Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$4,564.01

Service Code	APR-DRG 1442
Hospital Charge Code	APRDRG1444
Min. Negotiated Rate	$4,564.01
Max. Negotiated Rate	$4,564.01
Rate for Payer: AHCCCS Medicaid	$4,564.01
Rate for Payer: Allwell Medicaid	$4,564.01
Rate for Payer: AZCH Complete Medicaid	$4,564.01
Rate for Payer: Banner UC Health Medicaid	$4,564.01
Rate for Payer: Mercy Care Medicaid	$4,564.01

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$6,396.07

Service Code	APR-DRG 1443
Hospital Charge Code	APRDRG1444
Min. Negotiated Rate	$6,396.07
Max. Negotiated Rate	$6,396.07
Rate for Payer: AHCCCS Medicaid	$6,396.07
Rate for Payer: Allwell Medicaid	$6,396.07
Rate for Payer: AZCH Complete Medicaid	$6,396.07
Rate for Payer: Banner UC Health Medicaid	$6,396.07
Rate for Payer: Mercy Care Medicaid	$6,396.07

Respiratory Syncytial Virus (RSV)

Facility

OP

$251.00

Service Code	CPT 87807
Hospital Charge Code	787102
Hospital Revenue Code	306
Min. Negotiated Rate	$13.10
Max. Negotiated Rate	$225.90
Rate for Payer: Aetna of AZ Commercial	$225.90
Rate for Payer: Aetna of AZ Medicare	$70.28
Rate for Payer: AHCCCS Medicaid	$13.10
Rate for Payer: Allwell Medicaid	$13.10
Rate for Payer: Allwell Medicare	$37.65
Rate for Payer: Amerigroup Medicare	$37.65
Rate for Payer: APIPA Medicare/Medicaid	$93.75
Rate for Payer: AZCH Complete Medicaid	$13.10
Rate for Payer: AZCH Complete Medicare	$37.65
Rate for Payer: Banner UC Health Medicaid	$13.10
Rate for Payer: Banner UC Health Medicare	$37.65
Rate for Payer: Bisbee Police All Plans	$65.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$170.68
Rate for Payer: Cash Price	$200.80
Rate for Payer: Cash Price	$200.80
Rate for Payer: Cigna of AZ Commercial	$163.15
Rate for Payer: Copperpoint Commercial	$62.12
Rate for Payer: Health Net of AZ Commercial	$150.60
Rate for Payer: Health Net of AZ Medicare	$70.28
Rate for Payer: Humana of AZ Medicare	$37.65
Rate for Payer: Mercy Care Medicaid	$13.10
Rate for Payer: Self Pay Self Pay	$200.80
Rate for Payer: TriWest Medicare	$37.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$146.33
Rate for Payer: UnitedHealth Group of AZ Medicare	$45.18

Respiratory Syncytial Virus (RSV)

Facility

IP

$251.00

Service Code	CPT 87807
Hospital Charge Code	787102
Hospital Revenue Code	306
Min. Negotiated Rate	$65.26
Max. Negotiated Rate	$225.90
Rate for Payer: Aetna of AZ Commercial	$225.90
Rate for Payer: Bisbee Police All Plans	$65.26
Rate for Payer: Cash Price	$200.80
Rate for Payer: Self Pay Self Pay	$200.80

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$26,639.87

Service Code	APR-DRG 1303
Hospital Charge Code	APRDRG1303
Min. Negotiated Rate	$26,639.87
Max. Negotiated Rate	$26,639.87
Rate for Payer: AHCCCS Medicaid	$26,639.87
Rate for Payer: Allwell Medicaid	$26,639.87
Rate for Payer: AZCH Complete Medicaid	$26,639.87
Rate for Payer: Banner UC Health Medicaid	$26,639.87
Rate for Payer: Mercy Care Medicaid	$26,639.87

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$19,074.57

Service Code	APR-DRG 1301
Hospital Charge Code	APRDRG1303
Min. Negotiated Rate	$19,074.57
Max. Negotiated Rate	$19,074.57
Rate for Payer: AHCCCS Medicaid	$19,074.57
Rate for Payer: Allwell Medicaid	$19,074.57
Rate for Payer: AZCH Complete Medicaid	$19,074.57
Rate for Payer: Banner UC Health Medicaid	$19,074.57
Rate for Payer: Mercy Care Medicaid	$19,074.57

