Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$6,833.04

Service Code	APR-DRG 4441
Hospital Charge Code	APRDRG4444
Min. Negotiated Rate	$6,833.04
Max. Negotiated Rate	$6,833.04
Rate for Payer: AHCCCS Medicaid	$6,833.04
Rate for Payer: Allwell Medicaid	$6,833.04
Rate for Payer: AZCH Complete Medicaid	$6,833.04
Rate for Payer: Banner UC Health Medicaid	$6,833.04
Rate for Payer: Mercy Care Medicaid	$6,833.04

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$10,436.13

Service Code	APR-DRG 4442
Hospital Charge Code	APRDRG4444
Min. Negotiated Rate	$10,436.13
Max. Negotiated Rate	$10,436.13
Rate for Payer: AHCCCS Medicaid	$10,436.13
Rate for Payer: Allwell Medicaid	$10,436.13
Rate for Payer: AZCH Complete Medicaid	$10,436.13
Rate for Payer: Banner UC Health Medicaid	$10,436.13
Rate for Payer: Mercy Care Medicaid	$10,436.13

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$16,643.52

Service Code	APR-DRG 4443
Hospital Charge Code	APRDRG4444
Min. Negotiated Rate	$16,643.52
Max. Negotiated Rate	$16,643.52
Rate for Payer: AHCCCS Medicaid	$16,643.52
Rate for Payer: Allwell Medicaid	$16,643.52
Rate for Payer: AZCH Complete Medicaid	$16,643.52
Rate for Payer: Banner UC Health Medicaid	$16,643.52
Rate for Payer: Mercy Care Medicaid	$16,643.52

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$10,436.13

Service Code	APR-DRG 4442
Hospital Charge Code	APRDRG4442
Min. Negotiated Rate	$10,436.13
Max. Negotiated Rate	$10,436.13
Rate for Payer: AHCCCS Medicaid	$10,436.13
Rate for Payer: Allwell Medicaid	$10,436.13
Rate for Payer: AZCH Complete Medicaid	$10,436.13
Rate for Payer: Banner UC Health Medicaid	$10,436.13
Rate for Payer: Mercy Care Medicaid	$10,436.13

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$16,643.52

Service Code	APR-DRG 4443
Hospital Charge Code	APRDRG4442
Min. Negotiated Rate	$16,643.52
Max. Negotiated Rate	$16,643.52
Rate for Payer: AHCCCS Medicaid	$16,643.52
Rate for Payer: Allwell Medicaid	$16,643.52
Rate for Payer: AZCH Complete Medicaid	$16,643.52
Rate for Payer: Banner UC Health Medicaid	$16,643.52
Rate for Payer: Mercy Care Medicaid	$16,643.52

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$10,436.13

Service Code	APR-DRG 4442
Hospital Charge Code	APRDRG4441
Min. Negotiated Rate	$10,436.13
Max. Negotiated Rate	$10,436.13
Rate for Payer: AHCCCS Medicaid	$10,436.13
Rate for Payer: Allwell Medicaid	$10,436.13
Rate for Payer: AZCH Complete Medicaid	$10,436.13
Rate for Payer: Banner UC Health Medicaid	$10,436.13
Rate for Payer: Mercy Care Medicaid	$10,436.13

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$16,643.52

Service Code	APR-DRG 4443
Hospital Charge Code	APRDRG4441
Min. Negotiated Rate	$16,643.52
Max. Negotiated Rate	$16,643.52
Rate for Payer: AHCCCS Medicaid	$16,643.52
Rate for Payer: Allwell Medicaid	$16,643.52
Rate for Payer: AZCH Complete Medicaid	$16,643.52
Rate for Payer: Banner UC Health Medicaid	$16,643.52
Rate for Payer: Mercy Care Medicaid	$16,643.52

Renal Function Panel Standard

Facility

IP

$159.00

Service Code	CPT 80069
Hospital Charge Code	22141046
Hospital Revenue Code	301
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Cash Price	$127.20
Rate for Payer: Self Pay Self Pay	$127.20

