Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Major Skin Disorders

Facility

$23,974.55

Service Code	APR-DRG 3814
Hospital Charge Code	APRDRG3814
Min. Negotiated Rate	$23,974.55
Max. Negotiated Rate	$23,974.55
Rate for Payer: AHCCCS Medicaid	$23,974.55
Rate for Payer: Allwell Medicaid	$23,974.55
Rate for Payer: AZCH Complete Medicaid	$23,974.55
Rate for Payer: Banner UC Health Medicaid	$23,974.55
Rate for Payer: Mercy Care Medicaid	$23,974.55

Major Skin Disorders

Facility

$23,974.55

Service Code	APR-DRG 3814
Hospital Charge Code	APRDRG3813
Min. Negotiated Rate	$23,974.55
Max. Negotiated Rate	$23,974.55
Rate for Payer: AHCCCS Medicaid	$23,974.55
Rate for Payer: Allwell Medicaid	$23,974.55
Rate for Payer: AZCH Complete Medicaid	$23,974.55
Rate for Payer: Banner UC Health Medicaid	$23,974.55
Rate for Payer: Mercy Care Medicaid	$23,974.55

Major Skin Disorders

Facility

$23,974.55

Service Code	APR-DRG 3814
Hospital Charge Code	APRDRG3811
Min. Negotiated Rate	$23,974.55
Max. Negotiated Rate	$23,974.55
Rate for Payer: AHCCCS Medicaid	$23,974.55
Rate for Payer: Allwell Medicaid	$23,974.55
Rate for Payer: AZCH Complete Medicaid	$23,974.55
Rate for Payer: Banner UC Health Medicaid	$23,974.55
Rate for Payer: Mercy Care Medicaid	$23,974.55

Major Skin Disorders

Facility

$23,974.55

Service Code	APR-DRG 3814
Hospital Charge Code	APRDRG3812
Min. Negotiated Rate	$23,974.55
Max. Negotiated Rate	$23,974.55
Rate for Payer: AHCCCS Medicaid	$23,974.55
Rate for Payer: Allwell Medicaid	$23,974.55
Rate for Payer: AZCH Complete Medicaid	$23,974.55
Rate for Payer: Banner UC Health Medicaid	$23,974.55
Rate for Payer: Mercy Care Medicaid	$23,974.55

Major Skin Disorders

Facility

$5,306.79

Service Code	APR-DRG 3812
Hospital Charge Code	APRDRG3814
Min. Negotiated Rate	$5,306.79
Max. Negotiated Rate	$5,306.79
Rate for Payer: AHCCCS Medicaid	$5,306.79
Rate for Payer: Allwell Medicaid	$5,306.79
Rate for Payer: AZCH Complete Medicaid	$5,306.79
Rate for Payer: Banner UC Health Medicaid	$5,306.79
Rate for Payer: Mercy Care Medicaid	$5,306.79

Major Skin Disorders

Facility

$9,989.34

Service Code	APR-DRG 3813
Hospital Charge Code	APRDRG3814
Min. Negotiated Rate	$9,989.34
Max. Negotiated Rate	$9,989.34
Rate for Payer: AHCCCS Medicaid	$9,989.34
Rate for Payer: Allwell Medicaid	$9,989.34
Rate for Payer: AZCH Complete Medicaid	$9,989.34
Rate for Payer: Banner UC Health Medicaid	$9,989.34
Rate for Payer: Mercy Care Medicaid	$9,989.34

Major Skin Disorders

Facility

$5,306.79

Service Code	APR-DRG 3812
Hospital Charge Code	APRDRG3811
Min. Negotiated Rate	$5,306.79
Max. Negotiated Rate	$5,306.79
Rate for Payer: AHCCCS Medicaid	$5,306.79
Rate for Payer: Allwell Medicaid	$5,306.79
Rate for Payer: AZCH Complete Medicaid	$5,306.79
Rate for Payer: Banner UC Health Medicaid	$5,306.79
Rate for Payer: Mercy Care Medicaid	$5,306.79

Major Skin Disorders

Facility

$2,962.71

Service Code	APR-DRG 3811
Hospital Charge Code	APRDRG3812
Min. Negotiated Rate	$2,962.71
Max. Negotiated Rate	$2,962.71
Rate for Payer: AHCCCS Medicaid	$2,962.71
Rate for Payer: Allwell Medicaid	$2,962.71
Rate for Payer: AZCH Complete Medicaid	$2,962.71
Rate for Payer: Banner UC Health Medicaid	$2,962.71
Rate for Payer: Mercy Care Medicaid	$2,962.71

