Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Open Craniotomy For Trauma

Facility

$18,754.73

Service Code	APR-DRG 0202
Hospital Charge Code	APRDRG0204
Min. Negotiated Rate	$18,754.73
Max. Negotiated Rate	$18,754.73
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$18,754.73
Rate for Payer: Mercy Care Medicaid	$18,754.73
Rate for Payer: NaphCare Correctional Healthcare	$18,754.73

Open Craniotomy For Trauma

Facility

$40,117.98

Service Code	APR-DRG 0204
Hospital Charge Code	APRDRG0203
Min. Negotiated Rate	$40,117.98
Max. Negotiated Rate	$40,117.98
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$40,117.98
Rate for Payer: Mercy Care Medicaid	$40,117.98
Rate for Payer: NaphCare Correctional Healthcare	$40,117.98

Open Craniotomy For Trauma

Facility

$40,117.98

Service Code	APR-DRG 0204
Hospital Charge Code	APRDRG0202
Min. Negotiated Rate	$40,117.98
Max. Negotiated Rate	$40,117.98
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$40,117.98
Rate for Payer: Mercy Care Medicaid	$40,117.98
Rate for Payer: NaphCare Correctional Healthcare	$40,117.98

Open Craniotomy For Trauma

Facility

$18,754.73

Service Code	APR-DRG 0202
Hospital Charge Code	APRDRG0201
Min. Negotiated Rate	$18,754.73
Max. Negotiated Rate	$18,754.73
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$18,754.73
Rate for Payer: Mercy Care Medicaid	$18,754.73
Rate for Payer: NaphCare Correctional Healthcare	$18,754.73

Open Craniotomy For Trauma

Facility

$14,951.74

Service Code	APR-DRG 0201
Hospital Charge Code	APRDRG0202
Min. Negotiated Rate	$14,951.74
Max. Negotiated Rate	$14,951.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,951.74
Rate for Payer: Mercy Care Medicaid	$14,951.74
Rate for Payer: NaphCare Correctional Healthcare	$14,951.74

Open Craniotomy For Trauma

Facility

$40,117.98

Service Code	APR-DRG 0204
Hospital Charge Code	APRDRG0201
Min. Negotiated Rate	$40,117.98
Max. Negotiated Rate	$40,117.98
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$40,117.98
Rate for Payer: Mercy Care Medicaid	$40,117.98
Rate for Payer: NaphCare Correctional Healthcare	$40,117.98

Open Craniotomy For Trauma

Facility

$18,754.73

Service Code	APR-DRG 0202
Hospital Charge Code	APRDRG0203
Min. Negotiated Rate	$18,754.73
Max. Negotiated Rate	$18,754.73
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$18,754.73
Rate for Payer: Mercy Care Medicaid	$18,754.73
Rate for Payer: NaphCare Correctional Healthcare	$18,754.73

Open Craniotomy For Trauma

Facility

$24,253.71

Service Code	APR-DRG 0203
Hospital Charge Code	APRDRG0201
Min. Negotiated Rate	$24,253.71
Max. Negotiated Rate	$24,253.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,253.71
Rate for Payer: Mercy Care Medicaid	$24,253.71
Rate for Payer: NaphCare Correctional Healthcare	$24,253.71

Open Craniotomy For Trauma

Facility

$24,253.71

Service Code	APR-DRG 0203
Hospital Charge Code	APRDRG0202
Min. Negotiated Rate	$24,253.71
Max. Negotiated Rate	$24,253.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,253.71
Rate for Payer: Mercy Care Medicaid	$24,253.71
Rate for Payer: NaphCare Correctional Healthcare	$24,253.71

Open Craniotomy For Trauma

Facility

$14,951.74

Service Code	APR-DRG 0201
Hospital Charge Code	APRDRG0203
Min. Negotiated Rate	$14,951.74
Max. Negotiated Rate	$14,951.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,951.74
Rate for Payer: Mercy Care Medicaid	$14,951.74
Rate for Payer: NaphCare Correctional Healthcare	$14,951.74

Open Craniotomy For Trauma

Facility

$24,253.71

Service Code	APR-DRG 0203
Hospital Charge Code	APRDRG0203
Min. Negotiated Rate	$24,253.71
Max. Negotiated Rate	$24,253.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,253.71
Rate for Payer: Mercy Care Medicaid	$24,253.71
Rate for Payer: NaphCare Correctional Healthcare	$24,253.71

Open Craniotomy For Trauma

Facility

$18,754.73

Service Code	APR-DRG 0202
Hospital Charge Code	APRDRG0202
Min. Negotiated Rate	$18,754.73
Max. Negotiated Rate	$18,754.73
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$18,754.73
Rate for Payer: Mercy Care Medicaid	$18,754.73
Rate for Payer: NaphCare Correctional Healthcare	$18,754.73

Open Craniotomy For Trauma

Facility

$40,117.98

Service Code	APR-DRG 0204
Hospital Charge Code	APRDRG0204
Min. Negotiated Rate	$40,117.98
Max. Negotiated Rate	$40,117.98
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$40,117.98
Rate for Payer: Mercy Care Medicaid	$40,117.98
Rate for Payer: NaphCare Correctional Healthcare	$40,117.98

Open Craniotomy For Trauma

Facility

$24,253.71

Service Code	APR-DRG 0203
Hospital Charge Code	APRDRG0204
Min. Negotiated Rate	$24,253.71
Max. Negotiated Rate	$24,253.71
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$24,253.71
Rate for Payer: Mercy Care Medicaid	$24,253.71
Rate for Payer: NaphCare Correctional Healthcare	$24,253.71

