Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies

Facility

IP

$7,869.71

Service Code	APR-DRG 0432
Hospital Charge Code	APRDRG0433
Min. Negotiated Rate	$7,869.71
Max. Negotiated Rate	$7,869.71
Rate for Payer: AHCCCS Medicaid	$7,869.71
Rate for Payer: Allwell Medicaid	$7,869.71
Rate for Payer: AZCH Complete Medicaid	$7,869.71
Rate for Payer: Banner UC Health Medicaid	$7,869.71
Rate for Payer: Mercy Care Medicaid	$7,869.71

Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies

Facility

IP

$12,183.32

Service Code	APR-DRG 0433
Hospital Charge Code	APRDRG0434
Min. Negotiated Rate	$12,183.32
Max. Negotiated Rate	$12,183.32
Rate for Payer: AHCCCS Medicaid	$12,183.32
Rate for Payer: Allwell Medicaid	$12,183.32
Rate for Payer: AZCH Complete Medicaid	$12,183.32
Rate for Payer: Banner UC Health Medicaid	$12,183.32
Rate for Payer: Mercy Care Medicaid	$12,183.32

Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies

Facility

IP

$23,520.05

Service Code	APR-DRG 0434
Hospital Charge Code	APRDRG0431
Min. Negotiated Rate	$23,520.05
Max. Negotiated Rate	$23,520.05
Rate for Payer: AHCCCS Medicaid	$23,520.05
Rate for Payer: Allwell Medicaid	$23,520.05
Rate for Payer: AZCH Complete Medicaid	$23,520.05
Rate for Payer: Banner UC Health Medicaid	$23,520.05
Rate for Payer: Mercy Care Medicaid	$23,520.05

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$21,711.14

Service Code	APR-DRG 9304
Hospital Charge Code	APRDRG9303
Min. Negotiated Rate	$21,711.14
Max. Negotiated Rate	$21,711.14
Rate for Payer: AHCCCS Medicaid	$21,711.14
Rate for Payer: Allwell Medicaid	$21,711.14
Rate for Payer: AZCH Complete Medicaid	$21,711.14
Rate for Payer: Banner UC Health Medicaid	$21,711.14
Rate for Payer: Mercy Care Medicaid	$21,711.14

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$10,476.11

Service Code	APR-DRG 9303
Hospital Charge Code	APRDRG9303
Min. Negotiated Rate	$10,476.11
Max. Negotiated Rate	$10,476.11
Rate for Payer: AHCCCS Medicaid	$10,476.11
Rate for Payer: Allwell Medicaid	$10,476.11
Rate for Payer: AZCH Complete Medicaid	$10,476.11
Rate for Payer: Banner UC Health Medicaid	$10,476.11
Rate for Payer: Mercy Care Medicaid	$10,476.11

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$6,601.58

Service Code	APR-DRG 9302
Hospital Charge Code	APRDRG9303
Min. Negotiated Rate	$6,601.58
Max. Negotiated Rate	$6,601.58
Rate for Payer: AHCCCS Medicaid	$6,601.58
Rate for Payer: Allwell Medicaid	$6,601.58
Rate for Payer: AZCH Complete Medicaid	$6,601.58
Rate for Payer: Banner UC Health Medicaid	$6,601.58
Rate for Payer: Mercy Care Medicaid	$6,601.58

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$21,711.14

Service Code	APR-DRG 9304
Hospital Charge Code	APRDRG9304
Min. Negotiated Rate	$21,711.14
Max. Negotiated Rate	$21,711.14
Rate for Payer: AHCCCS Medicaid	$21,711.14
Rate for Payer: Allwell Medicaid	$21,711.14
Rate for Payer: AZCH Complete Medicaid	$21,711.14
Rate for Payer: Banner UC Health Medicaid	$21,711.14
Rate for Payer: Mercy Care Medicaid	$21,711.14

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$10,476.11

Service Code	APR-DRG 9303
Hospital Charge Code	APRDRG9304
Min. Negotiated Rate	$10,476.11
Max. Negotiated Rate	$10,476.11
Rate for Payer: AHCCCS Medicaid	$10,476.11
Rate for Payer: Allwell Medicaid	$10,476.11
Rate for Payer: AZCH Complete Medicaid	$10,476.11
Rate for Payer: Banner UC Health Medicaid	$10,476.11
Rate for Payer: Mercy Care Medicaid	$10,476.11

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$21,711.14

Service Code	APR-DRG 9304
Hospital Charge Code	APRDRG9301
Min. Negotiated Rate	$21,711.14
Max. Negotiated Rate	$21,711.14
Rate for Payer: AHCCCS Medicaid	$21,711.14
Rate for Payer: Allwell Medicaid	$21,711.14
Rate for Payer: AZCH Complete Medicaid	$21,711.14
Rate for Payer: Banner UC Health Medicaid	$21,711.14
Rate for Payer: Mercy Care Medicaid	$21,711.14