Major Skin Disorders

Facility

$2,962.71

Service Code	APR-DRG 3811
Hospital Charge Code	APRDRG3811
Min. Negotiated Rate	$2,962.71
Max. Negotiated Rate	$2,962.71
Rate for Payer: AHCCCS Medicaid	$2,962.71
Rate for Payer: Allwell Medicaid	$2,962.71
Rate for Payer: AZCH Complete Medicaid	$2,962.71
Rate for Payer: Banner UC Health Medicaid	$2,962.71
Rate for Payer: Mercy Care Medicaid	$2,962.71

Major Skin Disorders

Facility

$9,989.34

Service Code	APR-DRG 3813
Hospital Charge Code	APRDRG3813
Min. Negotiated Rate	$9,989.34
Max. Negotiated Rate	$9,989.34
Rate for Payer: AHCCCS Medicaid	$9,989.34
Rate for Payer: Allwell Medicaid	$9,989.34
Rate for Payer: AZCH Complete Medicaid	$9,989.34
Rate for Payer: Banner UC Health Medicaid	$9,989.34
Rate for Payer: Mercy Care Medicaid	$9,989.34

Major Skin Disorders

Facility

$5,306.79

Service Code	APR-DRG 3812
Hospital Charge Code	APRDRG3812
Min. Negotiated Rate	$5,306.79
Max. Negotiated Rate	$5,306.79
Rate for Payer: AHCCCS Medicaid	$5,306.79
Rate for Payer: Allwell Medicaid	$5,306.79
Rate for Payer: AZCH Complete Medicaid	$5,306.79
Rate for Payer: Banner UC Health Medicaid	$5,306.79
Rate for Payer: Mercy Care Medicaid	$5,306.79

Major Small Bowel Procedures

Facility

$12,110.37

Service Code	APR-DRG 2302
Hospital Charge Code	APRDRG2303
Min. Negotiated Rate	$12,110.37
Max. Negotiated Rate	$12,110.37
Rate for Payer: AHCCCS Medicaid	$12,110.37
Rate for Payer: Allwell Medicaid	$12,110.37
Rate for Payer: AZCH Complete Medicaid	$12,110.37
Rate for Payer: Banner UC Health Medicaid	$12,110.37
Rate for Payer: Mercy Care Medicaid	$12,110.37

Major Small Bowel Procedures

Facility

$8,732.43

Service Code	APR-DRG 2301
Hospital Charge Code	APRDRG2301
Min. Negotiated Rate	$8,732.43
Max. Negotiated Rate	$8,732.43
Rate for Payer: AHCCCS Medicaid	$8,732.43
Rate for Payer: Allwell Medicaid	$8,732.43
Rate for Payer: AZCH Complete Medicaid	$8,732.43
Rate for Payer: Banner UC Health Medicaid	$8,732.43
Rate for Payer: Mercy Care Medicaid	$8,732.43

Major Small Bowel Procedures

Facility

$34,522.21

Service Code	APR-DRG 2304
Hospital Charge Code	APRDRG2304
Min. Negotiated Rate	$34,522.21
Max. Negotiated Rate	$34,522.21
Rate for Payer: AHCCCS Medicaid	$34,522.21
Rate for Payer: Allwell Medicaid	$34,522.21
Rate for Payer: AZCH Complete Medicaid	$34,522.21
Rate for Payer: Banner UC Health Medicaid	$34,522.21
Rate for Payer: Mercy Care Medicaid	$34,522.21

Major Small Bowel Procedures

Facility

$17,896.22

Service Code	APR-DRG 2303
Hospital Charge Code	APRDRG2303
Min. Negotiated Rate	$17,896.22
Max. Negotiated Rate	$17,896.22
Rate for Payer: AHCCCS Medicaid	$17,896.22
Rate for Payer: Allwell Medicaid	$17,896.22
Rate for Payer: AZCH Complete Medicaid	$17,896.22
Rate for Payer: Banner UC Health Medicaid	$17,896.22
Rate for Payer: Mercy Care Medicaid	$17,896.22

Major Small Bowel Procedures

Facility

$34,522.21

Service Code	APR-DRG 2304
Hospital Charge Code	APRDRG2302
Min. Negotiated Rate	$34,522.21
Max. Negotiated Rate	$34,522.21
Rate for Payer: AHCCCS Medicaid	$34,522.21
Rate for Payer: Allwell Medicaid	$34,522.21
Rate for Payer: AZCH Complete Medicaid	$34,522.21
Rate for Payer: Banner UC Health Medicaid	$34,522.21
Rate for Payer: Mercy Care Medicaid	$34,522.21

Major Small Bowel Procedures

Facility

$34,522.21

Service Code	APR-DRG 2304
Hospital Charge Code	APRDRG2301
Min. Negotiated Rate	$34,522.21
Max. Negotiated Rate	$34,522.21
Rate for Payer: AHCCCS Medicaid	$34,522.21
Rate for Payer: Allwell Medicaid	$34,522.21
Rate for Payer: AZCH Complete Medicaid	$34,522.21
Rate for Payer: Banner UC Health Medicaid	$34,522.21
Rate for Payer: Mercy Care Medicaid	$34,522.21

