Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

MRI TMJ

Facility

$1,985.00

Service Code	CPT 70336
Hospital Charge Code	1005507
Hospital Revenue Code	610
Min. Negotiated Rate	$516.10
Max. Negotiated Rate	$1,786.50
Rate for Payer: Aetna of AZ Commercial	$1,786.50
Rate for Payer: Bisbee Police All Plans	$516.10
Rate for Payer: Cash Price	$1,588.00
Rate for Payer: Self Pay Self Pay	$1,588.00

MRI TMJ

Facility

$1,985.00

Service Code	CPT 70336
Hospital Charge Code	1005507
Hospital Revenue Code	610
Min. Negotiated Rate	$317.60
Max. Negotiated Rate	$1,786.50
Rate for Payer: Aetna of AZ Commercial	$1,786.50
Rate for Payer: Aetna of AZ Medicare	$555.80
Rate for Payer: Allwell Medicare	$317.60
Rate for Payer: Amerigroup Medicare	$317.60
Rate for Payer: APIPA Medicare/Medicaid	$741.40
Rate for Payer: AZCH Complete Medicare	$317.60
Rate for Payer: Banner UC Health Medicare	$317.60
Rate for Payer: Bisbee Police All Plans	$516.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,349.80
Rate for Payer: Cash Price	$1,588.00
Rate for Payer: Cigna of AZ Commercial	$1,389.50
Rate for Payer: Copperpoint Commercial	$491.29
Rate for Payer: Health Net of AZ Commercial	$1,191.00
Rate for Payer: Health Net of AZ Medicare	$555.80
Rate for Payer: Humana of AZ Medicare	$317.60
Rate for Payer: Self Pay Self Pay	$1,588.00
Rate for Payer: TriWest Medicare	$317.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,157.26
Rate for Payer: UnitedHealth Group of AZ Medicare	$357.30

MRI UE Joint w/ Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73222 50
Hospital Charge Code	1007513
Hospital Revenue Code	610
Min. Negotiated Rate	$396.96
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Aetna of AZ Medicare	$694.68
Rate for Payer: Allwell Medicare	$396.96
Rate for Payer: Amerigroup Medicare	$396.96
Rate for Payer: APIPA Medicare/Medicaid	$926.65
Rate for Payer: AZCH Complete Medicare	$396.96
Rate for Payer: Banner UC Health Medicare	$396.96
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,687.08
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Cigna of AZ Commercial	$1,736.70
Rate for Payer: Copperpoint Commercial	$614.05
Rate for Payer: Health Net of AZ Commercial	$1,488.60
Rate for Payer: Health Net of AZ Medicare	$694.68
Rate for Payer: Humana of AZ Medicare	$396.96
Rate for Payer: Self Pay Self Pay	$1,984.80
Rate for Payer: TriWest Medicare	$396.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,446.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$446.58

MRI UE Joint w/ Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73222 50
Hospital Charge Code	1007513
Hospital Revenue Code	610
Min. Negotiated Rate	$645.06
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Self Pay Self Pay	$1,984.80

MRI UE Joint w/ Contrast Left

Facility

$2,233.00

Service Code	CPT 73222 LT
Hospital Charge Code	1007515
Hospital Revenue Code	610
Min. Negotiated Rate	$580.58
Max. Negotiated Rate	$2,009.70
Rate for Payer: Aetna of AZ Commercial	$2,009.70
Rate for Payer: Bisbee Police All Plans	$580.58
Rate for Payer: Cash Price	$1,786.40
Rate for Payer: Self Pay Self Pay	$1,786.40

MRI UE Joint w/ Contrast Left

Facility

$2,233.00

Service Code	CPT 73222 LT
Hospital Charge Code	1007515
Hospital Revenue Code	610
Min. Negotiated Rate	$357.28
Max. Negotiated Rate	$2,009.70
Rate for Payer: Aetna of AZ Commercial	$2,009.70
Rate for Payer: Aetna of AZ Medicare	$625.24
Rate for Payer: Allwell Medicare	$357.28
Rate for Payer: Amerigroup Medicare	$357.28
Rate for Payer: APIPA Medicare/Medicaid	$834.03
Rate for Payer: AZCH Complete Medicare	$357.28
Rate for Payer: Banner UC Health Medicare	$357.28
Rate for Payer: Bisbee Police All Plans	$580.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,518.44
Rate for Payer: Cash Price	$1,786.40
Rate for Payer: Cigna of AZ Commercial	$1,563.10
Rate for Payer: Copperpoint Commercial	$552.67
Rate for Payer: Health Net of AZ Commercial	$1,339.80
Rate for Payer: Health Net of AZ Medicare	$625.24
Rate for Payer: Humana of AZ Medicare	$357.28
Rate for Payer: Self Pay Self Pay	$1,786.40
Rate for Payer: TriWest Medicare	$357.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,301.84
Rate for Payer: UnitedHealth Group of AZ Medicare	$401.94

