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Charge Type Setting Price  
Service Code APR-DRG 6624
Hospital Charge Code APRDRG6624
Min. Negotiated Rate $16,471.68
Max. Negotiated Rate $16,471.68
Rate for Payer: AHCCCS Medicaid $16,471.68
Rate for Payer: Allwell Medicaid $16,471.68
Rate for Payer: AZCH Complete Medicaid $16,471.68
Rate for Payer: Banner UC Health Medicaid $16,471.68
Rate for Payer: Mercy Care Medicaid $16,471.68
Service Code APR-DRG 6623
Hospital Charge Code APRDRG6622
Min. Negotiated Rate $7,503.58
Max. Negotiated Rate $7,503.58
Rate for Payer: AHCCCS Medicaid $7,503.58
Rate for Payer: Allwell Medicaid $7,503.58
Rate for Payer: AZCH Complete Medicaid $7,503.58
Rate for Payer: Banner UC Health Medicaid $7,503.58
Rate for Payer: Mercy Care Medicaid $7,503.58
Service Code APR-DRG 6621
Hospital Charge Code APRDRG6622
Min. Negotiated Rate $3,701.29
Max. Negotiated Rate $3,701.29
Rate for Payer: AHCCCS Medicaid $3,701.29
Rate for Payer: Allwell Medicaid $3,701.29
Rate for Payer: AZCH Complete Medicaid $3,701.29
Rate for Payer: Banner UC Health Medicaid $3,701.29
Rate for Payer: Mercy Care Medicaid $3,701.29
Service Code APR-DRG 6623
Hospital Charge Code APRDRG6623
Min. Negotiated Rate $7,503.58
Max. Negotiated Rate $7,503.58
Rate for Payer: AHCCCS Medicaid $7,503.58
Rate for Payer: Allwell Medicaid $7,503.58
Rate for Payer: AZCH Complete Medicaid $7,503.58
Rate for Payer: Banner UC Health Medicaid $7,503.58
Rate for Payer: Mercy Care Medicaid $7,503.58
Service Code APR-DRG 6624
Hospital Charge Code APRDRG6623
Min. Negotiated Rate $16,471.68
Max. Negotiated Rate $16,471.68
Rate for Payer: AHCCCS Medicaid $16,471.68
Rate for Payer: Allwell Medicaid $16,471.68
Rate for Payer: AZCH Complete Medicaid $16,471.68
Rate for Payer: Banner UC Health Medicaid $16,471.68
Rate for Payer: Mercy Care Medicaid $16,471.68
Service Code APR-DRG 6622
Hospital Charge Code APRDRG6623
Min. Negotiated Rate $4,968.72
Max. Negotiated Rate $4,968.72
Rate for Payer: AHCCCS Medicaid $4,968.72
Rate for Payer: Allwell Medicaid $4,968.72
Rate for Payer: AZCH Complete Medicaid $4,968.72
Rate for Payer: Banner UC Health Medicaid $4,968.72
Rate for Payer: Mercy Care Medicaid $4,968.72
Service Code APR-DRG 6622
Hospital Charge Code APRDRG6624
Min. Negotiated Rate $4,968.72
Max. Negotiated Rate $4,968.72
Rate for Payer: AHCCCS Medicaid $4,968.72
Rate for Payer: Allwell Medicaid $4,968.72
Rate for Payer: AZCH Complete Medicaid $4,968.72
Rate for Payer: Banner UC Health Medicaid $4,968.72
Rate for Payer: Mercy Care Medicaid $4,968.72
Service Code APR-DRG 6621
Hospital Charge Code APRDRG6624
Min. Negotiated Rate $3,701.29
Max. Negotiated Rate $3,701.29
Rate for Payer: AHCCCS Medicaid $3,701.29
Rate for Payer: Allwell Medicaid $3,701.29
Rate for Payer: AZCH Complete Medicaid $3,701.29
Rate for Payer: Banner UC Health Medicaid $3,701.29
Rate for Payer: Mercy Care Medicaid $3,701.29
Service Code APR-DRG 6624
Hospital Charge Code APRDRG6621
Min. Negotiated Rate $16,471.68
Max. Negotiated Rate $16,471.68
Rate for Payer: AHCCCS Medicaid $16,471.68
Rate for Payer: Allwell Medicaid $16,471.68
Rate for Payer: AZCH Complete Medicaid $16,471.68
Rate for Payer: Banner UC Health Medicaid $16,471.68
Rate for Payer: Mercy Care Medicaid $16,471.68