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$35,760.18

Service Code	APR-DRG 1304
Hospital Charge Code	APRDRG1301
Min. Negotiated Rate	$35,760.18
Max. Negotiated Rate	$35,760.18
Rate for Payer: AHCCCS Medicaid	$35,760.18
Rate for Payer: Allwell Medicaid	$35,760.18
Rate for Payer: AZCH Complete Medicaid	$35,760.18
Rate for Payer: Banner UC Health Medicaid	$35,760.18
Rate for Payer: Mercy Care Medicaid	$35,760.18

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$19,074.57

Service Code	APR-DRG 1301
Hospital Charge Code	APRDRG1304
Min. Negotiated Rate	$19,074.57
Max. Negotiated Rate	$19,074.57
Rate for Payer: AHCCCS Medicaid	$19,074.57
Rate for Payer: Allwell Medicaid	$19,074.57
Rate for Payer: AZCH Complete Medicaid	$19,074.57
Rate for Payer: Banner UC Health Medicaid	$19,074.57
Rate for Payer: Mercy Care Medicaid	$19,074.57

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$22,654.52

Service Code	APR-DRG 1302
Hospital Charge Code	APRDRG1301
Min. Negotiated Rate	$22,654.52
Max. Negotiated Rate	$22,654.52
Rate for Payer: AHCCCS Medicaid	$22,654.52
Rate for Payer: Allwell Medicaid	$22,654.52
Rate for Payer: AZCH Complete Medicaid	$22,654.52
Rate for Payer: Banner UC Health Medicaid	$22,654.52
Rate for Payer: Mercy Care Medicaid	$22,654.52

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$22,654.52

Service Code	APR-DRG 1302
Hospital Charge Code	APRDRG1304
Min. Negotiated Rate	$22,654.52
Max. Negotiated Rate	$22,654.52
Rate for Payer: AHCCCS Medicaid	$22,654.52
Rate for Payer: Allwell Medicaid	$22,654.52
Rate for Payer: AZCH Complete Medicaid	$22,654.52
Rate for Payer: Banner UC Health Medicaid	$22,654.52
Rate for Payer: Mercy Care Medicaid	$22,654.52

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$26,639.87

Service Code	APR-DRG 1303
Hospital Charge Code	APRDRG1301
Min. Negotiated Rate	$26,639.87
Max. Negotiated Rate	$26,639.87
Rate for Payer: AHCCCS Medicaid	$26,639.87
Rate for Payer: Allwell Medicaid	$26,639.87
Rate for Payer: AZCH Complete Medicaid	$26,639.87
Rate for Payer: Banner UC Health Medicaid	$26,639.87
Rate for Payer: Mercy Care Medicaid	$26,639.87

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$19,074.57

Service Code	APR-DRG 1301
Hospital Charge Code	APRDRG1301
Min. Negotiated Rate	$19,074.57
Max. Negotiated Rate	$19,074.57
Rate for Payer: AHCCCS Medicaid	$19,074.57
Rate for Payer: Allwell Medicaid	$19,074.57
Rate for Payer: AZCH Complete Medicaid	$19,074.57
Rate for Payer: Banner UC Health Medicaid	$19,074.57
Rate for Payer: Mercy Care Medicaid	$19,074.57

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$26,639.87

Service Code	APR-DRG 1303
Hospital Charge Code	APRDRG1304
Min. Negotiated Rate	$26,639.87
Max. Negotiated Rate	$26,639.87
Rate for Payer: AHCCCS Medicaid	$26,639.87
Rate for Payer: Allwell Medicaid	$26,639.87
Rate for Payer: AZCH Complete Medicaid	$26,639.87
Rate for Payer: Banner UC Health Medicaid	$26,639.87
Rate for Payer: Mercy Care Medicaid	$26,639.87

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$26,639.87

Service Code	APR-DRG 1303
Hospital Charge Code	APRDRG1302
Min. Negotiated Rate	$26,639.87
Max. Negotiated Rate	$26,639.87
Rate for Payer: AHCCCS Medicaid	$26,639.87
Rate for Payer: Allwell Medicaid	$26,639.87
Rate for Payer: AZCH Complete Medicaid	$26,639.87
Rate for Payer: Banner UC Health Medicaid	$26,639.87
Rate for Payer: Mercy Care Medicaid	$26,639.87

