Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

.RMSF, IgG, IFA LC

Facility

$238.00

Service Code	CPT 86757
Hospital Charge Code	1285666
Hospital Revenue Code	302
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

.RMSF, IgG, IFA LC

Facility

$238.00

Service Code	CPT 86757
Hospital Charge Code	1285666
Hospital Revenue Code	302
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

RNA, PCR (NonGraph) rfx/Geno LC

Facility

$719.00

Service Code	CPT 87522
Hospital Charge Code	22311205
Hospital Revenue Code	306
Min. Negotiated Rate	$186.94
Max. Negotiated Rate	$647.10
Rate for Payer: Aetna of AZ Commercial	$647.10
Rate for Payer: Bisbee Police All Plans	$186.94
Rate for Payer: Cash Price	$575.20
Rate for Payer: Self Pay Self Pay	$575.20

RNA, PCR (NonGraph) rfx/Geno LC

Facility

$719.00

Service Code	CPT 87522
Hospital Charge Code	22311205
Hospital Revenue Code	306
Min. Negotiated Rate	$115.04
Max. Negotiated Rate	$647.10
Rate for Payer: Aetna of AZ Commercial	$647.10
Rate for Payer: Aetna of AZ Medicare	$201.32
Rate for Payer: Allwell Medicare	$115.04
Rate for Payer: Amerigroup Medicare	$115.04
Rate for Payer: APIPA Medicare/Medicaid	$268.55
Rate for Payer: AZCH Complete Medicare	$115.04
Rate for Payer: Banner UC Health Medicare	$115.04
Rate for Payer: Bisbee Police All Plans	$186.94
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$488.92
Rate for Payer: Cash Price	$575.20
Rate for Payer: Cigna of AZ Commercial	$467.35
Rate for Payer: Copperpoint Commercial	$177.95
Rate for Payer: Health Net of AZ Commercial	$431.40
Rate for Payer: Health Net of AZ Medicare	$201.32
Rate for Payer: Humana of AZ Medicare	$115.04
Rate for Payer: Self Pay Self Pay	$575.20
Rate for Payer: TriWest Medicare	$115.04
Rate for Payer: UnitedHealth Group of AZ Commercial	$419.18
Rate for Payer: UnitedHealth Group of AZ Medicare	$129.42

RNA Real Time PCR (Non-Graph) LC

Facility

$1,058.00

Service Code	CPT 87536
Hospital Charge Code	6781926
Hospital Revenue Code	302
Min. Negotiated Rate	$169.28
Max. Negotiated Rate	$952.20
Rate for Payer: Aetna of AZ Commercial	$952.20
Rate for Payer: Aetna of AZ Medicare	$296.24
Rate for Payer: Allwell Medicare	$169.28
Rate for Payer: Amerigroup Medicare	$169.28
Rate for Payer: APIPA Medicare/Medicaid	$395.16
Rate for Payer: AZCH Complete Medicare	$169.28
Rate for Payer: Banner UC Health Medicare	$169.28
Rate for Payer: Bisbee Police All Plans	$275.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$719.44
Rate for Payer: Cash Price	$846.40
Rate for Payer: Cigna of AZ Commercial	$687.70
Rate for Payer: Copperpoint Commercial	$261.86
Rate for Payer: Health Net of AZ Commercial	$634.80
Rate for Payer: Health Net of AZ Medicare	$296.24
Rate for Payer: Humana of AZ Medicare	$169.28
Rate for Payer: Self Pay Self Pay	$846.40
Rate for Payer: TriWest Medicare	$169.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$616.81
Rate for Payer: UnitedHealth Group of AZ Medicare	$190.44

RNA Real Time PCR (Non-Graph) LC

Facility

$1,058.00

Service Code	CPT 87536
Hospital Charge Code	6781926
Hospital Revenue Code	302
Min. Negotiated Rate	$275.08
Max. Negotiated Rate	$952.20
Rate for Payer: Aetna of AZ Commercial	$952.20
Rate for Payer: Bisbee Police All Plans	$275.08
Rate for Payer: Cash Price	$846.40
Rate for Payer: Self Pay Self Pay	$846.40

