Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

LEOS 2.7MM LOCKING SCREW 12MM

Facility

$2,510.00

Hospital Charge Code	27690542
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.7MM LOCKING SCREW 12MM

Facility

$2,510.00

Hospital Charge Code	27690542
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2.7MM LOCKING SCREW 14MM

Facility

$2,510.00

Hospital Charge Code	27663812
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.7MM LOCKING SCREW 14MM

Facility

$2,510.00

Hospital Charge Code	27663812
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2.7MM LOCKING SCREW 16MM

Facility

$2,510.00

Hospital Charge Code	27663806
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.7MM LOCKING SCREW 16MM

Facility

$2,510.00

Hospital Charge Code	27663806
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2.7MM LOCKING SCREW 18MM

Facility

$2,510.00

Hospital Charge Code	27663807
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.7MM LOCKING SCREW 18MM

Facility

$2,510.00

Hospital Charge Code	27663807
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2.7MM LOCKING SCREW 26MM

Facility

$2,510.00

Hospital Charge Code	27663813
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.7MM LOCKING SCREW 26MM

Facility

$2,510.00

Hospital Charge Code	27663813
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2.7MM NO LOCKING SCREW 18MM

Facility

$1,853.00

Hospital Charge Code	27663804
Hospital Revenue Code	270
Min. Negotiated Rate	$293.52
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Arizona Complete Health Allwell	$296.48
Rate for Payer: Banner UC Health Medicare	$296.48
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,260.04
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$296.48
Rate for Payer: Care1st Health Plan Arizona Medicare	$296.48
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Devoted Health Medicare	$333.54
Rate for Payer: Humana of AZ Medicare	$296.48
Rate for Payer: Southwest Service Administrators UFCW	$1,260.04
Rate for Payer: TriWest Medicare	$296.48
Rate for Payer: United Healthcare Commercial	$1,059.92
Rate for Payer: United Healthcare Medicare	$296.48
Rate for Payer: Veterans Affairs TRICARE	$293.52

LEOS 2.7MM NO LOCKING SCREW 18MM

Facility

$1,853.00

Hospital Charge Code	27663804
Hospital Revenue Code	270
Min. Negotiated Rate	$1,667.70
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Cash Price	$1,482.40

LEOS 2.7MM NO LOCKING SCREW 20MM

Facility

$1,853.00

Hospital Charge Code	27663805
Hospital Revenue Code	270
Min. Negotiated Rate	$1,667.70
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Cash Price	$1,482.40

LEOS 2.7MM NO LOCKING SCREW 20MM

Facility

$1,853.00

Hospital Charge Code	27663805
Hospital Revenue Code	270
Min. Negotiated Rate	$293.52
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Arizona Complete Health Allwell	$296.48
Rate for Payer: Banner UC Health Medicare	$296.48
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,260.04
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$296.48
Rate for Payer: Care1st Health Plan Arizona Medicare	$296.48
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Devoted Health Medicare	$333.54
Rate for Payer: Humana of AZ Medicare	$296.48
Rate for Payer: Southwest Service Administrators UFCW	$1,260.04
Rate for Payer: TriWest Medicare	$296.48
Rate for Payer: United Healthcare Commercial	$1,059.92
Rate for Payer: United Healthcare Medicare	$296.48
Rate for Payer: Veterans Affairs TRICARE	$293.52

LEOS 2.7MM NON LOCKING SCREW 22MM

Facility

$1,853.00

Hospital Charge Code	27690541
Hospital Revenue Code	270
Min. Negotiated Rate	$293.52
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Arizona Complete Health Allwell	$296.48
Rate for Payer: Banner UC Health Medicare	$296.48
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,260.04
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$296.48
Rate for Payer: Care1st Health Plan Arizona Medicare	$296.48
Rate for Payer: Cash Price	$1,482.40
Rate for Payer: Cigna of AZ Commercial	$1,297.10
Rate for Payer: Devoted Health Medicare	$333.54
Rate for Payer: Humana of AZ Medicare	$296.48
Rate for Payer: Southwest Service Administrators UFCW	$1,260.04
Rate for Payer: TriWest Medicare	$296.48
Rate for Payer: United Healthcare Commercial	$1,059.92
Rate for Payer: United Healthcare Medicare	$296.48
Rate for Payer: Veterans Affairs TRICARE	$293.52

LEOS 2.7MM NON LOCKING SCREW 22MM

Facility

$1,853.00

Hospital Charge Code	27690541
Hospital Revenue Code	270
Min. Negotiated Rate	$1,667.70
Max. Negotiated Rate	$1,667.70
Rate for Payer: Aetna of AZ Commercial	$1,667.70
Rate for Payer: Cash Price	$1,482.40

LEOS 2.8MM LOCKING SCREW 10MM

Facility

$2,510.00

Hospital Charge Code	27690540
Hospital Revenue Code	270
Min. Negotiated Rate	$397.58
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Arizona Complete Health Allwell	$401.60
Rate for Payer: Banner UC Health Medicare	$401.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,706.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$401.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$401.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,757.00
Rate for Payer: Devoted Health Medicare	$451.80
Rate for Payer: Humana of AZ Medicare	$401.60
Rate for Payer: Southwest Service Administrators UFCW	$1,706.80
Rate for Payer: TriWest Medicare	$401.60
Rate for Payer: United Healthcare Commercial	$1,435.72
Rate for Payer: United Healthcare Medicare	$401.60
Rate for Payer: Veterans Affairs TRICARE	$397.58

