Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$6,142.86

Service Code	APR-DRG 3442
Hospital Charge Code	APRDRG3443
Min. Negotiated Rate	$6,142.86
Max. Negotiated Rate	$6,142.86
Rate for Payer: AHCCCS Medicaid	$6,142.86
Rate for Payer: Allwell Medicaid	$6,142.86
Rate for Payer: AZCH Complete Medicaid	$6,142.86
Rate for Payer: Banner UC Health Medicaid	$6,142.86
Rate for Payer: Mercy Care Medicaid	$6,142.86

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$9,085.23

Service Code	APR-DRG 3443
Hospital Charge Code	APRDRG3442
Min. Negotiated Rate	$9,085.23
Max. Negotiated Rate	$9,085.23
Rate for Payer: AHCCCS Medicaid	$9,085.23
Rate for Payer: Allwell Medicaid	$9,085.23
Rate for Payer: AZCH Complete Medicaid	$9,085.23
Rate for Payer: Banner UC Health Medicaid	$9,085.23
Rate for Payer: Mercy Care Medicaid	$9,085.23

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$15,890.22

Service Code	APR-DRG 3444
Hospital Charge Code	APRDRG3441
Min. Negotiated Rate	$15,890.22
Max. Negotiated Rate	$15,890.22
Rate for Payer: AHCCCS Medicaid	$15,890.22
Rate for Payer: Allwell Medicaid	$15,890.22
Rate for Payer: AZCH Complete Medicaid	$15,890.22
Rate for Payer: Banner UC Health Medicaid	$15,890.22
Rate for Payer: Mercy Care Medicaid	$15,890.22

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$9,085.23

Service Code	APR-DRG 3443
Hospital Charge Code	APRDRG3441
Min. Negotiated Rate	$9,085.23
Max. Negotiated Rate	$9,085.23
Rate for Payer: AHCCCS Medicaid	$9,085.23
Rate for Payer: Allwell Medicaid	$9,085.23
Rate for Payer: AZCH Complete Medicaid	$9,085.23
Rate for Payer: Banner UC Health Medicaid	$9,085.23
Rate for Payer: Mercy Care Medicaid	$9,085.23

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$15,890.22

Service Code	APR-DRG 3444
Hospital Charge Code	APRDRG3442
Min. Negotiated Rate	$15,890.22
Max. Negotiated Rate	$15,890.22
Rate for Payer: AHCCCS Medicaid	$15,890.22
Rate for Payer: Allwell Medicaid	$15,890.22
Rate for Payer: AZCH Complete Medicaid	$15,890.22
Rate for Payer: Banner UC Health Medicaid	$15,890.22
Rate for Payer: Mercy Care Medicaid	$15,890.22

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$9,085.23

Service Code	APR-DRG 3443
Hospital Charge Code	APRDRG3444
Min. Negotiated Rate	$9,085.23
Max. Negotiated Rate	$9,085.23
Rate for Payer: AHCCCS Medicaid	$9,085.23
Rate for Payer: Allwell Medicaid	$9,085.23
Rate for Payer: AZCH Complete Medicaid	$9,085.23
Rate for Payer: Banner UC Health Medicaid	$9,085.23
Rate for Payer: Mercy Care Medicaid	$9,085.23

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$6,142.86

Service Code	APR-DRG 3442
Hospital Charge Code	APRDRG3441
Min. Negotiated Rate	$6,142.86
Max. Negotiated Rate	$6,142.86
Rate for Payer: AHCCCS Medicaid	$6,142.86
Rate for Payer: Allwell Medicaid	$6,142.86
Rate for Payer: AZCH Complete Medicaid	$6,142.86
Rate for Payer: Banner UC Health Medicaid	$6,142.86
Rate for Payer: Mercy Care Medicaid	$6,142.86

Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections

Facility

IP

$4,891.56

Service Code	APR-DRG 3441
Hospital Charge Code	APRDRG3442
Min. Negotiated Rate	$4,891.56
Max. Negotiated Rate	$4,891.56
Rate for Payer: AHCCCS Medicaid	$4,891.56
Rate for Payer: Allwell Medicaid	$4,891.56
Rate for Payer: AZCH Complete Medicaid	$4,891.56
Rate for Payer: Banner UC Health Medicaid	$4,891.56
Rate for Payer: Mercy Care Medicaid	$4,891.56