Robotic colpopexy

Facility

$5,050.00

Service Code	CPT 57425
Hospital Charge Code	27281899
Hospital Revenue Code	360
Min. Negotiated Rate	$1,313.00
Max. Negotiated Rate	$4,545.00
Rate for Payer: Aetna of AZ Commercial	$4,545.00
Rate for Payer: Bisbee Police All Plans	$1,313.00
Rate for Payer: Cash Price	$4,040.00
Rate for Payer: Self Pay Self Pay	$4,040.00

Robotic colpopexy

Facility

$5,050.00

Service Code	CPT 57425
Hospital Charge Code	27281899
Hospital Revenue Code	360
Min. Negotiated Rate	$808.00
Max. Negotiated Rate	$6,458.05
Rate for Payer: Aetna of AZ Commercial	$4,545.00
Rate for Payer: Aetna of AZ Medicare	$1,414.00
Rate for Payer: AHCCCS Medicaid	$6,458.05
Rate for Payer: Allwell Medicaid	$6,458.05
Rate for Payer: Allwell Medicare	$808.00
Rate for Payer: Amerigroup Medicare	$808.00
Rate for Payer: APIPA Medicare/Medicaid	$1,886.17
Rate for Payer: AZCH Complete Medicaid	$6,458.05
Rate for Payer: AZCH Complete Medicare	$808.00
Rate for Payer: Banner UC Health Medicaid	$6,458.05
Rate for Payer: Banner UC Health Medicare	$808.00
Rate for Payer: Bisbee Police All Plans	$1,313.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,434.00
Rate for Payer: Cash Price	$4,040.00
Rate for Payer: Cash Price	$4,040.00
Rate for Payer: Cigna of AZ Commercial	$2,525.00
Rate for Payer: Copperpoint Commercial	$1,249.88
Rate for Payer: Health Net of AZ Commercial	$3,030.00
Rate for Payer: Health Net of AZ Medicare	$1,414.00
Rate for Payer: Humana of AZ Medicare	$808.00
Rate for Payer: Mercy Care Medicaid	$6,458.05
Rate for Payer: Self Pay Self Pay	$4,040.00
Rate for Payer: TriWest Medicare	$808.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,944.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$909.00

ROCKER SWITCH SMOKE EVAC PENCIL UNCOATED

Facility

$1,410.00

Hospital Charge Code	27773153
Hospital Revenue Code	270
Min. Negotiated Rate	$366.60
Max. Negotiated Rate	$1,269.00
Rate for Payer: Aetna of AZ Commercial	$1,269.00
Rate for Payer: Bisbee Police All Plans	$366.60
Rate for Payer: Cash Price	$1,128.00
Rate for Payer: Self Pay Self Pay	$1,128.00

ROCKER SWITCH SMOKE EVAC PENCIL UNCOATED

Facility

$1,410.00

Hospital Charge Code	27773153
Hospital Revenue Code	270
Min. Negotiated Rate	$225.60
Max. Negotiated Rate	$1,269.00
Rate for Payer: Aetna of AZ Commercial	$1,269.00
Rate for Payer: Aetna of AZ Medicare	$394.80
Rate for Payer: Allwell Medicare	$225.60
Rate for Payer: Amerigroup Medicare	$225.60
Rate for Payer: APIPA Medicare/Medicaid	$526.63
Rate for Payer: AZCH Complete Medicare	$225.60
Rate for Payer: Banner UC Health Medicare	$225.60
Rate for Payer: Bisbee Police All Plans	$366.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$958.80
Rate for Payer: Cash Price	$1,128.00
Rate for Payer: Cigna of AZ Commercial	$987.00
Rate for Payer: Copperpoint Commercial	$348.98
Rate for Payer: Health Net of AZ Commercial	$846.00
Rate for Payer: Health Net of AZ Medicare	$394.80
Rate for Payer: Humana of AZ Medicare	$225.60
Rate for Payer: Self Pay Self Pay	$1,128.00
Rate for Payer: TriWest Medicare	$225.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$822.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$253.80

Rocky Mtn Spotted Fever, IgM LC

Facility

$226.00

Service Code	CPT 86757
Hospital Charge Code	1285661
Hospital Revenue Code	302
Min. Negotiated Rate	$58.76
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Cash Price	$180.80
Rate for Payer: Self Pay Self Pay	$180.80

