Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Peptic Ulcer And Gastritis

Facility

IP

$7,366.80

Service Code	APR-DRG 2413
Hospital Charge Code	APRDRG2412
Min. Negotiated Rate	$7,366.80
Max. Negotiated Rate	$7,366.80
Rate for Payer: AHCCCS Medicaid	$7,366.80
Rate for Payer: Allwell Medicaid	$7,366.80
Rate for Payer: AZCH Complete Medicaid	$7,366.80
Rate for Payer: Banner UC Health Medicaid	$7,366.80
Rate for Payer: Mercy Care Medicaid	$7,366.80

Peptic Ulcer And Gastritis

Facility

IP

$16,030.50

Service Code	APR-DRG 2414
Hospital Charge Code	APRDRG2411
Min. Negotiated Rate	$16,030.50
Max. Negotiated Rate	$16,030.50
Rate for Payer: AHCCCS Medicaid	$16,030.50
Rate for Payer: Allwell Medicaid	$16,030.50
Rate for Payer: AZCH Complete Medicaid	$16,030.50
Rate for Payer: Banner UC Health Medicaid	$16,030.50
Rate for Payer: Mercy Care Medicaid	$16,030.50

PERCUTANEOUS 18GA ACCESS NEEDLE

Facility

OP

$81.00

Hospital Charge Code	22354210
Hospital Revenue Code	270
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$72.90
Rate for Payer: Aetna of AZ Commercial	$72.90
Rate for Payer: Aetna of AZ Medicare	$22.68
Rate for Payer: Allwell Medicare	$12.96
Rate for Payer: Amerigroup Medicare	$12.96
Rate for Payer: APIPA Medicare/Medicaid	$30.25
Rate for Payer: AZCH Complete Medicare	$12.96
Rate for Payer: Banner UC Health Medicare	$12.96
Rate for Payer: Bisbee Police All Plans	$21.06
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$55.08
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cigna of AZ Commercial	$56.70
Rate for Payer: Copperpoint Commercial	$20.05
Rate for Payer: Health Net of AZ Commercial	$48.60
Rate for Payer: Health Net of AZ Medicare	$22.68
Rate for Payer: Humana of AZ Medicare	$12.96
Rate for Payer: Self Pay Self Pay	$64.80
Rate for Payer: TriWest Medicare	$12.96
Rate for Payer: UnitedHealth Group of AZ Commercial	$47.22
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.58

PERCUTANEOUS 18GA ACCESS NEEDLE

Facility

IP

$81.00

Hospital Charge Code	22354210
Hospital Revenue Code	270
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$72.90
Rate for Payer: Aetna of AZ Commercial	$72.90
Rate for Payer: Bisbee Police All Plans	$21.06
Rate for Payer: Cash Price	$64.80
Rate for Payer: Self Pay Self Pay	$64.80

Percutaneous Cardiac Intervention With Ami

Facility

IP

$12,050.75

Service Code	APR-DRG 1741
Hospital Charge Code	APRDRG1741
Min. Negotiated Rate	$12,050.75
Max. Negotiated Rate	$12,050.75
Rate for Payer: AHCCCS Medicaid	$12,050.75
Rate for Payer: Allwell Medicaid	$12,050.75
Rate for Payer: AZCH Complete Medicaid	$12,050.75
Rate for Payer: Banner UC Health Medicaid	$12,050.75
Rate for Payer: Mercy Care Medicaid	$12,050.75

Percutaneous Cardiac Intervention With Ami

Facility

IP

$25,371.74

Service Code	APR-DRG 1744
Hospital Charge Code	APRDRG1741
Min. Negotiated Rate	$25,371.74
Max. Negotiated Rate	$25,371.74
Rate for Payer: AHCCCS Medicaid	$25,371.74
Rate for Payer: Allwell Medicaid	$25,371.74
Rate for Payer: AZCH Complete Medicaid	$25,371.74
Rate for Payer: Banner UC Health Medicaid	$25,371.74
Rate for Payer: Mercy Care Medicaid	$25,371.74