Renal Function Panel Standard

Facility

OP

$159.00

Service Code	CPT 80069
Hospital Charge Code	22141046
Hospital Revenue Code	301
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$143.10
Rate for Payer: Aetna of AZ Commercial	$143.10
Rate for Payer: Aetna of AZ Medicare	$44.52
Rate for Payer: AHCCCS Medicaid	$8.68
Rate for Payer: Allwell Medicaid	$8.68
Rate for Payer: Allwell Medicare	$23.85
Rate for Payer: Amerigroup Medicare	$23.85
Rate for Payer: APIPA Medicare/Medicaid	$59.39
Rate for Payer: AZCH Complete Medicaid	$8.68
Rate for Payer: AZCH Complete Medicare	$23.85
Rate for Payer: Banner UC Health Medicaid	$8.68
Rate for Payer: Banner UC Health Medicare	$23.85
Rate for Payer: Bisbee Police All Plans	$41.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$108.12
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cash Price	$127.20
Rate for Payer: Cigna of AZ Commercial	$103.35
Rate for Payer: Copperpoint Commercial	$39.35
Rate for Payer: Health Net of AZ Commercial	$95.40
Rate for Payer: Health Net of AZ Medicare	$44.52
Rate for Payer: Humana of AZ Medicare	$23.85
Rate for Payer: Mercy Care Medicaid	$8.68
Rate for Payer: Self Pay Self Pay	$127.20
Rate for Payer: TriWest Medicare	$23.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$92.70
Rate for Payer: UnitedHealth Group of AZ Medicare	$28.62

Renin Activity, Plasma LC

Facility

OP

$289.00

Service Code	CPT 84244
Hospital Charge Code	1905527
Hospital Revenue Code	301
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$260.10
Rate for Payer: Aetna of AZ Commercial	$260.10
Rate for Payer: Aetna of AZ Medicare	$80.92
Rate for Payer: AHCCCS Medicaid	$21.99
Rate for Payer: Allwell Medicaid	$21.99
Rate for Payer: Allwell Medicare	$43.35
Rate for Payer: Amerigroup Medicare	$43.35
Rate for Payer: APIPA Medicare/Medicaid	$107.94
Rate for Payer: AZCH Complete Medicaid	$21.99
Rate for Payer: AZCH Complete Medicare	$43.35
Rate for Payer: Banner UC Health Medicaid	$21.99
Rate for Payer: Banner UC Health Medicare	$43.35
Rate for Payer: Bisbee Police All Plans	$75.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$196.52
Rate for Payer: Cash Price	$231.20
Rate for Payer: Cash Price	$231.20
Rate for Payer: Cigna of AZ Commercial	$187.85
Rate for Payer: Copperpoint Commercial	$71.53
Rate for Payer: Health Net of AZ Commercial	$173.40
Rate for Payer: Health Net of AZ Medicare	$80.92
Rate for Payer: Humana of AZ Medicare	$43.35
Rate for Payer: Mercy Care Medicaid	$21.99
Rate for Payer: Self Pay Self Pay	$231.20
Rate for Payer: TriWest Medicare	$43.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$168.49
Rate for Payer: UnitedHealth Group of AZ Medicare	$52.02

Renin Activity, Plasma LC

Facility

IP

$289.00

Service Code	CPT 84244
Hospital Charge Code	1905527
Hospital Revenue Code	301
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$260.10
Rate for Payer: Aetna of AZ Commercial	$260.10
Rate for Payer: Bisbee Police All Plans	$75.14
Rate for Payer: Cash Price	$231.20
Rate for Payer: Self Pay Self Pay	$231.20

REPAIR OF FLUID COLLECTION IN TESTICLE AND SPERM RESERVOIR

Facility

IP

$1,985.00

Service Code	CPT 55060
Hospital Charge Code	27802896
Hospital Revenue Code	360
Min. Negotiated Rate	$516.10
Max. Negotiated Rate	$1,786.50
Rate for Payer: Aetna of AZ Commercial	$1,786.50
Rate for Payer: Bisbee Police All Plans	$516.10
Rate for Payer: Cash Price	$1,588.00
Rate for Payer: Self Pay Self Pay	$1,588.00

