Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Postpartum And Post Abortion Diagnoses Without Procedure

Facility

IP

$9,424.71

Service Code	APR-DRG 5614
Hospital Charge Code	APRDRG5612
Min. Negotiated Rate	$9,424.71
Max. Negotiated Rate	$9,424.71
Rate for Payer: AHCCCS Medicaid	$9,424.71
Rate for Payer: Allwell Medicaid	$9,424.71
Rate for Payer: AZCH Complete Medicaid	$9,424.71
Rate for Payer: Banner UC Health Medicaid	$9,424.71
Rate for Payer: Mercy Care Medicaid	$9,424.71

Postpartum And Post Abortion Diagnoses Without Procedure

Facility

IP

$2,764.92

Service Code	APR-DRG 5612
Hospital Charge Code	APRDRG5611
Min. Negotiated Rate	$2,764.92
Max. Negotiated Rate	$2,764.92
Rate for Payer: AHCCCS Medicaid	$2,764.92
Rate for Payer: Allwell Medicaid	$2,764.92
Rate for Payer: AZCH Complete Medicaid	$2,764.92
Rate for Payer: Banner UC Health Medicaid	$2,764.92
Rate for Payer: Mercy Care Medicaid	$2,764.92

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$2,447.89

Service Code	APR-DRG 5481
Hospital Charge Code	APRDRG5481
Min. Negotiated Rate	$2,447.89
Max. Negotiated Rate	$2,447.89
Rate for Payer: AHCCCS Medicaid	$2,447.89
Rate for Payer: Allwell Medicaid	$2,447.89
Rate for Payer: AZCH Complete Medicaid	$2,447.89
Rate for Payer: Banner UC Health Medicaid	$2,447.89
Rate for Payer: Mercy Care Medicaid	$2,447.89

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$10,381.42

Service Code	APR-DRG 5483
Hospital Charge Code	APRDRG5482
Min. Negotiated Rate	$10,381.42
Max. Negotiated Rate	$10,381.42
Rate for Payer: AHCCCS Medicaid	$10,381.42
Rate for Payer: Allwell Medicaid	$10,381.42
Rate for Payer: AZCH Complete Medicaid	$10,381.42
Rate for Payer: Banner UC Health Medicaid	$10,381.42
Rate for Payer: Mercy Care Medicaid	$10,381.42

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$32,425.02

Service Code	APR-DRG 5484
Hospital Charge Code	APRDRG5483
Min. Negotiated Rate	$32,425.02
Max. Negotiated Rate	$32,425.02
Rate for Payer: AHCCCS Medicaid	$32,425.02
Rate for Payer: Allwell Medicaid	$32,425.02
Rate for Payer: AZCH Complete Medicaid	$32,425.02
Rate for Payer: Banner UC Health Medicaid	$32,425.02
Rate for Payer: Mercy Care Medicaid	$32,425.02

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$2,447.89

Service Code	APR-DRG 5481
Hospital Charge Code	APRDRG5482
Min. Negotiated Rate	$2,447.89
Max. Negotiated Rate	$2,447.89
Rate for Payer: AHCCCS Medicaid	$2,447.89
Rate for Payer: Allwell Medicaid	$2,447.89
Rate for Payer: AZCH Complete Medicaid	$2,447.89
Rate for Payer: Banner UC Health Medicaid	$2,447.89
Rate for Payer: Mercy Care Medicaid	$2,447.89

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$10,381.42

Service Code	APR-DRG 5483
Hospital Charge Code	APRDRG5484
Min. Negotiated Rate	$10,381.42
Max. Negotiated Rate	$10,381.42
Rate for Payer: AHCCCS Medicaid	$10,381.42
Rate for Payer: Allwell Medicaid	$10,381.42
Rate for Payer: AZCH Complete Medicaid	$10,381.42
Rate for Payer: Banner UC Health Medicaid	$10,381.42
Rate for Payer: Mercy Care Medicaid	$10,381.42

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$32,425.02

Service Code	APR-DRG 5484
Hospital Charge Code	APRDRG5482
Min. Negotiated Rate	$32,425.02
Max. Negotiated Rate	$32,425.02
Rate for Payer: AHCCCS Medicaid	$32,425.02
Rate for Payer: Allwell Medicaid	$32,425.02
Rate for Payer: AZCH Complete Medicaid	$32,425.02
Rate for Payer: Banner UC Health Medicaid	$32,425.02
Rate for Payer: Mercy Care Medicaid	$32,425.02

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$5,311.70

Service Code	APR-DRG 5482
Hospital Charge Code	APRDRG5484
Min. Negotiated Rate	$5,311.70
Max. Negotiated Rate	$5,311.70
Rate for Payer: AHCCCS Medicaid	$5,311.70
Rate for Payer: Allwell Medicaid	$5,311.70
Rate for Payer: AZCH Complete Medicaid	$5,311.70
Rate for Payer: Banner UC Health Medicaid	$5,311.70
Rate for Payer: Mercy Care Medicaid	$5,311.70

