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Hospital Charge Code 22951123
Hospital Revenue Code 270
Min. Negotiated Rate $141.75
Max. Negotiated Rate $850.50
Rate for Payer: Aetna of AZ Commercial $850.50
Rate for Payer: Aetna of AZ Medicare $264.60
Rate for Payer: Allwell Medicare $141.75
Rate for Payer: Amerigroup Medicare $141.75
Rate for Payer: APIPA Medicare/Medicaid $352.96
Rate for Payer: AZCH Complete Medicare $141.75
Rate for Payer: Banner UC Health Medicare $141.75
Rate for Payer: Bisbee Police All Plans $245.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $642.60
Rate for Payer: Cash Price $756.00
Rate for Payer: Cigna of AZ Commercial $661.50
Rate for Payer: Copperpoint Commercial $233.89
Rate for Payer: Health Net of AZ Commercial $567.00
Rate for Payer: Health Net of AZ Medicare $264.60
Rate for Payer: Humana of AZ Medicare $141.75
Rate for Payer: Self Pay Self Pay $756.00
Rate for Payer: TriWest Medicare $141.75
Rate for Payer: UnitedHealth Group of AZ Commercial $550.94
Rate for Payer: UnitedHealth Group of AZ Medicare $170.10
Service Code CPT 83690
Hospital Charge Code 633776
Hospital Revenue Code 301
Min. Negotiated Rate $47.84
Max. Negotiated Rate $165.60
Rate for Payer: Aetna of AZ Commercial $165.60
Rate for Payer: Bisbee Police All Plans $47.84
Rate for Payer: Cash Price $147.20
Rate for Payer: Self Pay Self Pay $147.20
Service Code CPT 83690
Hospital Charge Code 633776
Hospital Revenue Code 301
Min. Negotiated Rate $6.89
Max. Negotiated Rate $165.60
Rate for Payer: Aetna of AZ Commercial $165.60
Rate for Payer: Aetna of AZ Medicare $51.52
Rate for Payer: AHCCCS Medicaid $6.89
Rate for Payer: Allwell Medicaid $6.89
Rate for Payer: Allwell Medicare $27.60
Rate for Payer: Amerigroup Medicare $27.60
Rate for Payer: APIPA Medicare/Medicaid $68.72
Rate for Payer: AZCH Complete Medicaid $6.89
Rate for Payer: AZCH Complete Medicare $27.60
Rate for Payer: Banner UC Health Medicaid $6.89
Rate for Payer: Banner UC Health Medicare $27.60
Rate for Payer: Bisbee Police All Plans $47.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $125.12
Rate for Payer: Cash Price $147.20
Rate for Payer: Cash Price $147.20
Rate for Payer: Cigna of AZ Commercial $119.60
Rate for Payer: Copperpoint Commercial $45.54
Rate for Payer: Health Net of AZ Commercial $110.40
Rate for Payer: Health Net of AZ Medicare $51.52
Rate for Payer: Humana of AZ Medicare $27.60
Rate for Payer: Mercy Care Medicaid $6.89
Rate for Payer: Self Pay Self Pay $147.20
Rate for Payer: TriWest Medicare $27.60
Rate for Payer: UnitedHealth Group of AZ Commercial $107.27
Rate for Payer: UnitedHealth Group of AZ Medicare $33.12
Service Code CPT 80061
Hospital Charge Code 22141051
Hospital Revenue Code 301
Min. Negotiated Rate $53.82
Max. Negotiated Rate $186.30
Rate for Payer: Aetna of AZ Commercial $186.30
Rate for Payer: Bisbee Police All Plans $53.82
Rate for Payer: Cash Price $165.60
Rate for Payer: Self Pay Self Pay $165.60
Service Code CPT 80061
Hospital Charge Code 22141051
Hospital Revenue Code 301
Min. Negotiated Rate $13.39
Max. Negotiated Rate $186.30
Rate for Payer: Aetna of AZ Commercial $186.30
Rate for Payer: Aetna of AZ Medicare $57.96
Rate for Payer: AHCCCS Medicaid $13.39
Rate for Payer: Allwell Medicaid $13.39
Rate for Payer: Allwell Medicare $31.05
Rate for Payer: Amerigroup Medicare $31.05
Rate for Payer: APIPA Medicare/Medicaid $77.31
Rate for Payer: AZCH Complete Medicaid $13.39
Rate for Payer: AZCH Complete Medicare $31.05
Rate for Payer: Banner UC Health Medicaid $13.39
Rate for Payer: Banner UC Health Medicare $31.05
Rate for Payer: Bisbee Police All Plans $53.82
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $140.76