Percutaneous Cardiac Intervention With Ami

Facility

IP

$25,371.74

Service Code	APR-DRG 1744
Hospital Charge Code	APRDRG1742
Min. Negotiated Rate	$25,371.74
Max. Negotiated Rate	$25,371.74
Rate for Payer: AHCCCS Medicaid	$25,371.74
Rate for Payer: Allwell Medicaid	$25,371.74
Rate for Payer: AZCH Complete Medicaid	$25,371.74
Rate for Payer: Banner UC Health Medicaid	$25,371.74
Rate for Payer: Mercy Care Medicaid	$25,371.74

Percutaneous Cardiac Intervention With Ami

Facility

IP

$13,351.15

Service Code	APR-DRG 1742
Hospital Charge Code	APRDRG1741
Min. Negotiated Rate	$13,351.15
Max. Negotiated Rate	$13,351.15
Rate for Payer: AHCCCS Medicaid	$13,351.15
Rate for Payer: Allwell Medicaid	$13,351.15
Rate for Payer: AZCH Complete Medicaid	$13,351.15
Rate for Payer: Banner UC Health Medicaid	$13,351.15
Rate for Payer: Mercy Care Medicaid	$13,351.15

Percutaneous Cardiac Intervention With Ami

Facility

IP

$13,351.15

Service Code	APR-DRG 1742
Hospital Charge Code	APRDRG1744
Min. Negotiated Rate	$13,351.15
Max. Negotiated Rate	$13,351.15
Rate for Payer: AHCCCS Medicaid	$13,351.15
Rate for Payer: Allwell Medicaid	$13,351.15
Rate for Payer: AZCH Complete Medicaid	$13,351.15
Rate for Payer: Banner UC Health Medicaid	$13,351.15
Rate for Payer: Mercy Care Medicaid	$13,351.15

Percutaneous Cardiac Intervention With Ami

Facility

IP

$17,279.69

Service Code	APR-DRG 1743
Hospital Charge Code	APRDRG1742
Min. Negotiated Rate	$17,279.69
Max. Negotiated Rate	$17,279.69
Rate for Payer: AHCCCS Medicaid	$17,279.69
Rate for Payer: Allwell Medicaid	$17,279.69
Rate for Payer: AZCH Complete Medicaid	$17,279.69
Rate for Payer: Banner UC Health Medicaid	$17,279.69
Rate for Payer: Mercy Care Medicaid	$17,279.69

Percutaneous Cardiac Intervention With Ami

Facility

IP

$17,279.69

Service Code	APR-DRG 1743
Hospital Charge Code	APRDRG1743
Min. Negotiated Rate	$17,279.69
Max. Negotiated Rate	$17,279.69
Rate for Payer: AHCCCS Medicaid	$17,279.69
Rate for Payer: Allwell Medicaid	$17,279.69
Rate for Payer: AZCH Complete Medicaid	$17,279.69
Rate for Payer: Banner UC Health Medicaid	$17,279.69
Rate for Payer: Mercy Care Medicaid	$17,279.69

Percutaneous Cardiac Intervention With Ami

Facility

IP

$25,371.74

Service Code	APR-DRG 1744
Hospital Charge Code	APRDRG1744
Min. Negotiated Rate	$25,371.74
Max. Negotiated Rate	$25,371.74
Rate for Payer: AHCCCS Medicaid	$25,371.74
Rate for Payer: Allwell Medicaid	$25,371.74
Rate for Payer: AZCH Complete Medicaid	$25,371.74
Rate for Payer: Banner UC Health Medicaid	$25,371.74
Rate for Payer: Mercy Care Medicaid	$25,371.74