Open Craniotomy For Trauma

Facility

$14,951.74

Service Code	APR-DRG 0201
Hospital Charge Code	APRDRG0201
Min. Negotiated Rate	$14,951.74
Max. Negotiated Rate	$14,951.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,951.74
Rate for Payer: Mercy Care Medicaid	$14,951.74
Rate for Payer: NaphCare Correctional Healthcare	$14,951.74

Open Craniotomy For Trauma

Facility

$14,951.74

Service Code	APR-DRG 0201
Hospital Charge Code	APRDRG0204
Min. Negotiated Rate	$14,951.74
Max. Negotiated Rate	$14,951.74
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,951.74
Rate for Payer: Mercy Care Medicaid	$14,951.74
Rate for Payer: NaphCare Correctional Healthcare	$14,951.74

Open Ended Flexi Tip Urethral Catheter

Facility

$156.00

Hospital Charge Code	22926478
Hospital Revenue Code	272
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$140.40
Rate for Payer: Aetna of AZ Commercial	$140.40
Rate for Payer: Arizona Complete Health Allwell	$24.96
Rate for Payer: Banner UC Health Medicare	$24.96
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$106.08
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$24.96
Rate for Payer: Care1st Health Plan Arizona Medicare	$24.96
Rate for Payer: Cash Price	$124.80
Rate for Payer: Cigna of AZ Commercial	$109.20
Rate for Payer: Devoted Health Medicare	$28.08
Rate for Payer: Humana of AZ Medicare	$24.96
Rate for Payer: Southwest Service Administrators UFCW	$106.08
Rate for Payer: TriWest Medicare	$24.96
Rate for Payer: United Healthcare Commercial	$89.23
Rate for Payer: United Healthcare Medicare	$24.96
Rate for Payer: Veterans Affairs TRICARE	$24.71

Open Ended Flexi Tip Urethral Catheter

Facility

$156.00

Hospital Charge Code	22926478
Hospital Revenue Code	272
Min. Negotiated Rate	$140.40
Max. Negotiated Rate	$140.40
Rate for Payer: Aetna of AZ Commercial	$140.40
Rate for Payer: Cash Price	$124.80

OPEN END FLEXI TIP URETERAL CATHERER

Facility

$71.00

Hospital Charge Code	22636871
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Arizona Complete Health Allwell	$11.36
Rate for Payer: Banner UC Health Medicare	$11.36
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$48.28
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$11.36
Rate for Payer: Care1st Health Plan Arizona Medicare	$11.36
Rate for Payer: Cash Price	$56.80
Rate for Payer: Cigna of AZ Commercial	$49.70
Rate for Payer: Devoted Health Medicare	$12.78
Rate for Payer: Humana of AZ Medicare	$11.36
Rate for Payer: Southwest Service Administrators UFCW	$48.28
Rate for Payer: TriWest Medicare	$11.36
Rate for Payer: United Healthcare Commercial	$40.61
Rate for Payer: United Healthcare Medicare	$11.36
Rate for Payer: Veterans Affairs TRICARE	$11.25

OPEN END FLEXI TIP URETERAL CATHERER

Facility

$71.00

Hospital Charge Code	22636871
Hospital Revenue Code	272
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Cash Price	$56.80

OPEN END URETHRAL CATH 6FR

Facility

$110.61

Hospital Charge Code	27703251
Hospital Revenue Code	270
Min. Negotiated Rate	$17.52
Max. Negotiated Rate	$99.55
Rate for Payer: Aetna of AZ Commercial	$99.55
Rate for Payer: Arizona Complete Health Allwell	$17.70
Rate for Payer: Banner UC Health Medicare	$17.70
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$75.21
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$17.70
Rate for Payer: Care1st Health Plan Arizona Medicare	$17.70
Rate for Payer: Cash Price	$88.49
Rate for Payer: Cigna of AZ Commercial	$77.43
Rate for Payer: Devoted Health Medicare	$19.91
Rate for Payer: Humana of AZ Medicare	$17.70
Rate for Payer: Southwest Service Administrators UFCW	$75.21
Rate for Payer: TriWest Medicare	$17.70
Rate for Payer: United Healthcare Commercial	$63.27
Rate for Payer: United Healthcare Medicare	$17.70
Rate for Payer: Veterans Affairs TRICARE	$17.52

OPEN END URETHRAL CATH 6FR

Facility

$110.61

Hospital Charge Code	27703251
Hospital Revenue Code	270
Min. Negotiated Rate	$99.55
Max. Negotiated Rate	$99.55
Rate for Payer: Aetna of AZ Commercial	$99.55
Rate for Payer: Cash Price	$88.49

Open Extracranial Vascular Procedures

Facility

$15,424.49

Service Code	APR-DRG 0243
Hospital Charge Code	APRDRG0241
Min. Negotiated Rate	$15,424.49
Max. Negotiated Rate	$15,424.49
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$15,424.49
Rate for Payer: Mercy Care Medicaid	$15,424.49
Rate for Payer: NaphCare Correctional Healthcare	$15,424.49

Open Extracranial Vascular Procedures

Facility

$15,424.49

Service Code	APR-DRG 0243
Hospital Charge Code	APRDRG0243
Min. Negotiated Rate	$15,424.49
Max. Negotiated Rate	$15,424.49
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$15,424.49
Rate for Payer: Mercy Care Medicaid	$15,424.49
Rate for Payer: NaphCare Correctional Healthcare	$15,424.49

Open Extracranial Vascular Procedures

Facility

$8,391.55

Service Code	APR-DRG 0242
Hospital Charge Code	APRDRG0242
Min. Negotiated Rate	$8,391.55
Max. Negotiated Rate	$8,391.55
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,391.55
Rate for Payer: Mercy Care Medicaid	$8,391.55
Rate for Payer: NaphCare Correctional Healthcare	$8,391.55

Know your out-of-pocket cost for care.

All Charges