Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Partial Thickness Burns Without Skin Graft

Facility

IP

$5,268.92

Service Code	APR-DRG 8442
Hospital Charge Code	APRDRG8444
Min. Negotiated Rate	$5,268.92
Max. Negotiated Rate	$5,268.92
Rate for Payer: AHCCCS Medicaid	$5,268.92
Rate for Payer: Allwell Medicaid	$5,268.92
Rate for Payer: AZCH Complete Medicaid	$5,268.92
Rate for Payer: Banner UC Health Medicaid	$5,268.92
Rate for Payer: Mercy Care Medicaid	$5,268.92

Partial Thickness Burns Without Skin Graft

Facility

IP

$8,655.28

Service Code	APR-DRG 8443
Hospital Charge Code	APRDRG8441
Min. Negotiated Rate	$8,655.28
Max. Negotiated Rate	$8,655.28
Rate for Payer: AHCCCS Medicaid	$8,655.28
Rate for Payer: Allwell Medicaid	$8,655.28
Rate for Payer: AZCH Complete Medicaid	$8,655.28
Rate for Payer: Banner UC Health Medicaid	$8,655.28
Rate for Payer: Mercy Care Medicaid	$8,655.28

Partial Thickness Burns Without Skin Graft

Facility

IP

$8,655.28

Service Code	APR-DRG 8443
Hospital Charge Code	APRDRG8442
Min. Negotiated Rate	$8,655.28
Max. Negotiated Rate	$8,655.28
Rate for Payer: AHCCCS Medicaid	$8,655.28
Rate for Payer: Allwell Medicaid	$8,655.28
Rate for Payer: AZCH Complete Medicaid	$8,655.28
Rate for Payer: Banner UC Health Medicaid	$8,655.28
Rate for Payer: Mercy Care Medicaid	$8,655.28

Partial Thickness Burns Without Skin Graft

Facility

IP

$8,655.28

Service Code	APR-DRG 8443
Hospital Charge Code	APRDRG8444
Min. Negotiated Rate	$8,655.28
Max. Negotiated Rate	$8,655.28
Rate for Payer: AHCCCS Medicaid	$8,655.28
Rate for Payer: Allwell Medicaid	$8,655.28
Rate for Payer: AZCH Complete Medicaid	$8,655.28
Rate for Payer: Banner UC Health Medicaid	$8,655.28
Rate for Payer: Mercy Care Medicaid	$8,655.28

Partial Thickness Burns Without Skin Graft

Facility

IP

$3,100.89

Service Code	APR-DRG 8441
Hospital Charge Code	APRDRG8441
Min. Negotiated Rate	$3,100.89
Max. Negotiated Rate	$3,100.89
Rate for Payer: AHCCCS Medicaid	$3,100.89
Rate for Payer: Allwell Medicaid	$3,100.89
Rate for Payer: AZCH Complete Medicaid	$3,100.89
Rate for Payer: Banner UC Health Medicaid	$3,100.89
Rate for Payer: Mercy Care Medicaid	$3,100.89

Partial Thickness Burns Without Skin Graft

Facility

IP

$5,268.92

Service Code	APR-DRG 8442
Hospital Charge Code	APRDRG8441
Min. Negotiated Rate	$5,268.92
Max. Negotiated Rate	$5,268.92
Rate for Payer: AHCCCS Medicaid	$5,268.92
Rate for Payer: Allwell Medicaid	$5,268.92
Rate for Payer: AZCH Complete Medicaid	$5,268.92
Rate for Payer: Banner UC Health Medicaid	$5,268.92
Rate for Payer: Mercy Care Medicaid	$5,268.92

Partial Thickness Burns Without Skin Graft

Facility

IP

$8,655.28

Service Code	APR-DRG 8443
Hospital Charge Code	APRDRG8443
Min. Negotiated Rate	$8,655.28
Max. Negotiated Rate	$8,655.28
Rate for Payer: AHCCCS Medicaid	$8,655.28
Rate for Payer: Allwell Medicaid	$8,655.28
Rate for Payer: AZCH Complete Medicaid	$8,655.28
Rate for Payer: Banner UC Health Medicaid	$8,655.28
Rate for Payer: Mercy Care Medicaid	$8,655.28

Partial Thickness Burns Without Skin Graft

Facility

IP

$5,268.92

Service Code	APR-DRG 8442
Hospital Charge Code	APRDRG8442
Min. Negotiated Rate	$5,268.92
Max. Negotiated Rate	$5,268.92
Rate for Payer: AHCCCS Medicaid	$5,268.92
Rate for Payer: Allwell Medicaid	$5,268.92
Rate for Payer: AZCH Complete Medicaid	$5,268.92
Rate for Payer: Banner UC Health Medicaid	$5,268.92
Rate for Payer: Mercy Care Medicaid	$5,268.92

