Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Septicemia And Disseminated Infections

Facility

IP

$14,811.46

Service Code	APR-DRG 7204
Hospital Charge Code	APRDRG7201
Min. Negotiated Rate	$14,811.46
Max. Negotiated Rate	$14,811.46
Rate for Payer: AHCCCS Medicaid	$14,811.46
Rate for Payer: Allwell Medicaid	$14,811.46
Rate for Payer: AZCH Complete Medicaid	$14,811.46
Rate for Payer: Banner UC Health Medicaid	$14,811.46
Rate for Payer: Mercy Care Medicaid	$14,811.46

Septicemia And Disseminated Infections

Facility

IP

$4,966.61

Service Code	APR-DRG 7202
Hospital Charge Code	APRDRG7202
Min. Negotiated Rate	$4,966.61
Max. Negotiated Rate	$4,966.61
Rate for Payer: AHCCCS Medicaid	$4,966.61
Rate for Payer: Allwell Medicaid	$4,966.61
Rate for Payer: AZCH Complete Medicaid	$4,966.61
Rate for Payer: Banner UC Health Medicaid	$4,966.61
Rate for Payer: Mercy Care Medicaid	$4,966.61

Septicemia And Disseminated Infections

Facility

IP

$3,873.13

Service Code	APR-DRG 7201
Hospital Charge Code	APRDRG7202
Min. Negotiated Rate	$3,873.13
Max. Negotiated Rate	$3,873.13
Rate for Payer: AHCCCS Medicaid	$3,873.13
Rate for Payer: Allwell Medicaid	$3,873.13
Rate for Payer: AZCH Complete Medicaid	$3,873.13
Rate for Payer: Banner UC Health Medicaid	$3,873.13
Rate for Payer: Mercy Care Medicaid	$3,873.13

Septicemia And Disseminated Infections

Facility

IP

$4,966.61

Service Code	APR-DRG 7202
Hospital Charge Code	APRDRG7203
Min. Negotiated Rate	$4,966.61
Max. Negotiated Rate	$4,966.61
Rate for Payer: AHCCCS Medicaid	$4,966.61
Rate for Payer: Allwell Medicaid	$4,966.61
Rate for Payer: AZCH Complete Medicaid	$4,966.61
Rate for Payer: Banner UC Health Medicaid	$4,966.61
Rate for Payer: Mercy Care Medicaid	$4,966.61

Septicemia And Disseminated Infections

Facility

IP

$3,873.13

Service Code	APR-DRG 7201
Hospital Charge Code	APRDRG7204
Min. Negotiated Rate	$3,873.13
Max. Negotiated Rate	$3,873.13
Rate for Payer: AHCCCS Medicaid	$3,873.13
Rate for Payer: Allwell Medicaid	$3,873.13
Rate for Payer: AZCH Complete Medicaid	$3,873.13
Rate for Payer: Banner UC Health Medicaid	$3,873.13
Rate for Payer: Mercy Care Medicaid	$3,873.13

Septicemia And Disseminated Infections

Facility

IP

$7,570.91

Service Code	APR-DRG 7203
Hospital Charge Code	APRDRG7201
Min. Negotiated Rate	$7,570.91
Max. Negotiated Rate	$7,570.91
Rate for Payer: AHCCCS Medicaid	$7,570.91
Rate for Payer: Allwell Medicaid	$7,570.91
Rate for Payer: AZCH Complete Medicaid	$7,570.91
Rate for Payer: Banner UC Health Medicaid	$7,570.91
Rate for Payer: Mercy Care Medicaid	$7,570.91

Septicemia And Disseminated Infections

Facility

IP

$14,811.46

Service Code	APR-DRG 7204
Hospital Charge Code	APRDRG7203
Min. Negotiated Rate	$14,811.46
Max. Negotiated Rate	$14,811.46
Rate for Payer: AHCCCS Medicaid	$14,811.46
Rate for Payer: Allwell Medicaid	$14,811.46
Rate for Payer: AZCH Complete Medicaid	$14,811.46
Rate for Payer: Banner UC Health Medicaid	$14,811.46
Rate for Payer: Mercy Care Medicaid	$14,811.46