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$10,476.11

Service Code	APR-DRG 9303
Hospital Charge Code	APRDRG9302
Min. Negotiated Rate	$10,476.11
Max. Negotiated Rate	$10,476.11
Rate for Payer: AHCCCS Medicaid	$10,476.11
Rate for Payer: Allwell Medicaid	$10,476.11
Rate for Payer: AZCH Complete Medicaid	$10,476.11
Rate for Payer: Banner UC Health Medicaid	$10,476.11
Rate for Payer: Mercy Care Medicaid	$10,476.11

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$6,601.58

Service Code	APR-DRG 9302
Hospital Charge Code	APRDRG9301
Min. Negotiated Rate	$6,601.58
Max. Negotiated Rate	$6,601.58
Rate for Payer: AHCCCS Medicaid	$6,601.58
Rate for Payer: Allwell Medicaid	$6,601.58
Rate for Payer: AZCH Complete Medicaid	$6,601.58
Rate for Payer: Banner UC Health Medicaid	$6,601.58
Rate for Payer: Mercy Care Medicaid	$6,601.58

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$6,601.58

Service Code	APR-DRG 9302
Hospital Charge Code	APRDRG9302
Min. Negotiated Rate	$6,601.58
Max. Negotiated Rate	$6,601.58
Rate for Payer: AHCCCS Medicaid	$6,601.58
Rate for Payer: Allwell Medicaid	$6,601.58
Rate for Payer: AZCH Complete Medicaid	$6,601.58
Rate for Payer: Banner UC Health Medicaid	$6,601.58
Rate for Payer: Mercy Care Medicaid	$6,601.58

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$5,101.98

Service Code	APR-DRG 9301
Hospital Charge Code	APRDRG9302
Min. Negotiated Rate	$5,101.98
Max. Negotiated Rate	$5,101.98
Rate for Payer: AHCCCS Medicaid	$5,101.98
Rate for Payer: Allwell Medicaid	$5,101.98
Rate for Payer: AZCH Complete Medicaid	$5,101.98
Rate for Payer: Banner UC Health Medicaid	$5,101.98
Rate for Payer: Mercy Care Medicaid	$5,101.98

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$5,101.98

Service Code	APR-DRG 9301
Hospital Charge Code	APRDRG9301
Min. Negotiated Rate	$5,101.98
Max. Negotiated Rate	$5,101.98
Rate for Payer: AHCCCS Medicaid	$5,101.98
Rate for Payer: Allwell Medicaid	$5,101.98
Rate for Payer: AZCH Complete Medicaid	$5,101.98
Rate for Payer: Banner UC Health Medicaid	$5,101.98
Rate for Payer: Mercy Care Medicaid	$5,101.98

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$10,476.11

Service Code	APR-DRG 9303
Hospital Charge Code	APRDRG9301
Min. Negotiated Rate	$10,476.11
Max. Negotiated Rate	$10,476.11
Rate for Payer: AHCCCS Medicaid	$10,476.11
Rate for Payer: Allwell Medicaid	$10,476.11
Rate for Payer: AZCH Complete Medicaid	$10,476.11
Rate for Payer: Banner UC Health Medicaid	$10,476.11
Rate for Payer: Mercy Care Medicaid	$10,476.11

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$5,101.98

Service Code	APR-DRG 9301
Hospital Charge Code	APRDRG9304
Min. Negotiated Rate	$5,101.98
Max. Negotiated Rate	$5,101.98
Rate for Payer: AHCCCS Medicaid	$5,101.98
Rate for Payer: Allwell Medicaid	$5,101.98
Rate for Payer: AZCH Complete Medicaid	$5,101.98
Rate for Payer: Banner UC Health Medicaid	$5,101.98
Rate for Payer: Mercy Care Medicaid	$5,101.98

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$6,601.58

Service Code	APR-DRG 9302
Hospital Charge Code	APRDRG9304
Min. Negotiated Rate	$6,601.58
Max. Negotiated Rate	$6,601.58
Rate for Payer: AHCCCS Medicaid	$6,601.58
Rate for Payer: Allwell Medicaid	$6,601.58
Rate for Payer: AZCH Complete Medicaid	$6,601.58
Rate for Payer: Banner UC Health Medicaid	$6,601.58
Rate for Payer: Mercy Care Medicaid	$6,601.58

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$5,101.98

Service Code	APR-DRG 9301
Hospital Charge Code	APRDRG9303
Min. Negotiated Rate	$5,101.98
Max. Negotiated Rate	$5,101.98
Rate for Payer: AHCCCS Medicaid	$5,101.98
Rate for Payer: Allwell Medicaid	$5,101.98
Rate for Payer: AZCH Complete Medicaid	$5,101.98
Rate for Payer: Banner UC Health Medicaid	$5,101.98
Rate for Payer: Mercy Care Medicaid	$5,101.98

