Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$14,817.08

Service Code	APR-DRG 9122
Hospital Charge Code	APRDRG9122
Min. Negotiated Rate	$14,817.08
Max. Negotiated Rate	$14,817.08
Rate for Payer: AHCCCS Medicaid	$14,817.08
Rate for Payer: Allwell Medicaid	$14,817.08
Rate for Payer: AZCH Complete Medicaid	$14,817.08
Rate for Payer: Banner UC Health Medicaid	$14,817.08
Rate for Payer: Mercy Care Medicaid	$14,817.08

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$24,008.22

Service Code	APR-DRG 9123
Hospital Charge Code	APRDRG9121
Min. Negotiated Rate	$24,008.22
Max. Negotiated Rate	$24,008.22
Rate for Payer: AHCCCS Medicaid	$24,008.22
Rate for Payer: Allwell Medicaid	$24,008.22
Rate for Payer: AZCH Complete Medicaid	$24,008.22
Rate for Payer: Banner UC Health Medicaid	$24,008.22
Rate for Payer: Mercy Care Medicaid	$24,008.22

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$13,661.87

Service Code	APR-DRG 9121
Hospital Charge Code	APRDRG9122
Min. Negotiated Rate	$13,661.87
Max. Negotiated Rate	$13,661.87
Rate for Payer: AHCCCS Medicaid	$13,661.87
Rate for Payer: Allwell Medicaid	$13,661.87
Rate for Payer: AZCH Complete Medicaid	$13,661.87
Rate for Payer: Banner UC Health Medicaid	$13,661.87
Rate for Payer: Mercy Care Medicaid	$13,661.87

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$46,137.39

Service Code	APR-DRG 9124
Hospital Charge Code	APRDRG9121
Min. Negotiated Rate	$46,137.39
Max. Negotiated Rate	$46,137.39
Rate for Payer: AHCCCS Medicaid	$46,137.39
Rate for Payer: Allwell Medicaid	$46,137.39
Rate for Payer: AZCH Complete Medicaid	$46,137.39
Rate for Payer: Banner UC Health Medicaid	$46,137.39
Rate for Payer: Mercy Care Medicaid	$46,137.39

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$46,137.39

Service Code	APR-DRG 9124
Hospital Charge Code	APRDRG9122
Min. Negotiated Rate	$46,137.39
Max. Negotiated Rate	$46,137.39
Rate for Payer: AHCCCS Medicaid	$46,137.39
Rate for Payer: Allwell Medicaid	$46,137.39
Rate for Payer: AZCH Complete Medicaid	$46,137.39
Rate for Payer: Banner UC Health Medicaid	$46,137.39
Rate for Payer: Mercy Care Medicaid	$46,137.39

Musculoskeletal And Other Procedures For Multiple Significant Trauma

Facility

IP

$24,008.22

Service Code	APR-DRG 9123
Hospital Charge Code	APRDRG9122
Min. Negotiated Rate	$24,008.22
Max. Negotiated Rate	$24,008.22
Rate for Payer: AHCCCS Medicaid	$24,008.22
Rate for Payer: Allwell Medicaid	$24,008.22
Rate for Payer: AZCH Complete Medicaid	$24,008.22
Rate for Payer: Banner UC Health Medicaid	$24,008.22
Rate for Payer: Mercy Care Medicaid	$24,008.22

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$5,616.11

Service Code	APR-DRG 3431
Hospital Charge Code	APRDRG3433
Min. Negotiated Rate	$5,616.11
Max. Negotiated Rate	$5,616.11
Rate for Payer: AHCCCS Medicaid	$5,616.11
Rate for Payer: Allwell Medicaid	$5,616.11
Rate for Payer: AZCH Complete Medicaid	$5,616.11
Rate for Payer: Banner UC Health Medicaid	$5,616.11
Rate for Payer: Mercy Care Medicaid	$5,616.11

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$10,084.73

Service Code	APR-DRG 3433
Hospital Charge Code	APRDRG3431
Min. Negotiated Rate	$10,084.73
Max. Negotiated Rate	$10,084.73
Rate for Payer: AHCCCS Medicaid	$10,084.73
Rate for Payer: Allwell Medicaid	$10,084.73
Rate for Payer: AZCH Complete Medicaid	$10,084.73
Rate for Payer: Banner UC Health Medicaid	$10,084.73
Rate for Payer: Mercy Care Medicaid	$10,084.73

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$6,634.54

Service Code	APR-DRG 3432
Hospital Charge Code	APRDRG3432
Min. Negotiated Rate	$6,634.54
Max. Negotiated Rate	$6,634.54
Rate for Payer: AHCCCS Medicaid	$6,634.54
Rate for Payer: Allwell Medicaid	$6,634.54
Rate for Payer: AZCH Complete Medicaid	$6,634.54
Rate for Payer: Banner UC Health Medicaid	$6,634.54
Rate for Payer: Mercy Care Medicaid	$6,634.54