Partial Thickness Burns Without Skin Graft

Facility

IP

$3,100.89

Service Code	APR-DRG 8441
Hospital Charge Code	APRDRG8443
Min. Negotiated Rate	$3,100.89
Max. Negotiated Rate	$3,100.89
Rate for Payer: AHCCCS Medicaid	$3,100.89
Rate for Payer: Allwell Medicaid	$3,100.89
Rate for Payer: AZCH Complete Medicaid	$3,100.89
Rate for Payer: Banner UC Health Medicaid	$3,100.89
Rate for Payer: Mercy Care Medicaid	$3,100.89

Partial Thickness Burns Without Skin Graft

Facility

IP

$19,419.66

Service Code	APR-DRG 8444
Hospital Charge Code	APRDRG8443
Min. Negotiated Rate	$19,419.66
Max. Negotiated Rate	$19,419.66
Rate for Payer: AHCCCS Medicaid	$19,419.66
Rate for Payer: Allwell Medicaid	$19,419.66
Rate for Payer: AZCH Complete Medicaid	$19,419.66
Rate for Payer: Banner UC Health Medicaid	$19,419.66
Rate for Payer: Mercy Care Medicaid	$19,419.66

Partial Thickness Burns Without Skin Graft

Facility

IP

$19,419.66

Service Code	APR-DRG 8444
Hospital Charge Code	APRDRG8441
Min. Negotiated Rate	$19,419.66
Max. Negotiated Rate	$19,419.66
Rate for Payer: AHCCCS Medicaid	$19,419.66
Rate for Payer: Allwell Medicaid	$19,419.66
Rate for Payer: AZCH Complete Medicaid	$19,419.66
Rate for Payer: Banner UC Health Medicaid	$19,419.66
Rate for Payer: Mercy Care Medicaid	$19,419.66

Partial Thickness Burns Without Skin Graft

Facility

IP

$3,100.89

Service Code	APR-DRG 8441
Hospital Charge Code	APRDRG8444
Min. Negotiated Rate	$3,100.89
Max. Negotiated Rate	$3,100.89
Rate for Payer: AHCCCS Medicaid	$3,100.89
Rate for Payer: Allwell Medicaid	$3,100.89
Rate for Payer: AZCH Complete Medicaid	$3,100.89
Rate for Payer: Banner UC Health Medicaid	$3,100.89
Rate for Payer: Mercy Care Medicaid	$3,100.89

Partial Thickness Burns Without Skin Graft

Facility

IP

$5,268.92

Service Code	APR-DRG 8442
Hospital Charge Code	APRDRG8443
Min. Negotiated Rate	$5,268.92
Max. Negotiated Rate	$5,268.92
Rate for Payer: AHCCCS Medicaid	$5,268.92
Rate for Payer: Allwell Medicaid	$5,268.92
Rate for Payer: AZCH Complete Medicaid	$5,268.92
Rate for Payer: Banner UC Health Medicaid	$5,268.92
Rate for Payer: Mercy Care Medicaid	$5,268.92

Partial Thickness Burns Without Skin Graft

Facility

IP

$19,419.66

Service Code	APR-DRG 8444
Hospital Charge Code	APRDRG8442
Min. Negotiated Rate	$19,419.66
Max. Negotiated Rate	$19,419.66
Rate for Payer: AHCCCS Medicaid	$19,419.66
Rate for Payer: Allwell Medicaid	$19,419.66
Rate for Payer: AZCH Complete Medicaid	$19,419.66
Rate for Payer: Banner UC Health Medicaid	$19,419.66
Rate for Payer: Mercy Care Medicaid	$19,419.66

Partial Thickness Burns Without Skin Graft

Facility

IP

$19,419.66

Service Code	APR-DRG 8444
Hospital Charge Code	APRDRG8444
Min. Negotiated Rate	$19,419.66
Max. Negotiated Rate	$19,419.66
Rate for Payer: AHCCCS Medicaid	$19,419.66
Rate for Payer: Allwell Medicaid	$19,419.66
Rate for Payer: AZCH Complete Medicaid	$19,419.66
Rate for Payer: Banner UC Health Medicaid	$19,419.66
Rate for Payer: Mercy Care Medicaid	$19,419.66

