Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Respiratory Failure

Facility

$4,633.45

Service Code	APR-DRG 1332
Hospital Charge Code	APRDRG1332
Min. Negotiated Rate	$4,633.45
Max. Negotiated Rate	$4,633.45
Rate for Payer: AHCCCS Medicaid	$4,633.45
Rate for Payer: Allwell Medicaid	$4,633.45
Rate for Payer: AZCH Complete Medicaid	$4,633.45
Rate for Payer: Banner UC Health Medicaid	$4,633.45
Rate for Payer: Mercy Care Medicaid	$4,633.45

Respiratory Failure

Facility

$2,807.70

Service Code	APR-DRG 1331
Hospital Charge Code	APRDRG1334
Min. Negotiated Rate	$2,807.70
Max. Negotiated Rate	$2,807.70
Rate for Payer: AHCCCS Medicaid	$2,807.70
Rate for Payer: Allwell Medicaid	$2,807.70
Rate for Payer: AZCH Complete Medicaid	$2,807.70
Rate for Payer: Banner UC Health Medicaid	$2,807.70
Rate for Payer: Mercy Care Medicaid	$2,807.70

Respiratory Failure

Facility

$2,807.70

Service Code	APR-DRG 1331
Hospital Charge Code	APRDRG1331
Min. Negotiated Rate	$2,807.70
Max. Negotiated Rate	$2,807.70
Rate for Payer: AHCCCS Medicaid	$2,807.70
Rate for Payer: Allwell Medicaid	$2,807.70
Rate for Payer: AZCH Complete Medicaid	$2,807.70
Rate for Payer: Banner UC Health Medicaid	$2,807.70
Rate for Payer: Mercy Care Medicaid	$2,807.70

Respiratory Failure

Facility

$12,428.81

Service Code	APR-DRG 1334
Hospital Charge Code	APRDRG1331
Min. Negotiated Rate	$12,428.81
Max. Negotiated Rate	$12,428.81
Rate for Payer: AHCCCS Medicaid	$12,428.81
Rate for Payer: Allwell Medicaid	$12,428.81
Rate for Payer: AZCH Complete Medicaid	$12,428.81
Rate for Payer: Banner UC Health Medicaid	$12,428.81
Rate for Payer: Mercy Care Medicaid	$12,428.81

Respiratory Failure

Facility

$7,082.04

Service Code	APR-DRG 1333
Hospital Charge Code	APRDRG1333
Min. Negotiated Rate	$7,082.04
Max. Negotiated Rate	$7,082.04
Rate for Payer: AHCCCS Medicaid	$7,082.04
Rate for Payer: Allwell Medicaid	$7,082.04
Rate for Payer: AZCH Complete Medicaid	$7,082.04
Rate for Payer: Banner UC Health Medicaid	$7,082.04
Rate for Payer: Mercy Care Medicaid	$7,082.04

Respiratory Failure

Facility

$4,633.45

Service Code	APR-DRG 1332
Hospital Charge Code	APRDRG1333
Min. Negotiated Rate	$4,633.45
Max. Negotiated Rate	$4,633.45
Rate for Payer: AHCCCS Medicaid	$4,633.45
Rate for Payer: Allwell Medicaid	$4,633.45
Rate for Payer: AZCH Complete Medicaid	$4,633.45
Rate for Payer: Banner UC Health Medicaid	$4,633.45
Rate for Payer: Mercy Care Medicaid	$4,633.45

Respiratory Malignancy

Facility

$8,765.40

Service Code	APR-DRG 1363
Hospital Charge Code	APRDRG1363
Min. Negotiated Rate	$8,765.40
Max. Negotiated Rate	$8,765.40
Rate for Payer: AHCCCS Medicaid	$8,765.40
Rate for Payer: Allwell Medicaid	$8,765.40
Rate for Payer: AZCH Complete Medicaid	$8,765.40
Rate for Payer: Banner UC Health Medicaid	$8,765.40
Rate for Payer: Mercy Care Medicaid	$8,765.40

Respiratory Malignancy

Facility

$12,962.57

Service Code	APR-DRG 1364
Hospital Charge Code	APRDRG1363
Min. Negotiated Rate	$12,962.57
Max. Negotiated Rate	$12,962.57
Rate for Payer: AHCCCS Medicaid	$12,962.57
Rate for Payer: Allwell Medicaid	$12,962.57
Rate for Payer: AZCH Complete Medicaid	$12,962.57
Rate for Payer: Banner UC Health Medicaid	$12,962.57
Rate for Payer: Mercy Care Medicaid	$12,962.57

Respiratory Malignancy

Facility

$12,962.57

Service Code	APR-DRG 1364
Hospital Charge Code	APRDRG1362
Min. Negotiated Rate	$12,962.57
Max. Negotiated Rate	$12,962.57
Rate for Payer: AHCCCS Medicaid	$12,962.57
Rate for Payer: Allwell Medicaid	$12,962.57
Rate for Payer: AZCH Complete Medicaid	$12,962.57
Rate for Payer: Banner UC Health Medicaid	$12,962.57
Rate for Payer: Mercy Care Medicaid	$12,962.57

