Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$4,204.19

Service Code	APR-DRG 5643
Hospital Charge Code	APRDRG5641
Min. Negotiated Rate	$4,204.19
Max. Negotiated Rate	$4,204.19
Rate for Payer: AHCCCS Medicaid	$4,204.19
Rate for Payer: Allwell Medicaid	$4,204.19
Rate for Payer: AZCH Complete Medicaid	$4,204.19
Rate for Payer: Banner UC Health Medicaid	$4,204.19
Rate for Payer: Mercy Care Medicaid	$4,204.19

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,025.64

Service Code	APR-DRG 5641
Hospital Charge Code	APRDRG5644
Min. Negotiated Rate	$2,025.64
Max. Negotiated Rate	$2,025.64
Rate for Payer: AHCCCS Medicaid	$2,025.64
Rate for Payer: Allwell Medicaid	$2,025.64
Rate for Payer: AZCH Complete Medicaid	$2,025.64
Rate for Payer: Banner UC Health Medicaid	$2,025.64
Rate for Payer: Mercy Care Medicaid	$2,025.64

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$4,204.19

Service Code	APR-DRG 5643
Hospital Charge Code	APRDRG5642
Min. Negotiated Rate	$4,204.19
Max. Negotiated Rate	$4,204.19
Rate for Payer: AHCCCS Medicaid	$4,204.19
Rate for Payer: Allwell Medicaid	$4,204.19
Rate for Payer: AZCH Complete Medicaid	$4,204.19
Rate for Payer: Banner UC Health Medicaid	$4,204.19
Rate for Payer: Mercy Care Medicaid	$4,204.19

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,687.76

Service Code	APR-DRG 5642
Hospital Charge Code	APRDRG5641
Min. Negotiated Rate	$2,687.76
Max. Negotiated Rate	$2,687.76
Rate for Payer: AHCCCS Medicaid	$2,687.76
Rate for Payer: Allwell Medicaid	$2,687.76
Rate for Payer: AZCH Complete Medicaid	$2,687.76
Rate for Payer: Banner UC Health Medicaid	$2,687.76
Rate for Payer: Mercy Care Medicaid	$2,687.76

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,687.76

Service Code	APR-DRG 5642
Hospital Charge Code	APRDRG5642
Min. Negotiated Rate	$2,687.76
Max. Negotiated Rate	$2,687.76
Rate for Payer: AHCCCS Medicaid	$2,687.76
Rate for Payer: Allwell Medicaid	$2,687.76
Rate for Payer: AZCH Complete Medicaid	$2,687.76
Rate for Payer: Banner UC Health Medicaid	$2,687.76
Rate for Payer: Mercy Care Medicaid	$2,687.76

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,025.64

Service Code	APR-DRG 5641
Hospital Charge Code	APRDRG5642
Min. Negotiated Rate	$2,025.64
Max. Negotiated Rate	$2,025.64
Rate for Payer: AHCCCS Medicaid	$2,025.64
Rate for Payer: Allwell Medicaid	$2,025.64
Rate for Payer: AZCH Complete Medicaid	$2,025.64
Rate for Payer: Banner UC Health Medicaid	$2,025.64
Rate for Payer: Mercy Care Medicaid	$2,025.64

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$10,044.05

Service Code	APR-DRG 5644
Hospital Charge Code	APRDRG5644
Min. Negotiated Rate	$10,044.05
Max. Negotiated Rate	$10,044.05
Rate for Payer: AHCCCS Medicaid	$10,044.05
Rate for Payer: Allwell Medicaid	$10,044.05
Rate for Payer: AZCH Complete Medicaid	$10,044.05
Rate for Payer: Banner UC Health Medicaid	$10,044.05
Rate for Payer: Mercy Care Medicaid	$10,044.05

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,687.76

Service Code	APR-DRG 5642
Hospital Charge Code	APRDRG5643
Min. Negotiated Rate	$2,687.76
Max. Negotiated Rate	$2,687.76
Rate for Payer: AHCCCS Medicaid	$2,687.76
Rate for Payer: Allwell Medicaid	$2,687.76
Rate for Payer: AZCH Complete Medicaid	$2,687.76
Rate for Payer: Banner UC Health Medicaid	$2,687.76
Rate for Payer: Mercy Care Medicaid	$2,687.76

