|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN BASE CHG AND 1ST MI
|
Facility
OP
|
$689.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406138
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$117.13 |
| Max. Negotiated Rate |
$620.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$620.10
|
| Rate for Payer: Aetna Medicare |
$192.92
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$117.13
|
| Rate for Payer: Amerigroup Medicare |
$117.13
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$257.34
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$117.13
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$117.13
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$450.16
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$179.14
|
| Rate for Payer: Cigna All Products |
$482.30
|
| Rate for Payer: Copperpoint |
$193.26
|
| Rate for Payer: HealthNet Commercial |
$413.40
|
| Rate for Payer: HealthNet Medicare |
$192.92
|
| Rate for Payer: Humana Medicare |
$117.13
|
| Rate for Payer: SELF PAY |
$551.20
|
| Rate for Payer: Veterans (Triwest) |
$117.13
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$401.69
|
| Rate for Payer: United Healthcare Medicare |
$124.02
|
|
|
00840 ANES INTRAPERITONEAL LOWER ABDOMEN BASE CHG AND 1ST MI
|
Facility
IP
|
$689.00
|
|
|
Service Code
|
CPT 00840
|
| Hospital Charge Code |
22406138
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$117.13 |
| Max. Negotiated Rate |
$620.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$620.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$117.13
|
| Rate for Payer: Amerigroup Medicare |
$117.13
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$117.13
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$117.13
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$450.16
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$179.14
|
| Rate for Payer: Copperpoint |
$193.26
|
| Rate for Payer: Humana Medicare |
$117.13
|
| Rate for Payer: SELF PAY |
$551.20
|
| Rate for Payer: Veterans (Triwest) |
$117.13
|
|
|
00851 ANES TUBAL LIGATION TRASECTION ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00851
|
| Hospital Charge Code |
22406142
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$6.30
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00851 ANES TUBAL LIGATION TRASECTION ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00851
|
| Hospital Charge Code |
22406142
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00851 ANES TUBAL LIGATION TRASECTION BASE CHARGE AND 1ST MIN
|
Facility
IP
|
$689.00
|
|
|
Service Code
|
CPT 00851
|
| Hospital Charge Code |
22406141
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$117.13 |
| Max. Negotiated Rate |
$620.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$620.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$117.13
|
| Rate for Payer: Amerigroup Medicare |
$117.13
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$117.13
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$117.13
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$179.14
|
| Rate for Payer: Copperpoint |
$193.26
|
| Rate for Payer: Humana Medicare |
$117.13
|
| Rate for Payer: SELF PAY |
$551.20
|
| Rate for Payer: Veterans (Triwest) |
$117.13
|
|
|
00851 ANES TUBAL LIGATION TRASECTION BASE CHARGE AND 1ST MIN
|
Facility
OP
|
$689.00
|
|
|
Service Code
|
CPT 00851
|
| Hospital Charge Code |
22406141
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$117.13 |
| Max. Negotiated Rate |
$620.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$620.10
|
| Rate for Payer: Aetna Medicare |
$192.92
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$117.13
|
| Rate for Payer: Amerigroup Medicare |
$117.13
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$257.34
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$117.13
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$117.13
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$179.14
|
| Rate for Payer: Cigna All Products |
$482.30
|
| Rate for Payer: Copperpoint |
$193.26
|
| Rate for Payer: HealthNet Commercial |
$413.40
|
| Rate for Payer: HealthNet Medicare |
$192.92
|
| Rate for Payer: Humana Medicare |
$117.13
|
| Rate for Payer: SELF PAY |
$551.20
|
| Rate for Payer: Veterans (Triwest) |
$117.13
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$401.69
|
| Rate for Payer: United Healthcare Medicare |
$124.02
|
|
|
00860 ANES LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406210
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00860 ANES LOWER ABDOMEN ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406210
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00860 ANES LOWER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406213
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00860 ANES LOWER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
OP
|
$525.00
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
23968344
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.13 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$472.50
|
| Rate for Payer: Aetna Medicare |
$147.00
|
| Rate for Payer: AHCCCS Medicaid |
$42.13
|
| Rate for Payer: Allwell from Arizona Medicaid by Arizona Complete Health Medicaid |
$42.13
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$89.25
|
| Rate for Payer: Amerigroup Medicare |
$89.25
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$196.09
|
| Rate for Payer: Arizona Complete Care Health Medicaid |
$42.13
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$89.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$89.25
|
| Rate for Payer: Banner University Family Care Medicaid |
$42.13
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$142.80
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$136.50
|
