|
Inguinal, Femoral And Umbilical Hernia Procedures
|
Facility
|
IP
|
$5,855.99
|
|
|
Service Code
|
APR-DRG 2281
|
| Hospital Charge Code |
APRDRG2283
|
| Min. Negotiated Rate |
$5,855.99 |
| Max. Negotiated Rate |
$5,855.99 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,855.99
|
| Rate for Payer: Mercy Care Medicaid |
$5,855.99
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,855.99
|
|
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
Facility
|
IP
|
$21,389.19
|
|
|
Service Code
|
APR-DRG 2284
|
| Hospital Charge Code |
APRDRG2282
|
| Min. Negotiated Rate |
$21,389.19 |
| Max. Negotiated Rate |
$21,389.19 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,389.19
|
| Rate for Payer: Mercy Care Medicaid |
$21,389.19
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,389.19
|
|
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
Facility
|
IP
|
$7,529.53
|
|
|
Service Code
|
APR-DRG 2282
|
| Hospital Charge Code |
APRDRG2281
|
| Min. Negotiated Rate |
$7,529.53 |
| Max. Negotiated Rate |
$7,529.53 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,529.53
|
| Rate for Payer: Mercy Care Medicaid |
$7,529.53
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,529.53
|
|
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
Facility
|
IP
|
$5,855.99
|
|
|
Service Code
|
APR-DRG 2281
|
| Hospital Charge Code |
APRDRG2284
|
| Min. Negotiated Rate |
$5,855.99 |
| Max. Negotiated Rate |
$5,855.99 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,855.99
|
| Rate for Payer: Mercy Care Medicaid |
$5,855.99
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,855.99
|
|
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
Facility
|
IP
|
$11,253.26
|
|
|
Service Code
|
APR-DRG 2283
|
| Hospital Charge Code |
APRDRG2282
|
| Min. Negotiated Rate |
$11,253.26 |
| Max. Negotiated Rate |
$11,253.26 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$11,253.26
|
| Rate for Payer: Mercy Care Medicaid |
$11,253.26
|
| Rate for Payer: NaphCare Correctional Healthcare |
$11,253.26
|
|
|
INITIAL MOD COMPLEX ADMISSION
|
Facility
|
OP
|
$501.00
|
|
|
Service Code
|
CPT 99222
|
| Hospital Charge Code |
22653268
|
| Min. Negotiated Rate |
$79.36 |
| Max. Negotiated Rate |
$450.90 |
| Rate for Payer: Aetna of AZ Commercial |
$450.90
|
| Rate for Payer: Arizona Complete Health Allwell |
$80.16
|
| Rate for Payer: Banner UC Health Medicare |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$340.68
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$80.16
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$80.16
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cigna of AZ Commercial |
$350.70
|
| Rate for Payer: Devoted Health Medicare |
$90.18
|
| Rate for Payer: Humana of AZ Medicare |
$80.16
|
| Rate for Payer: Southwest Service Administrators UFCW |
$340.68
|
| Rate for Payer: TriWest Medicare |
$80.16
|
| Rate for Payer: United Healthcare Commercial |
$286.57
|
| Rate for Payer: United Healthcare Medicare |
$80.16
|
| Rate for Payer: Veterans Affairs TRICARE |
$79.36
|
|
|
INITIAL MOD COMPLEX ADMISSION
|
Facility
|
IP
|
$501.00
|
|
|
Service Code
|
CPT 99222
|
| Hospital Charge Code |
22653268
|
| Min. Negotiated Rate |
$450.90 |
| Max. Negotiated Rate |
$450.90 |
| Rate for Payer: Aetna of AZ Commercial |
$450.90
|
| Rate for Payer: Cash Price |
$400.80
|
|
|
Initial preventive exam
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
HCPCS G0402
|
| Hospital Charge Code |
1167786
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.84 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Aetna of AZ Commercial |
$271.80
|
| Rate for Payer: Arizona Complete Health Allwell |
$48.32
|
| Rate for Payer: Banner UC Health Medicare |
$48.32
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$205.36
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$48.32
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$48.32
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cigna of AZ Commercial |
$211.40
|
| Rate for Payer: Devoted Health Medicare |
$54.36
|
| Rate for Payer: Humana of AZ Medicare |
$48.32
|
| Rate for Payer: Seven Corners Travel Insurance |
$206.00
|
| Rate for Payer: Southwest Service Administrators UFCW |
$205.36
|
| Rate for Payer: TriWest Medicare |
$48.32
|
| Rate for Payer: United Healthcare Commercial |
$172.74
|
| Rate for Payer: United Healthcare Medicare |
$48.32
|
| Rate for Payer: Veterans Affairs TRICARE |
$47.84
|
|
|
Initial preventive exam
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
HCPCS G0402
|
| Hospital Charge Code |
1167786
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$271.80 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Aetna of AZ Commercial |
$271.80
|
| Rate for Payer: Cash Price |
$241.60
|
|
|
INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANC
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
24049524
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna of AZ Commercial |
$93.60
|
| Rate for Payer: Aetna of AZ Commercial |
$196.20
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$83.20
|
|
|
INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANC
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
24049524
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$3,098.00 |
| Rate for Payer: Aetna of AZ Commercial |
$93.60
|
| Rate for Payer: Aetna of AZ Commercial |
$196.20
|