Respiratory Malignancy

Facility

$4,724.63

Service Code	APR-DRG 1361
Hospital Charge Code	APRDRG1362
Min. Negotiated Rate	$4,724.63
Max. Negotiated Rate	$4,724.63
Rate for Payer: AHCCCS Medicaid	$4,724.63
Rate for Payer: Allwell Medicaid	$4,724.63
Rate for Payer: AZCH Complete Medicaid	$4,724.63
Rate for Payer: Banner UC Health Medicaid	$4,724.63
Rate for Payer: Mercy Care Medicaid	$4,724.63

Respiratory Malignancy

Facility

$12,962.57

Service Code	APR-DRG 1364
Hospital Charge Code	APRDRG1361
Min. Negotiated Rate	$12,962.57
Max. Negotiated Rate	$12,962.57
Rate for Payer: AHCCCS Medicaid	$12,962.57
Rate for Payer: Allwell Medicaid	$12,962.57
Rate for Payer: AZCH Complete Medicaid	$12,962.57
Rate for Payer: Banner UC Health Medicaid	$12,962.57
Rate for Payer: Mercy Care Medicaid	$12,962.57

Respiratory Malignancy

Facility

$6,182.14

Service Code	APR-DRG 1362
Hospital Charge Code	APRDRG1361
Min. Negotiated Rate	$6,182.14
Max. Negotiated Rate	$6,182.14
Rate for Payer: AHCCCS Medicaid	$6,182.14
Rate for Payer: Allwell Medicaid	$6,182.14
Rate for Payer: AZCH Complete Medicaid	$6,182.14
Rate for Payer: Banner UC Health Medicaid	$6,182.14
Rate for Payer: Mercy Care Medicaid	$6,182.14

Respiratory Malignancy

Facility

$4,724.63

Service Code	APR-DRG 1361
Hospital Charge Code	APRDRG1363
Min. Negotiated Rate	$4,724.63
Max. Negotiated Rate	$4,724.63
Rate for Payer: AHCCCS Medicaid	$4,724.63
Rate for Payer: Allwell Medicaid	$4,724.63
Rate for Payer: AZCH Complete Medicaid	$4,724.63
Rate for Payer: Banner UC Health Medicaid	$4,724.63
Rate for Payer: Mercy Care Medicaid	$4,724.63

Respiratory Malignancy

Facility

$4,724.63

Service Code	APR-DRG 1361
Hospital Charge Code	APRDRG1364
Min. Negotiated Rate	$4,724.63
Max. Negotiated Rate	$4,724.63
Rate for Payer: AHCCCS Medicaid	$4,724.63
Rate for Payer: Allwell Medicaid	$4,724.63
Rate for Payer: AZCH Complete Medicaid	$4,724.63
Rate for Payer: Banner UC Health Medicaid	$4,724.63
Rate for Payer: Mercy Care Medicaid	$4,724.63

Respiratory Malignancy

Facility

$8,765.40

Service Code	APR-DRG 1363
Hospital Charge Code	APRDRG1362
Min. Negotiated Rate	$8,765.40
Max. Negotiated Rate	$8,765.40
Rate for Payer: AHCCCS Medicaid	$8,765.40
Rate for Payer: Allwell Medicaid	$8,765.40
Rate for Payer: AZCH Complete Medicaid	$8,765.40
Rate for Payer: Banner UC Health Medicaid	$8,765.40
Rate for Payer: Mercy Care Medicaid	$8,765.40

Respiratory Malignancy

Facility

$6,182.14

Service Code	APR-DRG 1362
Hospital Charge Code	APRDRG1364
Min. Negotiated Rate	$6,182.14
Max. Negotiated Rate	$6,182.14
Rate for Payer: AHCCCS Medicaid	$6,182.14
Rate for Payer: Allwell Medicaid	$6,182.14
Rate for Payer: AZCH Complete Medicaid	$6,182.14
Rate for Payer: Banner UC Health Medicaid	$6,182.14
Rate for Payer: Mercy Care Medicaid	$6,182.14

Respiratory Malignancy

Facility

$6,182.14

Service Code	APR-DRG 1362
Hospital Charge Code	APRDRG1362
Min. Negotiated Rate	$6,182.14
Max. Negotiated Rate	$6,182.14
Rate for Payer: AHCCCS Medicaid	$6,182.14
Rate for Payer: Allwell Medicaid	$6,182.14
Rate for Payer: AZCH Complete Medicaid	$6,182.14
Rate for Payer: Banner UC Health Medicaid	$6,182.14
Rate for Payer: Mercy Care Medicaid	$6,182.14