Rocky Mtn Spotted Fever, IgM LC

Facility

$226.00

Service Code	CPT 86757
Hospital Charge Code	1285661
Hospital Revenue Code	302
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Aetna of AZ Medicare	$63.28
Rate for Payer: Allwell Medicare	$36.16
Rate for Payer: Amerigroup Medicare	$36.16
Rate for Payer: APIPA Medicare/Medicaid	$84.41
Rate for Payer: AZCH Complete Medicare	$36.16
Rate for Payer: Banner UC Health Medicare	$36.16
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$153.68
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cigna of AZ Commercial	$146.90
Rate for Payer: Copperpoint Commercial	$55.94
Rate for Payer: Health Net of AZ Commercial	$135.60
Rate for Payer: Health Net of AZ Medicare	$63.28
Rate for Payer: Humana of AZ Medicare	$36.16
Rate for Payer: Self Pay Self Pay	$180.80
Rate for Payer: TriWest Medicare	$36.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$131.76
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.68

Rocky Mtn Spotted Fev, IgG, Qn LC

Facility

$226.00

Service Code	CPT 86757
Hospital Charge Code	1285665
Hospital Revenue Code	302
Min. Negotiated Rate	$58.76
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Cash Price	$180.80
Rate for Payer: Self Pay Self Pay	$180.80

Rocky Mtn Spotted Fev, IgG, Qn LC

Facility

$226.00

Service Code	CPT 86757
Hospital Charge Code	1285665
Hospital Revenue Code	302
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna of AZ Commercial	$203.40
Rate for Payer: Aetna of AZ Medicare	$63.28
Rate for Payer: Allwell Medicare	$36.16
Rate for Payer: Amerigroup Medicare	$36.16
Rate for Payer: APIPA Medicare/Medicaid	$84.41
Rate for Payer: AZCH Complete Medicare	$36.16
Rate for Payer: Banner UC Health Medicare	$36.16
Rate for Payer: Bisbee Police All Plans	$58.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$153.68
Rate for Payer: Cash Price	$180.80
Rate for Payer: Cigna of AZ Commercial	$146.90
Rate for Payer: Copperpoint Commercial	$55.94
Rate for Payer: Health Net of AZ Commercial	$135.60
Rate for Payer: Health Net of AZ Medicare	$63.28
Rate for Payer: Humana of AZ Medicare	$36.16
Rate for Payer: Self Pay Self Pay	$180.80
Rate for Payer: TriWest Medicare	$36.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$131.76
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.68

rocuronium 100 mg/10 mL inj Sol [CQCH]

Facility

$0.35

Service Code	NDC 55150022610
Hospital Charge Code	108079385
Hospital Revenue Code	251
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.32
Rate for Payer: Aetna of AZ Commercial	$0.32
Rate for Payer: Aetna of AZ Medicare	$0.10
Rate for Payer: Allwell Medicare	$0.06
Rate for Payer: Amerigroup Medicare	$0.06
Rate for Payer: APIPA Medicare/Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$0.06
Rate for Payer: Banner UC Health Medicare	$0.06
Rate for Payer: Bisbee Police All Plans	$0.09
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.24
Rate for Payer: Cash Price	$0.28
Rate for Payer: Cigna of AZ Commercial	$0.23
Rate for Payer: Copperpoint Commercial	$0.09
Rate for Payer: Health Net of AZ Commercial	$0.21
Rate for Payer: Health Net of AZ Medicare	$0.10
Rate for Payer: Humana of AZ Medicare	$0.06
Rate for Payer: Self Pay Self Pay	$0.28
Rate for Payer: TriWest Medicare	$0.06
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.20
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.06

rocuronium 100 mg/10 mL inj Sol [CQCH]

Facility

$0.35

Service Code	NDC 55150022610
Hospital Charge Code	108079385
Hospital Revenue Code	251
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.32
Rate for Payer: Aetna of AZ Commercial	$0.32
Rate for Payer: Bisbee Police All Plans	$0.09
Rate for Payer: Cash Price	$0.28
Rate for Payer: Self Pay Self Pay	$0.28

romiPLOStim 125 mcg REC[CQCH]