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,025.64

Service Code	APR-DRG 5641
Hospital Charge Code	APRDRG5643
Min. Negotiated Rate	$2,025.64
Max. Negotiated Rate	$2,025.64
Rate for Payer: AHCCCS Medicaid	$2,025.64
Rate for Payer: Allwell Medicaid	$2,025.64
Rate for Payer: AZCH Complete Medicaid	$2,025.64
Rate for Payer: Banner UC Health Medicaid	$2,025.64
Rate for Payer: Mercy Care Medicaid	$2,025.64

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$2,025.64

Service Code	APR-DRG 5641
Hospital Charge Code	APRDRG5641
Min. Negotiated Rate	$2,025.64
Max. Negotiated Rate	$2,025.64
Rate for Payer: AHCCCS Medicaid	$2,025.64
Rate for Payer: Allwell Medicaid	$2,025.64
Rate for Payer: AZCH Complete Medicaid	$2,025.64
Rate for Payer: Banner UC Health Medicaid	$2,025.64
Rate for Payer: Mercy Care Medicaid	$2,025.64

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$10,044.05

Service Code	APR-DRG 5644
Hospital Charge Code	APRDRG5642
Min. Negotiated Rate	$10,044.05
Max. Negotiated Rate	$10,044.05
Rate for Payer: AHCCCS Medicaid	$10,044.05
Rate for Payer: Allwell Medicaid	$10,044.05
Rate for Payer: AZCH Complete Medicaid	$10,044.05
Rate for Payer: Banner UC Health Medicaid	$10,044.05
Rate for Payer: Mercy Care Medicaid	$10,044.05

Abortion Without D&C, Aspiration Curettage Or Hysterotomy

Facility

IP

$4,204.19

Service Code	APR-DRG 5643
Hospital Charge Code	APRDRG5644
Min. Negotiated Rate	$4,204.19
Max. Negotiated Rate	$4,204.19
Rate for Payer: AHCCCS Medicaid	$4,204.19
Rate for Payer: Allwell Medicaid	$4,204.19
Rate for Payer: AZCH Complete Medicaid	$4,204.19
Rate for Payer: Banner UC Health Medicaid	$4,204.19
Rate for Payer: Mercy Care Medicaid	$4,204.19

ABSORBTACK 5MM

Facility

IP

$1,451.00

Hospital Charge Code	22528831
Hospital Revenue Code	272
Min. Negotiated Rate	$377.26
Max. Negotiated Rate	$1,305.90
Rate for Payer: Aetna of AZ Commercial	$1,305.90
Rate for Payer: Bisbee Police All Plans	$377.26
Rate for Payer: Cash Price	$1,160.80
Rate for Payer: Self Pay Self Pay	$1,160.80

ABSORBTACK 5MM

Facility

OP

$1,451.00

Hospital Charge Code	22528831
Hospital Revenue Code	272
Min. Negotiated Rate	$217.65
Max. Negotiated Rate	$1,305.90
Rate for Payer: Aetna of AZ Commercial	$1,305.90
Rate for Payer: Aetna of AZ Medicare	$406.28
Rate for Payer: Allwell Medicare	$217.65
Rate for Payer: Amerigroup Medicare	$217.65
Rate for Payer: APIPA Medicare/Medicaid	$541.95
Rate for Payer: AZCH Complete Medicare	$217.65
Rate for Payer: Banner UC Health Medicare	$217.65
Rate for Payer: Bisbee Police All Plans	$377.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$986.68
Rate for Payer: Cash Price	$1,160.80
Rate for Payer: Cigna of AZ Commercial	$1,015.70
Rate for Payer: Copperpoint Commercial	$359.12
Rate for Payer: Health Net of AZ Commercial	$870.60
Rate for Payer: Health Net of AZ Medicare	$406.28
Rate for Payer: Humana of AZ Medicare	$217.65
Rate for Payer: Self Pay Self Pay	$1,160.80
Rate for Payer: TriWest Medicare	$217.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$845.93
Rate for Payer: UnitedHealth Group of AZ Medicare	$261.18

