Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Lower Extremity Arterial Procedures

Facility

IP

$37,239.43

Service Code	APR-DRG 1814
Hospital Charge Code	APRDRG1813
Min. Negotiated Rate	$37,239.43
Max. Negotiated Rate	$37,239.43
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,239.43
Rate for Payer: Mercy Care Medicaid	$37,239.43
Rate for Payer: NaphCare Correctional Healthcare	$37,239.43

Lower Extremity Arterial Procedures

Facility

IP

$9,384.03

Service Code	APR-DRG 1811
Hospital Charge Code	APRDRG1814
Min. Negotiated Rate	$9,384.03
Max. Negotiated Rate	$9,384.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,384.03
Rate for Payer: Mercy Care Medicaid	$9,384.03
Rate for Payer: NaphCare Correctional Healthcare	$9,384.03

Lower Extremity Arterial Procedures

Facility

IP

$13,613.47

Service Code	APR-DRG 1812
Hospital Charge Code	APRDRG1813
Min. Negotiated Rate	$13,613.47
Max. Negotiated Rate	$13,613.47
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,613.47
Rate for Payer: Mercy Care Medicaid	$13,613.47
Rate for Payer: NaphCare Correctional Healthcare	$13,613.47

Lower Extremity Arterial Procedures

Facility

IP

$37,239.43

Service Code	APR-DRG 1814
Hospital Charge Code	APRDRG1811
Min. Negotiated Rate	$37,239.43
Max. Negotiated Rate	$37,239.43
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,239.43
Rate for Payer: Mercy Care Medicaid	$37,239.43
Rate for Payer: NaphCare Correctional Healthcare	$37,239.43

Lower Extremity Arterial Procedures

Facility

IP

$22,058.33

Service Code	APR-DRG 1813
Hospital Charge Code	APRDRG1811
Min. Negotiated Rate	$22,058.33
Max. Negotiated Rate	$22,058.33
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,058.33
Rate for Payer: Mercy Care Medicaid	$22,058.33
Rate for Payer: NaphCare Correctional Healthcare	$22,058.33

Lower Extremity Arterial Procedures

Facility

IP

$13,613.47

Service Code	APR-DRG 1812
Hospital Charge Code	APRDRG1811
Min. Negotiated Rate	$13,613.47
Max. Negotiated Rate	$13,613.47
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,613.47
Rate for Payer: Mercy Care Medicaid	$13,613.47
Rate for Payer: NaphCare Correctional Healthcare	$13,613.47

Lower Extremity Arterial Procedures

Facility

IP

$37,239.43

Service Code	APR-DRG 1814
Hospital Charge Code	APRDRG1814
Min. Negotiated Rate	$37,239.43
Max. Negotiated Rate	$37,239.43
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$37,239.43
Rate for Payer: Mercy Care Medicaid	$37,239.43
Rate for Payer: NaphCare Correctional Healthcare	$37,239.43

Lower Extremity Arterial Procedures

Facility

IP

$13,613.47

Service Code	APR-DRG 1812
Hospital Charge Code	APRDRG1812
Min. Negotiated Rate	$13,613.47
Max. Negotiated Rate	$13,613.47
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,613.47
Rate for Payer: Mercy Care Medicaid	$13,613.47
Rate for Payer: NaphCare Correctional Healthcare	$13,613.47

Lower Extremity Arterial Procedures

Facility

IP

$9,384.03

Service Code	APR-DRG 1811
Hospital Charge Code	APRDRG1812
Min. Negotiated Rate	$9,384.03
Max. Negotiated Rate	$9,384.03
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$9,384.03
Rate for Payer: Mercy Care Medicaid	$9,384.03
Rate for Payer: NaphCare Correctional Healthcare	$9,384.03

Lower Extremity Arterial Procedures

Facility

IP

$22,058.33

Service Code	APR-DRG 1813
Hospital Charge Code	APRDRG1814
Min. Negotiated Rate	$22,058.33
Max. Negotiated Rate	$22,058.33
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,058.33
Rate for Payer: Mercy Care Medicaid	$22,058.33
Rate for Payer: NaphCare Correctional Healthcare	$22,058.33