MRI UE Joint w/ Contrast Right

Facility

$2,233.00

Service Code	CPT 73222 RT
Hospital Charge Code	1007517
Hospital Revenue Code	610
Min. Negotiated Rate	$580.58
Max. Negotiated Rate	$2,009.70
Rate for Payer: Aetna of AZ Commercial	$2,009.70
Rate for Payer: Bisbee Police All Plans	$580.58
Rate for Payer: Cash Price	$1,786.40
Rate for Payer: Self Pay Self Pay	$1,786.40

MRI UE Joint w/ Contrast Right

Facility

$2,233.00

Service Code	CPT 73222 RT
Hospital Charge Code	1007517
Hospital Revenue Code	610
Min. Negotiated Rate	$357.28
Max. Negotiated Rate	$2,009.70
Rate for Payer: Aetna of AZ Commercial	$2,009.70
Rate for Payer: Aetna of AZ Medicare	$625.24
Rate for Payer: Allwell Medicare	$357.28
Rate for Payer: Amerigroup Medicare	$357.28
Rate for Payer: APIPA Medicare/Medicaid	$834.03
Rate for Payer: AZCH Complete Medicare	$357.28
Rate for Payer: Banner UC Health Medicare	$357.28
Rate for Payer: Bisbee Police All Plans	$580.58
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,518.44
Rate for Payer: Cash Price	$1,786.40
Rate for Payer: Cigna of AZ Commercial	$1,563.10
Rate for Payer: Copperpoint Commercial	$552.67
Rate for Payer: Health Net of AZ Commercial	$1,339.80
Rate for Payer: Health Net of AZ Medicare	$625.24
Rate for Payer: Humana of AZ Medicare	$357.28
Rate for Payer: Self Pay Self Pay	$1,786.40
Rate for Payer: TriWest Medicare	$357.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,301.84
Rate for Payer: UnitedHealth Group of AZ Medicare	$401.94

MRI UE Joint w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73221 50
Hospital Charge Code	821453
Hospital Revenue Code	610
Min. Negotiated Rate	$645.06
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Self Pay Self Pay	$1,984.80

MRI UE Joint w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73221 50
Hospital Charge Code	821453
Hospital Revenue Code	610
Min. Negotiated Rate	$396.96
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Aetna of AZ Medicare	$694.68
Rate for Payer: Allwell Medicare	$396.96
Rate for Payer: Amerigroup Medicare	$396.96
Rate for Payer: APIPA Medicare/Medicaid	$926.65
Rate for Payer: AZCH Complete Medicare	$396.96
Rate for Payer: Banner UC Health Medicare	$396.96
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,687.08
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Cigna of AZ Commercial	$1,736.70
Rate for Payer: Copperpoint Commercial	$614.05
Rate for Payer: Health Net of AZ Commercial	$1,488.60
Rate for Payer: Health Net of AZ Medicare	$694.68
Rate for Payer: Humana of AZ Medicare	$396.96
Rate for Payer: Self Pay Self Pay	$1,984.80
Rate for Payer: TriWest Medicare	$396.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,446.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$446.58

