Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy

Facility

$4,314.31

Service Code	APR-DRG 7722
Hospital Charge Code	APRDRG7723
Min. Negotiated Rate	$4,314.31
Max. Negotiated Rate	$4,314.31
Rate for Payer: AHCCCS Medicaid	$4,314.31
Rate for Payer: Allwell Medicaid	$4,314.31
Rate for Payer: AZCH Complete Medicaid	$4,314.31
Rate for Payer: Banner UC Health Medicaid	$4,314.31
Rate for Payer: Mercy Care Medicaid	$4,314.31

Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy

Facility

$3,490.87

Service Code	APR-DRG 7721
Hospital Charge Code	APRDRG7721
Min. Negotiated Rate	$3,490.87
Max. Negotiated Rate	$3,490.87
Rate for Payer: AHCCCS Medicaid	$3,490.87
Rate for Payer: Allwell Medicaid	$3,490.87
Rate for Payer: AZCH Complete Medicaid	$3,490.87
Rate for Payer: Banner UC Health Medicaid	$3,490.87
Rate for Payer: Mercy Care Medicaid	$3,490.87

Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy

Facility

$16,819.57

Service Code	APR-DRG 7724
Hospital Charge Code	APRDRG7723
Min. Negotiated Rate	$16,819.57
Max. Negotiated Rate	$16,819.57
Rate for Payer: AHCCCS Medicaid	$16,819.57
Rate for Payer: Allwell Medicaid	$16,819.57
Rate for Payer: AZCH Complete Medicaid	$16,819.57
Rate for Payer: Banner UC Health Medicaid	$16,819.57
Rate for Payer: Mercy Care Medicaid	$16,819.57

Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy

Facility

$4,314.31

Service Code	APR-DRG 7722
Hospital Charge Code	APRDRG7722
Min. Negotiated Rate	$4,314.31
Max. Negotiated Rate	$4,314.31
Rate for Payer: AHCCCS Medicaid	$4,314.31
Rate for Payer: Allwell Medicaid	$4,314.31
Rate for Payer: AZCH Complete Medicaid	$4,314.31
Rate for Payer: Banner UC Health Medicaid	$4,314.31
Rate for Payer: Mercy Care Medicaid	$4,314.31

Alcohol Breath

Facility

$47.00

Service Code	CPT 82075
Hospital Charge Code	22600606
Hospital Revenue Code	301
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$42.30
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Bisbee Police All Plans	$12.22
Rate for Payer: Cash Price	$37.60
Rate for Payer: Self Pay Self Pay	$37.60

Alcohol Breath

Facility

$47.00

Service Code	CPT 82075
Hospital Charge Code	22600606
Hospital Revenue Code	301
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$42.30
Rate for Payer: Aetna of AZ Commercial	$42.30
Rate for Payer: Aetna of AZ Medicare	$13.16
Rate for Payer: AHCCCS Medicaid	$30.00
Rate for Payer: Allwell Medicaid	$30.00
Rate for Payer: Allwell Medicare	$7.05
Rate for Payer: Amerigroup Medicare	$7.05
Rate for Payer: APIPA Medicare/Medicaid	$17.55
Rate for Payer: AZCH Complete Medicaid	$30.00
Rate for Payer: AZCH Complete Medicare	$7.05
Rate for Payer: Banner UC Health Medicaid	$30.00
Rate for Payer: Banner UC Health Medicare	$7.05
Rate for Payer: Bisbee Police All Plans	$12.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$31.96
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cash Price	$37.60
Rate for Payer: Cigna of AZ Commercial	$30.55
Rate for Payer: Copperpoint Commercial	$11.63
Rate for Payer: Health Net of AZ Commercial	$28.20
Rate for Payer: Health Net of AZ Medicare	$13.16
Rate for Payer: Humana of AZ Medicare	$7.05
Rate for Payer: Mercy Care Medicaid	$30.00
Rate for Payer: Self Pay Self Pay	$37.60
Rate for Payer: TriWest Medicare	$7.05
Rate for Payer: UnitedHealth Group of AZ Commercial	$27.40
Rate for Payer: UnitedHealth Group of AZ Medicare	$8.46