Septicemia And Disseminated Infections

Facility

IP

$7,570.91

Service Code	APR-DRG 7203
Hospital Charge Code	APRDRG7203
Min. Negotiated Rate	$7,570.91
Max. Negotiated Rate	$7,570.91
Rate for Payer: AHCCCS Medicaid	$7,570.91
Rate for Payer: Allwell Medicaid	$7,570.91
Rate for Payer: AZCH Complete Medicaid	$7,570.91
Rate for Payer: Banner UC Health Medicaid	$7,570.91
Rate for Payer: Mercy Care Medicaid	$7,570.91

Septicemia And Disseminated Infections

Facility

IP

$14,811.46

Service Code	APR-DRG 7204
Hospital Charge Code	APRDRG7204
Min. Negotiated Rate	$14,811.46
Max. Negotiated Rate	$14,811.46
Rate for Payer: AHCCCS Medicaid	$14,811.46
Rate for Payer: Allwell Medicaid	$14,811.46
Rate for Payer: AZCH Complete Medicaid	$14,811.46
Rate for Payer: Banner UC Health Medicaid	$14,811.46
Rate for Payer: Mercy Care Medicaid	$14,811.46

Septicemia And Disseminated Infections

Facility

IP

$7,570.91

Service Code	APR-DRG 7203
Hospital Charge Code	APRDRG7204
Min. Negotiated Rate	$7,570.91
Max. Negotiated Rate	$7,570.91
Rate for Payer: AHCCCS Medicaid	$7,570.91
Rate for Payer: Allwell Medicaid	$7,570.91
Rate for Payer: AZCH Complete Medicaid	$7,570.91
Rate for Payer: Banner UC Health Medicaid	$7,570.91
Rate for Payer: Mercy Care Medicaid	$7,570.91

Septicemia And Disseminated Infections

Facility

IP

$3,873.13

Service Code	APR-DRG 7201
Hospital Charge Code	APRDRG7201
Min. Negotiated Rate	$3,873.13
Max. Negotiated Rate	$3,873.13
Rate for Payer: AHCCCS Medicaid	$3,873.13
Rate for Payer: Allwell Medicaid	$3,873.13
Rate for Payer: AZCH Complete Medicaid	$3,873.13
Rate for Payer: Banner UC Health Medicaid	$3,873.13
Rate for Payer: Mercy Care Medicaid	$3,873.13

Septicemia And Disseminated Infections

Facility

IP

$4,966.61

Service Code	APR-DRG 7202
Hospital Charge Code	APRDRG7201
Min. Negotiated Rate	$4,966.61
Max. Negotiated Rate	$4,966.61
Rate for Payer: AHCCCS Medicaid	$4,966.61
Rate for Payer: Allwell Medicaid	$4,966.61
Rate for Payer: AZCH Complete Medicaid	$4,966.61
Rate for Payer: Banner UC Health Medicaid	$4,966.61
Rate for Payer: Mercy Care Medicaid	$4,966.61

Septicemia And Disseminated Infections

Facility

IP

$3,873.13

Service Code	APR-DRG 7201
Hospital Charge Code	APRDRG7203
Min. Negotiated Rate	$3,873.13
Max. Negotiated Rate	$3,873.13
Rate for Payer: AHCCCS Medicaid	$3,873.13
Rate for Payer: Allwell Medicaid	$3,873.13
Rate for Payer: AZCH Complete Medicaid	$3,873.13
Rate for Payer: Banner UC Health Medicaid	$3,873.13
Rate for Payer: Mercy Care Medicaid	$3,873.13

Septicemia And Disseminated Infections

Facility

IP

$4,966.61

Service Code	APR-DRG 7202
Hospital Charge Code	APRDRG7204
Min. Negotiated Rate	$4,966.61
Max. Negotiated Rate	$4,966.61
Rate for Payer: AHCCCS Medicaid	$4,966.61
Rate for Payer: Allwell Medicaid	$4,966.61
Rate for Payer: AZCH Complete Medicaid	$4,966.61
Rate for Payer: Banner UC Health Medicaid	$4,966.61
Rate for Payer: Mercy Care Medicaid	$4,966.61

