Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Hip And Femur Fracture Repair

Facility

$19,971.66

Service Code	APR-DRG 3084
Hospital Charge Code	APRDRG3082
Min. Negotiated Rate	$19,971.66
Max. Negotiated Rate	$19,971.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$19,971.66
Rate for Payer: Mercy Care Medicaid	$19,971.66
Rate for Payer: NaphCare Correctional Healthcare	$19,971.66

Hip And Femur Fracture Repair

Facility

$8,388.74

Service Code	APR-DRG 3081
Hospital Charge Code	APRDRG3083
Min. Negotiated Rate	$8,388.74
Max. Negotiated Rate	$8,388.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,388.74
Rate for Payer: Mercy Care Medicaid	$8,388.74
Rate for Payer: NaphCare Correctional Healthcare	$8,388.74

Hip And Femur Fracture Repair

Facility

$9,774.71

Service Code	APR-DRG 3082
Hospital Charge Code	APRDRG3081
Min. Negotiated Rate	$9,774.71
Max. Negotiated Rate	$9,774.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,774.71
Rate for Payer: Mercy Care Medicaid	$9,774.71
Rate for Payer: NaphCare Correctional Healthcare	$9,774.71

Hip And Femur Fracture Repair

Facility

$13,332.91

Service Code	APR-DRG 3083
Hospital Charge Code	APRDRG3082
Min. Negotiated Rate	$13,332.91
Max. Negotiated Rate	$13,332.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,332.91
Rate for Payer: Mercy Care Medicaid	$13,332.91
Rate for Payer: NaphCare Correctional Healthcare	$13,332.91

Hip And Femur Fracture Repair

Facility

$19,971.66

Service Code	APR-DRG 3084
Hospital Charge Code	APRDRG3081
Min. Negotiated Rate	$19,971.66
Max. Negotiated Rate	$19,971.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$19,971.66
Rate for Payer: Mercy Care Medicaid	$19,971.66
Rate for Payer: NaphCare Correctional Healthcare	$19,971.66

Hip And Femur Fracture Repair

Facility

$8,388.74

Service Code	APR-DRG 3081
Hospital Charge Code	APRDRG3081
Min. Negotiated Rate	$8,388.74
Max. Negotiated Rate	$8,388.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,388.74
Rate for Payer: Mercy Care Medicaid	$8,388.74
Rate for Payer: NaphCare Correctional Healthcare	$8,388.74

Hip And Femur Fracture Repair

Facility

$8,388.74

Service Code	APR-DRG 3081
Hospital Charge Code	APRDRG3082
Min. Negotiated Rate	$8,388.74
Max. Negotiated Rate	$8,388.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,388.74
Rate for Payer: Mercy Care Medicaid	$8,388.74
Rate for Payer: NaphCare Correctional Healthcare	$8,388.74

Hip And Femur Fracture Repair

Facility

$8,388.74

Service Code	APR-DRG 3081
Hospital Charge Code	APRDRG3084
Min. Negotiated Rate	$8,388.74
Max. Negotiated Rate	$8,388.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,388.74
Rate for Payer: Mercy Care Medicaid	$8,388.74
Rate for Payer: NaphCare Correctional Healthcare	$8,388.74

Hip And Femur Fracture Repair

Facility

$19,971.66

Service Code	APR-DRG 3084
Hospital Charge Code	APRDRG3083
Min. Negotiated Rate	$19,971.66
Max. Negotiated Rate	$19,971.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$19,971.66
Rate for Payer: Mercy Care Medicaid	$19,971.66
Rate for Payer: NaphCare Correctional Healthcare	$19,971.66

Hip And Femur Fracture Repair

Facility

$9,774.71

Service Code	APR-DRG 3082
Hospital Charge Code	APRDRG3082
Min. Negotiated Rate	$9,774.71
Max. Negotiated Rate	$9,774.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,774.71
Rate for Payer: Mercy Care Medicaid	$9,774.71
Rate for Payer: NaphCare Correctional Healthcare	$9,774.71

Hip And Femur Fracture Repair

Facility

$13,332.91

Service Code	APR-DRG 3083
Hospital Charge Code	APRDRG3081
Min. Negotiated Rate	$13,332.91
Max. Negotiated Rate	$13,332.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,332.91
Rate for Payer: Mercy Care Medicaid	$13,332.91
Rate for Payer: NaphCare Correctional Healthcare	$13,332.91

Hip And Femur Fracture Repair

Facility

$9,774.71

Service Code	APR-DRG 3082
Hospital Charge Code	APRDRG3084
Min. Negotiated Rate	$9,774.71
Max. Negotiated Rate	$9,774.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,774.71
Rate for Payer: Mercy Care Medicaid	$9,774.71
Rate for Payer: NaphCare Correctional Healthcare	$9,774.71

Hip And Femur Fracture Repair

Facility

$13,332.91

Service Code	APR-DRG 3083
Hospital Charge Code	APRDRG3083
Min. Negotiated Rate	$13,332.91
Max. Negotiated Rate	$13,332.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,332.91
Rate for Payer: Mercy Care Medicaid	$13,332.91
Rate for Payer: NaphCare Correctional Healthcare	$13,332.91