Alcoholic Liver Disease

Facility

$17,034.20

Service Code	APR-DRG 2804
Hospital Charge Code	APRDRG2802
Min. Negotiated Rate	$17,034.20
Max. Negotiated Rate	$17,034.20
Rate for Payer: AHCCCS Medicaid	$17,034.20
Rate for Payer: Allwell Medicaid	$17,034.20
Rate for Payer: AZCH Complete Medicaid	$17,034.20
Rate for Payer: Banner UC Health Medicaid	$17,034.20
Rate for Payer: Mercy Care Medicaid	$17,034.20

Alcoholic Liver Disease

Facility

$3,475.44

Service Code	APR-DRG 2801
Hospital Charge Code	APRDRG2801
Min. Negotiated Rate	$3,475.44
Max. Negotiated Rate	$3,475.44
Rate for Payer: AHCCCS Medicaid	$3,475.44
Rate for Payer: Allwell Medicaid	$3,475.44
Rate for Payer: AZCH Complete Medicaid	$3,475.44
Rate for Payer: Banner UC Health Medicaid	$3,475.44
Rate for Payer: Mercy Care Medicaid	$3,475.44

Alcoholic Liver Disease

Facility

$7,137.45

Service Code	APR-DRG 2803
Hospital Charge Code	APRDRG2803
Min. Negotiated Rate	$7,137.45
Max. Negotiated Rate	$7,137.45
Rate for Payer: AHCCCS Medicaid	$7,137.45
Rate for Payer: Allwell Medicaid	$7,137.45
Rate for Payer: AZCH Complete Medicaid	$7,137.45
Rate for Payer: Banner UC Health Medicaid	$7,137.45
Rate for Payer: Mercy Care Medicaid	$7,137.45

Alcoholic Liver Disease

Facility

$4,535.95

Service Code	APR-DRG 2802
Hospital Charge Code	APRDRG2804
Min. Negotiated Rate	$4,535.95
Max. Negotiated Rate	$4,535.95
Rate for Payer: AHCCCS Medicaid	$4,535.95
Rate for Payer: Allwell Medicaid	$4,535.95
Rate for Payer: AZCH Complete Medicaid	$4,535.95
Rate for Payer: Banner UC Health Medicaid	$4,535.95
Rate for Payer: Mercy Care Medicaid	$4,535.95

Alcoholic Liver Disease

Facility

$4,535.95

Service Code	APR-DRG 2802
Hospital Charge Code	APRDRG2803
Min. Negotiated Rate	$4,535.95
Max. Negotiated Rate	$4,535.95
Rate for Payer: AHCCCS Medicaid	$4,535.95
Rate for Payer: Allwell Medicaid	$4,535.95
Rate for Payer: AZCH Complete Medicaid	$4,535.95
Rate for Payer: Banner UC Health Medicaid	$4,535.95
Rate for Payer: Mercy Care Medicaid	$4,535.95

Alcoholic Liver Disease

Facility

$17,034.20

Service Code	APR-DRG 2804
Hospital Charge Code	APRDRG2803
Min. Negotiated Rate	$17,034.20
Max. Negotiated Rate	$17,034.20
Rate for Payer: AHCCCS Medicaid	$17,034.20
Rate for Payer: Allwell Medicaid	$17,034.20
Rate for Payer: AZCH Complete Medicaid	$17,034.20
Rate for Payer: Banner UC Health Medicaid	$17,034.20
Rate for Payer: Mercy Care Medicaid	$17,034.20

Alcoholic Liver Disease

Facility

$3,475.44

Service Code	APR-DRG 2801
Hospital Charge Code	APRDRG2802
Min. Negotiated Rate	$3,475.44
Max. Negotiated Rate	$3,475.44
Rate for Payer: AHCCCS Medicaid	$3,475.44
Rate for Payer: Allwell Medicaid	$3,475.44
Rate for Payer: AZCH Complete Medicaid	$3,475.44
Rate for Payer: Banner UC Health Medicaid	$3,475.44
Rate for Payer: Mercy Care Medicaid	$3,475.44

