Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

80360 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80360
Hospital Charge Code	28073691
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80360 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80360
Hospital Charge Code	28073691
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80361 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$227.00

Service Code	CPT 80361
Hospital Charge Code	28077444
Hospital Revenue Code	301
Min. Negotiated Rate	$36.32
Max. Negotiated Rate	$204.30
Rate for Payer: Aetna of AZ Commercial	$204.30
Rate for Payer: Aetna of AZ Medicare	$63.56
Rate for Payer: Allwell Medicare	$36.32
Rate for Payer: Amerigroup Medicare	$36.32
Rate for Payer: APIPA Medicare/Medicaid	$84.78
Rate for Payer: AZCH Complete Medicare	$36.32
Rate for Payer: Banner UC Health Medicare	$36.32
Rate for Payer: Bisbee Police All Plans	$59.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$154.36
Rate for Payer: Cash Price	$181.60
Rate for Payer: Cigna of AZ Commercial	$147.55
Rate for Payer: Copperpoint Commercial	$56.18
Rate for Payer: Health Net of AZ Commercial	$136.20
Rate for Payer: Health Net of AZ Medicare	$63.56
Rate for Payer: Humana of AZ Medicare	$36.32
Rate for Payer: Self Pay Self Pay	$181.60
Rate for Payer: TriWest Medicare	$36.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$132.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.86

80361 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$227.00

Service Code	CPT 80361
Hospital Charge Code	28077444
Hospital Revenue Code	301
Min. Negotiated Rate	$59.02
Max. Negotiated Rate	$204.30
Rate for Payer: Aetna of AZ Commercial	$204.30
Rate for Payer: Bisbee Police All Plans	$59.02
Rate for Payer: Cash Price	$181.60
Rate for Payer: Self Pay Self Pay	$181.60

80364 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80364
Hospital Charge Code	28075340
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80364 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80364
Hospital Charge Code	28075340
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80365 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$254.00

Service Code	CPT 80365
Hospital Charge Code	28077253
Hospital Revenue Code	301
Min. Negotiated Rate	$40.64
Max. Negotiated Rate	$228.60
Rate for Payer: Aetna of AZ Commercial	$228.60
Rate for Payer: Aetna of AZ Medicare	$71.12
Rate for Payer: Allwell Medicare	$40.64
Rate for Payer: Amerigroup Medicare	$40.64
Rate for Payer: APIPA Medicare/Medicaid	$94.87
Rate for Payer: AZCH Complete Medicare	$40.64
Rate for Payer: Banner UC Health Medicare	$40.64
Rate for Payer: Bisbee Police All Plans	$66.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$172.72
Rate for Payer: Cash Price	$203.20
Rate for Payer: Cigna of AZ Commercial	$165.10
Rate for Payer: Copperpoint Commercial	$62.87
Rate for Payer: Health Net of AZ Commercial	$152.40
Rate for Payer: Health Net of AZ Medicare	$71.12
Rate for Payer: Humana of AZ Medicare	$40.64
Rate for Payer: Self Pay Self Pay	$203.20
Rate for Payer: TriWest Medicare	$40.64
Rate for Payer: UnitedHealth Group of AZ Commercial	$148.08
Rate for Payer: UnitedHealth Group of AZ Medicare	$45.72

80365 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$254.00

Service Code	CPT 80365
Hospital Charge Code	28077253
Hospital Revenue Code	301
Min. Negotiated Rate	$66.04
Max. Negotiated Rate	$228.60
Rate for Payer: Aetna of AZ Commercial	$228.60
Rate for Payer: Bisbee Police All Plans	$66.04
Rate for Payer: Cash Price	$203.20
Rate for Payer: Self Pay Self Pay	$203.20

80366 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80366
Hospital Charge Code	28075341
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80366 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80366
Hospital Charge Code	28075341
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80367 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80367
Hospital Charge Code	28077254
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80367 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80367
Hospital Charge Code	28077254
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80368 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80368
Hospital Charge Code	28075342
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80368 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80368
Hospital Charge Code	28075342
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80370 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80370
Hospital Charge Code	28075343
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80370 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80370
Hospital Charge Code	28075343
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80371 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80371
Hospital Charge Code	28075344
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80371 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80371
Hospital Charge Code	28075344
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80372 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80372
Hospital Charge Code	28077255
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