Multiple Significant Trauma Without O.R. Procedure

Facility

IP

$21,711.14

Service Code	APR-DRG 9304
Hospital Charge Code	APRDRG9302
Min. Negotiated Rate	$21,711.14
Max. Negotiated Rate	$21,711.14
Rate for Payer: AHCCCS Medicaid	$21,711.14
Rate for Payer: Allwell Medicaid	$21,711.14
Rate for Payer: AZCH Complete Medicaid	$21,711.14
Rate for Payer: Banner UC Health Medicaid	$21,711.14
Rate for Payer: Mercy Care Medicaid	$21,711.14

Multiple Vitamins IV Sol 10 mL [CQCH]

Facility

IP

$0.39

Service Code	NDC 54643564901
Hospital Charge Code	105933153
Hospital Revenue Code	251
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.35
Rate for Payer: Aetna of AZ Commercial	$0.35
Rate for Payer: Bisbee Police All Plans	$0.10
Rate for Payer: Cash Price	$0.31
Rate for Payer: Self Pay Self Pay	$0.31

Multiple Vitamins IV Sol 10 mL [CQCH]

Facility

OP

$0.39

Service Code	NDC 54643564901
Hospital Charge Code	105933153
Hospital Revenue Code	251
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.35
Rate for Payer: Aetna of AZ Commercial	$0.35
Rate for Payer: Aetna of AZ Medicare	$0.11
Rate for Payer: Allwell Medicare	$0.06
Rate for Payer: Amerigroup Medicare	$0.06
Rate for Payer: APIPA Medicare/Medicaid	$0.15
Rate for Payer: AZCH Complete Medicare	$0.06
Rate for Payer: Banner UC Health Medicare	$0.06
Rate for Payer: Bisbee Police All Plans	$0.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.27
Rate for Payer: Cash Price	$0.31
Rate for Payer: Cigna of AZ Commercial	$0.25
Rate for Payer: Copperpoint Commercial	$0.10
Rate for Payer: Health Net of AZ Commercial	$0.23
Rate for Payer: Health Net of AZ Medicare	$0.11
Rate for Payer: Humana of AZ Medicare	$0.06
Rate for Payer: Self Pay Self Pay	$0.31
Rate for Payer: TriWest Medicare	$0.06
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.23
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.07

Multiple Vitamins with Minerals Tab [CQCH]

Facility

IP

$0.05

Service Code	NDC 904549261
Hospital Charge Code	105933220
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Cash Price	$0.04
Rate for Payer: Self Pay Self Pay	$0.04

Multiple Vitamins with Minerals Tab [CQCH]

Facility

OP

$0.05

Service Code	NDC 904549261
Hospital Charge Code	105933220
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Aetna of AZ Medicare	$0.01
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.02
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.03
Rate for Payer: Cash Price	$0.04
Rate for Payer: Cigna of AZ Commercial	$0.03
Rate for Payer: Copperpoint Commercial	$0.01
Rate for Payer: Health Net of AZ Commercial	$0.03
Rate for Payer: Health Net of AZ Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Self Pay Self Pay	$0.04
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

Mumps Antibodies, IgG LC

Facility

OP

$174.00

Service Code	CPT 86735
Hospital Charge Code	7314623
Hospital Revenue Code	302
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$156.60
Rate for Payer: Aetna of AZ Commercial	$156.60
Rate for Payer: Aetna of AZ Medicare	$48.72
Rate for Payer: AHCCCS Medicaid	$13.05
Rate for Payer: Allwell Medicaid	$13.05
Rate for Payer: Allwell Medicare	$26.10
Rate for Payer: Amerigroup Medicare	$26.10
Rate for Payer: APIPA Medicare/Medicaid	$64.99
Rate for Payer: AZCH Complete Medicaid	$13.05
Rate for Payer: AZCH Complete Medicare	$26.10
Rate for Payer: Banner UC Health Medicaid	$13.05
Rate for Payer: Banner UC Health Medicare	$26.10
Rate for Payer: Bisbee Police All Plans	$45.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$118.32
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cash Price	$139.20
Rate for Payer: Cigna of AZ Commercial	$113.10
Rate for Payer: Copperpoint Commercial	$43.06
Rate for Payer: Health Net of AZ Commercial	$104.40
Rate for Payer: Health Net of AZ Medicare	$48.72
Rate for Payer: Humana of AZ Medicare	$26.10
Rate for Payer: Mercy Care Medicaid	$13.05
Rate for Payer: Self Pay Self Pay	$139.20
Rate for Payer: TriWest Medicare	$26.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$101.44
Rate for Payer: UnitedHealth Group of AZ Medicare	$31.32

Mumps Antibodies, IgG LC

Facility

IP

$174.00

Service Code	CPT 86735
Hospital Charge Code	7314623
Hospital Revenue Code	302
Min. Negotiated Rate	$45.24
Max. Negotiated Rate	$156.60
Rate for Payer: Aetna of AZ Commercial	$156.60
Rate for Payer: Bisbee Police All Plans	$45.24
Rate for Payer: Cash Price	$139.20
Rate for Payer: Self Pay Self Pay	$139.20

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