Alcoholic Liver Disease

Facility

$7,137.45

Service Code	APR-DRG 2803
Hospital Charge Code	APRDRG2804
Min. Negotiated Rate	$7,137.45
Max. Negotiated Rate	$7,137.45
Rate for Payer: AHCCCS Medicaid	$7,137.45
Rate for Payer: Allwell Medicaid	$7,137.45
Rate for Payer: AZCH Complete Medicaid	$7,137.45
Rate for Payer: Banner UC Health Medicaid	$7,137.45
Rate for Payer: Mercy Care Medicaid	$7,137.45

Alcoholic Liver Disease

Facility

$3,475.44

Service Code	APR-DRG 2801
Hospital Charge Code	APRDRG2803
Min. Negotiated Rate	$3,475.44
Max. Negotiated Rate	$3,475.44
Rate for Payer: AHCCCS Medicaid	$3,475.44
Rate for Payer: Allwell Medicaid	$3,475.44
Rate for Payer: AZCH Complete Medicaid	$3,475.44
Rate for Payer: Banner UC Health Medicaid	$3,475.44
Rate for Payer: Mercy Care Medicaid	$3,475.44

Alcoholic Liver Disease

Facility

$4,535.95

Service Code	APR-DRG 2802
Hospital Charge Code	APRDRG2801
Min. Negotiated Rate	$4,535.95
Max. Negotiated Rate	$4,535.95
Rate for Payer: AHCCCS Medicaid	$4,535.95
Rate for Payer: Allwell Medicaid	$4,535.95
Rate for Payer: AZCH Complete Medicaid	$4,535.95
Rate for Payer: Banner UC Health Medicaid	$4,535.95
Rate for Payer: Mercy Care Medicaid	$4,535.95

Alcoholic Liver Disease

Facility

$17,034.20

Service Code	APR-DRG 2804
Hospital Charge Code	APRDRG2801
Min. Negotiated Rate	$17,034.20
Max. Negotiated Rate	$17,034.20
Rate for Payer: AHCCCS Medicaid	$17,034.20
Rate for Payer: Allwell Medicaid	$17,034.20
Rate for Payer: AZCH Complete Medicaid	$17,034.20
Rate for Payer: Banner UC Health Medicaid	$17,034.20
Rate for Payer: Mercy Care Medicaid	$17,034.20

Alcoholic Liver Disease

Facility

$7,137.45

Service Code	APR-DRG 2803
Hospital Charge Code	APRDRG2801
Min. Negotiated Rate	$7,137.45
Max. Negotiated Rate	$7,137.45
Rate for Payer: AHCCCS Medicaid	$7,137.45
Rate for Payer: Allwell Medicaid	$7,137.45
Rate for Payer: AZCH Complete Medicaid	$7,137.45
Rate for Payer: Banner UC Health Medicaid	$7,137.45
Rate for Payer: Mercy Care Medicaid	$7,137.45

Alcoholic Liver Disease

Facility

$17,034.20

Service Code	APR-DRG 2804
Hospital Charge Code	APRDRG2804
Min. Negotiated Rate	$17,034.20
Max. Negotiated Rate	$17,034.20
Rate for Payer: AHCCCS Medicaid	$17,034.20
Rate for Payer: Allwell Medicaid	$17,034.20
Rate for Payer: AZCH Complete Medicaid	$17,034.20
Rate for Payer: Banner UC Health Medicaid	$17,034.20
Rate for Payer: Mercy Care Medicaid	$17,034.20

Alcoholic Liver Disease

Facility

$3,475.44

Service Code	APR-DRG 2801
Hospital Charge Code	APRDRG2804
Min. Negotiated Rate	$3,475.44
Max. Negotiated Rate	$3,475.44
Rate for Payer: AHCCCS Medicaid	$3,475.44
Rate for Payer: Allwell Medicaid	$3,475.44
Rate for Payer: AZCH Complete Medicaid	$3,475.44
Rate for Payer: Banner UC Health Medicaid	$3,475.44
Rate for Payer: Mercy Care Medicaid	$3,475.44

Alcoholic Liver Disease

Facility

$4,535.95

Service Code	APR-DRG 2802
Hospital Charge Code	APRDRG2802
Min. Negotiated Rate	$4,535.95
Max. Negotiated Rate	$4,535.95
Rate for Payer: AHCCCS Medicaid	$4,535.95
Rate for Payer: Allwell Medicaid	$4,535.95
Rate for Payer: AZCH Complete Medicaid	$4,535.95
Rate for Payer: Banner UC Health Medicaid	$4,535.95
Rate for Payer: Mercy Care Medicaid	$4,535.95