MRI UE Joint w/o Contrast Left

Facility

$3,085.00

Service Code	CPT 73221 LT
Hospital Charge Code	821455
Hospital Revenue Code	610
Min. Negotiated Rate	$493.60
Max. Negotiated Rate	$2,776.50
Rate for Payer: Aetna of AZ Commercial	$2,776.50
Rate for Payer: Aetna of AZ Medicare	$863.80
Rate for Payer: Allwell Medicare	$493.60
Rate for Payer: Amerigroup Medicare	$493.60
Rate for Payer: APIPA Medicare/Medicaid	$1,152.25
Rate for Payer: AZCH Complete Medicare	$493.60
Rate for Payer: Banner UC Health Medicare	$493.60
Rate for Payer: Bisbee Police All Plans	$802.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,097.80
Rate for Payer: Cash Price	$2,468.00
Rate for Payer: Cigna of AZ Commercial	$2,159.50
Rate for Payer: Copperpoint Commercial	$763.54
Rate for Payer: Health Net of AZ Commercial	$1,851.00
Rate for Payer: Health Net of AZ Medicare	$863.80
Rate for Payer: Humana of AZ Medicare	$493.60
Rate for Payer: Self Pay Self Pay	$2,468.00
Rate for Payer: TriWest Medicare	$493.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,798.56
Rate for Payer: UnitedHealth Group of AZ Medicare	$555.30

MRI UE Joint w/o Contrast Left

Facility

$3,085.00

Service Code	CPT 73221 LT
Hospital Charge Code	821455
Hospital Revenue Code	610
Min. Negotiated Rate	$802.10
Max. Negotiated Rate	$2,776.50
Rate for Payer: Aetna of AZ Commercial	$2,776.50
Rate for Payer: Bisbee Police All Plans	$802.10
Rate for Payer: Cash Price	$2,468.00
Rate for Payer: Self Pay Self Pay	$2,468.00

MRI UE Joint w/o Contrast Right

Facility

$3,085.00

Service Code	CPT 73221 RT
Hospital Charge Code	821457
Hospital Revenue Code	610
Min. Negotiated Rate	$802.10
Max. Negotiated Rate	$2,776.50
Rate for Payer: Aetna of AZ Commercial	$2,776.50
Rate for Payer: Bisbee Police All Plans	$802.10
Rate for Payer: Cash Price	$2,468.00
Rate for Payer: Self Pay Self Pay	$2,468.00

MRI UE Joint w/o Contrast Right

Facility

$3,085.00

Service Code	CPT 73221 RT
Hospital Charge Code	821457
Hospital Revenue Code	610
Min. Negotiated Rate	$493.60
Max. Negotiated Rate	$2,776.50
Rate for Payer: Aetna of AZ Commercial	$2,776.50
Rate for Payer: Aetna of AZ Medicare	$863.80
Rate for Payer: Allwell Medicare	$493.60
Rate for Payer: Amerigroup Medicare	$493.60
Rate for Payer: APIPA Medicare/Medicaid	$1,152.25
Rate for Payer: AZCH Complete Medicare	$493.60
Rate for Payer: Banner UC Health Medicare	$493.60
Rate for Payer: Bisbee Police All Plans	$802.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,097.80
Rate for Payer: Cash Price	$2,468.00
Rate for Payer: Cigna of AZ Commercial	$2,159.50
Rate for Payer: Copperpoint Commercial	$763.54
Rate for Payer: Health Net of AZ Commercial	$1,851.00
Rate for Payer: Health Net of AZ Medicare	$863.80
Rate for Payer: Humana of AZ Medicare	$493.60
Rate for Payer: Self Pay Self Pay	$2,468.00
Rate for Payer: TriWest Medicare	$493.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,798.56
Rate for Payer: UnitedHealth Group of AZ Medicare	$555.30

MRI UE Joint w/ + w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73221 50
Hospital Charge Code	821451
Hospital Revenue Code	610
Min. Negotiated Rate	$645.06
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Self Pay Self Pay	$1,984.80

MRI UE Joint w/ + w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73221 50
Hospital Charge Code	821451
Hospital Revenue Code	610
Min. Negotiated Rate	$396.96
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Aetna of AZ Medicare	$694.68
Rate for Payer: Allwell Medicare	$396.96
Rate for Payer: Amerigroup Medicare	$396.96
Rate for Payer: APIPA Medicare/Medicaid	$926.65
Rate for Payer: AZCH Complete Medicare	$396.96
Rate for Payer: Banner UC Health Medicare	$396.96
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,687.08
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Cigna of AZ Commercial	$1,736.70
Rate for Payer: Copperpoint Commercial	$614.05
Rate for Payer: Health Net of AZ Commercial	$1,488.60
Rate for Payer: Health Net of AZ Medicare	$694.68
Rate for Payer: Humana of AZ Medicare	$396.96
Rate for Payer: Self Pay Self Pay	$1,984.80
Rate for Payer: TriWest Medicare	$396.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,446.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$446.58