Lp-PLA2 Activity

Facility

OP

$618.00

Service Code	CPT 81400
Hospital Charge Code	23092587
Hospital Revenue Code	301
Min. Negotiated Rate	$92.74
Max. Negotiated Rate	$556.20
Rate for Payer: Aetna of AZ Commercial	$556.20
Rate for Payer: Arizona Complete Health Allwell	$98.88
Rate for Payer: Banner UC Health Medicare	$98.88
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$420.24
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$98.88
Rate for Payer: Care1st Health Plan Arizona Medicare	$98.88
Rate for Payer: Cash Price	$494.40
Rate for Payer: Cash Price	$494.40
Rate for Payer: Cigna of AZ Commercial	$401.70
Rate for Payer: Devoted Health Medicare	$111.24
Rate for Payer: Humana of AZ Medicare	$98.88
Rate for Payer: Seven Corners Travel Insurance	$92.74
Rate for Payer: Southwest Service Administrators UFCW	$420.24
Rate for Payer: TriWest Medicare	$98.88
Rate for Payer: United Healthcare Commercial	$353.50
Rate for Payer: United Healthcare Medicare	$98.88
Rate for Payer: Veterans Affairs TRICARE	$97.89

Lp-PLA2 Activity

Facility

IP

$618.00

Service Code	CPT 81400
Hospital Charge Code	23092587
Hospital Revenue Code	301
Min. Negotiated Rate	$556.20
Max. Negotiated Rate	$556.20
Rate for Payer: Aetna of AZ Commercial	$556.20
Rate for Payer: Cash Price	$494.40

L/S supracerv hyst uter > 250G with USO/BSO

Facility

IP

$4,951.00

Service Code	CPT 58544
Hospital Charge Code	27267833
Hospital Revenue Code	360
Min. Negotiated Rate	$4,455.90
Max. Negotiated Rate	$4,455.90
Rate for Payer: Aetna of AZ Commercial	$4,455.90
Rate for Payer: Cash Price	$3,960.80

L/S supracerv hyst uter > 250G with USO/BSO

Facility

OP

$4,951.00

Service Code	CPT 58544
Hospital Charge Code	27267833
Hospital Revenue Code	360
Min. Negotiated Rate	$784.24
Max. Negotiated Rate	$16,447.22
Rate for Payer: Aetna of AZ Commercial	$4,455.90
Rate for Payer: Arizona Complete Health Allwell	$792.16
Rate for Payer: Banner UC Health Medicare	$3,457.91
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$3,366.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$792.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$792.16
Rate for Payer: Cash Price	$3,960.80
Rate for Payer: Cash Price	$3,960.80
Rate for Payer: Cash Price	$3,960.80
Rate for Payer: Cigna of AZ Commercial	$2,475.50
Rate for Payer: Devoted Health Medicare	$891.18
Rate for Payer: Humana of AZ Medicare	$792.16
Rate for Payer: NaphCare Correctional Healthcare	$3,457.91
Rate for Payer: Seven Corners Travel Insurance	$16,447.22
Rate for Payer: Southwest Service Administrators UFCW	$3,366.68
Rate for Payer: TriWest Medicare	$792.16
Rate for Payer: United Healthcare Commercial	$6,508.00
Rate for Payer: United Healthcare Medicare	$792.16
Rate for Payer: Veterans Affairs TRICARE	$784.24