Facility

$1,032.35

Service Code	HCPCS J2796
Hospital Charge Code	189610323
Hospital Revenue Code	251
Min. Negotiated Rate	$268.41
Max. Negotiated Rate	$929.12
Rate for Payer: Aetna of AZ Commercial	$929.12
Rate for Payer: Bisbee Police All Plans	$268.41
Rate for Payer: Cash Price	$825.88
Rate for Payer: Self Pay Self Pay	$825.88

romiPLOStim 125 mcg REC[CQCH]

Facility

$1,032.35

Service Code	HCPCS J2796
Hospital Charge Code	189610323
Hospital Revenue Code	251
Min. Negotiated Rate	$165.18
Max. Negotiated Rate	$929.12
Rate for Payer: Aetna of AZ Commercial	$929.12
Rate for Payer: Aetna of AZ Medicare	$289.06
Rate for Payer: Allwell Medicare	$165.18
Rate for Payer: Amerigroup Medicare	$165.18
Rate for Payer: APIPA Medicare/Medicaid	$385.58
Rate for Payer: AZCH Complete Medicare	$165.18
Rate for Payer: Banner UC Health Medicare	$165.18
Rate for Payer: Bisbee Police All Plans	$268.41
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$702.00
Rate for Payer: Cash Price	$825.88
Rate for Payer: Cigna of AZ Commercial	$671.03
Rate for Payer: Copperpoint Commercial	$255.51
Rate for Payer: Health Net of AZ Commercial	$619.41
Rate for Payer: Health Net of AZ Medicare	$289.06
Rate for Payer: Humana of AZ Medicare	$165.18
Rate for Payer: Self Pay Self Pay	$825.88
Rate for Payer: TriWest Medicare	$165.18
Rate for Payer: UnitedHealth Group of AZ Commercial	$601.86
Rate for Payer: UnitedHealth Group of AZ Medicare	$185.82

romiPLOStim 250 mcg REC[CQCH]

Facility

$2,064.68

Service Code	HCPCS J2796
Hospital Charge Code	189307178
Hospital Revenue Code	251
Min. Negotiated Rate	$330.35
Max. Negotiated Rate	$1,858.21
Rate for Payer: Aetna of AZ Commercial	$1,858.21
Rate for Payer: Aetna of AZ Medicare	$578.11
Rate for Payer: Allwell Medicare	$330.35
Rate for Payer: Amerigroup Medicare	$330.35
Rate for Payer: APIPA Medicare/Medicaid	$771.16
Rate for Payer: AZCH Complete Medicare	$330.35
Rate for Payer: Banner UC Health Medicare	$330.35
Rate for Payer: Bisbee Police All Plans	$536.82
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,403.98
Rate for Payer: Cash Price	$1,651.74
Rate for Payer: Cigna of AZ Commercial	$1,342.04
Rate for Payer: Copperpoint Commercial	$511.01
Rate for Payer: Health Net of AZ Commercial	$1,238.81
Rate for Payer: Health Net of AZ Medicare	$578.11
Rate for Payer: Humana of AZ Medicare	$330.35
Rate for Payer: Self Pay Self Pay	$1,651.74
Rate for Payer: TriWest Medicare	$330.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,203.71
Rate for Payer: UnitedHealth Group of AZ Medicare	$371.64

romiPLOStim 250 mcg REC[CQCH]

Facility

$2,064.68

Service Code	HCPCS J2796
Hospital Charge Code	189307178
Hospital Revenue Code	251
Min. Negotiated Rate	$536.82
Max. Negotiated Rate	$1,858.21
Rate for Payer: Aetna of AZ Commercial	$1,858.21
Rate for Payer: Bisbee Police All Plans	$536.82
Rate for Payer: Cash Price	$1,651.74
Rate for Payer: Self Pay Self Pay	$1,651.74

