Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Kidney And Urinary Tract Procedures For Non-Malignancy

Facility

$7,889.35

Service Code	APR-DRG 4431
Hospital Charge Code	APRDRG4431
Min. Negotiated Rate	$7,889.35
Max. Negotiated Rate	$7,889.35
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,889.35
Rate for Payer: Mercy Care Medicaid	$7,889.35
Rate for Payer: NaphCare Correctional Healthcare	$7,889.35

Kidney And Urinary Tract Procedures For Non-Malignancy

Facility

$9,200.26

Service Code	APR-DRG 4432
Hospital Charge Code	APRDRG4432
Min. Negotiated Rate	$9,200.26
Max. Negotiated Rate	$9,200.26
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,200.26
Rate for Payer: Mercy Care Medicaid	$9,200.26
Rate for Payer: NaphCare Correctional Healthcare	$9,200.26

Kidney And Urinary Tract Procedures For Non-Malignancy

Facility

$7,889.35

Service Code	APR-DRG 4431
Hospital Charge Code	APRDRG4434
Min. Negotiated Rate	$7,889.35
Max. Negotiated Rate	$7,889.35
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,889.35
Rate for Payer: Mercy Care Medicaid	$7,889.35
Rate for Payer: NaphCare Correctional Healthcare	$7,889.35

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$14,848.75

Service Code	MSDRG 695
Min. Negotiated Rate	$14,848.75
Max. Negotiated Rate	$14,848.75
Rate for Payer: Seven Corners Travel Insurance	$14,848.75

KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$9,085.89

Service Code	MSDRG 696
Min. Negotiated Rate	$9,085.89
Max. Negotiated Rate	$9,085.89
Rate for Payer: Seven Corners Travel Insurance	$9,085.89

Kidney Stone Urine/Saturation LC

Facility

$55.00

Service Code	CPT 81003
Hospital Charge Code	22052206
Hospital Revenue Code	301
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna of AZ Commercial	$49.50
Rate for Payer: Arizona Complete Health Allwell	$8.80
Rate for Payer: Banner UC Health Medicare	$8.80
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$37.40
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$8.80
Rate for Payer: Care1st Health Plan Arizona Medicare	$8.80
Rate for Payer: Cash Price	$44.00
Rate for Payer: Cash Price	$44.00
Rate for Payer: Cigna of AZ Commercial	$35.75
Rate for Payer: Devoted Health Medicare	$9.90
Rate for Payer: Humana of AZ Medicare	$8.80
Rate for Payer: Seven Corners Travel Insurance	$3.26
Rate for Payer: Southwest Service Administrators UFCW	$37.40
Rate for Payer: TriWest Medicare	$8.80
Rate for Payer: United Healthcare Commercial	$31.46
Rate for Payer: United Healthcare Medicare	$8.80
Rate for Payer: Veterans Affairs TRICARE	$8.71

Kidney Stone Urine/Saturation LC

Facility

$55.00

Service Code	CPT 81003
Hospital Charge Code	22052206
Hospital Revenue Code	301
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna of AZ Commercial	$49.50
Rate for Payer: Cash Price	$44.00

Kidney Transplant

Facility

$32,709.79

Service Code	APR-DRG 4402
Hospital Charge Code	APRDRG4404
Min. Negotiated Rate	$32,709.79
Max. Negotiated Rate	$32,709.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$32,709.79
Rate for Payer: Mercy Care Medicaid	$32,709.79
Rate for Payer: NaphCare Correctional Healthcare	$32,709.79

Kidney Transplant

Facility

$58,385.24

Service Code	APR-DRG 4404
Hospital Charge Code	APRDRG4401
Min. Negotiated Rate	$58,385.24
Max. Negotiated Rate	$58,385.24
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$58,385.24
Rate for Payer: Mercy Care Medicaid	$58,385.24
Rate for Payer: NaphCare Correctional Healthcare	$58,385.24

Kidney Transplant

Facility

$30,772.52

Service Code	APR-DRG 4401
Hospital Charge Code	APRDRG4401
Min. Negotiated Rate	$30,772.52
Max. Negotiated Rate	$30,772.52
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,772.52
Rate for Payer: Mercy Care Medicaid	$30,772.52
Rate for Payer: NaphCare Correctional Healthcare	$30,772.52

Kidney Transplant

Facility

$32,709.79

Service Code	APR-DRG 4402
Hospital Charge Code	APRDRG4403
Min. Negotiated Rate	$32,709.79
Max. Negotiated Rate	$32,709.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$32,709.79
Rate for Payer: Mercy Care Medicaid	$32,709.79
Rate for Payer: NaphCare Correctional Healthcare	$32,709.79

Kidney Transplant

Facility

$30,772.52

Service Code	APR-DRG 4401
Hospital Charge Code	APRDRG4403
Min. Negotiated Rate	$30,772.52
Max. Negotiated Rate	$30,772.52
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,772.52
Rate for Payer: Mercy Care Medicaid	$30,772.52
Rate for Payer: NaphCare Correctional Healthcare	$30,772.52