Septicemia And Disseminated Infections

Facility

IP

$14,811.46

Service Code	APR-DRG 7204
Hospital Charge Code	APRDRG7202
Min. Negotiated Rate	$14,811.46
Max. Negotiated Rate	$14,811.46
Rate for Payer: AHCCCS Medicaid	$14,811.46
Rate for Payer: Allwell Medicaid	$14,811.46
Rate for Payer: AZCH Complete Medicaid	$14,811.46
Rate for Payer: Banner UC Health Medicaid	$14,811.46
Rate for Payer: Mercy Care Medicaid	$14,811.46

Septicemia And Disseminated Infections

Facility

IP

$7,570.91

Service Code	APR-DRG 7203
Hospital Charge Code	APRDRG7202
Min. Negotiated Rate	$7,570.91
Max. Negotiated Rate	$7,570.91
Rate for Payer: AHCCCS Medicaid	$7,570.91
Rate for Payer: Allwell Medicaid	$7,570.91
Rate for Payer: AZCH Complete Medicaid	$7,570.91
Rate for Payer: Banner UC Health Medicaid	$7,570.91
Rate for Payer: Mercy Care Medicaid	$7,570.91

sertraline 50 mg Tab [CQCH]

Facility

IP

$0.21

Service Code	NDC 60687024201
Hospital Charge Code	105940109
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Bisbee Police All Plans	$0.05
Rate for Payer: Cash Price	$0.17
Rate for Payer: Self Pay Self Pay	$0.17

sertraline 50 mg Tab [CQCH]

Facility

OP

$0.21

Service Code	NDC 60687024201
Hospital Charge Code	105940109
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Aetna of AZ Medicare	$0.06
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.08
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.05
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.14
Rate for Payer: Cash Price	$0.17
Rate for Payer: Cigna of AZ Commercial	$0.14
Rate for Payer: Copperpoint Commercial	$0.05
Rate for Payer: Health Net of AZ Commercial	$0.13
Rate for Payer: Health Net of AZ Medicare	$0.06
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.17
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.12
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.04

Services performed by qualified Physical Therapist in the ho

Facility

IP

$215.00

Service Code	CPT G0151
Hospital Charge Code	27342346
Hospital Revenue Code	420
Min. Negotiated Rate	$55.90
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna of AZ Commercial	$193.50
Rate for Payer: Bisbee Police All Plans	$55.90
Rate for Payer: Cash Price	$172.00
Rate for Payer: Self Pay Self Pay	$172.00

Services performed by qualified Physical Therapist in the ho

Facility

OP

$215.00

Service Code	CPT G0151
Hospital Charge Code	27342346
Hospital Revenue Code	420
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna of AZ Commercial	$193.50
Rate for Payer: Aetna of AZ Medicare	$60.20
Rate for Payer: AHCCCS Medicaid	$0.13
Rate for Payer: Allwell Medicaid	$0.13
Rate for Payer: Allwell Medicare	$32.25
Rate for Payer: Amerigroup Medicare	$32.25
Rate for Payer: APIPA Medicare/Medicaid	$80.30
Rate for Payer: AZCH Complete Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$32.25
Rate for Payer: Banner UC Health Medicaid	$0.13
Rate for Payer: Banner UC Health Medicare	$32.25
Rate for Payer: Bisbee Police All Plans	$55.90
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$146.20
Rate for Payer: Cash Price	$172.00
Rate for Payer: Cash Price	$172.00
Rate for Payer: Cigna of AZ Commercial	$150.50
Rate for Payer: Copperpoint Commercial	$53.21
Rate for Payer: Health Net of AZ Commercial	$129.00
Rate for Payer: Health Net of AZ Medicare	$60.20
Rate for Payer: Humana of AZ Medicare	$32.25
Rate for Payer: Mercy Care Medicaid	$0.13
Rate for Payer: Self Pay Self Pay	$172.00
Rate for Payer: TriWest Medicare	$32.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$125.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$38.70

Services provided by Occupational therapist in the home or h

Facility

IP

$205.00

Service Code	CPT G0152
Hospital Charge Code	27377828
Hospital Revenue Code	420
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$184.50
Rate for Payer: Aetna of AZ Commercial	$184.50
Rate for Payer: Bisbee Police All Plans	$53.30
Rate for Payer: Cash Price	$164.00
Rate for Payer: Self Pay Self Pay	$164.00