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$6,634.54

Service Code	APR-DRG 3432
Hospital Charge Code	APRDRG3433
Min. Negotiated Rate	$6,634.54
Max. Negotiated Rate	$6,634.54
Rate for Payer: AHCCCS Medicaid	$6,634.54
Rate for Payer: Allwell Medicaid	$6,634.54
Rate for Payer: AZCH Complete Medicaid	$6,634.54
Rate for Payer: Banner UC Health Medicaid	$6,634.54
Rate for Payer: Mercy Care Medicaid	$6,634.54

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$17,739.81

Service Code	APR-DRG 3434
Hospital Charge Code	APRDRG3434
Min. Negotiated Rate	$17,739.81
Max. Negotiated Rate	$17,739.81
Rate for Payer: AHCCCS Medicaid	$17,739.81
Rate for Payer: Allwell Medicaid	$17,739.81
Rate for Payer: AZCH Complete Medicaid	$17,739.81
Rate for Payer: Banner UC Health Medicaid	$17,739.81
Rate for Payer: Mercy Care Medicaid	$17,739.81

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$10,084.73

Service Code	APR-DRG 3433
Hospital Charge Code	APRDRG3432
Min. Negotiated Rate	$10,084.73
Max. Negotiated Rate	$10,084.73
Rate for Payer: AHCCCS Medicaid	$10,084.73
Rate for Payer: Allwell Medicaid	$10,084.73
Rate for Payer: AZCH Complete Medicaid	$10,084.73
Rate for Payer: Banner UC Health Medicaid	$10,084.73
Rate for Payer: Mercy Care Medicaid	$10,084.73

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$5,616.11

Service Code	APR-DRG 3431
Hospital Charge Code	APRDRG3431
Min. Negotiated Rate	$5,616.11
Max. Negotiated Rate	$5,616.11
Rate for Payer: AHCCCS Medicaid	$5,616.11
Rate for Payer: Allwell Medicaid	$5,616.11
Rate for Payer: AZCH Complete Medicaid	$5,616.11
Rate for Payer: Banner UC Health Medicaid	$5,616.11
Rate for Payer: Mercy Care Medicaid	$5,616.11

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$6,634.54

Service Code	APR-DRG 3432
Hospital Charge Code	APRDRG3434
Min. Negotiated Rate	$6,634.54
Max. Negotiated Rate	$6,634.54
Rate for Payer: AHCCCS Medicaid	$6,634.54
Rate for Payer: Allwell Medicaid	$6,634.54
Rate for Payer: AZCH Complete Medicaid	$6,634.54
Rate for Payer: Banner UC Health Medicaid	$6,634.54
Rate for Payer: Mercy Care Medicaid	$6,634.54

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$17,739.81

Service Code	APR-DRG 3434
Hospital Charge Code	APRDRG3432
Min. Negotiated Rate	$17,739.81
Max. Negotiated Rate	$17,739.81
Rate for Payer: AHCCCS Medicaid	$17,739.81
Rate for Payer: Allwell Medicaid	$17,739.81
Rate for Payer: AZCH Complete Medicaid	$17,739.81
Rate for Payer: Banner UC Health Medicaid	$17,739.81
Rate for Payer: Mercy Care Medicaid	$17,739.81

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$5,616.11

Service Code	APR-DRG 3431
Hospital Charge Code	APRDRG3432
Min. Negotiated Rate	$5,616.11
Max. Negotiated Rate	$5,616.11
Rate for Payer: AHCCCS Medicaid	$5,616.11
Rate for Payer: Allwell Medicaid	$5,616.11
Rate for Payer: AZCH Complete Medicaid	$5,616.11
Rate for Payer: Banner UC Health Medicaid	$5,616.11
Rate for Payer: Mercy Care Medicaid	$5,616.11

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$10,084.73

Service Code	APR-DRG 3433
Hospital Charge Code	APRDRG3433
Min. Negotiated Rate	$10,084.73
Max. Negotiated Rate	$10,084.73
Rate for Payer: AHCCCS Medicaid	$10,084.73
Rate for Payer: Allwell Medicaid	$10,084.73
Rate for Payer: AZCH Complete Medicaid	$10,084.73
Rate for Payer: Banner UC Health Medicaid	$10,084.73
Rate for Payer: Mercy Care Medicaid	$10,084.73

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$17,739.81

Service Code	APR-DRG 3434
Hospital Charge Code	APRDRG3433
Min. Negotiated Rate	$17,739.81
Max. Negotiated Rate	$17,739.81
Rate for Payer: AHCCCS Medicaid	$17,739.81
Rate for Payer: Allwell Medicaid	$17,739.81
Rate for Payer: AZCH Complete Medicaid	$17,739.81
Rate for Payer: Banner UC Health Medicaid	$17,739.81
Rate for Payer: Mercy Care Medicaid	$17,739.81

