Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Nephritis And Nephrosis

Facility

$22,136.18

Service Code	APR-DRG 4624
Hospital Charge Code	APRDRG4621
Min. Negotiated Rate	$22,136.18
Max. Negotiated Rate	$22,136.18
Rate for Payer: AHCCCS Medicaid	$22,136.18
Rate for Payer: Allwell Medicaid	$22,136.18
Rate for Payer: AZCH Complete Medicaid	$22,136.18
Rate for Payer: Banner UC Health Medicaid	$22,136.18
Rate for Payer: Mercy Care Medicaid	$22,136.18

Nephritis And Nephrosis

Facility

$4,672.03

Service Code	APR-DRG 4622
Hospital Charge Code	APRDRG4624
Min. Negotiated Rate	$4,672.03
Max. Negotiated Rate	$4,672.03
Rate for Payer: AHCCCS Medicaid	$4,672.03
Rate for Payer: Allwell Medicaid	$4,672.03
Rate for Payer: AZCH Complete Medicaid	$4,672.03
Rate for Payer: Banner UC Health Medicaid	$4,672.03
Rate for Payer: Mercy Care Medicaid	$4,672.03

Nephritis And Nephrosis

Facility

$3,229.95

Service Code	APR-DRG 4621
Hospital Charge Code	APRDRG4622
Min. Negotiated Rate	$3,229.95
Max. Negotiated Rate	$3,229.95
Rate for Payer: AHCCCS Medicaid	$3,229.95
Rate for Payer: Allwell Medicaid	$3,229.95
Rate for Payer: AZCH Complete Medicaid	$3,229.95
Rate for Payer: Banner UC Health Medicaid	$3,229.95
Rate for Payer: Mercy Care Medicaid	$3,229.95

Nephritis And Nephrosis

Facility

$9,501.87

Service Code	APR-DRG 4623
Hospital Charge Code	APRDRG4622
Min. Negotiated Rate	$9,501.87
Max. Negotiated Rate	$9,501.87
Rate for Payer: AHCCCS Medicaid	$9,501.87
Rate for Payer: Allwell Medicaid	$9,501.87
Rate for Payer: AZCH Complete Medicaid	$9,501.87
Rate for Payer: Banner UC Health Medicaid	$9,501.87
Rate for Payer: Mercy Care Medicaid	$9,501.87

Nephritis And Nephrosis

Facility

$22,136.18

Service Code	APR-DRG 4624
Hospital Charge Code	APRDRG4623
Min. Negotiated Rate	$22,136.18
Max. Negotiated Rate	$22,136.18
Rate for Payer: AHCCCS Medicaid	$22,136.18
Rate for Payer: Allwell Medicaid	$22,136.18
Rate for Payer: AZCH Complete Medicaid	$22,136.18
Rate for Payer: Banner UC Health Medicaid	$22,136.18
Rate for Payer: Mercy Care Medicaid	$22,136.18

Nephritis And Nephrosis

Facility

$9,501.87

Service Code	APR-DRG 4623
Hospital Charge Code	APRDRG4621
Min. Negotiated Rate	$9,501.87
Max. Negotiated Rate	$9,501.87
Rate for Payer: AHCCCS Medicaid	$9,501.87
Rate for Payer: Allwell Medicaid	$9,501.87
Rate for Payer: AZCH Complete Medicaid	$9,501.87
Rate for Payer: Banner UC Health Medicaid	$9,501.87
Rate for Payer: Mercy Care Medicaid	$9,501.87

Nephritis And Nephrosis

Facility

$4,672.03

Service Code	APR-DRG 4622
Hospital Charge Code	APRDRG4621
Min. Negotiated Rate	$4,672.03
Max. Negotiated Rate	$4,672.03
Rate for Payer: AHCCCS Medicaid	$4,672.03
Rate for Payer: Allwell Medicaid	$4,672.03
Rate for Payer: AZCH Complete Medicaid	$4,672.03
Rate for Payer: Banner UC Health Medicaid	$4,672.03
Rate for Payer: Mercy Care Medicaid	$4,672.03

Nephritis And Nephrosis

Facility

$22,136.18

Service Code	APR-DRG 4624
Hospital Charge Code	APRDRG4624
Min. Negotiated Rate	$22,136.18
Max. Negotiated Rate	$22,136.18
Rate for Payer: AHCCCS Medicaid	$22,136.18
Rate for Payer: Allwell Medicaid	$22,136.18
Rate for Payer: AZCH Complete Medicaid	$22,136.18
Rate for Payer: Banner UC Health Medicaid	$22,136.18
Rate for Payer: Mercy Care Medicaid	$22,136.18