Hip And Femur Fracture Repair

Facility

$13,332.91

Service Code	APR-DRG 3083
Hospital Charge Code	APRDRG3084
Min. Negotiated Rate	$13,332.91
Max. Negotiated Rate	$13,332.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,332.91
Rate for Payer: Mercy Care Medicaid	$13,332.91
Rate for Payer: NaphCare Correctional Healthcare	$13,332.91

Hip And Femur Fracture Repair

Facility

$19,971.66

Service Code	APR-DRG 3084
Hospital Charge Code	APRDRG3084
Min. Negotiated Rate	$19,971.66
Max. Negotiated Rate	$19,971.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$19,971.66
Rate for Payer: Mercy Care Medicaid	$19,971.66
Rate for Payer: NaphCare Correctional Healthcare	$19,971.66

Hip And Femur Fracture Repair

Facility

$9,774.71

Service Code	APR-DRG 3082
Hospital Charge Code	APRDRG3083
Min. Negotiated Rate	$9,774.71
Max. Negotiated Rate	$9,774.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,774.71
Rate for Payer: Mercy Care Medicaid	$9,774.71
Rate for Payer: NaphCare Correctional Healthcare	$9,774.71

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$27,069.62

Service Code	MSDRG 481
Min. Negotiated Rate	$27,069.62
Max. Negotiated Rate	$27,069.62
Rate for Payer: Seven Corners Travel Insurance	$27,069.62

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$37,638.96

Service Code	MSDRG 480
Min. Negotiated Rate	$37,638.96
Max. Negotiated Rate	$37,638.96
Rate for Payer: Seven Corners Travel Insurance	$37,638.96

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$21,079.26

Service Code	MSDRG 482
Min. Negotiated Rate	$21,079.26
Max. Negotiated Rate	$21,079.26
Rate for Payer: Seven Corners Travel Insurance	$21,079.26

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

Facility

$37,094.87

Service Code	MSDRG 521
Min. Negotiated Rate	$37,094.87
Max. Negotiated Rate	$37,094.87
Rate for Payer: Seven Corners Travel Insurance	$37,094.87

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC

Facility

$27,369.46

Service Code	MSDRG 522
Min. Negotiated Rate	$27,369.46
Max. Negotiated Rate	$27,369.46
Rate for Payer: Seven Corners Travel Insurance	$27,369.46

.HIV 1/2 Supplemental Ab Test LC

Facility

$420.00

Service Code	CPT 86701
Hospital Charge Code	11067502
Hospital Revenue Code	302
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna of AZ Commercial	$378.00
Rate for Payer: Arizona Complete Health Allwell	$67.20
Rate for Payer: Banner UC Health Medicare	$67.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$285.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$67.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$67.20
Rate for Payer: Cash Price	$336.00
Rate for Payer: Cash Price	$336.00
Rate for Payer: Cigna of AZ Commercial	$273.00
Rate for Payer: Devoted Health Medicare	$75.60
Rate for Payer: Humana of AZ Medicare	$67.20
Rate for Payer: Seven Corners Travel Insurance	$12.89
Rate for Payer: Southwest Service Administrators UFCW	$285.60
Rate for Payer: TriWest Medicare	$67.20
Rate for Payer: United Healthcare Commercial	$240.24
Rate for Payer: United Healthcare Medicare	$67.20
Rate for Payer: Veterans Affairs TRICARE	$66.53

.HIV 1/2 Supplemental Ab Test LC

Facility

$420.00

Service Code	CPT 86701
Hospital Charge Code	11067502
Hospital Revenue Code	302
Min. Negotiated Rate	$378.00
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna of AZ Commercial	$378.00
Rate for Payer: Cash Price	$336.00

HIV-1 Genosure Archive

Facility

$1,244.00

Service Code	CPT 87901
Hospital Charge Code	23175970
Hospital Revenue Code	300
Min. Negotiated Rate	$197.05
Max. Negotiated Rate	$1,119.60
Rate for Payer: Aetna of AZ Commercial	$1,119.60
Rate for Payer: Arizona Complete Health Allwell	$199.04
Rate for Payer: Banner UC Health Medicare	$199.04
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$845.92
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$199.04
Rate for Payer: Care1st Health Plan Arizona Medicare	$199.04
Rate for Payer: Cash Price	$995.20
Rate for Payer: Cash Price	$995.20
Rate for Payer: Cigna of AZ Commercial	$808.60
Rate for Payer: Devoted Health Medicare	$223.92
Rate for Payer: Humana of AZ Medicare	$199.04
Rate for Payer: Seven Corners Travel Insurance	$373.30
Rate for Payer: Southwest Service Administrators UFCW	$845.92
Rate for Payer: TriWest Medicare	$199.04
Rate for Payer: United Healthcare Commercial	$711.57
Rate for Payer: United Healthcare Medicare	$199.04
Rate for Payer: Veterans Affairs TRICARE	$197.05

HIV-1 Genosure Archive

Facility

$1,244.00

Service Code	CPT 87901
Hospital Charge Code	23175970
Hospital Revenue Code	300
Min. Negotiated Rate	$1,119.60
Max. Negotiated Rate	$1,119.60
Rate for Payer: Aetna of AZ Commercial	$1,119.60
Rate for Payer: Cash Price	$995.20

Know your out-of-pocket cost for care.

All Charges