Percutaneous Cardiac Intervention With Ami

Facility

IP

$17,279.69

Service Code	APR-DRG 1743
Hospital Charge Code	APRDRG1741
Min. Negotiated Rate	$17,279.69
Max. Negotiated Rate	$17,279.69
Rate for Payer: AHCCCS Medicaid	$17,279.69
Rate for Payer: Allwell Medicaid	$17,279.69
Rate for Payer: AZCH Complete Medicaid	$17,279.69
Rate for Payer: Banner UC Health Medicaid	$17,279.69
Rate for Payer: Mercy Care Medicaid	$17,279.69

Percutaneous Cardiac Intervention With Ami

Facility

IP

$13,351.15

Service Code	APR-DRG 1742
Hospital Charge Code	APRDRG1742
Min. Negotiated Rate	$13,351.15
Max. Negotiated Rate	$13,351.15
Rate for Payer: AHCCCS Medicaid	$13,351.15
Rate for Payer: Allwell Medicaid	$13,351.15
Rate for Payer: AZCH Complete Medicaid	$13,351.15
Rate for Payer: Banner UC Health Medicaid	$13,351.15
Rate for Payer: Mercy Care Medicaid	$13,351.15

Percutaneous Cardiac Intervention With Ami

Facility

IP

$25,371.74

Service Code	APR-DRG 1744
Hospital Charge Code	APRDRG1743
Min. Negotiated Rate	$25,371.74
Max. Negotiated Rate	$25,371.74
Rate for Payer: AHCCCS Medicaid	$25,371.74
Rate for Payer: Allwell Medicaid	$25,371.74
Rate for Payer: AZCH Complete Medicaid	$25,371.74
Rate for Payer: Banner UC Health Medicaid	$25,371.74
Rate for Payer: Mercy Care Medicaid	$25,371.74

Percutaneous Cardiac Intervention With Ami

Facility

IP

$17,279.69

Service Code	APR-DRG 1743
Hospital Charge Code	APRDRG1744
Min. Negotiated Rate	$17,279.69
Max. Negotiated Rate	$17,279.69
Rate for Payer: AHCCCS Medicaid	$17,279.69
Rate for Payer: Allwell Medicaid	$17,279.69
Rate for Payer: AZCH Complete Medicaid	$17,279.69
Rate for Payer: Banner UC Health Medicaid	$17,279.69
Rate for Payer: Mercy Care Medicaid	$17,279.69

Percutaneous Cardiac Intervention With Ami

Facility

IP

$12,050.75

Service Code	APR-DRG 1741
Hospital Charge Code	APRDRG1742
Min. Negotiated Rate	$12,050.75
Max. Negotiated Rate	$12,050.75
Rate for Payer: AHCCCS Medicaid	$12,050.75
Rate for Payer: Allwell Medicaid	$12,050.75
Rate for Payer: AZCH Complete Medicaid	$12,050.75
Rate for Payer: Banner UC Health Medicaid	$12,050.75
Rate for Payer: Mercy Care Medicaid	$12,050.75

Percutaneous Cardiac Intervention With Ami

Facility

IP

$12,050.75

Service Code	APR-DRG 1741
Hospital Charge Code	APRDRG1743
Min. Negotiated Rate	$12,050.75
Max. Negotiated Rate	$12,050.75
Rate for Payer: AHCCCS Medicaid	$12,050.75
Rate for Payer: Allwell Medicaid	$12,050.75
Rate for Payer: AZCH Complete Medicaid	$12,050.75
Rate for Payer: Banner UC Health Medicaid	$12,050.75
Rate for Payer: Mercy Care Medicaid	$12,050.75

Percutaneous Cardiac Intervention With Ami

Facility

IP

$13,351.15

Service Code	APR-DRG 1742
Hospital Charge Code	APRDRG1743
Min. Negotiated Rate	$13,351.15
Max. Negotiated Rate	$13,351.15
Rate for Payer: AHCCCS Medicaid	$13,351.15
Rate for Payer: Allwell Medicaid	$13,351.15
Rate for Payer: AZCH Complete Medicaid	$13,351.15
Rate for Payer: Banner UC Health Medicaid	$13,351.15
Rate for Payer: Mercy Care Medicaid	$13,351.15

