Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Intracranial Hemorrhage

Facility

$14,299.44

Service Code	APR-DRG 0444
Hospital Charge Code	APRDRG0442
Min. Negotiated Rate	$14,299.44
Max. Negotiated Rate	$14,299.44
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,299.44
Rate for Payer: Mercy Care Medicaid	$14,299.44
Rate for Payer: NaphCare Correctional Healthcare	$14,299.44

Intracranial Hemorrhage

Facility

$5,516.51

Service Code	APR-DRG 0441
Hospital Charge Code	APRDRG0443
Min. Negotiated Rate	$5,516.51
Max. Negotiated Rate	$5,516.51
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,516.51
Rate for Payer: Mercy Care Medicaid	$5,516.51
Rate for Payer: NaphCare Correctional Healthcare	$5,516.51

Intracranial Hemorrhage

Facility

$10,328.12

Service Code	APR-DRG 0443
Hospital Charge Code	APRDRG0444
Min. Negotiated Rate	$10,328.12
Max. Negotiated Rate	$10,328.12
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,328.12
Rate for Payer: Mercy Care Medicaid	$10,328.12
Rate for Payer: NaphCare Correctional Healthcare	$10,328.12

Intracranial Hemorrhage

Facility

$10,328.12

Service Code	APR-DRG 0443
Hospital Charge Code	APRDRG0442
Min. Negotiated Rate	$10,328.12
Max. Negotiated Rate	$10,328.12
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,328.12
Rate for Payer: Mercy Care Medicaid	$10,328.12
Rate for Payer: NaphCare Correctional Healthcare	$10,328.12

Intracranial Hemorrhage

Facility

$10,328.12

Service Code	APR-DRG 0443
Hospital Charge Code	APRDRG0443
Min. Negotiated Rate	$10,328.12
Max. Negotiated Rate	$10,328.12
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,328.12
Rate for Payer: Mercy Care Medicaid	$10,328.12
Rate for Payer: NaphCare Correctional Healthcare	$10,328.12

Intracranial Hemorrhage

Facility

$5,516.51

Service Code	APR-DRG 0441
Hospital Charge Code	APRDRG0442
Min. Negotiated Rate	$5,516.51
Max. Negotiated Rate	$5,516.51
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,516.51
Rate for Payer: Mercy Care Medicaid	$5,516.51
Rate for Payer: NaphCare Correctional Healthcare	$5,516.51

Intracranial Hemorrhage

Facility

$14,299.44

Service Code	APR-DRG 0444
Hospital Charge Code	APRDRG0441
Min. Negotiated Rate	$14,299.44
Max. Negotiated Rate	$14,299.44
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,299.44
Rate for Payer: Mercy Care Medicaid	$14,299.44
Rate for Payer: NaphCare Correctional Healthcare	$14,299.44

Intracranial Hemorrhage

Facility

$10,328.12

Service Code	APR-DRG 0443
Hospital Charge Code	APRDRG0441
Min. Negotiated Rate	$10,328.12
Max. Negotiated Rate	$10,328.12
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,328.12
Rate for Payer: Mercy Care Medicaid	$10,328.12
Rate for Payer: NaphCare Correctional Healthcare	$10,328.12

Intracranial Hemorrhage

Facility

$7,286.84

Service Code	APR-DRG 0442
Hospital Charge Code	APRDRG0441
Min. Negotiated Rate	$7,286.84
Max. Negotiated Rate	$7,286.84
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,286.84
Rate for Payer: Mercy Care Medicaid	$7,286.84
Rate for Payer: NaphCare Correctional Healthcare	$7,286.84

Intracranial Hemorrhage

Facility

$14,299.44

Service Code	APR-DRG 0444
Hospital Charge Code	APRDRG0444
Min. Negotiated Rate	$14,299.44
Max. Negotiated Rate	$14,299.44
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,299.44
Rate for Payer: Mercy Care Medicaid	$14,299.44
Rate for Payer: NaphCare Correctional Healthcare	$14,299.44

Intracranial Hemorrhage

Facility

$7,286.84

Service Code	APR-DRG 0442
Hospital Charge Code	APRDRG0442
Min. Negotiated Rate	$7,286.84
Max. Negotiated Rate	$7,286.84
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,286.84
Rate for Payer: Mercy Care Medicaid	$7,286.84
Rate for Payer: NaphCare Correctional Healthcare	$7,286.84

Intracranial Hemorrhage

Facility

$14,299.44

Service Code	APR-DRG 0444
Hospital Charge Code	APRDRG0443
Min. Negotiated Rate	$14,299.44
Max. Negotiated Rate	$14,299.44
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,299.44
Rate for Payer: Mercy Care Medicaid	$14,299.44
Rate for Payer: NaphCare Correctional Healthcare	$14,299.44