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: Copperpoint Commercial $51.23
Rate for Payer: Health Net of AZ Commercial $124.20
Rate for Payer: Health Net of AZ Medicare $57.96
Rate for Payer: Humana of AZ Medicare $31.05
Rate for Payer: Mercy Care Medicaid $13.39
Rate for Payer: Self Pay Self Pay $165.60
Rate for Payer: TriWest Medicare $31.05
Rate for Payer: UnitedHealth Group of AZ Commercial $120.68
Rate for Payer: UnitedHealth Group of AZ Medicare $37.26
Service Code CPT 83701
Hospital Charge Code 22481447
Hospital Revenue Code 301
Min. Negotiated Rate $119.08
Max. Negotiated Rate $412.20
Rate for Payer: Aetna of AZ Commercial $412.20
Rate for Payer: Bisbee Police All Plans $119.08
Rate for Payer: Cash Price $366.40
Rate for Payer: Self Pay Self Pay $366.40
Service Code CPT 83701
Hospital Charge Code 22481447
Hospital Revenue Code 301
Min. Negotiated Rate $33.86
Max. Negotiated Rate $412.20
Rate for Payer: Aetna of AZ Commercial $412.20
Rate for Payer: Aetna of AZ Medicare $128.24
Rate for Payer: AHCCCS Medicaid $33.86
Rate for Payer: Allwell Medicaid $33.86
Rate for Payer: Allwell Medicare $68.70
Rate for Payer: Amerigroup Medicare $68.70
Rate for Payer: APIPA Medicare/Medicaid $171.06
Rate for Payer: AZCH Complete Medicaid $33.86
Rate for Payer: AZCH Complete Medicare $68.70
Rate for Payer: Banner UC Health Medicaid $33.86
Rate for Payer: Banner UC Health Medicare $68.70
Rate for Payer: Bisbee Police All Plans $119.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $311.44
Rate for Payer: Cash Price $366.40
Rate for Payer: Cash Price $366.40
Rate for Payer: Cigna of AZ Commercial $297.70
Rate for Payer: Copperpoint Commercial $113.36
Rate for Payer: Health Net of AZ Commercial $274.80
Rate for Payer: Health Net of AZ Medicare $128.24
Rate for Payer: Humana of AZ Medicare $68.70
Rate for Payer: Mercy Care Medicaid $33.86
Rate for Payer: Self Pay Self Pay $366.40
Rate for Payer: TriWest Medicare $68.70
Rate for Payer: UnitedHealth Group of AZ Commercial $267.01
Rate for Payer: UnitedHealth Group of AZ Medicare $82.44
Service Code CPT 83695
Hospital Charge Code 4711245
Hospital Revenue Code 301
Min. Negotiated Rate $76.70
Max. Negotiated Rate $265.50
Rate for Payer: Aetna of AZ Commercial $265.50
Rate for Payer: Bisbee Police All Plans $76.70
Rate for Payer: Cash Price $236.00
Rate for Payer: Self Pay Self Pay $236.00
Service Code CPT 83695
Hospital Charge Code 4711245
Hospital Revenue Code 301
Min. Negotiated Rate $14.32
Max. Negotiated Rate $265.50
Rate for Payer: Aetna of AZ Commercial $265.50
Rate for Payer: Aetna of AZ Medicare $82.60
Rate for Payer: AHCCCS Medicaid $14.32
Rate for Payer: Allwell Medicaid $14.32
Rate for Payer: Allwell Medicare $44.25
Rate for Payer: Amerigroup Medicare $44.25
Rate for Payer: APIPA Medicare/Medicaid $110.18
Rate for Payer: AZCH Complete Medicaid $14.32
Rate for Payer: AZCH Complete Medicare $44.25
Rate for Payer: Banner UC Health Medicaid $14.32
Rate for Payer: Banner UC Health Medicare $44.25
Rate for Payer: Bisbee Police All Plans $76.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $200.60
Rate for Payer: Cash Price $236.00
Rate for Payer: Cash Price $236.00
Rate for Payer: Cigna of AZ Commercial $191.75
Rate for Payer: Copperpoint Commercial $73.01
Rate for Payer: Health Net of AZ Commercial $177.00
Rate for Payer: Health Net of AZ Medicare $82.60
Rate for Payer: Humana of AZ Medicare $44.25
Rate for Payer: Mercy Care Medicaid $14.32
Rate for Payer: Self Pay Self Pay $236.00
Rate for Payer: TriWest Medicare $44.25
Rate for Payer: UnitedHealth Group of AZ Commercial $171.98
Rate for Payer: UnitedHealth Group of AZ Medicare $53.10