L/S supracerv hyst uter < 250G w USO BSO

Facility

OP

$4,531.00

Service Code	CPT 58542
Hospital Charge Code	27291804
Hospital Revenue Code	360
Min. Negotiated Rate	$717.71
Max. Negotiated Rate	$16,447.22
Rate for Payer: Aetna of AZ Commercial	$4,077.90
Rate for Payer: Arizona Complete Health Allwell	$724.96
Rate for Payer: Banner UC Health Medicare	$3,457.91
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$3,081.08
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$724.96
Rate for Payer: Care1st Health Plan Arizona Medicare	$724.96
Rate for Payer: Cash Price	$3,624.80
Rate for Payer: Cash Price	$3,624.80
Rate for Payer: Cash Price	$3,624.80
Rate for Payer: Cigna of AZ Commercial	$2,265.50
Rate for Payer: Devoted Health Medicare	$815.58
Rate for Payer: Humana of AZ Medicare	$724.96
Rate for Payer: NaphCare Correctional Healthcare	$3,457.91
Rate for Payer: Seven Corners Travel Insurance	$16,447.22
Rate for Payer: Southwest Service Administrators UFCW	$3,081.08
Rate for Payer: TriWest Medicare	$724.96
Rate for Payer: United Healthcare Commercial	$6,508.00
Rate for Payer: United Healthcare Medicare	$724.96
Rate for Payer: Veterans Affairs TRICARE	$717.71

L/S supracerv hyst uter < 250G w USO BSO

Facility

IP

$4,531.00

Service Code	CPT 58542
Hospital Charge Code	27291804
Hospital Revenue Code	360
Min. Negotiated Rate	$4,077.90
Max. Negotiated Rate	$4,077.90
Rate for Payer: Aetna of AZ Commercial	$4,077.90
Rate for Payer: Cash Price	$3,624.80

L/S supracervical hyst for uterus > 250g

Facility

IP

$4,380.00

Service Code	CPT 58543
Hospital Charge Code	27281900
Hospital Revenue Code	360
Min. Negotiated Rate	$3,942.00
Max. Negotiated Rate	$3,942.00
Rate for Payer: Aetna of AZ Commercial	$3,942.00
Rate for Payer: Cash Price	$3,504.00

L/S supracervical hyst for uterus > 250g

Facility

OP

$4,380.00

Service Code	CPT 58543
Hospital Charge Code	27281900
Hospital Revenue Code	360
Min. Negotiated Rate	$693.79
Max. Negotiated Rate	$16,447.22
Rate for Payer: Aetna of AZ Commercial	$3,942.00
Rate for Payer: Arizona Complete Health Allwell	$700.80
Rate for Payer: Banner UC Health Medicare	$3,457.91
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$2,978.40
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$700.80
Rate for Payer: Care1st Health Plan Arizona Medicare	$700.80
Rate for Payer: Cash Price	$3,504.00
Rate for Payer: Cash Price	$3,504.00
Rate for Payer: Cash Price	$3,504.00
Rate for Payer: Cigna of AZ Commercial	$2,190.00
Rate for Payer: Devoted Health Medicare	$788.40
Rate for Payer: Humana of AZ Medicare	$700.80
Rate for Payer: NaphCare Correctional Healthcare	$3,457.91
Rate for Payer: Seven Corners Travel Insurance	$16,447.22
Rate for Payer: Southwest Service Administrators UFCW	$2,978.40
Rate for Payer: TriWest Medicare	$700.80
Rate for Payer: United Healthcare Commercial	$6,508.00
Rate for Payer: United Healthcare Medicare	$700.80
Rate for Payer: Veterans Affairs TRICARE	$693.79

LUCAS SUCTION CUP DISPOSABLE 12 PACK

Facility

OP

$154.68

Hospital Charge Code	28202323
Hospital Revenue Code	270
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$139.21
Rate for Payer: Aetna of AZ Commercial	$139.21
Rate for Payer: Arizona Complete Health Allwell	$24.75
Rate for Payer: Banner UC Health Medicare	$24.75
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$105.18
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$24.75
Rate for Payer: Care1st Health Plan Arizona Medicare	$24.75
Rate for Payer: Cash Price	$123.74
Rate for Payer: Cigna of AZ Commercial	$108.28
Rate for Payer: Devoted Health Medicare	$27.84
Rate for Payer: Humana of AZ Medicare	$24.75
Rate for Payer: Southwest Service Administrators UFCW	$105.18
Rate for Payer: TriWest Medicare	$24.75
Rate for Payer: United Healthcare Commercial	$88.48
Rate for Payer: United Healthcare Medicare	$24.75
Rate for Payer: Veterans Affairs TRICARE	$24.50

