Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Actin (Smooth Muscle) Antibody LC

Facility

OP

$1,495.00

Service Code	CPT 83516
Hospital Charge Code	2029263
Hospital Revenue Code	302
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$1,345.50
Rate for Payer: Aetna of AZ Commercial	$1,345.50
Rate for Payer: Aetna of AZ Medicare	$418.60
Rate for Payer: AHCCCS Medicaid	$11.53
Rate for Payer: Allwell Medicaid	$11.53
Rate for Payer: Allwell Medicare	$224.25
Rate for Payer: Amerigroup Medicare	$224.25
Rate for Payer: APIPA Medicare/Medicaid	$558.38
Rate for Payer: AZCH Complete Medicaid	$11.53
Rate for Payer: AZCH Complete Medicare	$224.25
Rate for Payer: Banner UC Health Medicaid	$11.53
Rate for Payer: Banner UC Health Medicare	$224.25
Rate for Payer: Bisbee Police All Plans	$388.70
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,016.60
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Cigna of AZ Commercial	$971.75
Rate for Payer: Copperpoint Commercial	$370.01
Rate for Payer: Health Net of AZ Commercial	$897.00
Rate for Payer: Health Net of AZ Medicare	$418.60
Rate for Payer: Humana of AZ Medicare	$224.25
Rate for Payer: Mercy Care Medicaid	$11.53
Rate for Payer: Self Pay Self Pay	$1,196.00
Rate for Payer: TriWest Medicare	$224.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$871.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$269.10

Actin (Smooth Muscle) Antibody LC

Facility

IP

$1,495.00

Service Code	CPT 83516
Hospital Charge Code	2029263
Hospital Revenue Code	302
Min. Negotiated Rate	$388.70
Max. Negotiated Rate	$1,345.50
Rate for Payer: Aetna of AZ Commercial	$1,345.50
Rate for Payer: Bisbee Police All Plans	$388.70
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Self Pay Self Pay	$1,196.00

Acute And Subacute Endocarditis

Facility

IP

$11,496.65

Service Code	APR-DRG 1933
Hospital Charge Code	APRDRG1934
Min. Negotiated Rate	$11,496.65
Max. Negotiated Rate	$11,496.65
Rate for Payer: AHCCCS Medicaid	$11,496.65
Rate for Payer: Allwell Medicaid	$11,496.65
Rate for Payer: AZCH Complete Medicaid	$11,496.65
Rate for Payer: Banner UC Health Medicaid	$11,496.65
Rate for Payer: Mercy Care Medicaid	$11,496.65

Acute And Subacute Endocarditis

Facility

IP

$16,508.85

Service Code	APR-DRG 1934
Hospital Charge Code	APRDRG1933
Min. Negotiated Rate	$16,508.85
Max. Negotiated Rate	$16,508.85
Rate for Payer: AHCCCS Medicaid	$16,508.85
Rate for Payer: Allwell Medicaid	$16,508.85
Rate for Payer: AZCH Complete Medicaid	$16,508.85
Rate for Payer: Banner UC Health Medicaid	$16,508.85
Rate for Payer: Mercy Care Medicaid	$16,508.85

Acute And Subacute Endocarditis

Facility

IP

$7,461.49

Service Code	APR-DRG 1932
Hospital Charge Code	APRDRG1933
Min. Negotiated Rate	$7,461.49
Max. Negotiated Rate	$7,461.49
Rate for Payer: AHCCCS Medicaid	$7,461.49
Rate for Payer: Allwell Medicaid	$7,461.49
Rate for Payer: AZCH Complete Medicaid	$7,461.49
Rate for Payer: Banner UC Health Medicaid	$7,461.49
Rate for Payer: Mercy Care Medicaid	$7,461.49