LEOS 2.8MM LOCKING SCREW 10MM

Facility

$2,510.00

Hospital Charge Code	27690540
Hospital Revenue Code	270
Min. Negotiated Rate	$2,259.00
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Cash Price	$2,008.00

LEOS 2MM DRILL

Facility

$2,237.00

Hospital Charge Code	27663810
Hospital Revenue Code	270
Min. Negotiated Rate	$354.34
Max. Negotiated Rate	$2,013.30
Rate for Payer: Aetna of AZ Commercial	$2,013.30
Rate for Payer: Arizona Complete Health Allwell	$357.92
Rate for Payer: Banner UC Health Medicare	$357.92
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,521.16
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$357.92
Rate for Payer: Care1st Health Plan Arizona Medicare	$357.92
Rate for Payer: Cash Price	$1,789.60
Rate for Payer: Cigna of AZ Commercial	$1,565.90
Rate for Payer: Devoted Health Medicare	$402.66
Rate for Payer: Humana of AZ Medicare	$357.92
Rate for Payer: Southwest Service Administrators UFCW	$1,521.16
Rate for Payer: TriWest Medicare	$357.92
Rate for Payer: United Healthcare Commercial	$1,279.56
Rate for Payer: United Healthcare Medicare	$357.92
Rate for Payer: Veterans Affairs TRICARE	$354.34

LEOS 2MM DRILL

Facility

$2,237.00

Hospital Charge Code	27663810
Hospital Revenue Code	270
Min. Negotiated Rate	$2,013.30
Max. Negotiated Rate	$2,013.30
Rate for Payer: Aetna of AZ Commercial	$2,013.30
Rate for Payer: Cash Price	$1,789.60

LEOS 3.5MM LOCKING SCREW 16MM

Facility

$2,595.00

Hospital Charge Code	27808543
Hospital Revenue Code	270
Min. Negotiated Rate	$2,335.50
Max. Negotiated Rate	$2,335.50
Rate for Payer: Aetna of AZ Commercial	$2,335.50
Rate for Payer: Cash Price	$2,076.00

LEOS 3.5MM LOCKING SCREW 16MM

Facility

$2,595.00

Hospital Charge Code	27808543
Hospital Revenue Code	270
Min. Negotiated Rate	$411.05
Max. Negotiated Rate	$2,335.50
Rate for Payer: Aetna of AZ Commercial	$2,335.50
Rate for Payer: Arizona Complete Health Allwell	$415.20
Rate for Payer: Banner UC Health Medicare	$415.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,764.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$415.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$415.20
Rate for Payer: Cash Price	$2,076.00
Rate for Payer: Cigna of AZ Commercial	$1,816.50
Rate for Payer: Devoted Health Medicare	$467.10
Rate for Payer: Humana of AZ Medicare	$415.20
Rate for Payer: Southwest Service Administrators UFCW	$1,764.60
Rate for Payer: TriWest Medicare	$415.20
Rate for Payer: United Healthcare Commercial	$1,484.34
Rate for Payer: United Healthcare Medicare	$415.20
Rate for Payer: Veterans Affairs TRICARE	$411.05

LEOS 3.5MM LOCKING SCREW 18MM

Facility

$2,595.00

Hospital Charge Code	27808544
Hospital Revenue Code	270
Min. Negotiated Rate	$2,335.50
Max. Negotiated Rate	$2,335.50
Rate for Payer: Aetna of AZ Commercial	$2,335.50
Rate for Payer: Cash Price	$2,076.00

LEOS 3.5MM LOCKING SCREW 18MM

Facility

$2,595.00

Hospital Charge Code	27808544
Hospital Revenue Code	270
Min. Negotiated Rate	$411.05
Max. Negotiated Rate	$2,335.50
Rate for Payer: Aetna of AZ Commercial	$2,335.50
Rate for Payer: Arizona Complete Health Allwell	$415.20
Rate for Payer: Banner UC Health Medicare	$415.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,764.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$415.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$415.20
Rate for Payer: Cash Price	$2,076.00
Rate for Payer: Cigna of AZ Commercial	$1,816.50
Rate for Payer: Devoted Health Medicare	$467.10
Rate for Payer: Humana of AZ Medicare	$415.20
Rate for Payer: Southwest Service Administrators UFCW	$1,764.60
Rate for Payer: TriWest Medicare	$415.20
Rate for Payer: United Healthcare Commercial	$1,484.34
Rate for Payer: United Healthcare Medicare	$415.20
Rate for Payer: Veterans Affairs TRICARE	$411.05

LEOS 3.5MM LOCKING SCREW 8MM

Facility

$2,595.00

Hospital Charge Code	27808545
Hospital Revenue Code	270
Min. Negotiated Rate	$2,335.50
Max. Negotiated Rate	$2,335.50
Rate for Payer: Aetna of AZ Commercial	$2,335.50
Rate for Payer: Cash Price	$2,076.00

Know your out-of-pocket cost for care.

All Charges