OSTEOSET RESORBABLE MINI BEAD FAST

Facility

OP

$2,293.00

Hospital Charge Code	22354275
Hospital Revenue Code	270
Min. Negotiated Rate	$366.88
Max. Negotiated Rate	$2,063.70
Rate for Payer: Aetna of AZ Commercial	$2,063.70
Rate for Payer: Aetna of AZ Medicare	$642.04
Rate for Payer: Allwell Medicare	$366.88
Rate for Payer: Amerigroup Medicare	$366.88
Rate for Payer: APIPA Medicare/Medicaid	$856.44
Rate for Payer: AZCH Complete Medicare	$366.88
Rate for Payer: Banner UC Health Medicare	$366.88
Rate for Payer: Bisbee Police All Plans	$596.18
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,559.24
Rate for Payer: Cash Price	$1,834.40
Rate for Payer: Cigna of AZ Commercial	$1,605.10
Rate for Payer: Copperpoint Commercial	$567.52
Rate for Payer: Health Net of AZ Commercial	$1,375.80
Rate for Payer: Health Net of AZ Medicare	$642.04
Rate for Payer: Humana of AZ Medicare	$366.88
Rate for Payer: Self Pay Self Pay	$1,834.40
Rate for Payer: TriWest Medicare	$366.88
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,336.82
Rate for Payer: UnitedHealth Group of AZ Medicare	$412.74

OSTEOSET RESORBABLE MINI BEAD FAST

Facility

IP

$2,293.00

Hospital Charge Code	22354275
Hospital Revenue Code	270
Min. Negotiated Rate	$596.18
Max. Negotiated Rate	$2,063.70
Rate for Payer: Aetna of AZ Commercial	$2,063.70
Rate for Payer: Bisbee Police All Plans	$596.18
Rate for Payer: Cash Price	$1,834.40
Rate for Payer: Self Pay Self Pay	$1,834.40

OSTEOTOMY WITH OR WITHOUT LENGTHENING SHORTENING OR ANGULAR CORRECTION

Facility

IP

$1,966.00

Service Code	CPT 28306
Hospital Charge Code	24043263
Hospital Revenue Code	360
Min. Negotiated Rate	$511.16
Max. Negotiated Rate	$1,769.40
Rate for Payer: Aetna of AZ Commercial	$1,769.40
Rate for Payer: Bisbee Police All Plans	$511.16
Rate for Payer: Cash Price	$1,572.80
Rate for Payer: Self Pay Self Pay	$1,572.80

OSTEOTOMY WITH OR WITHOUT LENGTHENING SHORTENING OR ANGULAR CORRECTION

Facility

OP

$1,966.00

Service Code	CPT 28306
Hospital Charge Code	24043263
Hospital Revenue Code	360
Min. Negotiated Rate	$314.56
Max. Negotiated Rate	$4,542.09
Rate for Payer: Aetna of AZ Commercial	$1,769.40
Rate for Payer: Aetna of AZ Medicare	$550.48
Rate for Payer: AHCCCS Medicaid	$4,542.09
Rate for Payer: Allwell Medicaid	$4,542.09
Rate for Payer: Allwell Medicare	$314.56
Rate for Payer: Amerigroup Medicare	$314.56
Rate for Payer: APIPA Medicare/Medicaid	$734.30
Rate for Payer: AZCH Complete Medicaid	$4,542.09
Rate for Payer: AZCH Complete Medicare	$314.56
Rate for Payer: Banner UC Health Medicaid	$4,542.09
Rate for Payer: Banner UC Health Medicare	$314.56
Rate for Payer: Bisbee Police All Plans	$511.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,336.88
Rate for Payer: Cash Price	$1,572.80
Rate for Payer: Cash Price	$1,572.80
Rate for Payer: Cigna of AZ Commercial	$983.00
Rate for Payer: Copperpoint Commercial	$486.58
Rate for Payer: Health Net of AZ Commercial	$1,179.60
Rate for Payer: Health Net of AZ Medicare	$550.48
Rate for Payer: Humana of AZ Medicare	$314.56
Rate for Payer: Mercy Care Medicaid	$4,542.09
Rate for Payer: Self Pay Self Pay	$1,572.80
Rate for Payer: TriWest Medicare	$314.56
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$353.88

OSTEOTOMY WITH OR WITHOUT LENGTHENING SHORTENING OR ANGULAR CORRECTION - 28308

Facility

IP

$1,851.00

Service Code	CPT 28308
Hospital Charge Code	24043264
Hospital Revenue Code	360
Min. Negotiated Rate	$481.26
Max. Negotiated Rate	$1,665.90
Rate for Payer: Aetna of AZ Commercial	$1,665.90
Rate for Payer: Bisbee Police All Plans	$481.26
Rate for Payer: Cash Price	$1,480.80
Rate for Payer: Self Pay Self Pay	$1,480.80

