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Charge Type Setting Price  
Hospital Charge Code 22926474
Hospital Revenue Code 272
Min. Negotiated Rate $317.72
Max. Negotiated Rate $1,099.80
Rate for Payer: Aetna of AZ Commercial $1,099.80
Rate for Payer: Bisbee Police All Plans $317.72
Rate for Payer: Cash Price $977.60
Rate for Payer: Self Pay Self Pay $977.60
Hospital Charge Code 22926474
Hospital Revenue Code 272
Min. Negotiated Rate $183.30
Max. Negotiated Rate $1,099.80
Rate for Payer: Aetna of AZ Commercial $1,099.80
Rate for Payer: Aetna of AZ Medicare $342.16
Rate for Payer: Allwell Medicare $183.30
Rate for Payer: Amerigroup Medicare $183.30
Rate for Payer: APIPA Medicare/Medicaid $456.42
Rate for Payer: AZCH Complete Medicare $183.30
Rate for Payer: Banner UC Health Medicare $183.30
Rate for Payer: Bisbee Police All Plans $317.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $830.96
Rate for Payer: Cash Price $977.60
Rate for Payer: Cigna of AZ Commercial $855.40
Rate for Payer: Copperpoint Commercial $302.44
Rate for Payer: Health Net of AZ Commercial $733.20
Rate for Payer: Health Net of AZ Medicare $342.16
Rate for Payer: Humana of AZ Medicare $183.30
Rate for Payer: Self Pay Self Pay $977.60
Rate for Payer: TriWest Medicare $183.30
Rate for Payer: UnitedHealth Group of AZ Commercial $712.43
Rate for Payer: UnitedHealth Group of AZ Medicare $219.96
Service Code APR-DRG 0403
Hospital Charge Code APRDRG0404
Min. Negotiated Rate $13,968.38
Max. Negotiated Rate $13,968.38
Rate for Payer: AHCCCS Medicaid $13,968.38
Rate for Payer: Allwell Medicaid $13,968.38
Rate for Payer: AZCH Complete Medicaid $13,968.38
Rate for Payer: Banner UC Health Medicaid $13,968.38
Rate for Payer: Mercy Care Medicaid $13,968.38
Service Code APR-DRG 0403
Hospital Charge Code APRDRG0401
Min. Negotiated Rate $13,968.38
Max. Negotiated Rate $13,968.38
Rate for Payer: AHCCCS Medicaid $13,968.38
Rate for Payer: Allwell Medicaid $13,968.38
Rate for Payer: AZCH Complete Medicaid $13,968.38
Rate for Payer: Banner UC Health Medicaid $13,968.38
Rate for Payer: Mercy Care Medicaid $13,968.38
Service Code APR-DRG 0402
Hospital Charge Code APRDRG0404
Min. Negotiated Rate $9,300.56
Max. Negotiated Rate $9,300.56
Rate for Payer: AHCCCS Medicaid $9,300.56
Rate for Payer: Allwell Medicaid $9,300.56
Rate for Payer: AZCH Complete Medicaid $9,300.56
Rate for Payer: Banner UC Health Medicaid $9,300.56
Rate for Payer: Mercy Care Medicaid $9,300.56
Service Code APR-DRG 0404
Hospital Charge Code APRDRG0401
Min. Negotiated Rate $23,362.23
Max. Negotiated Rate $23,362.23
Rate for Payer: AHCCCS Medicaid $23,362.23
Rate for Payer: Allwell Medicaid $23,362.23
Rate for Payer: AZCH Complete Medicaid $23,362.23
Rate for Payer: Banner UC Health Medicaid $23,362.23
Rate for Payer: Mercy Care Medicaid $23,362.23
Service Code APR-DRG 0404
Hospital Charge Code APRDRG0402
Min. Negotiated Rate $23,362.23
Max. Negotiated Rate $23,362.23
Rate for Payer: AHCCCS Medicaid $23,362.23
Rate for Payer: Allwell Medicaid $23,362.23
Rate for Payer: AZCH Complete Medicaid $23,362.23
Rate for Payer: Banner UC Health Medicaid $23,362.23
Rate for Payer: Mercy Care Medicaid $23,362.23
Service Code APR-DRG 0404