MRI UE Joint w/ + w/o Contrast Left

Facility

$3,349.00

Service Code	CPT 73223 LT
Hospital Charge Code	1005509
Hospital Revenue Code	610
Min. Negotiated Rate	$870.74
Max. Negotiated Rate	$3,014.10
Rate for Payer: Aetna of AZ Commercial	$3,014.10
Rate for Payer: Bisbee Police All Plans	$870.74
Rate for Payer: Cash Price	$2,679.20
Rate for Payer: Self Pay Self Pay	$2,679.20

MRI UE Joint w/ + w/o Contrast Left

Facility

$3,349.00

Service Code	CPT 73223 LT
Hospital Charge Code	1005509
Hospital Revenue Code	610
Min. Negotiated Rate	$535.84
Max. Negotiated Rate	$3,014.10
Rate for Payer: Aetna of AZ Commercial	$3,014.10
Rate for Payer: Aetna of AZ Medicare	$937.72
Rate for Payer: Allwell Medicare	$535.84
Rate for Payer: Amerigroup Medicare	$535.84
Rate for Payer: APIPA Medicare/Medicaid	$1,250.85
Rate for Payer: AZCH Complete Medicare	$535.84
Rate for Payer: Banner UC Health Medicare	$535.84
Rate for Payer: Bisbee Police All Plans	$870.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,277.32
Rate for Payer: Cash Price	$2,679.20
Rate for Payer: Cigna of AZ Commercial	$2,344.30
Rate for Payer: Copperpoint Commercial	$828.88
Rate for Payer: Health Net of AZ Commercial	$2,009.40
Rate for Payer: Health Net of AZ Medicare	$937.72
Rate for Payer: Humana of AZ Medicare	$535.84
Rate for Payer: Self Pay Self Pay	$2,679.20
Rate for Payer: TriWest Medicare	$535.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,952.47
Rate for Payer: UnitedHealth Group of AZ Medicare	$602.82

MRI UE Joint w/ + w/o Contrast Right

Facility

$3,349.00

Service Code	CPT 73223 RT
Hospital Charge Code	1005511
Hospital Revenue Code	610
Min. Negotiated Rate	$535.84
Max. Negotiated Rate	$3,014.10
Rate for Payer: Aetna of AZ Commercial	$3,014.10
Rate for Payer: Aetna of AZ Medicare	$937.72
Rate for Payer: Allwell Medicare	$535.84
Rate for Payer: Amerigroup Medicare	$535.84
Rate for Payer: APIPA Medicare/Medicaid	$1,250.85
Rate for Payer: AZCH Complete Medicare	$535.84
Rate for Payer: Banner UC Health Medicare	$535.84
Rate for Payer: Bisbee Police All Plans	$870.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$2,277.32
Rate for Payer: Cash Price	$2,679.20
Rate for Payer: Cigna of AZ Commercial	$2,344.30
Rate for Payer: Copperpoint Commercial	$828.88
Rate for Payer: Health Net of AZ Commercial	$2,009.40
Rate for Payer: Health Net of AZ Medicare	$937.72
Rate for Payer: Humana of AZ Medicare	$535.84
Rate for Payer: Self Pay Self Pay	$2,679.20
Rate for Payer: TriWest Medicare	$535.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,952.47
Rate for Payer: UnitedHealth Group of AZ Medicare	$602.82

MRI UE Joint w/ + w/o Contrast Right

Facility

$3,349.00

Service Code	CPT 73223 RT
Hospital Charge Code	1005511
Hospital Revenue Code	610
Min. Negotiated Rate	$870.74
Max. Negotiated Rate	$3,014.10
Rate for Payer: Aetna of AZ Commercial	$3,014.10
Rate for Payer: Bisbee Police All Plans	$870.74
Rate for Payer: Cash Price	$2,679.20
Rate for Payer: Self Pay Self Pay	$2,679.20

MRI UE Non Joint w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73218 50
Hospital Charge Code	1007535
Hospital Revenue Code	610
Min. Negotiated Rate	$396.96
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Aetna of AZ Medicare	$694.68
Rate for Payer: Allwell Medicare	$396.96
Rate for Payer: Amerigroup Medicare	$396.96
Rate for Payer: APIPA Medicare/Medicaid	$926.65
Rate for Payer: AZCH Complete Medicare	$396.96
Rate for Payer: Banner UC Health Medicare	$396.96
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,687.08
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Cigna of AZ Commercial	$1,736.70
Rate for Payer: Copperpoint Commercial	$614.05
Rate for Payer: Health Net of AZ Commercial	$1,488.60
Rate for Payer: Health Net of AZ Medicare	$694.68
Rate for Payer: Humana of AZ Medicare	$396.96
Rate for Payer: Self Pay Self Pay	$1,984.80
Rate for Payer: TriWest Medicare	$396.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,446.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$446.58