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$19,074.57

Service Code	APR-DRG 1301
Hospital Charge Code	APRDRG1302
Min. Negotiated Rate	$19,074.57
Max. Negotiated Rate	$19,074.57
Rate for Payer: AHCCCS Medicaid	$19,074.57
Rate for Payer: Allwell Medicaid	$19,074.57
Rate for Payer: AZCH Complete Medicaid	$19,074.57
Rate for Payer: Banner UC Health Medicaid	$19,074.57
Rate for Payer: Mercy Care Medicaid	$19,074.57

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$35,760.18

Service Code	APR-DRG 1304
Hospital Charge Code	APRDRG1303
Min. Negotiated Rate	$35,760.18
Max. Negotiated Rate	$35,760.18
Rate for Payer: AHCCCS Medicaid	$35,760.18
Rate for Payer: Allwell Medicaid	$35,760.18
Rate for Payer: AZCH Complete Medicaid	$35,760.18
Rate for Payer: Banner UC Health Medicaid	$35,760.18
Rate for Payer: Mercy Care Medicaid	$35,760.18

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$35,760.18

Service Code	APR-DRG 1304
Hospital Charge Code	APRDRG1302
Min. Negotiated Rate	$35,760.18
Max. Negotiated Rate	$35,760.18
Rate for Payer: AHCCCS Medicaid	$35,760.18
Rate for Payer: Allwell Medicaid	$35,760.18
Rate for Payer: AZCH Complete Medicaid	$35,760.18
Rate for Payer: Banner UC Health Medicaid	$35,760.18
Rate for Payer: Mercy Care Medicaid	$35,760.18

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$22,654.52

Service Code	APR-DRG 1302
Hospital Charge Code	APRDRG1303
Min. Negotiated Rate	$22,654.52
Max. Negotiated Rate	$22,654.52
Rate for Payer: AHCCCS Medicaid	$22,654.52
Rate for Payer: Allwell Medicaid	$22,654.52
Rate for Payer: AZCH Complete Medicaid	$22,654.52
Rate for Payer: Banner UC Health Medicaid	$22,654.52
Rate for Payer: Mercy Care Medicaid	$22,654.52

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$22,654.52

Service Code	APR-DRG 1302
Hospital Charge Code	APRDRG1302
Min. Negotiated Rate	$22,654.52
Max. Negotiated Rate	$22,654.52
Rate for Payer: AHCCCS Medicaid	$22,654.52
Rate for Payer: Allwell Medicaid	$22,654.52
Rate for Payer: AZCH Complete Medicaid	$22,654.52
Rate for Payer: Banner UC Health Medicaid	$22,654.52
Rate for Payer: Mercy Care Medicaid	$22,654.52

Respiratory System Diagnosis With Ventilator Support > 96 Hours

Facility

IP

$35,760.18

Service Code	APR-DRG 1304
Hospital Charge Code	APRDRG1304
Min. Negotiated Rate	$35,760.18
Max. Negotiated Rate	$35,760.18
Rate for Payer: AHCCCS Medicaid	$35,760.18
Rate for Payer: Allwell Medicaid	$35,760.18
Rate for Payer: AZCH Complete Medicaid	$35,760.18
Rate for Payer: Banner UC Health Medicaid	$35,760.18
Rate for Payer: Mercy Care Medicaid	$35,760.18

Respiratory Therapy

Facility

OP

$367.00

Service Code	CPT 94010
Hospital Charge Code	853605
Hospital Revenue Code	460
Min. Negotiated Rate	$55.05
Max. Negotiated Rate	$330.30
Rate for Payer: Aetna of AZ Commercial	$330.30
Rate for Payer: Aetna of AZ Medicare	$102.76
Rate for Payer: AHCCCS Medicaid	$202.34
Rate for Payer: Allwell Medicaid	$202.34
Rate for Payer: Allwell Medicare	$55.05
Rate for Payer: Amerigroup Medicare	$55.05
Rate for Payer: APIPA Medicare/Medicaid	$137.07
Rate for Payer: AZCH Complete Medicaid	$202.34
Rate for Payer: AZCH Complete Medicare	$55.05
Rate for Payer: Banner UC Health Medicaid	$202.34
Rate for Payer: Banner UC Health Medicare	$55.05
Rate for Payer: Bisbee Police All Plans	$95.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$249.56
Rate for Payer: Cash Price	$293.60
Rate for Payer: Cash Price	$293.60
Rate for Payer: Cigna of AZ Commercial	$256.90
Rate for Payer: Copperpoint Commercial	$90.83
Rate for Payer: Health Net of AZ Commercial	$220.20
Rate for Payer: Health Net of AZ Medicare	$102.76
Rate for Payer: Humana of AZ Medicare	$55.05
Rate for Payer: Mercy Care Medicaid	$202.34
Rate for Payer: Self Pay Self Pay	$293.60
Rate for Payer: TriWest Medicare	$55.05
Rate for Payer: UnitedHealth Group of AZ Commercial	$213.96
Rate for Payer: UnitedHealth Group of AZ Medicare	$66.06