Service Code NDC 904679861
Hospital Charge Code 105929476
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of AZ Commercial $0.05
Rate for Payer: Aetna of AZ Medicare $0.01
Rate for Payer: Allwell Medicare $0.01
Rate for Payer: Amerigroup Medicare $0.01
Rate for Payer: APIPA Medicare/Medicaid $0.02
Rate for Payer: AZCH Complete Medicare $0.01
Rate for Payer: Banner UC Health Medicare $0.01
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $0.03
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of AZ Commercial $0.03
Rate for Payer: Copperpoint Commercial $0.01
Rate for Payer: Health Net of AZ Commercial $0.03
Rate for Payer: Health Net of AZ Medicare $0.01
Rate for Payer: Humana of AZ Medicare $0.01
Rate for Payer: Self Pay Self Pay $0.04
Rate for Payer: TriWest Medicare $0.01
Rate for Payer: UnitedHealth Group of AZ Commercial $0.03
Rate for Payer: UnitedHealth Group of AZ Medicare $0.01
Service Code NDC 904679861
Hospital Charge Code 105929476
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of AZ Commercial $0.05
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Cash Price $0.04
Rate for Payer: Self Pay Self Pay $0.04
Service Code NDC 904679961
Hospital Charge Code 105929344
Hospital Revenue Code 251
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.06
Rate for Payer: Aetna of AZ Commercial $0.06
Rate for Payer: Bisbee Police All Plans $0.02
Rate for Payer: Cash Price $0.05
Rate for Payer: Self Pay Self Pay $0.06
Service Code NDC 904679961
Hospital Charge Code 105929344
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.06
Rate for Payer: Aetna of AZ Commercial $0.06
Rate for Payer: Aetna of AZ Medicare $0.02
Rate for Payer: Allwell Medicare $0.01
Rate for Payer: Amerigroup Medicare $0.01
Rate for Payer: APIPA Medicare/Medicaid $0.03
Rate for Payer: AZCH Complete Medicare $0.01
Rate for Payer: Banner UC Health Medicare $0.01
Rate for Payer: Bisbee Police All Plans $0.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $0.05
Rate for Payer: Cash Price $0.05
Rate for Payer: Cigna of AZ Commercial $0.05
Rate for Payer: Copperpoint Commercial $0.02
Rate for Payer: Health Net of AZ Commercial $0.04
Rate for Payer: Health Net of AZ Medicare $0.02
Rate for Payer: Humana of AZ Medicare $0.01
Rate for Payer: Self Pay Self Pay $0.06
Rate for Payer: TriWest Medicare $0.01
Rate for Payer: UnitedHealth Group of AZ Commercial $0.04
Rate for Payer: UnitedHealth Group of AZ Medicare $0.01
Service Code NDC 68084076525
Hospital Charge Code 105929411
Hospital Revenue Code 251
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.40
Rate for Payer: Aetna of AZ Commercial $0.40
Rate for Payer: Bisbee Police All Plans $0.11
Rate for Payer: Cash Price $0.35
Rate for Payer: Self Pay Self Pay $0.35
Service Code NDC 68084076525
Hospital Charge Code 105929411
Hospital Revenue Code 251
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.40
Rate for Payer: Aetna of AZ Commercial $0.40
Rate for Payer: Aetna of AZ Medicare $0.12
Rate for Payer: Allwell Medicare $0.07
Rate for Payer: Amerigroup Medicare $0.07
Rate for Payer: APIPA Medicare/Medicaid $0.16
Rate for Payer: AZCH Complete Medicare $0.07
Rate for Payer: Banner UC Health Medicare $0.07
Rate for Payer: Bisbee Police All Plans $0.11
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $0.30
Rate for Payer: Cash Price $0.35
Rate for Payer: Cigna of AZ Commercial $0.29
Rate for Payer: Copperpoint Commercial $0.11
Rate for Payer: Health Net of AZ Commercial $0.26
Rate for Payer: Health Net of AZ Medicare $0.12
Rate for Payer: Humana of AZ Medicare $0.07
Rate for Payer: Self Pay Self Pay $0.35
Rate for Payer: TriWest Medicare $0.07