Kidney Transplant

Facility

$37,932.41

Service Code	APR-DRG 4403
Hospital Charge Code	APRDRG4403
Min. Negotiated Rate	$37,932.41
Max. Negotiated Rate	$37,932.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,932.41
Rate for Payer: Mercy Care Medicaid	$37,932.41
Rate for Payer: NaphCare Correctional Healthcare	$37,932.41

Kidney Transplant

Facility

$30,772.52

Service Code	APR-DRG 4401
Hospital Charge Code	APRDRG4404
Min. Negotiated Rate	$30,772.52
Max. Negotiated Rate	$30,772.52
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,772.52
Rate for Payer: Mercy Care Medicaid	$30,772.52
Rate for Payer: NaphCare Correctional Healthcare	$30,772.52

Kidney Transplant

Facility

$32,709.79

Service Code	APR-DRG 4402
Hospital Charge Code	APRDRG4402
Min. Negotiated Rate	$32,709.79
Max. Negotiated Rate	$32,709.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$32,709.79
Rate for Payer: Mercy Care Medicaid	$32,709.79
Rate for Payer: NaphCare Correctional Healthcare	$32,709.79

Kidney Transplant

Facility

$30,772.52

Service Code	APR-DRG 4401
Hospital Charge Code	APRDRG4402
Min. Negotiated Rate	$30,772.52
Max. Negotiated Rate	$30,772.52
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,772.52
Rate for Payer: Mercy Care Medicaid	$30,772.52
Rate for Payer: NaphCare Correctional Healthcare	$30,772.52

Kidney Transplant

Facility

$58,385.24

Service Code	APR-DRG 4404
Hospital Charge Code	APRDRG4402
Min. Negotiated Rate	$58,385.24
Max. Negotiated Rate	$58,385.24
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$58,385.24
Rate for Payer: Mercy Care Medicaid	$58,385.24
Rate for Payer: NaphCare Correctional Healthcare	$58,385.24

Kidney Transplant

Facility

$58,385.24

Service Code	APR-DRG 4404
Hospital Charge Code	APRDRG4403
Min. Negotiated Rate	$58,385.24
Max. Negotiated Rate	$58,385.24
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$58,385.24
Rate for Payer: Mercy Care Medicaid	$58,385.24
Rate for Payer: NaphCare Correctional Healthcare	$58,385.24

Kidney Transplant

Facility

$58,385.24

Service Code	APR-DRG 4404
Hospital Charge Code	APRDRG4404
Min. Negotiated Rate	$58,385.24
Max. Negotiated Rate	$58,385.24
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$58,385.24
Rate for Payer: Mercy Care Medicaid	$58,385.24
Rate for Payer: NaphCare Correctional Healthcare	$58,385.24

Kidney Transplant

Facility

$37,932.41

Service Code	APR-DRG 4403
Hospital Charge Code	APRDRG4404
Min. Negotiated Rate	$37,932.41
Max. Negotiated Rate	$37,932.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,932.41
Rate for Payer: Mercy Care Medicaid	$37,932.41
Rate for Payer: NaphCare Correctional Healthcare	$37,932.41

Kidney Transplant

Facility

$32,709.79

Service Code	APR-DRG 4402
Hospital Charge Code	APRDRG4401
Min. Negotiated Rate	$32,709.79
Max. Negotiated Rate	$32,709.79
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$32,709.79
Rate for Payer: Mercy Care Medicaid	$32,709.79
Rate for Payer: NaphCare Correctional Healthcare	$32,709.79

Kidney Transplant

Facility

$37,932.41

Service Code	APR-DRG 4403
Hospital Charge Code	APRDRG4402
Min. Negotiated Rate	$37,932.41
Max. Negotiated Rate	$37,932.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,932.41
Rate for Payer: Mercy Care Medicaid	$37,932.41
Rate for Payer: NaphCare Correctional Healthcare	$37,932.41

Kidney Transplant

Facility

$37,932.41

Service Code	APR-DRG 4403
Hospital Charge Code	APRDRG4401
Min. Negotiated Rate	$37,932.41
Max. Negotiated Rate	$37,932.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,932.41
Rate for Payer: Mercy Care Medicaid	$37,932.41
Rate for Payer: NaphCare Correctional Healthcare	$37,932.41

KIDNEY TRANSPLANT

Facility

$41,738.53

Service Code	MSDRG 652
Min. Negotiated Rate	$41,738.53
Max. Negotiated Rate	$41,738.53
Rate for Payer: Seven Corners Travel Insurance	$41,738.53

KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$60,761.54

Service Code	MSDRG 650
Min. Negotiated Rate	$60,761.54
Max. Negotiated Rate	$60,761.54
Rate for Payer: Seven Corners Travel Insurance	$60,761.54

Know your out-of-pocket cost for care.

All Charges