ROOM/BED: Extended Recovery

Facility

$53.00

Hospital Charge Code	2091602
Hospital Revenue Code	710
Min. Negotiated Rate	$8.48
Max. Negotiated Rate	$47.70
Rate for Payer: Aetna of AZ Commercial	$47.70
Rate for Payer: Aetna of AZ Medicare	$14.84
Rate for Payer: Allwell Medicare	$8.48
Rate for Payer: Amerigroup Medicare	$8.48
Rate for Payer: APIPA Medicare/Medicaid	$19.80
Rate for Payer: AZCH Complete Medicare	$8.48
Rate for Payer: Banner UC Health Medicare	$8.48
Rate for Payer: Bisbee Police All Plans	$13.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$36.04
Rate for Payer: Cash Price	$42.40
Rate for Payer: Cigna of AZ Commercial	$37.10
Rate for Payer: Copperpoint Commercial	$13.12
Rate for Payer: Health Net of AZ Commercial	$31.80
Rate for Payer: Health Net of AZ Medicare	$14.84
Rate for Payer: Humana of AZ Medicare	$8.48
Rate for Payer: Self Pay Self Pay	$42.40
Rate for Payer: TriWest Medicare	$8.48
Rate for Payer: UnitedHealth Group of AZ Commercial	$30.90
Rate for Payer: UnitedHealth Group of AZ Medicare	$9.54

ROOM/BED: Extended Recovery

Facility

$53.00

Hospital Charge Code	2091602
Hospital Revenue Code	710
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$47.70
Rate for Payer: Aetna of AZ Commercial	$47.70
Rate for Payer: Bisbee Police All Plans	$13.78
Rate for Payer: Cash Price	$42.40
Rate for Payer: Self Pay Self Pay	$42.40

ROOM/BED: Observation

Facility

$104.00

Service Code	CPT G0378
Hospital Charge Code	1101857
Hospital Revenue Code	762
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of AZ Commercial	$93.60
Rate for Payer: Aetna of AZ Medicare	$29.12
Rate for Payer: Allwell Medicare	$16.64
Rate for Payer: Amerigroup Medicare	$16.64
Rate for Payer: APIPA Medicare/Medicaid	$38.84
Rate for Payer: AZCH Complete Medicare	$16.64
Rate for Payer: Banner UC Health Medicare	$16.64
Rate for Payer: Bisbee Police All Plans	$27.04
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$70.72
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cigna of AZ Commercial	$72.80
Rate for Payer: Copperpoint Commercial	$25.74
Rate for Payer: Health Net of AZ Commercial	$62.40
Rate for Payer: Health Net of AZ Medicare	$29.12
Rate for Payer: Humana of AZ Medicare	$16.64
Rate for Payer: Self Pay Self Pay	$83.20
Rate for Payer: TriWest Medicare	$16.64
Rate for Payer: UnitedHealth Group of AZ Commercial	$60.63
Rate for Payer: UnitedHealth Group of AZ Medicare	$18.72

ROOM/BED: Observation

Facility

$104.00

Service Code	CPT G0378
Hospital Charge Code	1101857
Hospital Revenue Code	762
Min. Negotiated Rate	$27.04
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of AZ Commercial	$93.60
Rate for Payer: Bisbee Police All Plans	$27.04
Rate for Payer: Cash Price	$83.20
Rate for Payer: Self Pay Self Pay	$83.20

ROOM/BED: Semi Private

Facility

$2,500.00

Hospital Charge Code	867361
Hospital Revenue Code	120
Min. Negotiated Rate	$650.00
Max. Negotiated Rate	$4,672.80
Rate for Payer: Aetna of AZ Commercial	$2,250.00
Rate for Payer: Aetna of AZ Medicare	$1,263.00
Rate for Payer: Allwell Medicare	$3,918.00
Rate for Payer: Amerigroup Medicare	$3,918.00
Rate for Payer: APIPA Medicare/Medicaid	$1,022.00
Rate for Payer: AZCH Complete Medicare	$3,918.00
Rate for Payer: Banner UC Health Medicare	$3,918.00
Rate for Payer: Bisbee Police All Plans	$650.00
Rate for Payer: Cash Price	$2,000.00
Rate for Payer: Cash Price	$2,000.00
Rate for Payer: Cigna of AZ Commercial	$1,700.00
Rate for Payer: Copperpoint Commercial	$4,672.80
Rate for Payer: Health Net of AZ Commercial	$1,231.00
Rate for Payer: Health Net of AZ Medicare	$1,176.00
Rate for Payer: Humana of AZ Medicare	$3,918.00
Rate for Payer: Self Pay Self Pay	$2,000.00
Rate for Payer: TriWest Medicare	$3,918.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,434.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$1,751.00

Know your out-of-pocket cost for care.

All Charges