Partial Thromboplastin Time

Facility

OP

$141.00

Service Code	CPT 85730
Hospital Charge Code	633794
Hospital Revenue Code	305
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$126.90
Rate for Payer: Aetna of AZ Commercial	$126.90
Rate for Payer: Aetna of AZ Medicare	$39.48
Rate for Payer: AHCCCS Medicaid	$6.01
Rate for Payer: Allwell Medicaid	$6.01
Rate for Payer: Allwell Medicare	$21.15
Rate for Payer: Amerigroup Medicare	$21.15
Rate for Payer: APIPA Medicare/Medicaid	$52.66
Rate for Payer: AZCH Complete Medicaid	$6.01
Rate for Payer: AZCH Complete Medicare	$21.15
Rate for Payer: Banner UC Health Medicaid	$6.01
Rate for Payer: Banner UC Health Medicare	$21.15
Rate for Payer: Bisbee Police All Plans	$36.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$95.88
Rate for Payer: Cash Price	$112.80
Rate for Payer: Cash Price	$112.80
Rate for Payer: Cigna of AZ Commercial	$91.65
Rate for Payer: Copperpoint Commercial	$34.90
Rate for Payer: Health Net of AZ Commercial	$84.60
Rate for Payer: Health Net of AZ Medicare	$39.48
Rate for Payer: Humana of AZ Medicare	$21.15
Rate for Payer: Mercy Care Medicaid	$6.01
Rate for Payer: Self Pay Self Pay	$112.80
Rate for Payer: TriWest Medicare	$21.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$82.20
Rate for Payer: UnitedHealth Group of AZ Medicare	$25.38

Partial Thromboplastin Time

Facility

IP

$141.00

Service Code	CPT 85730
Hospital Charge Code	633794
Hospital Revenue Code	305
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$126.90
Rate for Payer: Aetna of AZ Commercial	$126.90
Rate for Payer: Bisbee Police All Plans	$36.66
Rate for Payer: Cash Price	$112.80
Rate for Payer: Self Pay Self Pay	$112.80

.PARVOVIR IGM

Facility

OP

$185.00

Service Code	CPT 86747
Hospital Charge Code	22481449
Hospital Revenue Code	302
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Aetna of AZ Medicare	$51.80
Rate for Payer: AHCCCS Medicaid	$15.03
Rate for Payer: Allwell Medicaid	$15.03
Rate for Payer: Allwell Medicare	$27.75
Rate for Payer: Amerigroup Medicare	$27.75
Rate for Payer: APIPA Medicare/Medicaid	$69.10
Rate for Payer: AZCH Complete Medicaid	$15.03
Rate for Payer: AZCH Complete Medicare	$27.75
Rate for Payer: Banner UC Health Medicaid	$15.03
Rate for Payer: Banner UC Health Medicare	$27.75
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$125.80
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cigna of AZ Commercial	$120.25
Rate for Payer: Copperpoint Commercial	$45.79
Rate for Payer: Health Net of AZ Commercial	$111.00
Rate for Payer: Health Net of AZ Medicare	$51.80
Rate for Payer: Humana of AZ Medicare	$27.75
Rate for Payer: Mercy Care Medicaid	$15.03
Rate for Payer: Self Pay Self Pay	$148.00
Rate for Payer: TriWest Medicare	$27.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$107.86
Rate for Payer: UnitedHealth Group of AZ Medicare	$33.30

.PARVOVIR IGM

Facility

IP

$185.00

Service Code	CPT 86747
Hospital Charge Code	22481449
Hospital Revenue Code	302
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Cash Price	$148.00
Rate for Payer: Self Pay Self Pay	$148.00

Parvovirus B19, Human, IgG/IgM LC

Facility

IP

$194.00

Service Code	CPT 86747
Hospital Charge Code	2269428
Hospital Revenue Code	302
Min. Negotiated Rate	$50.44
Max. Negotiated Rate	$174.60
Rate for Payer: Aetna of AZ Commercial	$174.60
Rate for Payer: Bisbee Police All Plans	$50.44
Rate for Payer: Cash Price	$155.20
Rate for Payer: Self Pay Self Pay	$155.20