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$32,425.02

Service Code	APR-DRG 5484
Hospital Charge Code	APRDRG5484
Min. Negotiated Rate	$32,425.02
Max. Negotiated Rate	$32,425.02
Rate for Payer: AHCCCS Medicaid	$32,425.02
Rate for Payer: Allwell Medicaid	$32,425.02
Rate for Payer: AZCH Complete Medicaid	$32,425.02
Rate for Payer: Banner UC Health Medicaid	$32,425.02
Rate for Payer: Mercy Care Medicaid	$32,425.02

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$2,447.89

Service Code	APR-DRG 5481
Hospital Charge Code	APRDRG5483
Min. Negotiated Rate	$2,447.89
Max. Negotiated Rate	$2,447.89
Rate for Payer: AHCCCS Medicaid	$2,447.89
Rate for Payer: Allwell Medicaid	$2,447.89
Rate for Payer: AZCH Complete Medicaid	$2,447.89
Rate for Payer: Banner UC Health Medicaid	$2,447.89
Rate for Payer: Mercy Care Medicaid	$2,447.89

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$5,311.70

Service Code	APR-DRG 5482
Hospital Charge Code	APRDRG5482
Min. Negotiated Rate	$5,311.70
Max. Negotiated Rate	$5,311.70
Rate for Payer: AHCCCS Medicaid	$5,311.70
Rate for Payer: Allwell Medicaid	$5,311.70
Rate for Payer: AZCH Complete Medicaid	$5,311.70
Rate for Payer: Banner UC Health Medicaid	$5,311.70
Rate for Payer: Mercy Care Medicaid	$5,311.70

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$5,311.70

Service Code	APR-DRG 5482
Hospital Charge Code	APRDRG5481
Min. Negotiated Rate	$5,311.70
Max. Negotiated Rate	$5,311.70
Rate for Payer: AHCCCS Medicaid	$5,311.70
Rate for Payer: Allwell Medicaid	$5,311.70
Rate for Payer: AZCH Complete Medicaid	$5,311.70
Rate for Payer: Banner UC Health Medicaid	$5,311.70
Rate for Payer: Mercy Care Medicaid	$5,311.70

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$10,381.42

Service Code	APR-DRG 5483
Hospital Charge Code	APRDRG5481
Min. Negotiated Rate	$10,381.42
Max. Negotiated Rate	$10,381.42
Rate for Payer: AHCCCS Medicaid	$10,381.42
Rate for Payer: Allwell Medicaid	$10,381.42
Rate for Payer: AZCH Complete Medicaid	$10,381.42
Rate for Payer: Banner UC Health Medicaid	$10,381.42
Rate for Payer: Mercy Care Medicaid	$10,381.42

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$5,311.70

Service Code	APR-DRG 5482
Hospital Charge Code	APRDRG5483
Min. Negotiated Rate	$5,311.70
Max. Negotiated Rate	$5,311.70
Rate for Payer: AHCCCS Medicaid	$5,311.70
Rate for Payer: Allwell Medicaid	$5,311.70
Rate for Payer: AZCH Complete Medicaid	$5,311.70
Rate for Payer: Banner UC Health Medicaid	$5,311.70
Rate for Payer: Mercy Care Medicaid	$5,311.70

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$2,447.89

Service Code	APR-DRG 5481
Hospital Charge Code	APRDRG5484
Min. Negotiated Rate	$2,447.89
Max. Negotiated Rate	$2,447.89
Rate for Payer: AHCCCS Medicaid	$2,447.89
Rate for Payer: Allwell Medicaid	$2,447.89
Rate for Payer: AZCH Complete Medicaid	$2,447.89
Rate for Payer: Banner UC Health Medicaid	$2,447.89
Rate for Payer: Mercy Care Medicaid	$2,447.89

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$10,381.42

Service Code	APR-DRG 5483
Hospital Charge Code	APRDRG5483
Min. Negotiated Rate	$10,381.42
Max. Negotiated Rate	$10,381.42
Rate for Payer: AHCCCS Medicaid	$10,381.42
Rate for Payer: Allwell Medicaid	$10,381.42
Rate for Payer: AZCH Complete Medicaid	$10,381.42
Rate for Payer: Banner UC Health Medicaid	$10,381.42
Rate for Payer: Mercy Care Medicaid	$10,381.42

Postpartum And Post Abortion Diagnosis With O.R. Procedure

Facility

IP

$32,425.02

Service Code	APR-DRG 5484
Hospital Charge Code	APRDRG5481
Min. Negotiated Rate	$32,425.02
Max. Negotiated Rate	$32,425.02
Rate for Payer: AHCCCS Medicaid	$32,425.02
Rate for Payer: Allwell Medicaid	$32,425.02
Rate for Payer: AZCH Complete Medicaid	$32,425.02
Rate for Payer: Banner UC Health Medicaid	$32,425.02
Rate for Payer: Mercy Care Medicaid	$32,425.02