MRI UE Non Joint w/o Contrast Bilateral

Facility

$2,481.00

Service Code	CPT 73218 50
Hospital Charge Code	1007535
Hospital Revenue Code	610
Min. Negotiated Rate	$645.06
Max. Negotiated Rate	$2,232.90
Rate for Payer: Aetna of AZ Commercial	$2,232.90
Rate for Payer: Bisbee Police All Plans	$645.06
Rate for Payer: Cash Price	$1,984.80
Rate for Payer: Self Pay Self Pay	$1,984.80

MRI UE Non Joint w/o Contrast Left

Facility

$2,680.00

Service Code	CPT 73218 LT
Hospital Charge Code	1007537
Hospital Revenue Code	610
Min. Negotiated Rate	$428.80
Max. Negotiated Rate	$2,412.00
Rate for Payer: Aetna of AZ Commercial	$2,412.00
Rate for Payer: Aetna of AZ Medicare	$750.40
Rate for Payer: Allwell Medicare	$428.80
Rate for Payer: Amerigroup Medicare	$428.80
Rate for Payer: APIPA Medicare/Medicaid	$1,000.98
Rate for Payer: AZCH Complete Medicare	$428.80
Rate for Payer: Banner UC Health Medicare	$428.80
Rate for Payer: Bisbee Police All Plans	$696.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,822.40
Rate for Payer: Cash Price	$2,144.00
Rate for Payer: Cigna of AZ Commercial	$1,876.00
Rate for Payer: Copperpoint Commercial	$663.30
Rate for Payer: Health Net of AZ Commercial	$1,608.00
Rate for Payer: Health Net of AZ Medicare	$750.40
Rate for Payer: Humana of AZ Medicare	$428.80
Rate for Payer: Self Pay Self Pay	$2,144.00
Rate for Payer: TriWest Medicare	$428.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,562.44
Rate for Payer: UnitedHealth Group of AZ Medicare	$482.40

MRI UE Non Joint w/o Contrast Left

Facility

$2,680.00

Service Code	CPT 73218 LT
Hospital Charge Code	1007537
Hospital Revenue Code	610
Min. Negotiated Rate	$696.80
Max. Negotiated Rate	$2,412.00
Rate for Payer: Aetna of AZ Commercial	$2,412.00
Rate for Payer: Bisbee Police All Plans	$696.80
Rate for Payer: Cash Price	$2,144.00
Rate for Payer: Self Pay Self Pay	$2,144.00

MRI UE Non Joint w/o Contrast Right

Facility

$5,143.00

Service Code	CPT 73218 RT
Hospital Charge Code	1007539
Hospital Revenue Code	610
Min. Negotiated Rate	$822.88
Max. Negotiated Rate	$4,628.70
Rate for Payer: Aetna of AZ Commercial	$4,628.70
Rate for Payer: Aetna of AZ Medicare	$1,440.04
Rate for Payer: Allwell Medicare	$822.88
Rate for Payer: Amerigroup Medicare	$822.88
Rate for Payer: APIPA Medicare/Medicaid	$1,920.91
Rate for Payer: AZCH Complete Medicare	$822.88
Rate for Payer: Banner UC Health Medicare	$822.88
Rate for Payer: Bisbee Police All Plans	$1,337.18
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,497.24
Rate for Payer: Cash Price	$4,114.40
Rate for Payer: Cigna of AZ Commercial	$3,600.10
Rate for Payer: Copperpoint Commercial	$1,272.89
Rate for Payer: Health Net of AZ Commercial	$3,085.80
Rate for Payer: Health Net of AZ Medicare	$1,440.04
Rate for Payer: Humana of AZ Medicare	$822.88
Rate for Payer: Self Pay Self Pay	$4,114.40
Rate for Payer: TriWest Medicare	$822.88
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,998.37
Rate for Payer: UnitedHealth Group of AZ Medicare	$925.74

Know your out-of-pocket cost for care.

All Charges