Rate for Payer: UnitedHealth Group of AZ Commercial $0.26
Rate for Payer: UnitedHealth Group of AZ Medicare $0.08
Service Code NDC 904679761
Hospital Charge Code 105929279
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of AZ Commercial $0.05
Rate for Payer: Aetna of AZ Medicare $0.01
Rate for Payer: Allwell Medicare $0.01
Rate for Payer: Amerigroup Medicare $0.01
Rate for Payer: APIPA Medicare/Medicaid $0.02
Rate for Payer: AZCH Complete Medicare $0.01
Rate for Payer: Banner UC Health Medicare $0.01
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $0.03
Rate for Payer: Cash Price $0.04
Rate for Payer: Cigna of AZ Commercial $0.03
Rate for Payer: Copperpoint Commercial $0.01
Rate for Payer: Health Net of AZ Commercial $0.03
Rate for Payer: Health Net of AZ Medicare $0.01
Rate for Payer: Humana of AZ Medicare $0.01
Rate for Payer: Self Pay Self Pay $0.04
Rate for Payer: TriWest Medicare $0.01
Rate for Payer: UnitedHealth Group of AZ Commercial $0.03
Rate for Payer: UnitedHealth Group of AZ Medicare $0.01
Service Code NDC 904679761
Hospital Charge Code 105929279
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.05
Rate for Payer: Aetna of AZ Commercial $0.05
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Cash Price $0.04
Rate for Payer: Self Pay Self Pay $0.04
Service Code NDC 54252725
Hospital Charge Code 105929541
Hospital Revenue Code 251
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.03
Rate for Payer: Aetna of AZ Commercial $0.03
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Cash Price $0.02
Rate for Payer: Self Pay Self Pay $0.02
Service Code NDC 54252725
Hospital Charge Code 105929541
Hospital Revenue Code 251
Max. Negotiated Rate $0.03
Rate for Payer: Aetna of AZ Commercial $0.03
Rate for Payer: Aetna of AZ Medicare $0.01
Rate for Payer: Allwell Medicare $0.00
Rate for Payer: Amerigroup Medicare $0.00
Rate for Payer: APIPA Medicare/Medicaid $0.01
Rate for Payer: AZCH Complete Medicare $0.00
Rate for Payer: Banner UC Health Medicare $0.00
Rate for Payer: Bisbee Police All Plans $0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $0.02
Rate for Payer: Cash Price $0.02
Rate for Payer: Cigna of AZ Commercial $0.02
Rate for Payer: Copperpoint Commercial $0.01
Rate for Payer: Health Net of AZ Commercial $0.02
Rate for Payer: Health Net of AZ Medicare $0.01
Rate for Payer: Humana of AZ Medicare $0.00
Rate for Payer: Self Pay Self Pay $0.02
Rate for Payer: TriWest Medicare $0.00
Rate for Payer: UnitedHealth Group of AZ Commercial $0.02
Rate for Payer: UnitedHealth Group of AZ Medicare $0.01
Service Code CPT 80178
Hospital Charge Code 1905523
Hospital Revenue Code 301
Min. Negotiated Rate $6.61
Max. Negotiated Rate $115.20
Rate for Payer: Aetna of AZ Commercial $115.20
Rate for Payer: Aetna of AZ Medicare $35.84
Rate for Payer: AHCCCS Medicaid $6.61
Rate for Payer: Allwell Medicaid $6.61
Rate for Payer: Allwell Medicare $19.20
Rate for Payer: Amerigroup Medicare $19.20
Rate for Payer: APIPA Medicare/Medicaid $47.81
Rate for Payer: AZCH Complete Medicaid $6.61
Rate for Payer: AZCH Complete Medicare $19.20
Rate for Payer: Banner UC Health Medicaid $6.61
Rate for Payer: Banner UC Health Medicare $19.20
Rate for Payer: Bisbee Police All Plans $33.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $87.04
Rate for Payer: Cash Price $102.40
Rate for Payer: Cash Price $102.40
Rate for Payer: Cigna of AZ Commercial $83.20
Rate for Payer: Copperpoint Commercial $31.68
Rate for Payer: Health Net of AZ Commercial $76.80
Rate for Payer: Health Net of AZ Medicare $35.84
Rate for Payer: Humana of AZ Medicare $19.20
Rate for Payer: Mercy Care Medicaid $6.61