Parvovirus B19, Human, IgG/IgM LC

Facility

OP

$194.00

Service Code	CPT 86747
Hospital Charge Code	2269428
Hospital Revenue Code	302
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$174.60
Rate for Payer: Aetna of AZ Commercial	$174.60
Rate for Payer: Aetna of AZ Medicare	$54.32
Rate for Payer: AHCCCS Medicaid	$15.03
Rate for Payer: Allwell Medicaid	$15.03
Rate for Payer: Allwell Medicare	$29.10
Rate for Payer: Amerigroup Medicare	$29.10
Rate for Payer: APIPA Medicare/Medicaid	$72.46
Rate for Payer: AZCH Complete Medicaid	$15.03
Rate for Payer: AZCH Complete Medicare	$29.10
Rate for Payer: Banner UC Health Medicaid	$15.03
Rate for Payer: Banner UC Health Medicare	$29.10
Rate for Payer: Bisbee Police All Plans	$50.44
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$131.92
Rate for Payer: Cash Price	$155.20
Rate for Payer: Cash Price	$155.20
Rate for Payer: Cigna of AZ Commercial	$126.10
Rate for Payer: Copperpoint Commercial	$48.02
Rate for Payer: Health Net of AZ Commercial	$116.40
Rate for Payer: Health Net of AZ Medicare	$54.32
Rate for Payer: Humana of AZ Medicare	$29.10
Rate for Payer: Mercy Care Medicaid	$15.03
Rate for Payer: Self Pay Self Pay	$155.20
Rate for Payer: TriWest Medicare	$29.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$113.10
Rate for Payer: UnitedHealth Group of AZ Medicare	$34.92

PATH CONSULT INTRAOP 1 BLOCK

Facility

OP

$185.00

Service Code	CPT 88331
Hospital Charge Code	22545722
Hospital Revenue Code	310
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Aetna of AZ Medicare	$51.80
Rate for Payer: AHCCCS Medicaid	$108.14
Rate for Payer: Allwell Medicaid	$108.14
Rate for Payer: Allwell Medicare	$27.75
Rate for Payer: Amerigroup Medicare	$27.75
Rate for Payer: APIPA Medicare/Medicaid	$69.10
Rate for Payer: AZCH Complete Medicaid	$108.14
Rate for Payer: AZCH Complete Medicare	$27.75
Rate for Payer: Banner UC Health Medicaid	$108.14
Rate for Payer: Banner UC Health Medicare	$27.75
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$125.80
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cigna of AZ Commercial	$120.25
Rate for Payer: Copperpoint Commercial	$45.79
Rate for Payer: Health Net of AZ Commercial	$111.00
Rate for Payer: Health Net of AZ Medicare	$51.80
Rate for Payer: Humana of AZ Medicare	$27.75
Rate for Payer: Mercy Care Medicaid	$108.14
Rate for Payer: Self Pay Self Pay	$148.00
Rate for Payer: TriWest Medicare	$27.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$107.86
Rate for Payer: UnitedHealth Group of AZ Medicare	$33.30

PATH CONSULT INTRAOP 1 BLOCK

Facility

IP

$185.00

Service Code	CPT 88331
Hospital Charge Code	22545722
Hospital Revenue Code	310
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna of AZ Commercial	$166.50
Rate for Payer: Bisbee Police All Plans	$48.10
Rate for Payer: Cash Price	$148.00
Rate for Payer: Self Pay Self Pay	$148.00

PATH CONSULT INTRAOP EA ADDL

Facility

OP

$29.00

Service Code	CPT 88332
Hospital Charge Code	22545724
Hospital Revenue Code	310
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$26.10
Rate for Payer: Aetna of AZ Commercial	$26.10
Rate for Payer: Aetna of AZ Medicare	$8.12
Rate for Payer: AHCCCS Medicaid	$12.26
Rate for Payer: Allwell Medicaid	$12.26
Rate for Payer: Allwell Medicare	$4.35
Rate for Payer: Amerigroup Medicare	$4.35
Rate for Payer: APIPA Medicare/Medicaid	$10.83
Rate for Payer: AZCH Complete Medicaid	$12.26
Rate for Payer: AZCH Complete Medicare	$4.35
Rate for Payer: Banner UC Health Medicaid	$12.26
Rate for Payer: Banner UC Health Medicare	$4.35
Rate for Payer: Bisbee Police All Plans	$7.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$19.72
Rate for Payer: Cash Price	$23.20
Rate for Payer: Cash Price	$23.20
Rate for Payer: Cigna of AZ Commercial	$18.85
Rate for Payer: Copperpoint Commercial	$7.18
Rate for Payer: Health Net of AZ Commercial	$17.40
Rate for Payer: Health Net of AZ Medicare	$8.12
Rate for Payer: Humana of AZ Medicare	$4.35
Rate for Payer: Mercy Care Medicaid	$12.26
Rate for Payer: Self Pay Self Pay	$23.20
Rate for Payer: TriWest Medicare	$4.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$16.91
Rate for Payer: UnitedHealth Group of AZ Medicare	$5.22

PATH CONSULT INTRAOP EA ADDL

Facility

IP

$29.00

Service Code	CPT 88332
Hospital Charge Code	22545724
Hospital Revenue Code	310
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$26.10
Rate for Payer: Aetna of AZ Commercial	$26.10
Rate for Payer: Bisbee Police All Plans	$7.54
Rate for Payer: Cash Price	$23.20
Rate for Payer: Self Pay Self Pay	$23.20

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