Services provided by Occupational therapist in the home or h

Facility

OP

$205.00

Service Code	CPT G0152
Hospital Charge Code	27377828
Hospital Revenue Code	420
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$184.50
Rate for Payer: Aetna of AZ Commercial	$184.50
Rate for Payer: Aetna of AZ Medicare	$57.40
Rate for Payer: AHCCCS Medicaid	$0.13
Rate for Payer: Allwell Medicaid	$0.13
Rate for Payer: Allwell Medicare	$30.75
Rate for Payer: Amerigroup Medicare	$30.75
Rate for Payer: APIPA Medicare/Medicaid	$76.57
Rate for Payer: AZCH Complete Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$30.75
Rate for Payer: Banner UC Health Medicaid	$0.13
Rate for Payer: Banner UC Health Medicare	$30.75
Rate for Payer: Bisbee Police All Plans	$53.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$139.40
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cash Price	$164.00
Rate for Payer: Cigna of AZ Commercial	$143.50
Rate for Payer: Copperpoint Commercial	$50.74
Rate for Payer: Health Net of AZ Commercial	$123.00
Rate for Payer: Health Net of AZ Medicare	$57.40
Rate for Payer: Humana of AZ Medicare	$30.75
Rate for Payer: Mercy Care Medicaid	$0.13
Rate for Payer: Self Pay Self Pay	$164.00
Rate for Payer: TriWest Medicare	$30.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$119.52
Rate for Payer: UnitedHealth Group of AZ Medicare	$36.90

SESAMOIDECTOMY FIRST TOE (SEPARATE PROCEDURE)

Facility

OP

$1,590.00

Service Code	CPT 28315
Hospital Charge Code	24043328
Hospital Revenue Code	360
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$4,104.08
Rate for Payer: Aetna of AZ Commercial	$1,431.00
Rate for Payer: Aetna of AZ Medicare	$445.20
Rate for Payer: AHCCCS Medicaid	$4,104.08
Rate for Payer: Allwell Medicaid	$4,104.08
Rate for Payer: Allwell Medicare	$238.50
Rate for Payer: Amerigroup Medicare	$238.50
Rate for Payer: APIPA Medicare/Medicaid	$593.86
Rate for Payer: AZCH Complete Medicaid	$4,104.08
Rate for Payer: AZCH Complete Medicare	$238.50
Rate for Payer: Banner UC Health Medicaid	$4,104.08
Rate for Payer: Banner UC Health Medicare	$238.50
Rate for Payer: Bisbee Police All Plans	$413.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,081.20
Rate for Payer: Cash Price	$1,272.00
Rate for Payer: Cash Price	$1,272.00
Rate for Payer: Cigna of AZ Commercial	$795.00
Rate for Payer: Copperpoint Commercial	$393.52
Rate for Payer: Health Net of AZ Commercial	$954.00
Rate for Payer: Health Net of AZ Medicare	$445.20
Rate for Payer: Humana of AZ Medicare	$238.50
Rate for Payer: Mercy Care Medicaid	$4,104.08
Rate for Payer: Self Pay Self Pay	$1,272.00
Rate for Payer: TriWest Medicare	$238.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$286.20

SESAMOIDECTOMY FIRST TOE (SEPARATE PROCEDURE)

Facility

IP

$1,590.00

Service Code	CPT 28315
Hospital Charge Code	24043328
Hospital Revenue Code	360
Min. Negotiated Rate	$413.40
Max. Negotiated Rate	$1,431.00
Rate for Payer: Aetna of AZ Commercial	$1,431.00
Rate for Payer: Bisbee Police All Plans	$413.40
Rate for Payer: Cash Price	$1,272.00
Rate for Payer: Self Pay Self Pay	$1,272.00

SET BLOOD Y-TYPE HOSPIRA LIFESHIELD

Facility

IP

$101.00

Hospital Charge Code	22355308
Hospital Revenue Code	270
Min. Negotiated Rate	$26.26
Max. Negotiated Rate	$90.90
Rate for Payer: Aetna of AZ Commercial	$90.90
Rate for Payer: Bisbee Police All Plans	$26.26
Rate for Payer: Cash Price	$80.80
Rate for Payer: Self Pay Self Pay	$80.80

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