Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

REMOVER STAPLE PROXIMATE

Facility

IP

$37.00

Hospital Charge Code	22355173
Hospital Revenue Code	270
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of AZ Commercial	$33.30
Rate for Payer: Bisbee Police All Plans	$9.62
Rate for Payer: Cash Price	$29.60
Rate for Payer: Self Pay Self Pay	$29.60

REMOVER STAPLE PROXIMATE

Facility

OP

$37.00

Hospital Charge Code	22355173
Hospital Revenue Code	270
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of AZ Commercial	$33.30
Rate for Payer: Aetna of AZ Medicare	$10.36
Rate for Payer: Allwell Medicare	$5.92
Rate for Payer: Amerigroup Medicare	$5.92
Rate for Payer: APIPA Medicare/Medicaid	$13.82
Rate for Payer: AZCH Complete Medicare	$5.92
Rate for Payer: Banner UC Health Medicare	$5.92
Rate for Payer: Bisbee Police All Plans	$9.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$25.16
Rate for Payer: Cash Price	$29.60
Rate for Payer: Cigna of AZ Commercial	$25.90
Rate for Payer: Copperpoint Commercial	$9.16
Rate for Payer: Health Net of AZ Commercial	$22.20
Rate for Payer: Health Net of AZ Medicare	$10.36
Rate for Payer: Humana of AZ Medicare	$5.92
Rate for Payer: Self Pay Self Pay	$29.60
Rate for Payer: TriWest Medicare	$5.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$21.57
Rate for Payer: UnitedHealth Group of AZ Medicare	$6.66

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$6,833.04

Service Code	APR-DRG 4441
Hospital Charge Code	APRDRG4441
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	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

$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

$29,825.63

Service Code	APR-DRG 4444
Hospital Charge Code	APRDRG4444
Min. Negotiated Rate	$29,825.63
Max. Negotiated Rate	$29,825.63
Rate for Payer: AHCCCS Medicaid	$29,825.63
Rate for Payer: Allwell Medicaid	$29,825.63
Rate for Payer: AZCH Complete Medicaid	$29,825.63
Rate for Payer: Banner UC Health Medicaid	$29,825.63
Rate for Payer: Mercy Care Medicaid	$29,825.63

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

$6,833.04

Service Code	APR-DRG 4441
Hospital Charge Code	APRDRG4443
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

$29,825.63

Service Code	APR-DRG 4444
Hospital Charge Code	APRDRG4443
Min. Negotiated Rate	$29,825.63
Max. Negotiated Rate	$29,825.63
Rate for Payer: AHCCCS Medicaid	$29,825.63
Rate for Payer: Allwell Medicaid	$29,825.63
Rate for Payer: AZCH Complete Medicaid	$29,825.63
Rate for Payer: Banner UC Health Medicaid	$29,825.63
Rate for Payer: Mercy Care Medicaid	$29,825.63

Renal Dialysis Access Device Procedures And Vessel Repair

Facility

IP

$16,643.52

Service Code	APR-DRG 4443
Hospital Charge Code	APRDRG4443
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	APRDRG4443
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

$29,825.63

Service Code	APR-DRG 4444
Hospital Charge Code	APRDRG4441
Min. Negotiated Rate	$29,825.63
Max. Negotiated Rate	$29,825.63
Rate for Payer: AHCCCS Medicaid	$29,825.63
Rate for Payer: Allwell Medicaid	$29,825.63
Rate for Payer: AZCH Complete Medicaid	$29,825.63
Rate for Payer: Banner UC Health Medicaid	$29,825.63
Rate for Payer: Mercy Care Medicaid	$29,825.63

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

$29,825.63

Service Code	APR-DRG 4444
Hospital Charge Code	APRDRG4442
Min. Negotiated Rate	$29,825.63
Max. Negotiated Rate	$29,825.63
Rate for Payer: AHCCCS Medicaid	$29,825.63
Rate for Payer: Allwell Medicaid	$29,825.63
Rate for Payer: AZCH Complete Medicaid	$29,825.63
Rate for Payer: Banner UC Health Medicaid	$29,825.63
Rate for Payer: Mercy Care Medicaid	$29,825.63

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

$6,833.04

Service Code	APR-DRG 4441
Hospital Charge Code	APRDRG4442
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

$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 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 Function Panel Standard

Facility

OP

$151.00

Service Code	CPT 80069
Hospital Charge Code	22141046
Hospital Revenue Code	301
Min. Negotiated Rate	$24.16
Max. Negotiated Rate	$135.90
Rate for Payer: Aetna of AZ Commercial	$135.90
Rate for Payer: Aetna of AZ Medicare	$42.28
Rate for Payer: Allwell Medicare	$24.16
Rate for Payer: Amerigroup Medicare	$24.16
Rate for Payer: APIPA Medicare/Medicaid	$56.40
Rate for Payer: AZCH Complete Medicare	$24.16
Rate for Payer: Banner UC Health Medicare	$24.16
Rate for Payer: Bisbee Police All Plans	$39.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$102.68
Rate for Payer: Cash Price	$120.80
Rate for Payer: Cigna of AZ Commercial	$98.15
Rate for Payer: Copperpoint Commercial	$37.37
Rate for Payer: Health Net of AZ Commercial	$90.60
Rate for Payer: Health Net of AZ Medicare	$42.28
Rate for Payer: Humana of AZ Medicare	$24.16
Rate for Payer: Self Pay Self Pay	$120.80
Rate for Payer: TriWest Medicare	$24.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$88.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$27.18