Service Code APR-DRG 6622
Hospital Charge Code APRDRG6621
Min. Negotiated Rate $4,968.72
Max. Negotiated Rate $4,968.72
Rate for Payer: AHCCCS Medicaid $4,968.72
Rate for Payer: Allwell Medicaid $4,968.72
Rate for Payer: AZCH Complete Medicaid $4,968.72
Rate for Payer: Banner UC Health Medicaid $4,968.72
Rate for Payer: Mercy Care Medicaid $4,968.72
Service Code APR-DRG 6622
Hospital Charge Code APRDRG6622
Min. Negotiated Rate $4,968.72
Max. Negotiated Rate $4,968.72
Rate for Payer: AHCCCS Medicaid $4,968.72
Rate for Payer: Allwell Medicaid $4,968.72
Rate for Payer: AZCH Complete Medicaid $4,968.72
Rate for Payer: Banner UC Health Medicaid $4,968.72
Rate for Payer: Mercy Care Medicaid $4,968.72
Service Code APR-DRG 6624
Hospital Charge Code APRDRG6622
Min. Negotiated Rate $16,471.68
Max. Negotiated Rate $16,471.68
Rate for Payer: AHCCCS Medicaid $16,471.68
Rate for Payer: Allwell Medicaid $16,471.68
Rate for Payer: AZCH Complete Medicaid $16,471.68
Rate for Payer: Banner UC Health Medicaid $16,471.68
Rate for Payer: Mercy Care Medicaid $16,471.68
Service Code APR-DRG 6623
Hospital Charge Code APRDRG6624
Min. Negotiated Rate $7,503.58
Max. Negotiated Rate $7,503.58
Rate for Payer: AHCCCS Medicaid $7,503.58
Rate for Payer: Allwell Medicaid $7,503.58
Rate for Payer: AZCH Complete Medicaid $7,503.58
Rate for Payer: Banner UC Health Medicaid $7,503.58
Rate for Payer: Mercy Care Medicaid $7,503.58
Service Code APR-DRG 6623
Hospital Charge Code APRDRG6621
Min. Negotiated Rate $7,503.58
Max. Negotiated Rate $7,503.58
Rate for Payer: AHCCCS Medicaid $7,503.58
Rate for Payer: Allwell Medicaid $7,503.58
Rate for Payer: AZCH Complete Medicaid $7,503.58
Rate for Payer: Banner UC Health Medicaid $7,503.58
Rate for Payer: Mercy Care Medicaid $7,503.58
Service Code APR-DRG 6621
Hospital Charge Code APRDRG6623
Min. Negotiated Rate $3,701.29
Max. Negotiated Rate $3,701.29
Rate for Payer: AHCCCS Medicaid $3,701.29
Rate for Payer: Allwell Medicaid $3,701.29
Rate for Payer: AZCH Complete Medicaid $3,701.29
Rate for Payer: Banner UC Health Medicaid $3,701.29
Rate for Payer: Mercy Care Medicaid $3,701.29
Service Code APR-DRG 6621
Hospital Charge Code APRDRG6621
Min. Negotiated Rate $3,701.29
Max. Negotiated Rate $3,701.29
Rate for Payer: AHCCCS Medicaid $3,701.29
Rate for Payer: Allwell Medicaid $3,701.29
Rate for Payer: AZCH Complete Medicaid $3,701.29
Rate for Payer: Banner UC Health Medicaid $3,701.29
Rate for Payer: Mercy Care Medicaid $3,701.29
Service Code CPT 45330
Hospital Charge Code 1015557
Hospital Revenue Code 750
Min. Negotiated Rate $56.85
Max. Negotiated Rate $2,507.00
Rate for Payer: Aetna of AZ Commercial $341.10
Rate for Payer: Aetna of AZ Medicare $106.12
Rate for Payer: AHCCCS Medicaid $1,150.80
Rate for Payer: Allwell Medicaid $1,150.80
Rate for Payer: Allwell Medicare $56.85
Rate for Payer: Amerigroup Medicare $56.85
Rate for Payer: APIPA Medicare/Medicaid $141.56
Rate for Payer: AZCH Complete Medicaid $1,150.80
Rate for Payer: AZCH Complete Medicare $56.85
Rate for Payer: Banner UC Health Medicaid $1,150.80
Rate for Payer: Banner UC Health Medicare $56.85
Rate for Payer: Bisbee Police All Plans $98.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $257.72
Rate for Payer: Cash Price $303.20
Rate for Payer: Cash Price $303.20
