Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

NERVE TEASING PREPARATIONS

Facility

$1,084.00

Service Code	CPT 88362
Hospital Charge Code	22545742
Hospital Revenue Code	310
Min. Negotiated Rate	$158.38
Max. Negotiated Rate	$1,246.61
Rate for Payer: Aetna of AZ Commercial	$975.60
Rate for Payer: Arizona Complete Health Allwell	$173.44
Rate for Payer: Banner UC Health Medicare	$173.44
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$737.12
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$173.44
Rate for Payer: Care1st Health Plan Arizona Medicare	$158.38
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: Devoted Health Medicare	$195.12
Rate for Payer: Humana of AZ Medicare	$173.44
Rate for Payer: Seven Corners Travel Insurance	$1,246.61
Rate for Payer: Southwest Service Administrators UFCW	$737.12
Rate for Payer: TriWest Medicare	$173.44
Rate for Payer: United Healthcare Commercial	$620.05
Rate for Payer: United Healthcare Medicare	$173.44
Rate for Payer: Veterans Affairs TRICARE	$171.71

Nervous System Malignancy

Facility

$5,242.97

Service Code	APR-DRG 0411
Hospital Charge Code	APRDRG0411
Min. Negotiated Rate	$5,242.97
Max. Negotiated Rate	$5,242.97
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97
Rate for Payer: NaphCare Correctional Healthcare	$5,242.97

Nervous System Malignancy

Facility

$12,266.78

Service Code	APR-DRG 0414
Hospital Charge Code	APRDRG0412
Min. Negotiated Rate	$12,266.78
Max. Negotiated Rate	$12,266.78
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78
Rate for Payer: NaphCare Correctional Healthcare	$12,266.78

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: Blue Cross Blue Shield of Arizona Health Choice	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97
Rate for Payer: NaphCare Correctional Healthcare	$5,242.97

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: Blue Cross Blue Shield of Arizona Health Choice	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78
Rate for Payer: NaphCare Correctional Healthcare	$12,266.78

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: Blue Cross Blue Shield of Arizona Health Choice	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30
Rate for Payer: NaphCare Correctional Healthcare	$5,862.30

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: Blue Cross Blue Shield of Arizona Health Choice	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97
Rate for Payer: NaphCare Correctional Healthcare	$5,242.97

Nervous System Malignancy

Facility

$5,862.30

Service Code	APR-DRG 0412
Hospital Charge Code	APRDRG0414
Min. Negotiated Rate	$5,862.30
Max. Negotiated Rate	$5,862.30
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30
Rate for Payer: NaphCare Correctional Healthcare	$5,862.30

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: Blue Cross Blue Shield of Arizona Health Choice	$5,242.97
Rate for Payer: Mercy Care Medicaid	$5,242.97
Rate for Payer: NaphCare Correctional Healthcare	$5,242.97

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: Blue Cross Blue Shield of Arizona Health Choice	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03
Rate for Payer: NaphCare Correctional Healthcare	$7,829.03

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: Blue Cross Blue Shield of Arizona Health Choice	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03
Rate for Payer: NaphCare Correctional Healthcare	$7,829.03

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: Blue Cross Blue Shield of Arizona Health Choice	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30
Rate for Payer: NaphCare Correctional Healthcare	$5,862.30

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: Blue Cross Blue Shield of Arizona Health Choice	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03
Rate for Payer: NaphCare Correctional Healthcare	$7,829.03

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: Blue Cross Blue Shield of Arizona Health Choice	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78
Rate for Payer: NaphCare Correctional Healthcare	$12,266.78

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: Blue Cross Blue Shield of Arizona Health Choice	$7,829.03
Rate for Payer: Mercy Care Medicaid	$7,829.03
Rate for Payer: NaphCare Correctional Healthcare	$7,829.03

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: Blue Cross Blue Shield of Arizona Health Choice	$12,266.78
Rate for Payer: Mercy Care Medicaid	$12,266.78
Rate for Payer: NaphCare Correctional Healthcare	$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: Blue Cross Blue Shield of Arizona Health Choice	$5,862.30
Rate for Payer: Mercy Care Medicaid	$5,862.30
Rate for Payer: NaphCare Correctional Healthcare	$5,862.30

NERVOUS SYSTEM NEOPLASMS WITH MCC

Facility

$19,733.88

Service Code	MSDRG 054
Min. Negotiated Rate	$19,733.88
Max. Negotiated Rate	$19,733.88
Rate for Payer: Seven Corners Travel Insurance	$19,733.88