Hospital Charge Code APRDRG0403
Min. Negotiated Rate $23,362.23
Max. Negotiated Rate $23,362.23
Rate for Payer: AHCCCS Medicaid $23,362.23
Rate for Payer: Allwell Medicaid $23,362.23
Rate for Payer: AZCH Complete Medicaid $23,362.23
Rate for Payer: Banner UC Health Medicaid $23,362.23
Rate for Payer: Mercy Care Medicaid $23,362.23
Service Code APR-DRG 0401
Hospital Charge Code APRDRG0401
Min. Negotiated Rate $6,868.11
Max. Negotiated Rate $6,868.11
Rate for Payer: AHCCCS Medicaid $6,868.11
Rate for Payer: Allwell Medicaid $6,868.11
Rate for Payer: AZCH Complete Medicaid $6,868.11
Rate for Payer: Banner UC Health Medicaid $6,868.11
Rate for Payer: Mercy Care Medicaid $6,868.11
Service Code APR-DRG 0401
Hospital Charge Code APRDRG0403
Min. Negotiated Rate $6,868.11
Max. Negotiated Rate $6,868.11
Rate for Payer: AHCCCS Medicaid $6,868.11
Rate for Payer: Allwell Medicaid $6,868.11
Rate for Payer: AZCH Complete Medicaid $6,868.11
Rate for Payer: Banner UC Health Medicaid $6,868.11
Rate for Payer: Mercy Care Medicaid $6,868.11
Service Code APR-DRG 0403
Hospital Charge Code APRDRG0403
Min. Negotiated Rate $13,968.38
Max. Negotiated Rate $13,968.38
Rate for Payer: AHCCCS Medicaid $13,968.38
Rate for Payer: Allwell Medicaid $13,968.38
Rate for Payer: AZCH Complete Medicaid $13,968.38
Rate for Payer: Banner UC Health Medicaid $13,968.38
Rate for Payer: Mercy Care Medicaid $13,968.38
Service Code APR-DRG 0402
Hospital Charge Code APRDRG0401
Min. Negotiated Rate $9,300.56
Max. Negotiated Rate $9,300.56
Rate for Payer: AHCCCS Medicaid $9,300.56
Rate for Payer: Allwell Medicaid $9,300.56
Rate for Payer: AZCH Complete Medicaid $9,300.56
Rate for Payer: Banner UC Health Medicaid $9,300.56
Rate for Payer: Mercy Care Medicaid $9,300.56
Service Code APR-DRG 0401
Hospital Charge Code APRDRG0402
Min. Negotiated Rate $6,868.11
Max. Negotiated Rate $6,868.11
Rate for Payer: AHCCCS Medicaid $6,868.11
Rate for Payer: Allwell Medicaid $6,868.11
Rate for Payer: AZCH Complete Medicaid $6,868.11
Rate for Payer: Banner UC Health Medicaid $6,868.11
Rate for Payer: Mercy Care Medicaid $6,868.11
Service Code APR-DRG 0402
Hospital Charge Code APRDRG0402
Min. Negotiated Rate $9,300.56
Max. Negotiated Rate $9,300.56
Rate for Payer: AHCCCS Medicaid $9,300.56
Rate for Payer: Allwell Medicaid $9,300.56
Rate for Payer: AZCH Complete Medicaid $9,300.56
Rate for Payer: Banner UC Health Medicaid $9,300.56
Rate for Payer: Mercy Care Medicaid $9,300.56
Service Code APR-DRG 0402
Hospital Charge Code APRDRG0403
Min. Negotiated Rate $9,300.56
Max. Negotiated Rate $9,300.56
Rate for Payer: AHCCCS Medicaid $9,300.56
Rate for Payer: Allwell Medicaid $9,300.56
Rate for Payer: AZCH Complete Medicaid $9,300.56
Rate for Payer: Banner UC Health Medicaid $9,300.56
Rate for Payer: Mercy Care Medicaid $9,300.56
Service Code APR-DRG 0401
Hospital Charge Code APRDRG0404
Min. Negotiated Rate $6,868.11
Max. Negotiated Rate $6,868.11
Rate for Payer: AHCCCS Medicaid $6,868.11
Rate for Payer: Allwell Medicaid $6,868.11
Rate for Payer: AZCH Complete Medicaid $6,868.11
Rate for Payer: Banner UC Health Medicaid $6,868.11
Rate for Payer: Mercy Care Medicaid $6,868.11
Service Code APR-DRG 0404