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$5,616.11

Service Code	APR-DRG 3431
Hospital Charge Code	APRDRG3434
Min. Negotiated Rate	$5,616.11
Max. Negotiated Rate	$5,616.11
Rate for Payer: AHCCCS Medicaid	$5,616.11
Rate for Payer: Allwell Medicaid	$5,616.11
Rate for Payer: AZCH Complete Medicaid	$5,616.11
Rate for Payer: Banner UC Health Medicaid	$5,616.11
Rate for Payer: Mercy Care Medicaid	$5,616.11

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$6,634.54

Service Code	APR-DRG 3432
Hospital Charge Code	APRDRG3431
Min. Negotiated Rate	$6,634.54
Max. Negotiated Rate	$6,634.54
Rate for Payer: AHCCCS Medicaid	$6,634.54
Rate for Payer: Allwell Medicaid	$6,634.54
Rate for Payer: AZCH Complete Medicaid	$6,634.54
Rate for Payer: Banner UC Health Medicaid	$6,634.54
Rate for Payer: Mercy Care Medicaid	$6,634.54

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$10,084.73

Service Code	APR-DRG 3433
Hospital Charge Code	APRDRG3434
Min. Negotiated Rate	$10,084.73
Max. Negotiated Rate	$10,084.73
Rate for Payer: AHCCCS Medicaid	$10,084.73
Rate for Payer: Allwell Medicaid	$10,084.73
Rate for Payer: AZCH Complete Medicaid	$10,084.73
Rate for Payer: Banner UC Health Medicaid	$10,084.73
Rate for Payer: Mercy Care Medicaid	$10,084.73

Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy

Facility

IP

$17,739.81

Service Code	APR-DRG 3434
Hospital Charge Code	APRDRG3431
Min. Negotiated Rate	$17,739.81
Max. Negotiated Rate	$17,739.81
Rate for Payer: AHCCCS Medicaid	$17,739.81
Rate for Payer: Allwell Medicaid	$17,739.81
Rate for Payer: AZCH Complete Medicaid	$17,739.81
Rate for Payer: Banner UC Health Medicaid	$17,739.81
Rate for Payer: Mercy Care Medicaid	$17,739.81

MUSTANG BALLOON 6X40X75

Facility

OP

$1,400.00

Hospital Charge Code	27977962
Hospital Revenue Code	270
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$1,260.00
Rate for Payer: Aetna of AZ Commercial	$1,260.00
Rate for Payer: Aetna of AZ Medicare	$392.00
Rate for Payer: Allwell Medicare	$224.00
Rate for Payer: Amerigroup Medicare	$224.00
Rate for Payer: APIPA Medicare/Medicaid	$522.90
Rate for Payer: AZCH Complete Medicare	$224.00
Rate for Payer: Banner UC Health Medicare	$224.00
Rate for Payer: Bisbee Police All Plans	$364.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$952.00
Rate for Payer: Cash Price	$1,120.00
Rate for Payer: Cigna of AZ Commercial	$980.00
Rate for Payer: Copperpoint Commercial	$346.50
Rate for Payer: Health Net of AZ Commercial	$840.00
Rate for Payer: Health Net of AZ Medicare	$392.00
Rate for Payer: Humana of AZ Medicare	$224.00
Rate for Payer: Self Pay Self Pay	$1,120.00
Rate for Payer: TriWest Medicare	$224.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$816.20
Rate for Payer: UnitedHealth Group of AZ Medicare	$252.00

MUSTANG BALLOON 6X40X75

Facility

IP

$1,400.00

Hospital Charge Code	27977962
Hospital Revenue Code	270
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$1,260.00
Rate for Payer: Aetna of AZ Commercial	$1,260.00
Rate for Payer: Bisbee Police All Plans	$364.00
Rate for Payer: Cash Price	$1,120.00
Rate for Payer: Self Pay Self Pay	$1,120.00

mycophenolate 500 mg Tab UD [CQCH]

Facility

OP

$0.62

Service Code	HCPCS J7517
Hospital Charge Code	108074965
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.56
Rate for Payer: Aetna of AZ Commercial	$0.56
Rate for Payer: Aetna of AZ Medicare	$0.17
Rate for Payer: Allwell Medicare	$0.10
Rate for Payer: Amerigroup Medicare	$0.10
Rate for Payer: APIPA Medicare/Medicaid	$0.23
Rate for Payer: AZCH Complete Medicare	$0.10
Rate for Payer: Banner UC Health Medicare	$0.10
Rate for Payer: Bisbee Police All Plans	$0.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.42
Rate for Payer: Cash Price	$0.50
Rate for Payer: Cigna of AZ Commercial	$0.40
Rate for Payer: Copperpoint Commercial	$0.15
Rate for Payer: Health Net of AZ Commercial	$0.37
Rate for Payer: Health Net of AZ Medicare	$0.17
Rate for Payer: Humana of AZ Medicare	$0.10
Rate for Payer: Self Pay Self Pay	$0.50
Rate for Payer: TriWest Medicare	$0.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.36
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.11

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