ACCESS SHEATH FORTE SET B7017

Facility

OP

$345.00

Hospital Charge Code	22354866
Hospital Revenue Code	270
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna of AZ Commercial	$310.50
Rate for Payer: Aetna of AZ Medicare	$96.60
Rate for Payer: Allwell Medicare	$51.75
Rate for Payer: Amerigroup Medicare	$51.75
Rate for Payer: APIPA Medicare/Medicaid	$128.86
Rate for Payer: AZCH Complete Medicare	$51.75
Rate for Payer: Banner UC Health Medicare	$51.75
Rate for Payer: Bisbee Police All Plans	$89.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$234.60
Rate for Payer: Cash Price	$276.00
Rate for Payer: Cigna of AZ Commercial	$241.50
Rate for Payer: Copperpoint Commercial	$85.39
Rate for Payer: Health Net of AZ Commercial	$207.00
Rate for Payer: Health Net of AZ Medicare	$96.60
Rate for Payer: Humana of AZ Medicare	$51.75
Rate for Payer: Self Pay Self Pay	$276.00
Rate for Payer: TriWest Medicare	$51.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$201.14
Rate for Payer: UnitedHealth Group of AZ Medicare	$62.10

ACCESS SHEATH FORTE SET B7017

Facility

IP

$345.00

Hospital Charge Code	22354866
Hospital Revenue Code	270
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna of AZ Commercial	$310.50
Rate for Payer: Bisbee Police All Plans	$89.70
Rate for Payer: Cash Price	$276.00
Rate for Payer: Self Pay Self Pay	$276.00

acetaminophen 1000 mg/100 mL IV Sol [CQCH]

Facility

IP

$0.44

Service Code	HCPCS J0131
Hospital Charge Code	105907606
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.40
Rate for Payer: Aetna of AZ Commercial	$0.40
Rate for Payer: Bisbee Police All Plans	$0.11
Rate for Payer: Cash Price	$0.35
Rate for Payer: Self Pay Self Pay	$0.35

acetaminophen 1000 mg/100 mL IV Sol [CQCH]

Facility

OP

$0.44

Service Code	HCPCS J0131
Hospital Charge Code	105907606
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.40
Rate for Payer: Aetna of AZ Commercial	$0.40
Rate for Payer: Aetna of AZ Medicare	$0.12
Rate for Payer: AHCCCS Medicaid	$0.20
Rate for Payer: Allwell Medicaid	$0.20
Rate for Payer: Allwell Medicare	$0.07
Rate for Payer: Amerigroup Medicare	$0.07
Rate for Payer: APIPA Medicare/Medicaid	$0.16
Rate for Payer: AZCH Complete Medicaid	$0.20
Rate for Payer: AZCH Complete Medicare	$0.07
Rate for Payer: Banner UC Health Medicaid	$0.20
Rate for Payer: Banner UC Health Medicare	$0.07
Rate for Payer: Bisbee Police All Plans	$0.11
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.30
Rate for Payer: Cash Price	$0.35
Rate for Payer: Cash Price	$0.35
Rate for Payer: Cigna of AZ Commercial	$0.29
Rate for Payer: Copperpoint Commercial	$0.11
Rate for Payer: Health Net of AZ Commercial	$0.26
Rate for Payer: Health Net of AZ Medicare	$0.12
Rate for Payer: Humana of AZ Medicare	$0.07
Rate for Payer: Mercy Care Medicaid	$0.20
Rate for Payer: Self Pay Self Pay	$0.35
Rate for Payer: TriWest Medicare	$0.07
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.26
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.08

acetaminophen 120 mg Supp [CQCH]

Facility

IP

$0.13

Service Code	NDC 713011812
Hospital Charge Code	105908025
Hospital Revenue Code	257
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna of AZ Commercial	$0.12
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Cash Price	$0.10
Rate for Payer: Self Pay Self Pay	$0.10

acetaminophen 120 mg Supp [CQCH]