REPAIR OF FLUID COLLECTION IN TESTICLE AND SPERM RESERVOIR

Facility

OP

$1,985.00

Service Code	CPT 55060
Hospital Charge Code	27802896
Hospital Revenue Code	360
Min. Negotiated Rate	$297.75
Max. Negotiated Rate	$4,460.70
Rate for Payer: Aetna of AZ Commercial	$1,786.50
Rate for Payer: Aetna of AZ Medicare	$555.80
Rate for Payer: AHCCCS Medicaid	$4,460.70
Rate for Payer: Allwell Medicaid	$4,460.70
Rate for Payer: Allwell Medicare	$297.75
Rate for Payer: Amerigroup Medicare	$297.75
Rate for Payer: APIPA Medicare/Medicaid	$741.40
Rate for Payer: AZCH Complete Medicaid	$4,460.70
Rate for Payer: AZCH Complete Medicare	$297.75
Rate for Payer: Banner UC Health Medicaid	$4,460.70
Rate for Payer: Banner UC Health Medicare	$297.75
Rate for Payer: Bisbee Police All Plans	$516.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,349.80
Rate for Payer: Cash Price	$1,588.00
Rate for Payer: Cash Price	$1,588.00
Rate for Payer: Cigna of AZ Commercial	$992.50
Rate for Payer: Copperpoint Commercial	$491.29
Rate for Payer: Health Net of AZ Commercial	$1,191.00
Rate for Payer: Health Net of AZ Medicare	$555.80
Rate for Payer: Humana of AZ Medicare	$297.75
Rate for Payer: Mercy Care Medicaid	$4,460.70
Rate for Payer: Self Pay Self Pay	$1,588.00
Rate for Payer: TriWest Medicare	$297.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$357.30

REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC

Facility

OP

$4,625.00

Service Code	CPT 23410
Hospital Charge Code	27371853
Hospital Revenue Code	360
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$9,084.18
Rate for Payer: Aetna of AZ Commercial	$4,162.50
Rate for Payer: Aetna of AZ Medicare	$1,295.00
Rate for Payer: AHCCCS Medicaid	$9,084.18
Rate for Payer: Allwell Medicaid	$9,084.18
Rate for Payer: Allwell Medicare	$693.75
Rate for Payer: Amerigroup Medicare	$693.75
Rate for Payer: APIPA Medicare/Medicaid	$1,727.44
Rate for Payer: AZCH Complete Medicaid	$9,084.18
Rate for Payer: AZCH Complete Medicare	$693.75
Rate for Payer: Banner UC Health Medicaid	$9,084.18
Rate for Payer: Banner UC Health Medicare	$693.75
Rate for Payer: Bisbee Police All Plans	$1,202.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,145.00
Rate for Payer: Cash Price	$3,700.00
Rate for Payer: Cash Price	$3,700.00
Rate for Payer: Cigna of AZ Commercial	$2,312.50
Rate for Payer: Copperpoint Commercial	$1,144.69
Rate for Payer: Health Net of AZ Commercial	$2,775.00
Rate for Payer: Health Net of AZ Medicare	$1,295.00
Rate for Payer: Humana of AZ Medicare	$693.75
Rate for Payer: Mercy Care Medicaid	$9,084.18
Rate for Payer: Self Pay Self Pay	$3,700.00
Rate for Payer: TriWest Medicare	$693.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$4,540.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$832.50

REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC

Facility

IP

$4,452.00

Service Code	CPT 23412
Hospital Charge Code	27368692
Hospital Revenue Code	360
Min. Negotiated Rate	$1,157.52
Max. Negotiated Rate	$4,006.80
Rate for Payer: Aetna of AZ Commercial	$4,006.80
Rate for Payer: Bisbee Police All Plans	$1,157.52
Rate for Payer: Cash Price	$3,561.60
Rate for Payer: Self Pay Self Pay	$3,561.60

REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC

Facility

OP

$4,452.00

Service Code	CPT 23412
Hospital Charge Code	27368692
Hospital Revenue Code	360
Min. Negotiated Rate	$667.80
Max. Negotiated Rate	$9,084.18
Rate for Payer: Aetna of AZ Commercial	$4,006.80
Rate for Payer: Aetna of AZ Medicare	$1,246.56
Rate for Payer: AHCCCS Medicaid	$9,084.18
Rate for Payer: Allwell Medicaid	$9,084.18
Rate for Payer: Allwell Medicare	$667.80
Rate for Payer: Amerigroup Medicare	$667.80
Rate for Payer: APIPA Medicare/Medicaid	$1,662.82
Rate for Payer: AZCH Complete Medicaid	$9,084.18
Rate for Payer: AZCH Complete Medicare	$667.80
Rate for Payer: Banner UC Health Medicaid	$9,084.18
Rate for Payer: Banner UC Health Medicare	$667.80
Rate for Payer: Bisbee Police All Plans	$1,157.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,027.36
Rate for Payer: Cash Price	$3,561.60
Rate for Payer: Cash Price	$3,561.60
Rate for Payer: Cigna of AZ Commercial	$2,226.00
Rate for Payer: Copperpoint Commercial	$1,101.87
Rate for Payer: Health Net of AZ Commercial	$2,671.20
Rate for Payer: Health Net of AZ Medicare	$1,246.56
Rate for Payer: Humana of AZ Medicare	$667.80
Rate for Payer: Mercy Care Medicaid	$9,084.18
Rate for Payer: Self Pay Self Pay	$3,561.60
Rate for Payer: TriWest Medicare	$667.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$4,540.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$801.36

REPAIR OF TORN TENDONS OF SHOULDER (ROTATOR CUFF), OPEN PROC

Facility

IP

$4,625.00

Service Code	CPT 23410
Hospital Charge Code	27371853
Hospital Revenue Code	360
Min. Negotiated Rate	$1,202.50
Max. Negotiated Rate	$4,162.50
Rate for Payer: Aetna of AZ Commercial	$4,162.50
Rate for Payer: Bisbee Police All Plans	$1,202.50
Rate for Payer: Cash Price	$3,700.00
Rate for Payer: Self Pay Self Pay	$3,700.00

RESCUENET RETRIEVAL NET

Facility

OP

$446.00

Hospital Charge Code	27497393
Hospital Revenue Code	270
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$401.40
Rate for Payer: Aetna of AZ Commercial	$401.40
Rate for Payer: Aetna of AZ Medicare	$124.88
Rate for Payer: Allwell Medicare	$66.90
Rate for Payer: Amerigroup Medicare	$66.90
Rate for Payer: APIPA Medicare/Medicaid	$166.58
Rate for Payer: AZCH Complete Medicare	$66.90
Rate for Payer: Banner UC Health Medicare	$66.90
Rate for Payer: Bisbee Police All Plans	$115.96
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$303.28
Rate for Payer: Cash Price	$356.80
Rate for Payer: Cigna of AZ Commercial	$312.20
Rate for Payer: Copperpoint Commercial	$110.38
Rate for Payer: Health Net of AZ Commercial	$267.60
Rate for Payer: Health Net of AZ Medicare	$124.88
Rate for Payer: Humana of AZ Medicare	$66.90
Rate for Payer: Self Pay Self Pay	$356.80
Rate for Payer: TriWest Medicare	$66.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$260.02
Rate for Payer: UnitedHealth Group of AZ Medicare	$80.28

RESCUENET RETRIEVAL NET

Facility

IP

$446.00

Hospital Charge Code	27497393
Hospital Revenue Code	270
Min. Negotiated Rate	$115.96
Max. Negotiated Rate	$401.40
Rate for Payer: Aetna of AZ Commercial	$401.40
Rate for Payer: Bisbee Police All Plans	$115.96
Rate for Payer: Cash Price	$356.80
Rate for Payer: Self Pay Self Pay	$356.80

RESCUENET RETRIEVAL NET

Facility

OP

$349.00

Hospital Charge Code	23839570
Hospital Revenue Code	270
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$314.10
Rate for Payer: Aetna of AZ Commercial	$314.10
Rate for Payer: Aetna of AZ Medicare	$97.72
Rate for Payer: Allwell Medicare	$52.35
Rate for Payer: Amerigroup Medicare	$52.35
Rate for Payer: APIPA Medicare/Medicaid	$130.35
Rate for Payer: AZCH Complete Medicare	$52.35
Rate for Payer: Banner UC Health Medicare	$52.35
Rate for Payer: Bisbee Police All Plans	$90.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$237.32
Rate for Payer: Cash Price	$279.20
Rate for Payer: Cigna of AZ Commercial	$244.30
Rate for Payer: Copperpoint Commercial	$86.38
Rate for Payer: Health Net of AZ Commercial	$209.40
Rate for Payer: Health Net of AZ Medicare	$97.72
Rate for Payer: Humana of AZ Medicare	$52.35
Rate for Payer: Self Pay Self Pay	$279.20
Rate for Payer: TriWest Medicare	$52.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$203.47
Rate for Payer: UnitedHealth Group of AZ Medicare	$62.82