Respiratory Therapy

Facility

OP

$898.00

Service Code	CPT 94060
Hospital Charge Code	884915
Hospital Revenue Code	460
Min. Negotiated Rate	$134.70
Max. Negotiated Rate	$808.20
Rate for Payer: Aetna of AZ Commercial	$808.20
Rate for Payer: Aetna of AZ Medicare	$251.44
Rate for Payer: AHCCCS Medicaid	$383.46
Rate for Payer: Allwell Medicaid	$383.46
Rate for Payer: Allwell Medicare	$134.70
Rate for Payer: Amerigroup Medicare	$134.70
Rate for Payer: APIPA Medicare/Medicaid	$335.40
Rate for Payer: AZCH Complete Medicaid	$383.46
Rate for Payer: AZCH Complete Medicare	$134.70
Rate for Payer: Banner UC Health Medicaid	$383.46
Rate for Payer: Banner UC Health Medicare	$134.70
Rate for Payer: Bisbee Police All Plans	$233.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$610.64
Rate for Payer: Cash Price	$718.40
Rate for Payer: Cash Price	$718.40
Rate for Payer: Cigna of AZ Commercial	$628.60
Rate for Payer: Copperpoint Commercial	$222.26
Rate for Payer: Health Net of AZ Commercial	$538.80
Rate for Payer: Health Net of AZ Medicare	$251.44
Rate for Payer: Humana of AZ Medicare	$134.70
Rate for Payer: Mercy Care Medicaid	$383.46
Rate for Payer: Self Pay Self Pay	$718.40
Rate for Payer: TriWest Medicare	$134.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$523.53
Rate for Payer: UnitedHealth Group of AZ Medicare	$161.64

Respiratory Therapy

Facility

IP

$367.00

Service Code	CPT 94010
Hospital Charge Code	853605
Hospital Revenue Code	460
Min. Negotiated Rate	$95.42
Max. Negotiated Rate	$330.30
Rate for Payer: Aetna of AZ Commercial	$330.30
Rate for Payer: Bisbee Police All Plans	$95.42
Rate for Payer: Cash Price	$293.60
Rate for Payer: Self Pay Self Pay	$293.60

Respiratory Therapy

Facility

IP

$898.00

Service Code	CPT 94060
Hospital Charge Code	884915
Hospital Revenue Code	460
Min. Negotiated Rate	$233.48
Max. Negotiated Rate	$808.20
Rate for Payer: Aetna of AZ Commercial	$808.20
Rate for Payer: Bisbee Police All Plans	$233.48
Rate for Payer: Cash Price	$718.40
Rate for Payer: Self Pay Self Pay	$718.40

RESTRAINT LIMB

Facility

OP

$19.00

Hospital Charge Code	22354291
Hospital Revenue Code	270
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$17.10
Rate for Payer: Aetna of AZ Commercial	$17.10
Rate for Payer: Aetna of AZ Medicare	$5.32
Rate for Payer: Allwell Medicare	$2.85
Rate for Payer: Amerigroup Medicare	$2.85
Rate for Payer: APIPA Medicare/Medicaid	$7.10
Rate for Payer: AZCH Complete Medicare	$2.85
Rate for Payer: Banner UC Health Medicare	$2.85
Rate for Payer: Bisbee Police All Plans	$4.94
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$12.92
Rate for Payer: Cash Price	$15.20
Rate for Payer: Cigna of AZ Commercial	$13.30
Rate for Payer: Copperpoint Commercial	$4.70
Rate for Payer: Health Net of AZ Commercial	$11.40
Rate for Payer: Health Net of AZ Medicare	$5.32
Rate for Payer: Humana of AZ Medicare	$2.85
Rate for Payer: Self Pay Self Pay	$15.20
Rate for Payer: TriWest Medicare	$2.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$11.08
Rate for Payer: UnitedHealth Group of AZ Medicare	$3.42

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