Facility

OP

$0.13

Service Code	NDC 713011812
Hospital Charge Code	105908025
Hospital Revenue Code	257
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna of AZ Commercial	$0.12
Rate for Payer: Aetna of AZ Medicare	$0.04
Rate for Payer: Allwell Medicare	$0.02
Rate for Payer: Amerigroup Medicare	$0.02
Rate for Payer: APIPA Medicare/Medicaid	$0.05
Rate for Payer: AZCH Complete Medicare	$0.02
Rate for Payer: Banner UC Health Medicare	$0.02
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.09
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cigna of AZ Commercial	$0.08
Rate for Payer: Copperpoint Commercial	$0.03
Rate for Payer: Health Net of AZ Commercial	$0.08
Rate for Payer: Health Net of AZ Medicare	$0.04
Rate for Payer: Humana of AZ Medicare	$0.02
Rate for Payer: Self Pay Self Pay	$0.10
Rate for Payer: TriWest Medicare	$0.02
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.08
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.02

acetaminophen 325 mg/10.15 mL Susp UD[CQCH]

Facility

OP

$0.17

Service Code	NDC 68094033062
Hospital Charge Code	177137384
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.15
Rate for Payer: Aetna of AZ Commercial	$0.15
Rate for Payer: Aetna of AZ Medicare	$0.05
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.06
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.12
Rate for Payer: Cash Price	$0.14
Rate for Payer: Cigna of AZ Commercial	$0.11
Rate for Payer: Copperpoint Commercial	$0.04
Rate for Payer: Health Net of AZ Commercial	$0.10
Rate for Payer: Health Net of AZ Medicare	$0.05
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.14
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.03

acetaminophen 325 mg/10.15 mL Susp UD[CQCH]

Facility

IP

$0.17

Service Code	NDC 68094033062
Hospital Charge Code	177137384
Hospital Revenue Code	251
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.15
Rate for Payer: Aetna of AZ Commercial	$0.15
Rate for Payer: Bisbee Police All Plans	$0.04
Rate for Payer: Cash Price	$0.14
Rate for Payer: Self Pay Self Pay	$0.14

acetaminophen 325 mg Supp [CQCH]

Facility

OP

$0.22

Service Code	NDC 713016412
Hospital Charge Code	105907880
Hospital Revenue Code	257
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.20
Rate for Payer: Aetna of AZ Commercial	$0.20
Rate for Payer: Aetna of AZ Medicare	$0.06
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.08
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.15
Rate for Payer: Cash Price	$0.18
Rate for Payer: Cigna of AZ Commercial	$0.14
Rate for Payer: Copperpoint Commercial	$0.05
Rate for Payer: Health Net of AZ Commercial	$0.13
Rate for Payer: Health Net of AZ Medicare	$0.06
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.18
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.13
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.04

acetaminophen 325 mg Supp [CQCH]

Facility

IP

$0.22

Service Code	NDC 713016412
Hospital Charge Code	105907880
Hospital Revenue Code	257
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.20
Rate for Payer: Aetna of AZ Commercial	$0.20
Rate for Payer: Bisbee Police All Plans	$0.06
Rate for Payer: Cash Price	$0.18
Rate for Payer: Self Pay Self Pay	$0.18

acetaminophen 325 mg Tab [CQCH]

Facility

OP

$0.01

Service Code	NDC 50580060002
Hospital Charge Code	105907813
Hospital Revenue Code	257
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Aetna of AZ Medicare	$0.00
Rate for Payer: Allwell Medicare	$0.00
Rate for Payer: Amerigroup Medicare	$0.00
Rate for Payer: APIPA Medicare/Medicaid	$0.00
Rate for Payer: AZCH Complete Medicare	$0.00
Rate for Payer: Banner UC Health Medicare	$0.00
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of AZ Commercial	$0.01
Rate for Payer: Copperpoint Commercial	$0.00
Rate for Payer: Health Net of AZ Commercial	$0.01
Rate for Payer: Health Net of AZ Medicare	$0.00
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Self Pay Self Pay	$0.01
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.01
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.00

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