| Rate for Payer: Cigna All Products |
$341.25
|
| Rate for Payer: Copperpoint |
$147.26
|
| Rate for Payer: HealthNet Commercial |
$315.00
|
| Rate for Payer: HealthNet Medicare |
$147.00
|
| Rate for Payer: Humana Medicare |
$89.25
|
| Rate for Payer: Mercy Care Medicaid |
$42.13
|
| Rate for Payer: SELF PAY |
$420.00
|
| Rate for Payer: Veterans (Triwest) |
$89.25
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$306.07
|
| Rate for Payer: United Healthcare Medicare |
$94.50
|
|
|
00860 ANES LOWER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
IP
|
$525.00
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
23968344
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna POS, PPO, HMO |
$472.50
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$89.25
|
| Rate for Payer: Amerigroup Medicare |
$89.25
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$89.25
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield AZ PPO |
$142.80
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$136.50
|
| Rate for Payer: Copperpoint |
$147.26
|
| Rate for Payer: Humana Medicare |
$89.25
|
| Rate for Payer: SELF PAY |
$420.00
|
| Rate for Payer: Veterans (Triwest) |
$89.25
|
|
|
00860 ANES LOWER ABDOMEN ADDTNL 0:30 CHARGE
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406213
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00860 ANES LOWER ABDOMEN BASE CHARGE AND 1ST MINUTE
|
Facility
OP
|
$467.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406208
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Aetna Medicare |
$130.76
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$174.42
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Cigna All Products |
$326.90
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: HealthNet Commercial |
$280.20
|
| Rate for Payer: HealthNet Medicare |
$130.76
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$272.26
|
| Rate for Payer: United Healthcare Medicare |
$84.06
|
|
|
00860 ANES LOWER ABDOMEN BASE CHARGE AND 1ST MINUTE
|
Facility
IP
|
$467.00
|
|
|
Service Code
|
CPT 00860
|
| Hospital Charge Code |
22406208
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
|
|
00902 ANES ANORECTAL PROCEDURE ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406144
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
00902 ANES ANORECTAL PROCEDURE ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406144
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
00902 ANES ANORECTAL PROCEDURE ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406145
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00902 ANES ANORECTAL PROCEDURE ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406145
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
00902 ANES ANORECTAL PROCEDURE BASE CHARGE AND 1ST MINUTE
|
Facility
IP
|
$467.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406143
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
|
|
00902 ANES ANORECTAL PROCEDURE BASE CHARGE AND 1ST MINUTE
|
Facility
OP
|
$467.00
|
|
|
Service Code
|
CPT 00902
|
| Hospital Charge Code |
22406143
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Aetna Medicare |
$130.76
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$174.42
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Cigna All Products |
$326.90
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: HealthNet Commercial |
$280.20
|
| Rate for Payer: HealthNet Medicare |
$130.76
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$272.26
|
| Rate for Payer: United Healthcare Medicare |
$84.06
|
|
|
00908 ANESTHESIA FOR; PERINEAL PROSTATECTOMY
|
Facility
IP
|
$563.00
|
|
|
Service Code
|
CPT 00908
|
| Hospital Charge Code |
23084417
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
|
|
00908 ANESTHESIA FOR; PERINEAL PROSTATECTOMY
|
Facility
OP
|
$563.00
|
|
|
Service Code
|
CPT 00908
|
| Hospital Charge Code |
23084417
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Aetna Medicare |
$157.64
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$210.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Cigna All Products |
$365.95
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: HealthNet Commercial |
$337.80
|
| Rate for Payer: HealthNet Medicare |
$157.64
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$328.23
|
| Rate for Payer: United Healthcare Medicare |
$101.34
|
|
|
00908 ANESTHESIA FOR; PERINEAL PROSTATECTOMY 1ST 0:30
|
Facility
IP
|
$563.00
|
|
|
Service Code
|
CPT 00908
|
| Hospital Charge Code |
23084423
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
|
|
00908 ANESTHESIA FOR; PERINEAL PROSTATECTOMY 1ST 0:30
|
Facility
OP
|
$563.00
|
|
|
Service Code
|
CPT 00908
|
| Hospital Charge Code |
23084423
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Aetna Medicare |
$157.64
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$210.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Cigna All Products |
$365.95
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: HealthNet Commercial |
$337.80
|
| Rate for Payer: HealthNet Medicare |
$157.64
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$328.23
|
| Rate for Payer: United Healthcare Medicare |
$101.34
|
|
|
00908 ANESTHESIA FOR; PERINEAL PROSTATECTOMY ADDTNL 0:30
|
Facility
OP
|
$563.00
|
|
|
Service Code
|
CPT 00908
|
| Hospital Charge Code |
23084424
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Aetna Medicare |
$157.64
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$210.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Cigna All Products |
$365.95
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: HealthNet Commercial |
$337.80
|
| Rate for Payer: HealthNet Medicare |
$157.64
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$328.23
|
| Rate for Payer: United Healthcare Medicare |
$101.34
|
|