Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45
Rate for Payer: NaphCare Correctional Healthcare	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45
Rate for Payer: NaphCare Correctional Healthcare	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96
Rate for Payer: NaphCare Correctional Healthcare	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1614
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96
Rate for Payer: NaphCare Correctional Healthcare	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45
Rate for Payer: NaphCare Correctional Healthcare	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$160,146.45

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$160,146.45
Max. Negotiated Rate	$160,146.45
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$160,146.45
Rate for Payer: Mercy Care Medicaid	$160,146.45
Rate for Payer: NaphCare Correctional Healthcare	$160,146.45

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96
Rate for Payer: NaphCare Correctional Healthcare	$111,650.96

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1613
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$78,199.79

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG1612
Min. Negotiated Rate	$78,199.79
Max. Negotiated Rate	$78,199.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$78,199.79
Rate for Payer: Mercy Care Medicaid	$78,199.79
Rate for Payer: NaphCare Correctional Healthcare	$78,199.79

Implantable Heart Assist Systems

Facility

IP

$111,650.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG1611
Min. Negotiated Rate	$111,650.96
Max. Negotiated Rate	$111,650.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$111,650.96
Rate for Payer: Mercy Care Medicaid	$111,650.96
Rate for Payer: NaphCare Correctional Healthcare	$111,650.96

IMUNNOHISTOCHEMIST 1ST

Facility

IP

$308.00

Service Code	HCPCS G0461
Hospital Charge Code	22545749
Hospital Revenue Code	310
Min. Negotiated Rate	$277.20
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Cash Price	$246.40

IMUNNOHISTOCHEMIST 1ST

Facility

OP

$308.00

Service Code	HCPCS G0461
Hospital Charge Code	22545749
Hospital Revenue Code	310
Min. Negotiated Rate	$48.79
Max. Negotiated Rate	$277.20
Rate for Payer: Aetna of AZ Commercial	$277.20
Rate for Payer: Arizona Complete Health Allwell	$49.28
Rate for Payer: Banner UC Health Medicare	$49.28
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$209.44
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$49.28
Rate for Payer: Care1st Health Plan Arizona Medicare	$49.28
Rate for Payer: Cash Price	$246.40
Rate for Payer: Cigna of AZ Commercial	$200.20
Rate for Payer: Devoted Health Medicare	$55.44
Rate for Payer: Humana of AZ Medicare	$49.28
Rate for Payer: Southwest Service Administrators UFCW	$209.44
Rate for Payer: TriWest Medicare	$49.28
Rate for Payer: United Healthcare Commercial	$176.18
Rate for Payer: United Healthcare Medicare	$49.28
Rate for Payer: Veterans Affairs TRICARE	$48.79

IMUNNOHISTOCHEMIST 2ND

Facility

OP

$312.00

Service Code	HCPCS G0462
Hospital Charge Code	22545750
Hospital Revenue Code	310
Min. Negotiated Rate	$49.42
Max. Negotiated Rate	$280.80
Rate for Payer: Aetna of AZ Commercial	$280.80
Rate for Payer: Arizona Complete Health Allwell	$49.92
Rate for Payer: Banner UC Health Medicare	$49.92
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$212.16
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$49.92
Rate for Payer: Care1st Health Plan Arizona Medicare	$49.92
Rate for Payer: Cash Price	$249.60
Rate for Payer: Cigna of AZ Commercial	$202.80
Rate for Payer: Devoted Health Medicare	$56.16
Rate for Payer: Humana of AZ Medicare	$49.92
Rate for Payer: Southwest Service Administrators UFCW	$212.16
Rate for Payer: TriWest Medicare	$49.92
Rate for Payer: United Healthcare Commercial	$178.46
Rate for Payer: United Healthcare Medicare	$49.92
Rate for Payer: Veterans Affairs TRICARE	$49.42

IMUNNOHISTOCHEMIST 2ND

Facility

IP

$312.00

Service Code	HCPCS G0462
Hospital Charge Code	22545750
Hospital Revenue Code	310
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$280.80
Rate for Payer: Aetna of AZ Commercial	$280.80
Rate for Payer: Cash Price	$249.60

IM visual acuity testing

Facility

IP

$68.00

Service Code	CPT 99173
Hospital Charge Code	2855983
Hospital Revenue Code	521
Min. Negotiated Rate	$61.20
Max. Negotiated Rate	$61.20
Rate for Payer: Aetna of AZ Commercial	$61.20
Rate for Payer: Cash Price	$54.40

IM visual acuity testing

Facility

OP

$68.00

Service Code	CPT 99173
Hospital Charge Code	2855983
Hospital Revenue Code	521
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$61.20
Rate for Payer: Aetna of AZ Commercial	$61.20
Rate for Payer: Arizona Complete Health Allwell	$10.88
Rate for Payer: Banner UC Health Medicare	$10.88
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$46.24
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$10.88
Rate for Payer: Care1st Health Plan Arizona Medicare	$10.88
Rate for Payer: Cash Price	$54.40
Rate for Payer: Cigna of AZ Commercial	$47.60
Rate for Payer: Devoted Health Medicare	$12.24
Rate for Payer: Humana of AZ Medicare	$10.88
Rate for Payer: Southwest Service Administrators UFCW	$46.24
Rate for Payer: TriWest Medicare	$10.88
Rate for Payer: United Healthcare Commercial	$38.90
Rate for Payer: United Healthcare Medicare	$10.88
Rate for Payer: Veterans Affairs TRICARE	$10.77

INBORN AND OTHER DISORDERS OF METABOLISM

Facility

IP

$18,379.42

Service Code	MSDRG 642
Min. Negotiated Rate	$18,379.42
Max. Negotiated Rate	$18,379.42
Rate for Payer: Seven Corners Travel Insurance	$18,379.42

Inborn Errors Of Metabolism

Facility

IP

$20,239.60

Service Code	APR-DRG 4234
Hospital Charge Code	APRDRG4233
Min. Negotiated Rate	$20,239.60
Max. Negotiated Rate	$20,239.60
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$20,239.60
Rate for Payer: Mercy Care Medicaid	$20,239.60
Rate for Payer: NaphCare Correctional Healthcare	$20,239.60

Inborn Errors Of Metabolism

Facility

IP

$20,239.60

Service Code	APR-DRG 4234
Hospital Charge Code	APRDRG4234
Min. Negotiated Rate	$20,239.60
Max. Negotiated Rate	$20,239.60
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$20,239.60
Rate for Payer: Mercy Care Medicaid	$20,239.60
Rate for Payer: NaphCare Correctional Healthcare	$20,239.60

Inborn Errors Of Metabolism

Facility

IP

$3,920.83

Service Code	APR-DRG 4231
Hospital Charge Code	APRDRG4231
Min. Negotiated Rate	$3,920.83
Max. Negotiated Rate	$3,920.83
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,920.83
Rate for Payer: Mercy Care Medicaid	$3,920.83
Rate for Payer: NaphCare Correctional Healthcare	$3,920.83

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