| Rate for Payer: Arizona Complete Health Allwell |
$34.88
|
| Rate for Payer: Arizona Complete Health Allwell |
$16.64
|
| Rate for Payer: Banner UC Health Medicare |
$29.75
|
| Rate for Payer: Banner UC Health Medicare |
$29.75
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$148.24
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$70.72
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$34.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$16.64
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$34.88
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$16.64
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cigna of AZ Commercial |
$52.00
|
| Rate for Payer: Cigna of AZ Commercial |
$109.00
|
| Rate for Payer: Devoted Health Medicare |
$18.72
|
| Rate for Payer: Devoted Health Medicare |
$39.24
|
| Rate for Payer: Humana of AZ Medicare |
$34.88
|
| Rate for Payer: Humana of AZ Medicare |
$16.64
|
| Rate for Payer: Mercy Care Medicaid |
$33.12
|
| Rate for Payer: Mercy Care Medicaid |
$33.12
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29.75
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29.75
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,092.18
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,092.18
|
| Rate for Payer: Southwest Service Administrators UFCW |
$70.72
|
| Rate for Payer: Southwest Service Administrators UFCW |
$148.24
|
| Rate for Payer: TriWest Medicare |
$16.64
|
| Rate for Payer: TriWest Medicare |
$34.88
|
| Rate for Payer: United Healthcare Commercial |
$3,098.00
|
| Rate for Payer: United Healthcare Commercial |
$3,098.00
|
| Rate for Payer: United Healthcare Medicare |
$34.88
|
| Rate for Payer: United Healthcare Medicare |
$16.64
|
| Rate for Payer: Veterans Affairs TRICARE |
$34.53
|
| Rate for Payer: Veterans Affairs TRICARE |
$16.47
|
|
|
Injection, Ceftriaxone Sodium, Per 250 MG Charge
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
788058
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.30 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna of AZ Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$53.60
|
|
|
Injection, Ceftriaxone Sodium, Per 250 MG Charge
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
788058
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Aetna of AZ Commercial |
$60.30
|
| Rate for Payer: Arizona Complete Health Allwell |
$10.72
|
| Rate for Payer: Banner UC Health Medicare |
$10.72
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$45.56
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$10.72
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$10.72
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cigna of AZ Commercial |
$46.90
|
| Rate for Payer: Devoted Health Medicare |
$12.06
|
| Rate for Payer: Humana of AZ Medicare |
$10.72
|
| Rate for Payer: Southwest Service Administrators UFCW |
$45.56
|
| Rate for Payer: TriWest Medicare |
$10.72
|
| Rate for Payer: United Healthcare Commercial |
$38.32
|
| Rate for Payer: United Healthcare Medicare |
$10.72
|
| Rate for Payer: United Healthcare New Mexico Commercial |
$12.73
|
| Rate for Payer: Veterans Affairs TRICARE |
$10.61
|
|
|
INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS J0735
|
| Hospital Charge Code |
3486195
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of AZ Commercial |
$30.60
|
| Rate for Payer: Arizona Complete Health Allwell |
$5.44
|
| Rate for Payer: Banner UC Health Medicare |
$5.44
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$5.44
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$5.44
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cigna of AZ Commercial |
$23.80
|
| Rate for Payer: Devoted Health Medicare |
$6.12
|
| Rate for Payer: Humana of AZ Medicare |
$5.44
|
| Rate for Payer: Southwest Service Administrators UFCW |
$23.12
|
| Rate for Payer: TriWest Medicare |
$5.44
|
| Rate for Payer: United Healthcare Commercial |
$19.45
|
| Rate for Payer: United Healthcare Medicare |
$5.44
|
| Rate for Payer: Veterans Affairs TRICARE |
$5.39
|
|
|
INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS J0735
|
| Hospital Charge Code |
3486195
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of AZ Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$27.20
|
|
|
Injection, Dexamethosone Sodium Phosphate, Up to 4mg/mL Med Admin POC
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
750145
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna of AZ Commercial |
$25.20
|
| Rate for Payer: Arizona Complete Health Allwell |
$4.48
|
| Rate for Payer: Banner UC Health Medicare |
$4.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$19.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$4.48
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$4.48
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cigna of AZ Commercial |
$19.60
|
| Rate for Payer: Devoted Health Medicare |
$5.04
|
| Rate for Payer: Humana of AZ Medicare |
$4.48
|
| Rate for Payer: Southwest Service Administrators UFCW |
$19.04
|
| Rate for Payer: TriWest Medicare |
$4.48
|
| Rate for Payer: United Healthcare Commercial |
$16.02
|
| Rate for Payer: United Healthcare Medicare |
$4.48
|
| Rate for Payer: Veterans Affairs TRICARE |
$4.44
|
|
|
Injection, Dexamethosone Sodium Phosphate, Up to 4mg/mL Med Admin POC
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
750145
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna of AZ Commercial |