Acute And Subacute Endocarditis

Facility

IP

$5,556.49

Service Code	APR-DRG 1931
Hospital Charge Code	APRDRG1931
Min. Negotiated Rate	$5,556.49
Max. Negotiated Rate	$5,556.49
Rate for Payer: AHCCCS Medicaid	$5,556.49
Rate for Payer: Allwell Medicaid	$5,556.49
Rate for Payer: AZCH Complete Medicaid	$5,556.49
Rate for Payer: Banner UC Health Medicaid	$5,556.49
Rate for Payer: Mercy Care Medicaid	$5,556.49

Acute And Subacute Endocarditis

Facility

IP

$5,556.49

Service Code	APR-DRG 1931
Hospital Charge Code	APRDRG1934
Min. Negotiated Rate	$5,556.49
Max. Negotiated Rate	$5,556.49
Rate for Payer: AHCCCS Medicaid	$5,556.49
Rate for Payer: Allwell Medicaid	$5,556.49
Rate for Payer: AZCH Complete Medicaid	$5,556.49
Rate for Payer: Banner UC Health Medicaid	$5,556.49
Rate for Payer: Mercy Care Medicaid	$5,556.49

Acute And Subacute Endocarditis

Facility

IP

$7,461.49

Service Code	APR-DRG 1932
Hospital Charge Code	APRDRG1931
Min. Negotiated Rate	$7,461.49
Max. Negotiated Rate	$7,461.49
Rate for Payer: AHCCCS Medicaid	$7,461.49
Rate for Payer: Allwell Medicaid	$7,461.49
Rate for Payer: AZCH Complete Medicaid	$7,461.49
Rate for Payer: Banner UC Health Medicaid	$7,461.49
Rate for Payer: Mercy Care Medicaid	$7,461.49

Acute And Subacute Endocarditis

Facility

IP

$5,556.49

Service Code	APR-DRG 1931
Hospital Charge Code	APRDRG1932
Min. Negotiated Rate	$5,556.49
Max. Negotiated Rate	$5,556.49
Rate for Payer: AHCCCS Medicaid	$5,556.49
Rate for Payer: Allwell Medicaid	$5,556.49
Rate for Payer: AZCH Complete Medicaid	$5,556.49
Rate for Payer: Banner UC Health Medicaid	$5,556.49
Rate for Payer: Mercy Care Medicaid	$5,556.49

Acute And Subacute Endocarditis

Facility

IP

$7,461.49

Service Code	APR-DRG 1932
Hospital Charge Code	APRDRG1934
Min. Negotiated Rate	$7,461.49
Max. Negotiated Rate	$7,461.49
Rate for Payer: AHCCCS Medicaid	$7,461.49
Rate for Payer: Allwell Medicaid	$7,461.49
Rate for Payer: AZCH Complete Medicaid	$7,461.49
Rate for Payer: Banner UC Health Medicaid	$7,461.49
Rate for Payer: Mercy Care Medicaid	$7,461.49

Acute And Subacute Endocarditis

Facility

IP

$11,496.65

Service Code	APR-DRG 1933
Hospital Charge Code	APRDRG1933
Min. Negotiated Rate	$11,496.65
Max. Negotiated Rate	$11,496.65
Rate for Payer: AHCCCS Medicaid	$11,496.65
Rate for Payer: Allwell Medicaid	$11,496.65
Rate for Payer: AZCH Complete Medicaid	$11,496.65
Rate for Payer: Banner UC Health Medicaid	$11,496.65
Rate for Payer: Mercy Care Medicaid	$11,496.65

Acute And Subacute Endocarditis

Facility

IP

$16,508.85

Service Code	APR-DRG 1934
Hospital Charge Code	APRDRG1932
Min. Negotiated Rate	$16,508.85
Max. Negotiated Rate	$16,508.85
Rate for Payer: AHCCCS Medicaid	$16,508.85
Rate for Payer: Allwell Medicaid	$16,508.85
Rate for Payer: AZCH Complete Medicaid	$16,508.85
Rate for Payer: Banner UC Health Medicaid	$16,508.85
Rate for Payer: Mercy Care Medicaid	$16,508.85