Nephritis And Nephrosis

Facility

$3,229.95

Service Code	APR-DRG 4621
Hospital Charge Code	APRDRG4621
Min. Negotiated Rate	$3,229.95
Max. Negotiated Rate	$3,229.95
Rate for Payer: AHCCCS Medicaid	$3,229.95
Rate for Payer: Allwell Medicaid	$3,229.95
Rate for Payer: AZCH Complete Medicaid	$3,229.95
Rate for Payer: Banner UC Health Medicaid	$3,229.95
Rate for Payer: Mercy Care Medicaid	$3,229.95

Nephritis And Nephrosis

Facility

$22,136.18

Service Code	APR-DRG 4624
Hospital Charge Code	APRDRG4622
Min. Negotiated Rate	$22,136.18
Max. Negotiated Rate	$22,136.18
Rate for Payer: AHCCCS Medicaid	$22,136.18
Rate for Payer: Allwell Medicaid	$22,136.18
Rate for Payer: AZCH Complete Medicaid	$22,136.18
Rate for Payer: Banner UC Health Medicaid	$22,136.18
Rate for Payer: Mercy Care Medicaid	$22,136.18

NERVE TEASING PREPARATIONS

Facility

$1,084.00

Service Code	CPT 88362
Hospital Charge Code	22545742
Hospital Revenue Code	310
Min. Negotiated Rate	$162.60
Max. Negotiated Rate	$975.60
Rate for Payer: Aetna of AZ Commercial	$975.60
Rate for Payer: Aetna of AZ Medicare	$303.52
Rate for Payer: AHCCCS Medicaid	$475.71
Rate for Payer: Allwell Medicaid	$475.71
Rate for Payer: Allwell Medicare	$162.60
Rate for Payer: Amerigroup Medicare	$162.60
Rate for Payer: APIPA Medicare/Medicaid	$404.87
Rate for Payer: AZCH Complete Medicaid	$475.71
Rate for Payer: AZCH Complete Medicare	$162.60
Rate for Payer: Banner UC Health Medicaid	$475.71
Rate for Payer: Banner UC Health Medicare	$162.60
Rate for Payer: Bisbee Police All Plans	$281.84
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$737.12
Rate for Payer: Cash Price	$867.20
Rate for Payer: Cash Price	$867.20
Rate for Payer: Cigna of AZ Commercial	$704.60
Rate for Payer: Copperpoint Commercial	$268.29
Rate for Payer: Health Net of AZ Commercial	$650.40
Rate for Payer: Health Net of AZ Medicare	$303.52
Rate for Payer: Humana of AZ Medicare	$162.60
Rate for Payer: Mercy Care Medicaid	$475.71
Rate for Payer: Self Pay Self Pay	$867.20
Rate for Payer: TriWest Medicare	$162.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$631.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$195.12

NERVE TEASING PREPARATIONS

Facility

$1,084.00

Service Code	CPT 88362
Hospital Charge Code	22545742
Hospital Revenue Code	310
Min. Negotiated Rate	$281.84
Max. Negotiated Rate	$975.60
Rate for Payer: Aetna of AZ Commercial	$975.60
Rate for Payer: Bisbee Police All Plans	$281.84
Rate for Payer: Cash Price	$867.20
Rate for Payer: Self Pay Self Pay	$867.20

Nervous System Malignancy

Facility

$5,242.97

Service Code	APR-DRG 0411
Hospital Charge Code	APRDRG0413
Min. Negotiated Rate	$5,242.97
Max. Negotiated Rate	$5,242.97
Rate for Payer: AHCCCS Medicaid	$5,242.97
Rate for Payer: Allwell Medicaid	$5,242.97
Rate for Payer: AZCH Complete Medicaid	$5,242.97
Rate for Payer: Banner UC Health Medicaid	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97

Nervous System Malignancy

Facility

$5,242.97

Service Code	APR-DRG 0411
Hospital Charge Code	APRDRG0412
Min. Negotiated Rate	$5,242.97
Max. Negotiated Rate	$5,242.97
Rate for Payer: AHCCCS Medicaid	$5,242.97
Rate for Payer: Allwell Medicaid	$5,242.97
Rate for Payer: AZCH Complete Medicaid	$5,242.97
Rate for Payer: Banner UC Health Medicaid	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97

Nervous System Malignancy

Facility

$12,266.78

Service Code	APR-DRG 0414
Hospital Charge Code	APRDRG0413
Min. Negotiated Rate	$12,266.78
Max. Negotiated Rate	$12,266.78
Rate for Payer: AHCCCS Medicaid	$12,266.78
Rate for Payer: Allwell Medicaid	$12,266.78
Rate for Payer: AZCH Complete Medicaid	$12,266.78
Rate for Payer: Banner UC Health Medicaid	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78