Major Small Bowel Procedures

Facility

$8,732.43

Service Code	APR-DRG 2301
Hospital Charge Code	APRDRG2302
Min. Negotiated Rate	$8,732.43
Max. Negotiated Rate	$8,732.43
Rate for Payer: AHCCCS Medicaid	$8,732.43
Rate for Payer: Allwell Medicaid	$8,732.43
Rate for Payer: AZCH Complete Medicaid	$8,732.43
Rate for Payer: Banner UC Health Medicaid	$8,732.43
Rate for Payer: Mercy Care Medicaid	$8,732.43

Major Small Bowel Procedures

Facility

$17,896.22

Service Code	APR-DRG 2303
Hospital Charge Code	APRDRG2301
Min. Negotiated Rate	$17,896.22
Max. Negotiated Rate	$17,896.22
Rate for Payer: AHCCCS Medicaid	$17,896.22
Rate for Payer: Allwell Medicaid	$17,896.22
Rate for Payer: AZCH Complete Medicaid	$17,896.22
Rate for Payer: Banner UC Health Medicaid	$17,896.22
Rate for Payer: Mercy Care Medicaid	$17,896.22

Major Small Bowel Procedures

Facility

$8,732.43

Service Code	APR-DRG 2301
Hospital Charge Code	APRDRG2303
Min. Negotiated Rate	$8,732.43
Max. Negotiated Rate	$8,732.43
Rate for Payer: AHCCCS Medicaid	$8,732.43
Rate for Payer: Allwell Medicaid	$8,732.43
Rate for Payer: AZCH Complete Medicaid	$8,732.43
Rate for Payer: Banner UC Health Medicaid	$8,732.43
Rate for Payer: Mercy Care Medicaid	$8,732.43

Major Small Bowel Procedures

Facility

$12,110.37

Service Code	APR-DRG 2302
Hospital Charge Code	APRDRG2301
Min. Negotiated Rate	$12,110.37
Max. Negotiated Rate	$12,110.37
Rate for Payer: AHCCCS Medicaid	$12,110.37
Rate for Payer: Allwell Medicaid	$12,110.37
Rate for Payer: AZCH Complete Medicaid	$12,110.37
Rate for Payer: Banner UC Health Medicaid	$12,110.37
Rate for Payer: Mercy Care Medicaid	$12,110.37

Major Small Bowel Procedures

Facility

$12,110.37

Service Code	APR-DRG 2302
Hospital Charge Code	APRDRG2302
Min. Negotiated Rate	$12,110.37
Max. Negotiated Rate	$12,110.37
Rate for Payer: AHCCCS Medicaid	$12,110.37
Rate for Payer: Allwell Medicaid	$12,110.37
Rate for Payer: AZCH Complete Medicaid	$12,110.37
Rate for Payer: Banner UC Health Medicaid	$12,110.37
Rate for Payer: Mercy Care Medicaid	$12,110.37

Major Small Bowel Procedures

Facility

$17,896.22

Service Code	APR-DRG 2303
Hospital Charge Code	APRDRG2302
Min. Negotiated Rate	$17,896.22
Max. Negotiated Rate	$17,896.22
Rate for Payer: AHCCCS Medicaid	$17,896.22
Rate for Payer: Allwell Medicaid	$17,896.22
Rate for Payer: AZCH Complete Medicaid	$17,896.22
Rate for Payer: Banner UC Health Medicaid	$17,896.22
Rate for Payer: Mercy Care Medicaid	$17,896.22

Major Small Bowel Procedures

Facility

$17,896.22

Service Code	APR-DRG 2303
Hospital Charge Code	APRDRG2304
Min. Negotiated Rate	$17,896.22
Max. Negotiated Rate	$17,896.22
Rate for Payer: AHCCCS Medicaid	$17,896.22
Rate for Payer: Allwell Medicaid	$17,896.22
Rate for Payer: AZCH Complete Medicaid	$17,896.22
Rate for Payer: Banner UC Health Medicaid	$17,896.22
Rate for Payer: Mercy Care Medicaid	$17,896.22

Major Small Bowel Procedures

Facility

$34,522.21

Service Code	APR-DRG 2304
Hospital Charge Code	APRDRG2303
Min. Negotiated Rate	$34,522.21
Max. Negotiated Rate	$34,522.21
Rate for Payer: AHCCCS Medicaid	$34,522.21
Rate for Payer: Allwell Medicaid	$34,522.21
Rate for Payer: AZCH Complete Medicaid	$34,522.21
Rate for Payer: Banner UC Health Medicaid	$34,522.21
Rate for Payer: Mercy Care Medicaid	$34,522.21

Know your out-of-pocket cost for care.

All Charges