Alcoholic Liver Disease

Facility

$7,137.45

Service Code	APR-DRG 2803
Hospital Charge Code	APRDRG2802
Min. Negotiated Rate	$7,137.45
Max. Negotiated Rate	$7,137.45
Rate for Payer: AHCCCS Medicaid	$7,137.45
Rate for Payer: Allwell Medicaid	$7,137.45
Rate for Payer: AZCH Complete Medicaid	$7,137.45
Rate for Payer: Banner UC Health Medicaid	$7,137.45
Rate for Payer: Mercy Care Medicaid	$7,137.45

Alcohol Level

Facility

$328.00

Service Code	CPT 80320
Hospital Charge Code	1279592
Hospital Revenue Code	301
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$295.20
Rate for Payer: Aetna of AZ Commercial	$295.20
Rate for Payer: Aetna of AZ Medicare	$91.84
Rate for Payer: AHCCCS Medicaid	$0.13
Rate for Payer: Allwell Medicaid	$0.13
Rate for Payer: Allwell Medicare	$49.20
Rate for Payer: Amerigroup Medicare	$49.20
Rate for Payer: APIPA Medicare/Medicaid	$122.51
Rate for Payer: AZCH Complete Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$49.20
Rate for Payer: Banner UC Health Medicaid	$0.13
Rate for Payer: Banner UC Health Medicare	$49.20
Rate for Payer: Bisbee Police All Plans	$85.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$223.04
Rate for Payer: Cash Price	$262.40
Rate for Payer: Cash Price	$262.40
Rate for Payer: Cigna of AZ Commercial	$213.20
Rate for Payer: Copperpoint Commercial	$81.18
Rate for Payer: Health Net of AZ Commercial	$196.80
Rate for Payer: Health Net of AZ Medicare	$91.84
Rate for Payer: Humana of AZ Medicare	$49.20
Rate for Payer: Mercy Care Medicaid	$0.13
Rate for Payer: Self Pay Self Pay	$262.40
Rate for Payer: TriWest Medicare	$49.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$191.22
Rate for Payer: UnitedHealth Group of AZ Medicare	$59.04

Alcohol Level

Facility

$328.00

Service Code	CPT 80320
Hospital Charge Code	1279592
Hospital Revenue Code	301
Min. Negotiated Rate	$85.28
Max. Negotiated Rate	$295.20
Rate for Payer: Aetna of AZ Commercial	$295.20
Rate for Payer: Bisbee Police All Plans	$85.28
Rate for Payer: Cash Price	$262.40
Rate for Payer: Self Pay Self Pay	$262.40

Alder Tree

Facility

$78.00

Service Code	CPT 86003
Hospital Charge Code	23168775
Hospital Revenue Code	301
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$70.20
Rate for Payer: Aetna of AZ Commercial	$70.20
Rate for Payer: Aetna of AZ Medicare	$21.84
Rate for Payer: AHCCCS Medicaid	$5.22
Rate for Payer: Allwell Medicaid	$5.22
Rate for Payer: Allwell Medicare	$11.70
Rate for Payer: Amerigroup Medicare	$11.70
Rate for Payer: APIPA Medicare/Medicaid	$29.13
Rate for Payer: AZCH Complete Medicaid	$5.22
Rate for Payer: AZCH Complete Medicare	$11.70
Rate for Payer: Banner UC Health Medicaid	$5.22
Rate for Payer: Banner UC Health Medicare	$11.70
Rate for Payer: Bisbee Police All Plans	$20.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$53.04
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cigna of AZ Commercial	$50.70
Rate for Payer: Copperpoint Commercial	$19.30
Rate for Payer: Health Net of AZ Commercial	$46.80
Rate for Payer: Health Net of AZ Medicare	$21.84
Rate for Payer: Humana of AZ Medicare	$11.70
Rate for Payer: Mercy Care Medicaid	$5.22
Rate for Payer: Self Pay Self Pay	$62.40
Rate for Payer: TriWest Medicare	$11.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$45.47
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.04

Know your out-of-pocket cost for care.

All Charges