Rate for Payer: Cigna of AZ Commercial $265.30
Rate for Payer: Copperpoint Commercial $93.80
Rate for Payer: Health Net of AZ Commercial $227.40
Rate for Payer: Health Net of AZ Medicare $106.12
Rate for Payer: Humana of AZ Medicare $56.85
Rate for Payer: Mercy Care Medicaid $1,150.80
Rate for Payer: Self Pay Self Pay $303.20
Rate for Payer: TriWest Medicare $56.85
Rate for Payer: UnitedHealth Group of AZ Commercial $2,507.00
Rate for Payer: UnitedHealth Group of AZ Medicare $68.22
Service Code CPT 45330
Hospital Charge Code 1015557
Hospital Revenue Code 750
Min. Negotiated Rate $98.54
Max. Negotiated Rate $341.10
Rate for Payer: Aetna of AZ Commercial $341.10
Rate for Payer: Bisbee Police All Plans $98.54
Rate for Payer: Cash Price $303.20
Rate for Payer: Self Pay Self Pay $303.20
Service Code APR-DRG 8612
Hospital Charge Code APRDRG8612
Min. Negotiated Rate $4,167.02
Max. Negotiated Rate $4,167.02
Rate for Payer: AHCCCS Medicaid $4,167.02
Rate for Payer: Allwell Medicaid $4,167.02
Rate for Payer: AZCH Complete Medicaid $4,167.02
Rate for Payer: Banner UC Health Medicaid $4,167.02
Rate for Payer: Mercy Care Medicaid $4,167.02
Service Code APR-DRG 8614
Hospital Charge Code APRDRG8614
Min. Negotiated Rate $9,865.19
Max. Negotiated Rate $9,865.19
Rate for Payer: AHCCCS Medicaid $9,865.19
Rate for Payer: Allwell Medicaid $9,865.19
Rate for Payer: AZCH Complete Medicaid $9,865.19
Rate for Payer: Banner UC Health Medicaid $9,865.19
Rate for Payer: Mercy Care Medicaid $9,865.19
Service Code APR-DRG 8613
Hospital Charge Code APRDRG8612
Min. Negotiated Rate $5,985.05
Max. Negotiated Rate $5,985.05
Rate for Payer: AHCCCS Medicaid $5,985.05
Rate for Payer: Allwell Medicaid $5,985.05
Rate for Payer: AZCH Complete Medicaid $5,985.05
Rate for Payer: Banner UC Health Medicaid $5,985.05
Rate for Payer: Mercy Care Medicaid $5,985.05
Service Code APR-DRG 8612
Hospital Charge Code APRDRG8614
Min. Negotiated Rate $4,167.02
Max. Negotiated Rate $4,167.02
Rate for Payer: AHCCCS Medicaid $4,167.02
Rate for Payer: Allwell Medicaid $4,167.02
Rate for Payer: AZCH Complete Medicaid $4,167.02
Rate for Payer: Banner UC Health Medicaid $4,167.02
Rate for Payer: Mercy Care Medicaid $4,167.02
Service Code APR-DRG 8611
Hospital Charge Code APRDRG8612
Min. Negotiated Rate $3,340.07
Max. Negotiated Rate $3,340.07
Rate for Payer: AHCCCS Medicaid $3,340.07
Rate for Payer: Allwell Medicaid $3,340.07
Rate for Payer: AZCH Complete Medicaid $3,340.07
Rate for Payer: Banner UC Health Medicaid $3,340.07
Rate for Payer: Mercy Care Medicaid $3,340.07
Service Code APR-DRG 8611
Hospital Charge Code APRDRG8614
Min. Negotiated Rate $3,340.07
Max. Negotiated Rate $3,340.07
Rate for Payer: AHCCCS Medicaid $3,340.07
Rate for Payer: Allwell Medicaid $3,340.07
Rate for Payer: AZCH Complete Medicaid $3,340.07
Rate for Payer: Banner UC Health Medicaid $3,340.07
Rate for Payer: Mercy Care Medicaid $3,340.07
Service Code APR-DRG 8613
Hospital Charge Code APRDRG8614
Min. Negotiated Rate $5,985.05
Max. Negotiated Rate $5,985.05
Rate for Payer: AHCCCS Medicaid $5,985.05
Rate for Payer: Allwell Medicaid $5,985.05
Rate for Payer: AZCH Complete Medicaid $5,985.05
Rate for Payer: Banner UC Health Medicaid $5,985.05
Rate for Payer: Mercy Care Medicaid $5,985.05