Acute And Subacute Endocarditis

Facility

IP

$11,496.65

Service Code	APR-DRG 1933
Hospital Charge Code	APRDRG1932
Min. Negotiated Rate	$11,496.65
Max. Negotiated Rate	$11,496.65
Rate for Payer: AHCCCS Medicaid	$11,496.65
Rate for Payer: Allwell Medicaid	$11,496.65
Rate for Payer: AZCH Complete Medicaid	$11,496.65
Rate for Payer: Banner UC Health Medicaid	$11,496.65
Rate for Payer: Mercy Care Medicaid	$11,496.65

Acute And Subacute Endocarditis

Facility

IP

$16,508.85

Service Code	APR-DRG 1934
Hospital Charge Code	APRDRG1931
Min. Negotiated Rate	$16,508.85
Max. Negotiated Rate	$16,508.85
Rate for Payer: AHCCCS Medicaid	$16,508.85
Rate for Payer: Allwell Medicaid	$16,508.85
Rate for Payer: AZCH Complete Medicaid	$16,508.85
Rate for Payer: Banner UC Health Medicaid	$16,508.85
Rate for Payer: Mercy Care Medicaid	$16,508.85

Acute And Subacute Endocarditis

Facility

IP

$5,556.49

Service Code	APR-DRG 1931
Hospital Charge Code	APRDRG1933
Min. Negotiated Rate	$5,556.49
Max. Negotiated Rate	$5,556.49
Rate for Payer: AHCCCS Medicaid	$5,556.49
Rate for Payer: Allwell Medicaid	$5,556.49
Rate for Payer: AZCH Complete Medicaid	$5,556.49
Rate for Payer: Banner UC Health Medicaid	$5,556.49
Rate for Payer: Mercy Care Medicaid	$5,556.49

Acute And Subacute Endocarditis

Facility

IP

$11,496.65

Service Code	APR-DRG 1933
Hospital Charge Code	APRDRG1931
Min. Negotiated Rate	$11,496.65
Max. Negotiated Rate	$11,496.65
Rate for Payer: AHCCCS Medicaid	$11,496.65
Rate for Payer: Allwell Medicaid	$11,496.65
Rate for Payer: AZCH Complete Medicaid	$11,496.65
Rate for Payer: Banner UC Health Medicaid	$11,496.65
Rate for Payer: Mercy Care Medicaid	$11,496.65

Acute And Subacute Endocarditis

Facility

IP

$7,461.49

Service Code	APR-DRG 1932
Hospital Charge Code	APRDRG1932
Min. Negotiated Rate	$7,461.49
Max. Negotiated Rate	$7,461.49
Rate for Payer: AHCCCS Medicaid	$7,461.49
Rate for Payer: Allwell Medicaid	$7,461.49
Rate for Payer: AZCH Complete Medicaid	$7,461.49
Rate for Payer: Banner UC Health Medicaid	$7,461.49
Rate for Payer: Mercy Care Medicaid	$7,461.49

Acute And Subacute Endocarditis

Facility

IP

$16,508.85

Service Code	APR-DRG 1934
Hospital Charge Code	APRDRG1934
Min. Negotiated Rate	$16,508.85
Max. Negotiated Rate	$16,508.85
Rate for Payer: AHCCCS Medicaid	$16,508.85
Rate for Payer: Allwell Medicaid	$16,508.85
Rate for Payer: AZCH Complete Medicaid	$16,508.85
Rate for Payer: Banner UC Health Medicaid	$16,508.85
Rate for Payer: Mercy Care Medicaid	$16,508.85