Renal Function Panel Standard

Facility

IP

$151.00

Service Code	CPT 80069
Hospital Charge Code	22141046
Hospital Revenue Code	301
Min. Negotiated Rate	$39.26
Max. Negotiated Rate	$135.90
Rate for Payer: Aetna of AZ Commercial	$135.90
Rate for Payer: Bisbee Police All Plans	$39.26
Rate for Payer: Cash Price	$120.80
Rate for Payer: Self Pay Self Pay	$120.80

Renin Activity, Plasma LC

Facility

IP

$275.00

Service Code	CPT 84244
Hospital Charge Code	1905527
Hospital Revenue Code	301
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna of AZ Commercial	$247.50
Rate for Payer: Bisbee Police All Plans	$71.50
Rate for Payer: Cash Price	$220.00
Rate for Payer: Self Pay Self Pay	$220.00

Renin Activity, Plasma LC

Facility

OP

$275.00

Service Code	CPT 84244
Hospital Charge Code	1905527
Hospital Revenue Code	301
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna of AZ Commercial	$247.50
Rate for Payer: Aetna of AZ Medicare	$77.00
Rate for Payer: Allwell Medicare	$44.00
Rate for Payer: Amerigroup Medicare	$44.00
Rate for Payer: APIPA Medicare/Medicaid	$102.71
Rate for Payer: AZCH Complete Medicare	$44.00
Rate for Payer: Banner UC Health Medicare	$44.00
Rate for Payer: Bisbee Police All Plans	$71.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$187.00
Rate for Payer: Cash Price	$220.00
Rate for Payer: Cigna of AZ Commercial	$178.75
Rate for Payer: Copperpoint Commercial	$68.06
Rate for Payer: Health Net of AZ Commercial	$165.00
Rate for Payer: Health Net of AZ Medicare	$77.00
Rate for Payer: Humana of AZ Medicare	$44.00
Rate for Payer: Self Pay Self Pay	$220.00
Rate for Payer: TriWest Medicare	$44.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$160.32
Rate for Payer: UnitedHealth Group of AZ Medicare	$49.50

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	$317.60
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$1,786.50
Rate for Payer: Aetna of AZ Medicare	$555.80
Rate for Payer: AHCCCS Medicaid	$2,230.35
Rate for Payer: Allwell Medicaid	$2,230.35
Rate for Payer: Allwell Medicare	$317.60
Rate for Payer: Amerigroup Medicare	$317.60
Rate for Payer: APIPA Medicare/Medicaid	$741.40
Rate for Payer: AZCH Complete Medicaid	$2,230.35
Rate for Payer: AZCH Complete Medicare	$317.60
Rate for Payer: Banner UC Health Medicaid	$2,230.35
Rate for Payer: Banner UC Health Medicare	$317.60
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	$317.60
Rate for Payer: Mercy Care Medicaid	$2,230.35
Rate for Payer: Self Pay Self Pay	$1,588.00
Rate for Payer: TriWest Medicare	$317.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$357.30

REPAIR OF STRICTURE IN KIDNEY USING AN ENDOSCOPE

Facility

OP

$1,777.00

Service Code	CPT 52343
Hospital Charge Code	28068481
Hospital Revenue Code	360
Min. Negotiated Rate	$284.32
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$1,599.30
Rate for Payer: Aetna of AZ Medicare	$497.56
Rate for Payer: AHCCCS Medicaid	$2,230.35
Rate for Payer: Allwell Medicaid	$2,230.35
Rate for Payer: Allwell Medicare	$284.32
Rate for Payer: Amerigroup Medicare	$284.32
Rate for Payer: APIPA Medicare/Medicaid	$663.71
Rate for Payer: AZCH Complete Medicaid	$2,230.35
Rate for Payer: AZCH Complete Medicare	$284.32
Rate for Payer: Banner UC Health Medicaid	$2,230.35
Rate for Payer: Banner UC Health Medicare	$284.32
Rate for Payer: Bisbee Police All Plans	$462.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,208.36
Rate for Payer: Cash Price	$1,421.60
Rate for Payer: Cash Price	$1,421.60
Rate for Payer: Cigna of AZ Commercial	$888.50
Rate for Payer: Copperpoint Commercial	$439.81
Rate for Payer: Health Net of AZ Commercial	$1,066.20
Rate for Payer: Health Net of AZ Medicare	$497.56
Rate for Payer: Humana of AZ Medicare	$284.32
Rate for Payer: Mercy Care Medicaid	$2,230.35
Rate for Payer: Self Pay Self Pay	$1,421.60
Rate for Payer: TriWest Medicare	$284.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$319.86

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