Rate for Payer: Self Pay Self Pay $102.40
Rate for Payer: TriWest Medicare $19.20
Rate for Payer: UnitedHealth Group of AZ Commercial $74.62
Rate for Payer: UnitedHealth Group of AZ Medicare $23.04
Service Code CPT 80178
Hospital Charge Code 1905523
Hospital Revenue Code 301
Min. Negotiated Rate $33.28
Max. Negotiated Rate $115.20
Rate for Payer: Aetna of AZ Commercial $115.20
Rate for Payer: Bisbee Police All Plans $33.28
Rate for Payer: Cash Price $102.40
Rate for Payer: Self Pay Self Pay $102.40
Service Code CPT 91200
Hospital Charge Code 22282825
Hospital Revenue Code 400
Min. Negotiated Rate $43.16
Max. Negotiated Rate $149.40
Rate for Payer: Aetna of AZ Commercial $149.40
Rate for Payer: Bisbee Police All Plans $43.16
Rate for Payer: Cash Price $132.80
Rate for Payer: Self Pay Self Pay $132.80
Service Code CPT 91200
Hospital Charge Code 22282825
Hospital Revenue Code 400
Min. Negotiated Rate $24.90
Max. Negotiated Rate $202.34
Rate for Payer: Aetna of AZ Commercial $149.40
Rate for Payer: Aetna of AZ Medicare $46.48
Rate for Payer: AHCCCS Medicaid $202.34
Rate for Payer: Allwell Medicaid $202.34
Rate for Payer: Allwell Medicare $24.90
Rate for Payer: Amerigroup Medicare $24.90
Rate for Payer: APIPA Medicare/Medicaid $62.00
Rate for Payer: AZCH Complete Medicaid $202.34
Rate for Payer: AZCH Complete Medicare $24.90
Rate for Payer: Banner UC Health Medicaid $202.34
Rate for Payer: Banner UC Health Medicare $24.90
Rate for Payer: Bisbee Police All Plans $43.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $112.88
Rate for Payer: Cash Price $132.80
Rate for Payer: Cash Price $132.80
Rate for Payer: Cigna of AZ Commercial $116.20
Rate for Payer: Copperpoint Commercial $41.08
Rate for Payer: Health Net of AZ Commercial $99.60
Rate for Payer: Health Net of AZ Medicare $46.48
Rate for Payer: Humana of AZ Medicare $24.90
Rate for Payer: Mercy Care Medicaid $202.34
Rate for Payer: Self Pay Self Pay $132.80
Rate for Payer: TriWest Medicare $24.90
Rate for Payer: UnitedHealth Group of AZ Commercial $96.78
Rate for Payer: UnitedHealth Group of AZ Medicare $29.88
Service Code CPT 86376
Hospital Charge Code 22011788
Hospital Revenue Code 302
Min. Negotiated Rate $14.55
Max. Negotiated Rate $162.90
Rate for Payer: Aetna of AZ Commercial $162.90
Rate for Payer: Aetna of AZ Medicare $50.68
Rate for Payer: AHCCCS Medicaid $14.55
Rate for Payer: Allwell Medicaid $14.55
Rate for Payer: Allwell Medicare $27.15
Rate for Payer: Amerigroup Medicare $27.15
Rate for Payer: APIPA Medicare/Medicaid $67.60
Rate for Payer: AZCH Complete Medicaid $14.55
Rate for Payer: AZCH Complete Medicare $27.15
Rate for Payer: Banner UC Health Medicaid $14.55
Rate for Payer: Banner UC Health Medicare $27.15
Rate for Payer: Bisbee Police All Plans $47.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $123.08
Rate for Payer: Cash Price $144.80
Rate for Payer: Cash Price $144.80
Rate for Payer: Cigna of AZ Commercial $117.65
Rate for Payer: Copperpoint Commercial $44.80
Rate for Payer: Health Net of AZ Commercial $108.60
Rate for Payer: Health Net of AZ Medicare $50.68
Rate for Payer: Humana of AZ Medicare $27.15
Rate for Payer: Mercy Care Medicaid $14.55
Rate for Payer: Self Pay Self Pay $144.80
Rate for Payer: TriWest Medicare $27.15
Rate for Payer: UnitedHealth Group of AZ Commercial $105.52
Rate for Payer: UnitedHealth Group of AZ Medicare $32.58
Service Code CPT 86376
Hospital Charge Code 22011788
Hospital Revenue Code 302
Min. Negotiated Rate $47.06
Max. Negotiated Rate $162.90
Rate for Payer: Aetna of AZ Commercial $162.90
Rate for Payer: Bisbee Police All Plans $47.06
Rate for Payer: Cash Price $144.80
Rate for Payer: Self Pay Self Pay $144.80