Respiratory Malignancy

Facility

$8,765.40

Service Code	APR-DRG 1363
Hospital Charge Code	APRDRG1361
Min. Negotiated Rate	$8,765.40
Max. Negotiated Rate	$8,765.40
Rate for Payer: AHCCCS Medicaid	$8,765.40
Rate for Payer: Allwell Medicaid	$8,765.40
Rate for Payer: AZCH Complete Medicaid	$8,765.40
Rate for Payer: Banner UC Health Medicaid	$8,765.40
Rate for Payer: Mercy Care Medicaid	$8,765.40

Respiratory Malignancy

Facility

$12,962.57

Service Code	APR-DRG 1364
Hospital Charge Code	APRDRG1364
Min. Negotiated Rate	$12,962.57
Max. Negotiated Rate	$12,962.57
Rate for Payer: AHCCCS Medicaid	$12,962.57
Rate for Payer: Allwell Medicaid	$12,962.57
Rate for Payer: AZCH Complete Medicaid	$12,962.57
Rate for Payer: Banner UC Health Medicaid	$12,962.57
Rate for Payer: Mercy Care Medicaid	$12,962.57

Respiratory Malignancy

Facility

$8,765.40

Service Code	APR-DRG 1363
Hospital Charge Code	APRDRG1364
Min. Negotiated Rate	$8,765.40
Max. Negotiated Rate	$8,765.40
Rate for Payer: AHCCCS Medicaid	$8,765.40
Rate for Payer: Allwell Medicaid	$8,765.40
Rate for Payer: AZCH Complete Medicaid	$8,765.40
Rate for Payer: Banner UC Health Medicaid	$8,765.40
Rate for Payer: Mercy Care Medicaid	$8,765.40

Respiratory Malignancy

Facility

$4,724.63

Service Code	APR-DRG 1361
Hospital Charge Code	APRDRG1361
Min. Negotiated Rate	$4,724.63
Max. Negotiated Rate	$4,724.63
Rate for Payer: AHCCCS Medicaid	$4,724.63
Rate for Payer: Allwell Medicaid	$4,724.63
Rate for Payer: AZCH Complete Medicaid	$4,724.63
Rate for Payer: Banner UC Health Medicaid	$4,724.63
Rate for Payer: Mercy Care Medicaid	$4,724.63

Respiratory Malignancy

Facility

$6,182.14

Service Code	APR-DRG 1362
Hospital Charge Code	APRDRG1363
Min. Negotiated Rate	$6,182.14
Max. Negotiated Rate	$6,182.14
Rate for Payer: AHCCCS Medicaid	$6,182.14
Rate for Payer: Allwell Medicaid	$6,182.14
Rate for Payer: AZCH Complete Medicaid	$6,182.14
Rate for Payer: Banner UC Health Medicaid	$6,182.14
Rate for Payer: Mercy Care Medicaid	$6,182.14

Respiratory Panel 2.1 (BioFire)

Facility

$1,979.00

Service Code	CPT 0202U
Hospital Charge Code	23979884
Hospital Revenue Code	301
Min. Negotiated Rate	$316.64
Max. Negotiated Rate	$1,781.10
Rate for Payer: Aetna of AZ Commercial	$1,781.10
Rate for Payer: Aetna of AZ Medicare	$554.12
Rate for Payer: Allwell Medicare	$316.64
Rate for Payer: Amerigroup Medicare	$316.64
Rate for Payer: APIPA Medicare/Medicaid	$739.16
Rate for Payer: AZCH Complete Medicare	$316.64
Rate for Payer: Banner UC Health Medicare	$316.64
Rate for Payer: Bisbee Police All Plans	$514.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,345.72
Rate for Payer: Cash Price	$1,583.20
Rate for Payer: Cigna of AZ Commercial	$1,286.35
Rate for Payer: Copperpoint Commercial	$489.80
Rate for Payer: Health Net of AZ Commercial	$1,187.40
Rate for Payer: Health Net of AZ Medicare	$554.12
Rate for Payer: Humana of AZ Medicare	$316.64
Rate for Payer: Self Pay Self Pay	$1,583.20
Rate for Payer: TriWest Medicare	$316.64
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,153.76
Rate for Payer: UnitedHealth Group of AZ Medicare	$356.22

Respiratory Panel 2.1 (BioFire)

Facility

$1,979.00

Service Code	CPT 0202U
Hospital Charge Code	23979884
Hospital Revenue Code	301
Min. Negotiated Rate	$514.54
Max. Negotiated Rate	$1,781.10
Rate for Payer: Aetna of AZ Commercial	$1,781.10
Rate for Payer: Bisbee Police All Plans	$514.54
Rate for Payer: Cash Price	$1,583.20
Rate for Payer: Self Pay Self Pay	$1,583.20

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

$6,396.07

Service Code	APR-DRG 1443
Hospital Charge Code	APRDRG1442
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

Know your out-of-pocket cost for care.

All Charges