RESCUENET RETRIEVAL NET

Facility

IP

$349.00

Hospital Charge Code	23839570
Hospital Revenue Code	270
Min. Negotiated Rate	$90.74
Max. Negotiated Rate	$314.10
Rate for Payer: Aetna of AZ Commercial	$314.10
Rate for Payer: Bisbee Police All Plans	$90.74
Rate for Payer: Cash Price	$279.20
Rate for Payer: Self Pay Self Pay	$279.20

RESECTOR SHAVER BLADE 3MM

Facility

OP

$236.00

Hospital Charge Code	25519687
Hospital Revenue Code	270
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$212.40
Rate for Payer: Aetna of AZ Commercial	$212.40
Rate for Payer: Aetna of AZ Medicare	$66.08
Rate for Payer: Allwell Medicare	$35.40
Rate for Payer: Amerigroup Medicare	$35.40
Rate for Payer: APIPA Medicare/Medicaid	$88.15
Rate for Payer: AZCH Complete Medicare	$35.40
Rate for Payer: Banner UC Health Medicare	$35.40
Rate for Payer: Bisbee Police All Plans	$61.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$160.48
Rate for Payer: Cash Price	$188.80
Rate for Payer: Cigna of AZ Commercial	$165.20
Rate for Payer: Copperpoint Commercial	$58.41
Rate for Payer: Health Net of AZ Commercial	$141.60
Rate for Payer: Health Net of AZ Medicare	$66.08
Rate for Payer: Humana of AZ Medicare	$35.40
Rate for Payer: Self Pay Self Pay	$188.80
Rate for Payer: TriWest Medicare	$35.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$137.59
Rate for Payer: UnitedHealth Group of AZ Medicare	$42.48

RESECTOR SHAVER BLADE 3MM

Facility

IP

$236.00

Hospital Charge Code	25519687
Hospital Revenue Code	270
Min. Negotiated Rate	$61.36
Max. Negotiated Rate	$212.40
Rate for Payer: Aetna of AZ Commercial	$212.40
Rate for Payer: Bisbee Police All Plans	$61.36
Rate for Payer: Cash Price	$188.80
Rate for Payer: Self Pay Self Pay	$188.80

RESECTOR SHAVER BLADE 4MM

Facility

OP

$236.00

Hospital Charge Code	25519688
Hospital Revenue Code	270
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$212.40
Rate for Payer: Aetna of AZ Commercial	$212.40
Rate for Payer: Aetna of AZ Medicare	$66.08
Rate for Payer: Allwell Medicare	$35.40
Rate for Payer: Amerigroup Medicare	$35.40
Rate for Payer: APIPA Medicare/Medicaid	$88.15
Rate for Payer: AZCH Complete Medicare	$35.40
Rate for Payer: Banner UC Health Medicare	$35.40
Rate for Payer: Bisbee Police All Plans	$61.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$160.48
Rate for Payer: Cash Price	$188.80
Rate for Payer: Cigna of AZ Commercial	$165.20
Rate for Payer: Copperpoint Commercial	$58.41
Rate for Payer: Health Net of AZ Commercial	$141.60
Rate for Payer: Health Net of AZ Medicare	$66.08
Rate for Payer: Humana of AZ Medicare	$35.40
Rate for Payer: Self Pay Self Pay	$188.80
Rate for Payer: TriWest Medicare	$35.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$137.59
Rate for Payer: UnitedHealth Group of AZ Medicare	$42.48

RESECTOR SHAVER BLADE 4MM

Facility

IP

$236.00

Hospital Charge Code	25519688
Hospital Revenue Code	270
Min. Negotiated Rate	$61.36
Max. Negotiated Rate	$212.40
Rate for Payer: Aetna of AZ Commercial	$212.40
Rate for Payer: Bisbee Police All Plans	$61.36
Rate for Payer: Cash Price	$188.80
Rate for Payer: Self Pay Self Pay	$188.80

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