Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$3,584.15

Service Code	APR-DRG 1441
Hospital Charge Code	APRDRG1441
Min. Negotiated Rate	$3,584.15
Max. Negotiated Rate	$3,584.15
Rate for Payer: AHCCCS Medicaid	$3,584.15
Rate for Payer: Allwell Medicaid	$3,584.15
Rate for Payer: AZCH Complete Medicaid	$3,584.15
Rate for Payer: Banner UC Health Medicaid	$3,584.15
Rate for Payer: Mercy Care Medicaid	$3,584.15

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 Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$4,564.01

Service Code	APR-DRG 1442
Hospital Charge Code	APRDRG1442
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	APRDRG1441
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 Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$4,564.01

Service Code	APR-DRG 1442
Hospital Charge Code	APRDRG1441
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	APRDRG1443
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 Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$10,920.10

Service Code	APR-DRG 1444
Hospital Charge Code	APRDRG1441
Min. Negotiated Rate	$10,920.10
Max. Negotiated Rate	$10,920.10
Rate for Payer: AHCCCS Medicaid	$10,920.10
Rate for Payer: Allwell Medicaid	$10,920.10
Rate for Payer: AZCH Complete Medicaid	$10,920.10
Rate for Payer: Banner UC Health Medicaid	$10,920.10
Rate for Payer: Mercy Care Medicaid	$10,920.10

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$3,584.15

Service Code	APR-DRG 1441
Hospital Charge Code	APRDRG1442
Min. Negotiated Rate	$3,584.15
Max. Negotiated Rate	$3,584.15
Rate for Payer: AHCCCS Medicaid	$3,584.15
Rate for Payer: Allwell Medicaid	$3,584.15
Rate for Payer: AZCH Complete Medicaid	$3,584.15
Rate for Payer: Banner UC Health Medicaid	$3,584.15
Rate for Payer: Mercy Care Medicaid	$3,584.15

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$10,920.10

Service Code	APR-DRG 1444
Hospital Charge Code	APRDRG1443
Min. Negotiated Rate	$10,920.10
Max. Negotiated Rate	$10,920.10
Rate for Payer: AHCCCS Medicaid	$10,920.10
Rate for Payer: Allwell Medicaid	$10,920.10
Rate for Payer: AZCH Complete Medicaid	$10,920.10
Rate for Payer: Banner UC Health Medicaid	$10,920.10
Rate for Payer: Mercy Care Medicaid	$10,920.10

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

$4,564.01

Service Code	APR-DRG 1442
Hospital Charge Code	APRDRG1443
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

$3,584.15

Service Code	APR-DRG 1441
Hospital Charge Code	APRDRG1444
Min. Negotiated Rate	$3,584.15
Max. Negotiated Rate	$3,584.15
Rate for Payer: AHCCCS Medicaid	$3,584.15
Rate for Payer: Allwell Medicaid	$3,584.15
Rate for Payer: AZCH Complete Medicaid	$3,584.15
Rate for Payer: Banner UC Health Medicaid	$3,584.15
Rate for Payer: Mercy Care Medicaid	$3,584.15

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$10,920.10

Service Code	APR-DRG 1444
Hospital Charge Code	APRDRG1444
Min. Negotiated Rate	$10,920.10
Max. Negotiated Rate	$10,920.10
Rate for Payer: AHCCCS Medicaid	$10,920.10
Rate for Payer: Allwell Medicaid	$10,920.10
Rate for Payer: AZCH Complete Medicaid	$10,920.10
Rate for Payer: Banner UC Health Medicaid	$10,920.10
Rate for Payer: Mercy Care Medicaid	$10,920.10

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$3,584.15

Service Code	APR-DRG 1441
Hospital Charge Code	APRDRG1443
Min. Negotiated Rate	$3,584.15
Max. Negotiated Rate	$3,584.15
Rate for Payer: AHCCCS Medicaid	$3,584.15
Rate for Payer: Allwell Medicaid	$3,584.15
Rate for Payer: AZCH Complete Medicaid	$3,584.15
Rate for Payer: Banner UC Health Medicaid	$3,584.15
Rate for Payer: Mercy Care Medicaid	$3,584.15

Respiratory Signs, Symptoms And Miscellaneous Diagnoses

Facility

IP

$10,920.10

Service Code	APR-DRG 1444
Hospital Charge Code	APRDRG1442
Min. Negotiated Rate	$10,920.10
Max. Negotiated Rate	$10,920.10
Rate for Payer: AHCCCS Medicaid	$10,920.10
Rate for Payer: Allwell Medicaid	$10,920.10
Rate for Payer: AZCH Complete Medicaid	$10,920.10
Rate for Payer: Banner UC Health Medicaid	$10,920.10
Rate for Payer: Mercy Care Medicaid	$10,920.10

Respiratory Syncytial Virus (RSV)

Facility

OP

$238.00

Service Code	CPT 87807
Hospital Charge Code	787102
Hospital Revenue Code	306
Min. Negotiated Rate	$38.08
Max. Negotiated Rate	$214.20
Rate for Payer: Aetna of AZ Commercial	$214.20
Rate for Payer: Aetna of AZ Medicare	$66.64
Rate for Payer: Allwell Medicare	$38.08
Rate for Payer: Amerigroup Medicare	$38.08
Rate for Payer: APIPA Medicare/Medicaid	$88.89
Rate for Payer: AZCH Complete Medicare	$38.08
Rate for Payer: Banner UC Health Medicare	$38.08
Rate for Payer: Bisbee Police All Plans	$61.88
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$161.84
Rate for Payer: Cash Price	$190.40
Rate for Payer: Cigna of AZ Commercial	$154.70
Rate for Payer: Copperpoint Commercial	$58.91
Rate for Payer: Health Net of AZ Commercial	$142.80
Rate for Payer: Health Net of AZ Medicare	$66.64
Rate for Payer: Humana of AZ Medicare	$38.08
Rate for Payer: Self Pay Self Pay	$190.40
Rate for Payer: TriWest Medicare	$38.08
Rate for Payer: UnitedHealth Group of AZ Commercial	$138.75
Rate for Payer: UnitedHealth Group of AZ Medicare	$42.84

Respiratory Syncytial Virus (RSV)

Facility

IP

$238.00

Service Code	CPT 87807
Hospital Charge Code	787102
Hospital Revenue Code	306
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$214.20
Rate for Payer: Aetna of AZ Commercial	$214.20
Rate for Payer: Bisbee Police All Plans	$61.88
Rate for Payer: Cash Price	$190.40
Rate for Payer: Self Pay Self Pay	$190.40

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

$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

$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 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

$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

$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

$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

$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

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