$25.20
|
| Rate for Payer: Cash Price |
$22.40
|
|
|
INJECTION INTO SKIN GROWTH, 1-7 GROWTHS
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
28134683
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna of AZ Commercial |
$135.00
|
| Rate for Payer: Cash Price |
$120.00
|
|
|
INJECTION INTO SKIN GROWTH, 1-7 GROWTHS
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
28134683
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$23.76 |
| Max. Negotiated Rate |
$2,671.00 |
| Rate for Payer: Aetna of AZ Commercial |
$135.00
|
| Rate for Payer: Arizona Complete Health Allwell |
$24.00
|
| Rate for Payer: Banner UC Health Medicare |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$102.00
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$28.59
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$24.00
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$24.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna of AZ Commercial |
$75.00
|
| Rate for Payer: Devoted Health Medicare |
$27.00
|
| Rate for Payer: Humana of AZ Medicare |
$24.00
|
| Rate for Payer: Mercy Care Medicaid |
$28.59
|
| Rate for Payer: NaphCare Correctional Healthcare |
$28.59
|
| Rate for Payer: Seven Corners Travel Insurance |
$310.43
|
| Rate for Payer: Southwest Service Administrators UFCW |
$102.00
|
| Rate for Payer: TriWest Medicare |
$24.00
|
| Rate for Payer: United Healthcare Commercial |
$2,671.00
|
| Rate for Payer: United Healthcare Medicare |
$24.00
|
| Rate for Payer: Veterans Affairs TRICARE |
$23.76
|
|
|
Injection, Ketorolac Tromethamine Charge
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
785968
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of AZ Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$27.20
|
|
|
Injection, Ketorolac Tromethamine Charge
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
785968
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of AZ Commercial |
$30.60
|
| Rate for Payer: Arizona Complete Health Allwell |
$5.44
|
| Rate for Payer: Banner UC Health Medicare |
$5.44
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$5.44
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$5.44
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cigna of AZ Commercial |
$23.80
|
| Rate for Payer: Devoted Health Medicare |
$6.12
|
| Rate for Payer: Humana of AZ Medicare |
$5.44
|
| Rate for Payer: Seven Corners Travel Insurance |
$0.44
|
| Rate for Payer: Southwest Service Administrators UFCW |
$23.12
|
| Rate for Payer: TriWest Medicare |
$5.44
|
| Rate for Payer: United Healthcare Commercial |
$19.45
|
| Rate for Payer: United Healthcare Medicare |
$5.44
|
| Rate for Payer: Veterans Affairs TRICARE |
$5.39
|
|
|
Injection, medroxyprogesterone acetate, 1 mg
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
HCPCS J1050
|
| Hospital Charge Code |
9038197
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$211.50 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna of AZ Commercial |
$211.50
|
| Rate for Payer: Cash Price |
$188.00
|
|
|
Injection, medroxyprogesterone acetate, 1 mg
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
HCPCS J1050
|
| Hospital Charge Code |
9038197
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.22 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna of AZ Commercial |
$211.50
|
| Rate for Payer: Arizona Complete Health Allwell |
$37.60
|
| Rate for Payer: Banner UC Health Medicare |
$37.60
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$159.80
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$37.60
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$37.60
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cigna of AZ Commercial |
$164.50
|
| Rate for Payer: Devoted Health Medicare |
$42.30
|
| Rate for Payer: Humana of AZ Medicare |
$37.60
|
| Rate for Payer: Southwest Service Administrators UFCW |
$159.80
|
| Rate for Payer: TriWest Medicare |
$37.60
|
| Rate for Payer: United Healthcare Commercial |
$134.42
|
| Rate for Payer: United Healthcare Medicare |
$37.60
|
| Rate for Payer: United Healthcare New Mexico Commercial |
$44.65
|
| Rate for Payer: Veterans Affairs TRICARE |
$37.22
|
|
|
INJECTION MEDROXYPROGESTERONE ACETATE 50MG
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
22051871
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna of AZ Commercial |
$189.00
|
| Rate for Payer: Cash Price |
$168.00
|
|
|
INJECTION MEDROXYPROGESTERONE ACETATE 50MG
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
22051871
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$33.26 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna of AZ Commercial |
$189.00
|
| Rate for Payer: Arizona Complete Health Allwell |
$33.60
|
| Rate for Payer: Banner UC Health Medicare |
$33.60
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$33.60
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$33.60
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cigna of AZ Commercial |
$147.00
|
| Rate for Payer: Devoted Health Medicare |
$37.80
|
| Rate for Payer: Humana of AZ Medicare |
$33.60
|
| Rate for Payer: Southwest Service Administrators UFCW |
$142.80
|
| Rate for Payer: TriWest Medicare |
$33.60
|
| Rate for Payer: United Healthcare Commercial |
$120.12
|
| Rate for Payer: United Healthcare Medicare |
$33.60
|
| Rate for Payer: Veterans Affairs TRICARE |
$33.26
|
|
