy Metal Profile II, LC

Facility

$463.00

Service Code	CPT 82300
Hospital Charge Code	4976987
Hospital Revenue Code	301
Min. Negotiated Rate	$416.70
Max. Negotiated Rate	$416.70
Rate for Payer: Aetna of AZ Commercial	$416.70
Rate for Payer: Cash Price	$370.40

HEEL BO S-M-L

Facility

$41.00

Hospital Charge Code	22355141
Hospital Revenue Code	270
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna of AZ Commercial	$36.90
Rate for Payer: Cash Price	$32.80

HEEL BO S-M-L

Facility

$41.00

Hospital Charge Code	22355141
Hospital Revenue Code	270
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna of AZ Commercial	$36.90
Rate for Payer: Arizona Complete Health Allwell	$6.56
Rate for Payer: Banner UC Health Medicare	$6.56
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$27.88
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$6.56
Rate for Payer: Care1st Health Plan Arizona Medicare	$6.56
Rate for Payer: Cash Price	$32.80
Rate for Payer: Cigna of AZ Commercial	$28.70
Rate for Payer: Devoted Health Medicare	$7.38
Rate for Payer: Humana of AZ Medicare	$6.56
Rate for Payer: Southwest Service Administrators UFCW	$27.88
Rate for Payer: TriWest Medicare	$6.56
Rate for Payer: United Healthcare Commercial	$23.45
Rate for Payer: United Healthcare Medicare	$6.56
Rate for Payer: Veterans Affairs TRICARE	$6.49

Helicobacter pylori, IgA LC

Facility

$212.00

Service Code	CPT 86677
Hospital Charge Code	7328629
Hospital Revenue Code	302
Min. Negotiated Rate	$190.80
Max. Negotiated Rate	$190.80
Rate for Payer: Aetna of AZ Commercial	$190.80
Rate for Payer: Cash Price	$169.60

Helicobacter pylori, IgA LC

Facility

$212.00

Service Code	CPT 86677
Hospital Charge Code	7328629
Hospital Revenue Code	302
Min. Negotiated Rate	$24.43
Max. Negotiated Rate	$190.80
Rate for Payer: Aetna of AZ Commercial	$190.80
Rate for Payer: Arizona Complete Health Allwell	$33.92
Rate for Payer: Banner UC Health Medicare	$33.92
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$144.16
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$33.92
Rate for Payer: Care1st Health Plan Arizona Medicare	$33.92
Rate for Payer: Cash Price	$169.60
Rate for Payer: Cash Price	$169.60
Rate for Payer: Cigna of AZ Commercial	$137.80
Rate for Payer: Devoted Health Medicare	$38.16
Rate for Payer: Humana of AZ Medicare	$33.92
Rate for Payer: Seven Corners Travel Insurance	$24.43
Rate for Payer: Southwest Service Administrators UFCW	$144.16
Rate for Payer: TriWest Medicare	$33.92
Rate for Payer: United Healthcare Commercial	$121.26
Rate for Payer: United Healthcare Medicare	$33.92
Rate for Payer: Veterans Affairs TRICARE	$33.58

Helper T-Lymph-CD4 LC

Facility

$331.00

Service Code	CPT 86361
Hospital Charge Code	22201913
Hospital Revenue Code	302
Min. Negotiated Rate	$38.83
Max. Negotiated Rate	$297.90
Rate for Payer: Aetna of AZ Commercial	$297.90
Rate for Payer: Arizona Complete Health Allwell	$52.96
Rate for Payer: Banner UC Health Medicare	$52.96
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$225.08
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$52.96
Rate for Payer: Care1st Health Plan Arizona Medicare	$52.96
Rate for Payer: Cash Price	$264.80
Rate for Payer: Cash Price	$264.80
Rate for Payer: Cigna of AZ Commercial	$215.15
Rate for Payer: Devoted Health Medicare	$59.58
Rate for Payer: Humana of AZ Medicare	$52.96
Rate for Payer: Seven Corners Travel Insurance	$38.83
Rate for Payer: Southwest Service Administrators UFCW	$225.08
Rate for Payer: TriWest Medicare	$52.96
Rate for Payer: United Healthcare Commercial	$189.33
Rate for Payer: United Healthcare Medicare	$52.96
Rate for Payer: Veterans Affairs TRICARE	$52.43

Helper T-Lymph-CD4 LC

Facility

$331.00

Service Code	CPT 86361
Hospital Charge Code	22201913
Hospital Revenue Code	302
Min. Negotiated Rate	$297.90
Max. Negotiated Rate	$297.90
Rate for Payer: Aetna of AZ Commercial	$297.90
Rate for Payer: Cash Price	$264.80

Know your out-of-pocket cost for care.

All Charges