80372 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80372
Hospital Charge Code	28077255
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80373 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$239.00

Service Code	CPT 80373
Hospital Charge Code	28077256
Hospital Revenue Code	301
Min. Negotiated Rate	$38.24
Max. Negotiated Rate	$215.10
Rate for Payer: Aetna of AZ Commercial	$215.10
Rate for Payer: Aetna of AZ Medicare	$66.92
Rate for Payer: Allwell Medicare	$38.24
Rate for Payer: Amerigroup Medicare	$38.24
Rate for Payer: APIPA Medicare/Medicaid	$89.27
Rate for Payer: AZCH Complete Medicare	$38.24
Rate for Payer: Banner UC Health Medicare	$38.24
Rate for Payer: Bisbee Police All Plans	$62.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$162.52
Rate for Payer: Cash Price	$191.20
Rate for Payer: Cigna of AZ Commercial	$155.35
Rate for Payer: Copperpoint Commercial	$59.15
Rate for Payer: Health Net of AZ Commercial	$143.40
Rate for Payer: Health Net of AZ Medicare	$66.92
Rate for Payer: Humana of AZ Medicare	$38.24
Rate for Payer: Self Pay Self Pay	$191.20
Rate for Payer: TriWest Medicare	$38.24
Rate for Payer: UnitedHealth Group of AZ Commercial	$139.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$43.02

80373 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$239.00

Service Code	CPT 80373
Hospital Charge Code	28077256
Hospital Revenue Code	301
Min. Negotiated Rate	$62.14
Max. Negotiated Rate	$215.10
Rate for Payer: Aetna of AZ Commercial	$215.10
Rate for Payer: Bisbee Police All Plans	$62.14
Rate for Payer: Cash Price	$191.20
Rate for Payer: Self Pay Self Pay	$191.20

80377 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80377
Hospital Charge Code	28073693
Hospital Revenue Code	301
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Aetna of AZ Medicare	$78.68
Rate for Payer: Allwell Medicare	$44.96
Rate for Payer: Amerigroup Medicare	$44.96
Rate for Payer: APIPA Medicare/Medicaid	$104.95
Rate for Payer: AZCH Complete Medicare	$44.96
Rate for Payer: Banner UC Health Medicare	$44.96
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$191.08
Rate for Payer: Cash Price	$224.80
Rate for Payer: Cigna of AZ Commercial	$182.65
Rate for Payer: Copperpoint Commercial	$69.55
Rate for Payer: Health Net of AZ Commercial	$168.60
Rate for Payer: Health Net of AZ Medicare	$78.68
Rate for Payer: Humana of AZ Medicare	$44.96
Rate for Payer: Self Pay Self Pay	$224.80
Rate for Payer: TriWest Medicare	$44.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$163.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$50.58

80377 Drug Analysis Profile, Comprehensive, Ur LC

Facility

$281.00

Service Code	CPT 80377
Hospital Charge Code	28073693
Hospital Revenue Code	301
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$252.90
Rate for Payer: Aetna of AZ Commercial	$252.90
Rate for Payer: Bisbee Police All Plans	$73.06
Rate for Payer: Cash Price	$224.80
Rate for Payer: Self Pay Self Pay	$224.80

82107 HEPATOCELLULAR

Facility

$226.00

Service Code	CPT 82107
Hospital Charge Code	23294379
Hospital Revenue Code	301
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Aetna of AZ Medicare	$63.28
Rate for Payer: Allwell Medicare	$36.16
Rate for Payer: Amerigroup Medicare	$36.16
Rate for Payer: APIPA Medicare/Medicaid	$84.41
Rate for Payer: AZCH Complete Medicare	$36.16
Rate for Payer: Banner UC Health Medicare	$36.16
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$153.68
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cigna of AZ Commercial	$146.90
Rate for Payer: Copperpoint Commercial	$55.94
Rate for Payer: Health Net of AZ Commercial	$135.60
Rate for Payer: Health Net of AZ Medicare	$63.28
Rate for Payer: Humana of AZ Medicare	$36.16
Rate for Payer: Self Pay Self Pay	$180.80
Rate for Payer: TriWest Medicare	$36.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$131.76
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.68

Know your out-of-pocket cost for care.

All Charges