Nervous System Malignancy

Facility

$5,862.30

Service Code	APR-DRG 0412
Hospital Charge Code	APRDRG0411
Min. Negotiated Rate	$5,862.30
Max. Negotiated Rate	$5,862.30
Rate for Payer: AHCCCS Medicaid	$5,862.30
Rate for Payer: Allwell Medicaid	$5,862.30
Rate for Payer: AZCH Complete Medicaid	$5,862.30
Rate for Payer: Banner UC Health Medicaid	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30

Nervous System Malignancy

Facility

$12,266.78

Service Code	APR-DRG 0414
Hospital Charge Code	APRDRG0414
Min. Negotiated Rate	$12,266.78
Max. Negotiated Rate	$12,266.78
Rate for Payer: AHCCCS Medicaid	$12,266.78
Rate for Payer: Allwell Medicaid	$12,266.78
Rate for Payer: AZCH Complete Medicaid	$12,266.78
Rate for Payer: Banner UC Health Medicaid	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78

Nervous System Malignancy

Facility

$5,862.30

Service Code	APR-DRG 0412
Hospital Charge Code	APRDRG0412
Min. Negotiated Rate	$5,862.30
Max. Negotiated Rate	$5,862.30
Rate for Payer: AHCCCS Medicaid	$5,862.30
Rate for Payer: Allwell Medicaid	$5,862.30
Rate for Payer: AZCH Complete Medicaid	$5,862.30
Rate for Payer: Banner UC Health Medicaid	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30

Nervous System Malignancy

Facility

$7,829.03

Service Code	APR-DRG 0413
Hospital Charge Code	APRDRG0413
Min. Negotiated Rate	$7,829.03
Max. Negotiated Rate	$7,829.03
Rate for Payer: AHCCCS Medicaid	$7,829.03
Rate for Payer: Allwell Medicaid	$7,829.03
Rate for Payer: AZCH Complete Medicaid	$7,829.03
Rate for Payer: Banner UC Health Medicaid	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03

Nervous System Malignancy

Facility

$5,862.30

Service Code	APR-DRG 0412
Hospital Charge Code	APRDRG0413
Min. Negotiated Rate	$5,862.30
Max. Negotiated Rate	$5,862.30
Rate for Payer: AHCCCS Medicaid	$5,862.30
Rate for Payer: Allwell Medicaid	$5,862.30
Rate for Payer: AZCH Complete Medicaid	$5,862.30
Rate for Payer: Banner UC Health Medicaid	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30

Nervous System Malignancy

Facility

$7,829.03

Service Code	APR-DRG 0413
Hospital Charge Code	APRDRG0412
Min. Negotiated Rate	$7,829.03
Max. Negotiated Rate	$7,829.03
Rate for Payer: AHCCCS Medicaid	$7,829.03
Rate for Payer: Allwell Medicaid	$7,829.03
Rate for Payer: AZCH Complete Medicaid	$7,829.03
Rate for Payer: Banner UC Health Medicaid	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03

Nervous System Malignancy

Facility

$7,829.03

Service Code	APR-DRG 0413
Hospital Charge Code	APRDRG0411
Min. Negotiated Rate	$7,829.03
Max. Negotiated Rate	$7,829.03
Rate for Payer: AHCCCS Medicaid	$7,829.03
Rate for Payer: Allwell Medicaid	$7,829.03
Rate for Payer: AZCH Complete Medicaid	$7,829.03
Rate for Payer: Banner UC Health Medicaid	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03

Nervous System Malignancy

Facility

$5,242.97

Service Code	APR-DRG 0411
Hospital Charge Code	APRDRG0414
Min. Negotiated Rate	$5,242.97
Max. Negotiated Rate	$5,242.97
Rate for Payer: AHCCCS Medicaid	$5,242.97
Rate for Payer: Allwell Medicaid	$5,242.97
Rate for Payer: AZCH Complete Medicaid	$5,242.97
Rate for Payer: Banner UC Health Medicaid	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97

Nervous System Malignancy

Facility

$12,266.78

Service Code	APR-DRG 0414
Hospital Charge Code	APRDRG0411
Min. Negotiated Rate	$12,266.78
Max. Negotiated Rate	$12,266.78
Rate for Payer: AHCCCS Medicaid	$12,266.78
Rate for Payer: Allwell Medicaid	$12,266.78
Rate for Payer: AZCH Complete Medicaid	$12,266.78
Rate for Payer: Banner UC Health Medicaid	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78

Nervous System Malignancy

Facility

$7,829.03

Service Code	APR-DRG 0413
Hospital Charge Code	APRDRG0414
Min. Negotiated Rate	$7,829.03
Max. Negotiated Rate	$7,829.03
Rate for Payer: AHCCCS Medicaid	$7,829.03
Rate for Payer: Allwell Medicaid	$7,829.03
Rate for Payer: AZCH Complete Medicaid	$7,829.03
Rate for Payer: Banner UC Health Medicaid	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03

Know your out-of-pocket cost for care.

All Charges