NERVOUS SYSTEM NEOPLASMS WITHOUT MCC

Facility

$13,274.98

Service Code	MSDRG 055
Min. Negotiated Rate	$13,274.98
Max. Negotiated Rate	$13,274.98
Rate for Payer: Seven Corners Travel Insurance	$13,274.98

NEUROLOGICAL EYE DISORDERS

Facility

$10,474.64

Service Code	MSDRG 123
Min. Negotiated Rate	$10,474.64
Max. Negotiated Rate	$10,474.64
Rate for Payer: Seven Corners Travel Insurance	$10,474.64

Neuroplasty and/or transposition; median nerve at carpal tunnel

Facility

$4,169.00

Service Code	CPT 64721
Hospital Revenue Code	360
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$4,169.00
Rate for Payer: Banner UC Health Medicare	$556.61
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7.67
Rate for Payer: Mercy Care Medicaid	$7.67
Rate for Payer: NaphCare Correctional Healthcare	$556.61
Rate for Payer: Seven Corners Travel Insurance	$3,021.39
Rate for Payer: United Healthcare Commercial	$4,169.00

NEUROSES EXCEPT DEPRESSIVE

Facility

$13,961.75

Service Code	MSDRG 882
Min. Negotiated Rate	$13,961.75
Max. Negotiated Rate	$13,961.75
Rate for Payer: Seven Corners Travel Insurance	$13,961.75

NEURO STIMULATOR

Facility

$62,920.00

Service Code	HCPCS C1767
Hospital Charge Code	22354564
Hospital Revenue Code	270
Min. Negotiated Rate	$9,966.53
Max. Negotiated Rate	$56,628.00
Rate for Payer: Aetna of AZ Commercial	$56,628.00
Rate for Payer: Arizona Complete Health Allwell	$10,067.20
Rate for Payer: Banner UC Health Medicare	$10,067.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$42,785.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$10,067.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$10,067.20
Rate for Payer: Cash Price	$50,336.00
Rate for Payer: Cigna of AZ Commercial	$44,044.00
Rate for Payer: Devoted Health Medicare	$11,325.60
Rate for Payer: Humana of AZ Medicare	$10,067.20
Rate for Payer: Southwest Service Administrators UFCW	$42,785.60
Rate for Payer: TriWest Medicare	$10,067.20
Rate for Payer: United Healthcare Commercial	$35,990.24
Rate for Payer: United Healthcare Medicare	$10,067.20
Rate for Payer: Veterans Affairs TRICARE	$9,966.53

NEURO STIMULATOR

Facility

$62,920.00

Service Code	HCPCS C1767
Hospital Charge Code	22354564
Hospital Revenue Code	270
Min. Negotiated Rate	$56,628.00
Max. Negotiated Rate	$56,628.00
Rate for Payer: Aetna of AZ Commercial	$56,628.00
Rate for Payer: Cash Price	$50,336.00

NEW PATIENT SYNCHRONOUS AUDIO-ONLY VISIT WITH HIGH MEDICAL DECISION MAKINGËœ

Facility

$304.00

Service Code	CPT 98011
Hospital Charge Code	27943052
Hospital Revenue Code	521
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$273.60
Rate for Payer: Aetna of AZ Commercial	$273.60
Rate for Payer: Arizona Complete Health Allwell	$48.64
Rate for Payer: Banner UC Health Medicare	$48.64
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$206.72
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6.23
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$48.64
Rate for Payer: Care1st Health Plan Arizona Medicare	$48.64
Rate for Payer: Cash Price	$243.20
Rate for Payer: Cash Price	$243.20
Rate for Payer: Cigna of AZ Commercial	$212.80
Rate for Payer: Devoted Health Medicare	$54.72
Rate for Payer: Humana of AZ Medicare	$48.64
Rate for Payer: Mercy Care Medicaid	$6.23
Rate for Payer: NaphCare Correctional Healthcare	$6.23
Rate for Payer: Southwest Service Administrators UFCW	$206.72
Rate for Payer: TriWest Medicare	$48.64
Rate for Payer: United Healthcare Commercial	$173.89
Rate for Payer: United Healthcare Medicare	$48.64
Rate for Payer: Veterans Affairs TRICARE	$48.15

Know your out-of-pocket cost for care.

All Charges