Intracranial Hemorrhage

Facility

$7,286.84

Service Code	APR-DRG 0442
Hospital Charge Code	APRDRG0444
Min. Negotiated Rate	$7,286.84
Max. Negotiated Rate	$7,286.84
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,286.84
Rate for Payer: Mercy Care Medicaid	$7,286.84
Rate for Payer: NaphCare Correctional Healthcare	$7,286.84

Intracranial Hemorrhage

Facility

$5,516.51

Service Code	APR-DRG 0441
Hospital Charge Code	APRDRG0441
Min. Negotiated Rate	$5,516.51
Max. Negotiated Rate	$5,516.51
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,516.51
Rate for Payer: Mercy Care Medicaid	$5,516.51
Rate for Payer: NaphCare Correctional Healthcare	$5,516.51

Intracranial Hemorrhage

Facility

$5,516.51

Service Code	APR-DRG 0441
Hospital Charge Code	APRDRG0444
Min. Negotiated Rate	$5,516.51
Max. Negotiated Rate	$5,516.51
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,516.51
Rate for Payer: Mercy Care Medicaid	$5,516.51
Rate for Payer: NaphCare Correctional Healthcare	$5,516.51

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$13,157.13

Service Code	MSDRG 065
Min. Negotiated Rate	$13,157.13
Max. Negotiated Rate	$13,157.13
Rate for Payer: Seven Corners Travel Insurance	$13,157.13

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$25,990.44

Service Code	MSDRG 064
Min. Negotiated Rate	$25,990.44
Max. Negotiated Rate	$25,990.44
Rate for Payer: Seven Corners Travel Insurance	$25,990.44

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$9,027.58

Service Code	MSDRG 066
Min. Negotiated Rate	$9,027.58
Max. Negotiated Rate	$9,027.58
Rate for Payer: Seven Corners Travel Insurance	$9,027.58

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$68,417.82

Service Code	MSDRG 021
Min. Negotiated Rate	$68,417.82
Max. Negotiated Rate	$68,417.82
Rate for Payer: Seven Corners Travel Insurance	$68,417.82

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$101,697.48

Service Code	MSDRG 020
Min. Negotiated Rate	$101,697.48
Max. Negotiated Rate	$101,697.48
Rate for Payer: Seven Corners Travel Insurance	$101,697.48

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$41,065.15

Service Code	MSDRG 022
Min. Negotiated Rate	$41,065.15
Max. Negotiated Rate	$41,065.15
Rate for Payer: Seven Corners Travel Insurance	$41,065.15

INTRAOCULAR PROCEDURES WITH CC/MCC

Facility

$23,368.13

Service Code	MSDRG 116
Min. Negotiated Rate	$23,368.13
Max. Negotiated Rate	$23,368.13
Rate for Payer: Seven Corners Travel Insurance	$23,368.13

INTRAOCULAR PROCEDURES WITHOUT CC/MCC

Facility

$14,102.40

Service Code	MSDRG 117
Min. Negotiated Rate	$14,102.40
Max. Negotiated Rate	$14,102.40
Rate for Payer: Seven Corners Travel Insurance	$14,102.40

INTRAOP CYTO PATH CONSULT 1

Facility

$217.00

Service Code	CPT 88333
Hospital Charge Code	22545739
Hospital Revenue Code	310
Min. Negotiated Rate	$195.30
Max. Negotiated Rate	$195.30
Rate for Payer: Aetna of AZ Commercial	$195.30
Rate for Payer: Cash Price	$173.60

INTRAOP CYTO PATH CONSULT 1

Facility

$217.00

Service Code	CPT 88333
Hospital Charge Code	22545739
Hospital Revenue Code	310
Min. Negotiated Rate	$34.37
Max. Negotiated Rate	$1,246.61
Rate for Payer: Aetna of AZ Commercial	$195.30
Rate for Payer: Arizona Complete Health Allwell	$34.72
Rate for Payer: Banner UC Health Medicare	$34.72
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$147.56
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$34.72
Rate for Payer: Care1st Health Plan Arizona Medicare	$64.20
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cash Price	$173.60
Rate for Payer: Cigna of AZ Commercial	$141.05
Rate for Payer: Devoted Health Medicare	$39.06
Rate for Payer: Humana of AZ Medicare	$34.72
Rate for Payer: Seven Corners Travel Insurance	$1,246.61
Rate for Payer: Southwest Service Administrators UFCW	$147.56
Rate for Payer: TriWest Medicare	$34.72
Rate for Payer: United Healthcare Commercial	$124.12
Rate for Payer: United Healthcare Medicare	$34.72
Rate for Payer: Veterans Affairs TRICARE	$34.37

Know your out-of-pocket cost for care.

All Charges