Percutaneous Cardiac Intervention With Ami

Facility

IP

$12,050.75

Service Code	APR-DRG 1741
Hospital Charge Code	APRDRG1744
Min. Negotiated Rate	$12,050.75
Max. Negotiated Rate	$12,050.75
Rate for Payer: AHCCCS Medicaid	$12,050.75
Rate for Payer: Allwell Medicaid	$12,050.75
Rate for Payer: AZCH Complete Medicaid	$12,050.75
Rate for Payer: Banner UC Health Medicaid	$12,050.75
Rate for Payer: Mercy Care Medicaid	$12,050.75

Percutaneous Cardiac Intervention Without Ami

Facility

IP

$28,128.95

Service Code	APR-DRG 1754
Hospital Charge Code	APRDRG1751
Min. Negotiated Rate	$28,128.95
Max. Negotiated Rate	$28,128.95
Rate for Payer: AHCCCS Medicaid	$28,128.95
Rate for Payer: Allwell Medicaid	$28,128.95
Rate for Payer: AZCH Complete Medicaid	$28,128.95
Rate for Payer: Banner UC Health Medicaid	$28,128.95
Rate for Payer: Mercy Care Medicaid	$28,128.95

Percutaneous Cardiac Intervention Without Ami

Facility

IP

$13,243.13

Service Code	APR-DRG 1751
Hospital Charge Code	APRDRG1752
Min. Negotiated Rate	$13,243.13
Max. Negotiated Rate	$13,243.13
Rate for Payer: AHCCCS Medicaid	$13,243.13
Rate for Payer: Allwell Medicaid	$13,243.13
Rate for Payer: AZCH Complete Medicaid	$13,243.13
Rate for Payer: Banner UC Health Medicaid	$13,243.13
Rate for Payer: Mercy Care Medicaid	$13,243.13

Percutaneous Cardiac Intervention Without Ami

Facility

IP

$18,408.24

Service Code	APR-DRG 1753
Hospital Charge Code	APRDRG1754
Min. Negotiated Rate	$18,408.24
Max. Negotiated Rate	$18,408.24
Rate for Payer: AHCCCS Medicaid	$18,408.24
Rate for Payer: Allwell Medicaid	$18,408.24
Rate for Payer: AZCH Complete Medicaid	$18,408.24
Rate for Payer: Banner UC Health Medicaid	$18,408.24
Rate for Payer: Mercy Care Medicaid	$18,408.24

Percutaneous Cardiac Intervention Without Ami

Facility

IP

$28,128.95

Service Code	APR-DRG 1754
Hospital Charge Code	APRDRG1752
Min. Negotiated Rate	$28,128.95
Max. Negotiated Rate	$28,128.95
Rate for Payer: AHCCCS Medicaid	$28,128.95
Rate for Payer: Allwell Medicaid	$28,128.95
Rate for Payer: AZCH Complete Medicaid	$28,128.95
Rate for Payer: Banner UC Health Medicaid	$28,128.95
Rate for Payer: Mercy Care Medicaid	$28,128.95

Percutaneous Cardiac Intervention Without Ami

Facility

IP

$14,984.71

Service Code	APR-DRG 1752
Hospital Charge Code	APRDRG1751
Min. Negotiated Rate	$14,984.71
Max. Negotiated Rate	$14,984.71
Rate for Payer: AHCCCS Medicaid	$14,984.71
Rate for Payer: Allwell Medicaid	$14,984.71
Rate for Payer: AZCH Complete Medicaid	$14,984.71
Rate for Payer: Banner UC Health Medicaid	$14,984.71
Rate for Payer: Mercy Care Medicaid	$14,984.71

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