LUCAS SUCTION CUP DISPOSABLE 12 PACK

Facility

IP

$154.68

Hospital Charge Code	28202323
Hospital Revenue Code	270
Min. Negotiated Rate	$139.21
Max. Negotiated Rate	$139.21
Rate for Payer: Aetna of AZ Commercial	$139.21
Rate for Payer: Cash Price	$123.74

LUNG TRANSPLANT

Facility

IP

$167,370.22

Service Code	MSDRG 007
Min. Negotiated Rate	$167,370.22
Max. Negotiated Rate	$167,370.22
Rate for Payer: Seven Corners Travel Insurance	$167,370.22

Lupus Anticoagulant Comp LC

Facility

OP

$213.00

Service Code	CPT 85597
Hospital Charge Code	1285803
Hospital Revenue Code	301
Min. Negotiated Rate	$26.07
Max. Negotiated Rate	$191.70
Rate for Payer: Aetna of AZ Commercial	$191.70
Rate for Payer: Arizona Complete Health Allwell	$34.08
Rate for Payer: Banner UC Health Medicare	$34.08
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$144.84
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$34.08
Rate for Payer: Care1st Health Plan Arizona Medicare	$34.08
Rate for Payer: Cash Price	$170.40
Rate for Payer: Cash Price	$170.40
Rate for Payer: Cigna of AZ Commercial	$138.45
Rate for Payer: Devoted Health Medicare	$38.34
Rate for Payer: Humana of AZ Medicare	$34.08
Rate for Payer: Seven Corners Travel Insurance	$26.07
Rate for Payer: Southwest Service Administrators UFCW	$144.84
Rate for Payer: TriWest Medicare	$34.08
Rate for Payer: United Healthcare Commercial	$121.84
Rate for Payer: United Healthcare Medicare	$34.08
Rate for Payer: Veterans Affairs TRICARE	$33.74

Lupus Anticoagulant Comp LC

Facility

IP

$213.00

Service Code	CPT 85597
Hospital Charge Code	1285803
Hospital Revenue Code	301
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$191.70
Rate for Payer: Aetna of AZ Commercial	$191.70
Rate for Payer: Cash Price	$170.40

Luteinizing Hormone(LH), S LC

Facility

IP

$492.00

Service Code	CPT 83002
Hospital Charge Code	2029219
Hospital Revenue Code	301
Min. Negotiated Rate	$442.80
Max. Negotiated Rate	$442.80
Rate for Payer: Aetna of AZ Commercial	$442.80
Rate for Payer: Cash Price	$393.60

Luteinizing Hormone(LH), S LC

Facility

OP

$492.00

Service Code	CPT 83002
Hospital Charge Code	2029219
Hospital Revenue Code	301
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$442.80
Rate for Payer: Aetna of AZ Commercial	$442.80
Rate for Payer: Arizona Complete Health Allwell	$78.72
Rate for Payer: Banner UC Health Medicare	$78.72
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$334.56
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$78.72
Rate for Payer: Care1st Health Plan Arizona Medicare	$78.72
Rate for Payer: Cash Price	$393.60
Rate for Payer: Cash Price	$393.60
Rate for Payer: Cigna of AZ Commercial	$319.80
Rate for Payer: Devoted Health Medicare	$88.56
Rate for Payer: Humana of AZ Medicare	$78.72
Rate for Payer: Seven Corners Travel Insurance	$26.85
Rate for Payer: Southwest Service Administrators UFCW	$334.56
Rate for Payer: TriWest Medicare	$78.72
Rate for Payer: United Healthcare Commercial	$281.42
Rate for Payer: United Healthcare Medicare	$78.72
Rate for Payer: Veterans Affairs TRICARE	$77.93

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