OSTEOTOMY WITH OR WITHOUT LENGTHENING SHORTENING OR ANGULAR CORRECTION - 28308

Facility

OP

$1,851.00

Service Code	CPT 28308
Hospital Charge Code	24043264
Hospital Revenue Code	360
Min. Negotiated Rate	$296.16
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$1,665.90
Rate for Payer: Aetna of AZ Medicare	$518.28
Rate for Payer: AHCCCS Medicaid	$2,052.04
Rate for Payer: Allwell Medicaid	$2,052.04
Rate for Payer: Allwell Medicare	$296.16
Rate for Payer: Amerigroup Medicare	$296.16
Rate for Payer: APIPA Medicare/Medicaid	$691.35
Rate for Payer: AZCH Complete Medicaid	$2,052.04
Rate for Payer: AZCH Complete Medicare	$296.16
Rate for Payer: Banner UC Health Medicaid	$2,052.04
Rate for Payer: Banner UC Health Medicare	$296.16
Rate for Payer: Bisbee Police All Plans	$481.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,258.68
Rate for Payer: Cash Price	$1,480.80
Rate for Payer: Cash Price	$1,480.80
Rate for Payer: Cigna of AZ Commercial	$925.50
Rate for Payer: Copperpoint Commercial	$458.12
Rate for Payer: Health Net of AZ Commercial	$1,110.60
Rate for Payer: Health Net of AZ Medicare	$518.28
Rate for Payer: Humana of AZ Medicare	$296.16
Rate for Payer: Mercy Care Medicaid	$2,052.04
Rate for Payer: Self Pay Self Pay	$1,480.80
Rate for Payer: TriWest Medicare	$296.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$333.18

OSTOMY BELT ADJUSTABLE

Facility

OP

$67.00

Service Code	CPT A4367
Hospital Charge Code	22354246
Hospital Revenue Code	270
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna of AZ Commercial	$60.30
Rate for Payer: Aetna of AZ Medicare	$18.76
Rate for Payer: Allwell Medicare	$10.72
Rate for Payer: Amerigroup Medicare	$10.72
Rate for Payer: APIPA Medicare/Medicaid	$25.02
Rate for Payer: AZCH Complete Medicare	$10.72
Rate for Payer: Banner UC Health Medicare	$10.72
Rate for Payer: Bisbee Police All Plans	$17.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$45.56
Rate for Payer: Cash Price	$53.60
Rate for Payer: Cigna of AZ Commercial	$46.90
Rate for Payer: Copperpoint Commercial	$16.58
Rate for Payer: Health Net of AZ Commercial	$40.20
Rate for Payer: Health Net of AZ Medicare	$18.76
Rate for Payer: Humana of AZ Medicare	$10.72
Rate for Payer: Self Pay Self Pay	$53.60
Rate for Payer: TriWest Medicare	$10.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$39.06
Rate for Payer: UnitedHealth Group of AZ Medicare	$12.06

OSTOMY BELT ADJUSTABLE

Facility

IP

$67.00

Service Code	CPT A4367
Hospital Charge Code	22354246
Hospital Revenue Code	270
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna of AZ Commercial	$60.30
Rate for Payer: Bisbee Police All Plans	$17.42
Rate for Payer: Cash Price	$53.60
Rate for Payer: Self Pay Self Pay	$53.60

OT Body Position Current Status G-8981 CH 0% impaired

Facility

IP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035061
Hospital Revenue Code	430
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

OT Body Position Current Status G-8981 CH 0% impaired

Facility

OP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035061
Hospital Revenue Code	430
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

OT Body Position Current Status G-8981 CI At least 1% but less than 20% impaired

Facility

OP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035060
Hospital Revenue Code	430
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

OT Body Position Current Status G-8981 CI At least 1% but less than 20% impaired

Facility

IP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035060
Hospital Revenue Code	430
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

OT Body Position Current Status G-8981 CJ At least 20% but less than 40% impaire

Facility

OP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035059
Hospital Revenue Code	430
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

OT Body Position Current Status G-8981 CJ At least 20% but less than 40% impaire

Facility

IP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035059
Hospital Revenue Code	430
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

OT Body Position Current Status G-8981 CK At least 40% but less than 60% impaire

Facility

IP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035058
Hospital Revenue Code	430
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

OT Body Position Current Status G-8981 CK At least 40% but less than 60% impaire

Facility

OP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035058
Hospital Revenue Code	430
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

OT Body Position Current Status G-8981 CL At least 60% but less than 80% impaire

Facility

IP

$0.01

Service Code	CPT G8981 GO
Hospital Charge Code	6035057
Hospital Revenue Code	430
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

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