Potassium 24 hr urine

Facility

OP

$67.00

Service Code	CPT 84133
Hospital Charge Code	633618
Hospital Revenue Code	301
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna of AZ Commercial	$60.30
Rate for Payer: Aetna of AZ Medicare	$18.76
Rate for Payer: Allwell Medicare	$10.72
Rate for Payer: Amerigroup Medicare	$10.72
Rate for Payer: APIPA Medicare/Medicaid	$25.02
Rate for Payer: AZCH Complete Medicare	$10.72
Rate for Payer: Banner UC Health Medicare	$10.72
Rate for Payer: Bisbee Police All Plans	$17.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$45.56
Rate for Payer: Cash Price	$53.60
Rate for Payer: Cigna of AZ Commercial	$43.55
Rate for Payer: Copperpoint Commercial	$16.58
Rate for Payer: Health Net of AZ Commercial	$40.20
Rate for Payer: Health Net of AZ Medicare	$18.76
Rate for Payer: Humana of AZ Medicare	$10.72
Rate for Payer: Self Pay Self Pay	$53.60
Rate for Payer: TriWest Medicare	$10.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$39.06
Rate for Payer: UnitedHealth Group of AZ Medicare	$12.06

Potassium 24 hr urine

Facility

IP

$67.00

Service Code	CPT 84133
Hospital Charge Code	633618
Hospital Revenue Code	301
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna of AZ Commercial	$60.30
Rate for Payer: Bisbee Police All Plans	$17.42
Rate for Payer: Cash Price	$53.60
Rate for Payer: Self Pay Self Pay	$53.60

potassium 25 mEq (bicarbonate, effervescence tab) [CQCH]

Facility

IP

$0.90

Service Code	NDC 245532630
Hospital Charge Code	113056106
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.81
Rate for Payer: Aetna of AZ Commercial	$0.81
Rate for Payer: Bisbee Police All Plans	$0.23
Rate for Payer: Cash Price	$0.72
Rate for Payer: Self Pay Self Pay	$0.72

potassium 25 mEq (bicarbonate, effervescence tab) [CQCH]

Facility

OP

$0.90

Service Code	NDC 245532630
Hospital Charge Code	113056106
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.81
Rate for Payer: Aetna of AZ Commercial	$0.81
Rate for Payer: Aetna of AZ Medicare	$0.25
Rate for Payer: Allwell Medicare	$0.14
Rate for Payer: Amerigroup Medicare	$0.14
Rate for Payer: APIPA Medicare/Medicaid	$0.34
Rate for Payer: AZCH Complete Medicare	$0.14
Rate for Payer: Banner UC Health Medicare	$0.14
Rate for Payer: Bisbee Police All Plans	$0.23
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.61
Rate for Payer: Cash Price	$0.72
Rate for Payer: Cigna of AZ Commercial	$0.59
Rate for Payer: Copperpoint Commercial	$0.22
Rate for Payer: Health Net of AZ Commercial	$0.54
Rate for Payer: Health Net of AZ Medicare	$0.25
Rate for Payer: Humana of AZ Medicare	$0.14
Rate for Payer: Self Pay Self Pay	$0.72
Rate for Payer: TriWest Medicare	$0.14
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.52
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.16

potassium chloride 10 mEq/50 mL Sol [CQCH]

Facility

IP

$0.10

Service Code	HCPCS J3480
Hospital Charge Code	204727734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.09
Rate for Payer: Aetna of AZ Commercial	$0.09
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Cash Price	$0.08
Rate for Payer: Self Pay Self Pay	$0.08

potassium chloride 10 mEq/50 mL Sol [CQCH]

Facility

OP

$0.10

Service Code	HCPCS J3480
Hospital Charge Code	204727734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.09
Rate for Payer: Aetna of AZ Commercial	$0.09
Rate for Payer: Aetna of AZ Medicare	$0.03
Rate for Payer: Allwell Medicare	$0.02
Rate for Payer: Amerigroup Medicare	$0.02
Rate for Payer: APIPA Medicare/Medicaid	$0.04
Rate for Payer: AZCH Complete Medicare	$0.02
Rate for Payer: Banner UC Health Medicare	$0.02
Rate for Payer: Bisbee Police All Plans	$0.03
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.07
Rate for Payer: Cash Price	$0.08
Rate for Payer: Cigna of AZ Commercial	$0.07
Rate for Payer: Copperpoint Commercial	$0.02
Rate for Payer: Health Net of AZ Commercial	$0.06
Rate for Payer: Health Net of AZ Medicare	$0.03
Rate for Payer: Humana of AZ Medicare	$0.02
Rate for Payer: Self Pay Self Pay	$0.08
Rate for Payer: TriWest Medicare	$0.02
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.06
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.02

potassium chloride 10 mEq ER Tab [CQCH]

Facility

IP

$0.42

Service Code	NDC 245531601
Hospital Charge Code	108127557
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.38
Rate for Payer: Aetna of AZ Commercial	$0.38
Rate for Payer: Bisbee Police All Plans	$0.11
Rate for Payer: Cash Price	$0.33
Rate for Payer: Self Pay Self Pay	$0.34

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