Hospital Charge Code APRDRG0404
Min. Negotiated Rate $23,362.23
Max. Negotiated Rate $23,362.23
Rate for Payer: AHCCCS Medicaid $23,362.23
Rate for Payer: Allwell Medicaid $23,362.23
Rate for Payer: AZCH Complete Medicaid $23,362.23
Rate for Payer: Banner UC Health Medicaid $23,362.23
Rate for Payer: Mercy Care Medicaid $23,362.23
Service Code APR-DRG 0403
Hospital Charge Code APRDRG0402
Min. Negotiated Rate $13,968.38
Max. Negotiated Rate $13,968.38
Rate for Payer: AHCCCS Medicaid $13,968.38
Rate for Payer: Allwell Medicaid $13,968.38
Rate for Payer: AZCH Complete Medicaid $13,968.38
Rate for Payer: Banner UC Health Medicaid $13,968.38
Rate for Payer: Mercy Care Medicaid $13,968.38
Service Code APR-DRG 0233
Hospital Charge Code APRDRG0232
Min. Negotiated Rate $25,776.45
Max. Negotiated Rate $25,776.45
Rate for Payer: AHCCCS Medicaid $25,776.45
Rate for Payer: Allwell Medicaid $25,776.45
Rate for Payer: AZCH Complete Medicaid $25,776.45
Rate for Payer: Banner UC Health Medicaid $25,776.45
Rate for Payer: Mercy Care Medicaid $25,776.45
Service Code APR-DRG 0232
Hospital Charge Code APRDRG0233
Min. Negotiated Rate $14,480.40
Max. Negotiated Rate $14,480.40
Rate for Payer: AHCCCS Medicaid $14,480.40
Rate for Payer: Allwell Medicaid $14,480.40
Rate for Payer: AZCH Complete Medicaid $14,480.40
Rate for Payer: Banner UC Health Medicaid $14,480.40
Rate for Payer: Mercy Care Medicaid $14,480.40
Service Code APR-DRG 0233
Hospital Charge Code APRDRG0234
Min. Negotiated Rate $25,776.45
Max. Negotiated Rate $25,776.45
Rate for Payer: AHCCCS Medicaid $25,776.45
Rate for Payer: Allwell Medicaid $25,776.45
Rate for Payer: AZCH Complete Medicaid $25,776.45
Rate for Payer: Banner UC Health Medicaid $25,776.45
Rate for Payer: Mercy Care Medicaid $25,776.45
Service Code APR-DRG 0231
Hospital Charge Code APRDRG0234
Min. Negotiated Rate $10,554.67
Max. Negotiated Rate $10,554.67
Rate for Payer: AHCCCS Medicaid $10,554.67
Rate for Payer: Allwell Medicaid $10,554.67
Rate for Payer: AZCH Complete Medicaid $10,554.67
Rate for Payer: Banner UC Health Medicaid $10,554.67
Rate for Payer: Mercy Care Medicaid $10,554.67
Service Code APR-DRG 0231
Hospital Charge Code APRDRG0232
Min. Negotiated Rate $10,554.67
Max. Negotiated Rate $10,554.67
Rate for Payer: AHCCCS Medicaid $10,554.67
Rate for Payer: Allwell Medicaid $10,554.67
Rate for Payer: AZCH Complete Medicaid $10,554.67
Rate for Payer: Banner UC Health Medicaid $10,554.67
Rate for Payer: Mercy Care Medicaid $10,554.67
Service Code APR-DRG 0234
Hospital Charge Code APRDRG0233
Min. Negotiated Rate $40,597.73
Max. Negotiated Rate $40,597.73
Rate for Payer: AHCCCS Medicaid $40,597.73
Rate for Payer: Allwell Medicaid $40,597.73
Rate for Payer: AZCH Complete Medicaid $40,597.73
Rate for Payer: Banner UC Health Medicaid $40,597.73
Rate for Payer: Mercy Care Medicaid $40,597.73
Service Code APR-DRG 0232
Hospital Charge Code APRDRG0231
Min. Negotiated Rate $14,480.40
Max. Negotiated Rate $14,480.40
Rate for Payer: AHCCCS Medicaid $14,480.40
Rate for Payer: Allwell Medicaid $14,480.40
Rate for Payer: AZCH Complete Medicaid $14,480.40
Rate for Payer: Banner UC Health Medicaid $14,480.40
Rate for Payer: Mercy Care Medicaid $14,480.40