Acute Anxiety And Delirium States

Facility

IP

$3,835.96

Service Code	APR-DRG 7562
Hospital Charge Code	APRDRG7561
Min. Negotiated Rate	$3,835.96
Max. Negotiated Rate	$3,835.96
Rate for Payer: AHCCCS Medicaid	$3,835.96
Rate for Payer: Allwell Medicaid	$3,835.96
Rate for Payer: AZCH Complete Medicaid	$3,835.96
Rate for Payer: Banner UC Health Medicaid	$3,835.96
Rate for Payer: Mercy Care Medicaid	$3,835.96

Acute Anxiety And Delirium States

Facility

IP

$3,004.10

Service Code	APR-DRG 7561
Hospital Charge Code	APRDRG7563
Min. Negotiated Rate	$3,004.10
Max. Negotiated Rate	$3,004.10
Rate for Payer: AHCCCS Medicaid	$3,004.10
Rate for Payer: Allwell Medicaid	$3,004.10
Rate for Payer: AZCH Complete Medicaid	$3,004.10
Rate for Payer: Banner UC Health Medicaid	$3,004.10
Rate for Payer: Mercy Care Medicaid	$3,004.10

Acute Anxiety And Delirium States

Facility

IP

$3,004.10

Service Code	APR-DRG 7561
Hospital Charge Code	APRDRG7561
Min. Negotiated Rate	$3,004.10
Max. Negotiated Rate	$3,004.10
Rate for Payer: AHCCCS Medicaid	$3,004.10
Rate for Payer: Allwell Medicaid	$3,004.10
Rate for Payer: AZCH Complete Medicaid	$3,004.10
Rate for Payer: Banner UC Health Medicaid	$3,004.10
Rate for Payer: Mercy Care Medicaid	$3,004.10

Acute Anxiety And Delirium States

Facility

IP

$3,004.10

Service Code	APR-DRG 7561
Hospital Charge Code	APRDRG7562
Min. Negotiated Rate	$3,004.10
Max. Negotiated Rate	$3,004.10
Rate for Payer: AHCCCS Medicaid	$3,004.10
Rate for Payer: Allwell Medicaid	$3,004.10
Rate for Payer: AZCH Complete Medicaid	$3,004.10
Rate for Payer: Banner UC Health Medicaid	$3,004.10
Rate for Payer: Mercy Care Medicaid	$3,004.10

Acute Anxiety And Delirium States

Facility

IP

$10,876.61

Service Code	APR-DRG 7564
Hospital Charge Code	APRDRG7562
Min. Negotiated Rate	$10,876.61
Max. Negotiated Rate	$10,876.61
Rate for Payer: AHCCCS Medicaid	$10,876.61
Rate for Payer: Allwell Medicaid	$10,876.61
Rate for Payer: AZCH Complete Medicaid	$10,876.61
Rate for Payer: Banner UC Health Medicaid	$10,876.61
Rate for Payer: Mercy Care Medicaid	$10,876.61

Acute Anxiety And Delirium States

Facility

IP

$4,012.71

Service Code	APR-DRG 7563
Hospital Charge Code	APRDRG7561
Min. Negotiated Rate	$4,012.71
Max. Negotiated Rate	$4,012.71
Rate for Payer: AHCCCS Medicaid	$4,012.71
Rate for Payer: Allwell Medicaid	$4,012.71
Rate for Payer: AZCH Complete Medicaid	$4,012.71
Rate for Payer: Banner UC Health Medicaid	$4,012.71
Rate for Payer: Mercy Care Medicaid	$4,012.71

Acute Anxiety And Delirium States

Facility

IP

$3,835.96

Service Code	APR-DRG 7562
Hospital Charge Code	APRDRG7563
Min. Negotiated Rate	$3,835.96
Max. Negotiated Rate	$3,835.96
Rate for Payer: AHCCCS Medicaid	$3,835.96
Rate for Payer: Allwell Medicaid	$3,835.96
Rate for Payer: AZCH Complete Medicaid	$3,835.96
Rate for Payer: Banner UC Health Medicaid	$3,835.96
Rate for Payer: Mercy Care Medicaid	$3,835.96

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