Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Speed Band Superview Super 7

Facility

$1,222.00

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

SPEEDRELEASE GUIDED RELEASE INSTRUMENT

Facility

$4,975.00

Hospital Charge Code	27820409
Hospital Revenue Code	270
Min. Negotiated Rate	$796.00
Max. Negotiated Rate	$4,477.50
Rate for Payer: Aetna of AZ Commercial	$4,477.50
Rate for Payer: Aetna of AZ Medicare	$1,393.00
Rate for Payer: Allwell Medicare	$796.00
Rate for Payer: Amerigroup Medicare	$796.00
Rate for Payer: APIPA Medicare/Medicaid	$1,858.16
Rate for Payer: AZCH Complete Medicare	$796.00
Rate for Payer: Banner UC Health Medicare	$796.00
Rate for Payer: Bisbee Police All Plans	$1,293.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,383.00
Rate for Payer: Cash Price	$3,980.00
Rate for Payer: Cigna of AZ Commercial	$3,482.50
Rate for Payer: Copperpoint Commercial	$1,231.31
Rate for Payer: Health Net of AZ Commercial	$2,985.00
Rate for Payer: Health Net of AZ Medicare	$1,393.00
Rate for Payer: Humana of AZ Medicare	$796.00
Rate for Payer: Self Pay Self Pay	$3,980.00
Rate for Payer: TriWest Medicare	$796.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,900.43
Rate for Payer: UnitedHealth Group of AZ Medicare	$895.50

SPEEDRELEASE GUIDED RELEASE INSTRUMENT

Facility

$4,975.00

Hospital Charge Code	27820409
Hospital Revenue Code	270
Min. Negotiated Rate	$1,293.50
Max. Negotiated Rate	$4,477.50
Rate for Payer: Aetna of AZ Commercial	$4,477.50
Rate for Payer: Bisbee Police All Plans	$1,293.50
Rate for Payer: Cash Price	$3,980.00
Rate for Payer: Self Pay Self Pay	$3,980.00

Spinal Disorders And Injuries

Facility

$9,300.56

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

Spinal Disorders And Injuries

Facility

$23,362.23

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

Spinal Disorders And Injuries

Facility

$6,868.11

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

Spinal Disorders And Injuries

Facility

$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

Spinal Disorders And Injuries

Facility

$6,868.11

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

Spinal Disorders And Injuries

Facility

$13,968.38

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

Spinal Disorders And Injuries

Facility

$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

Spinal Disorders And Injuries

Facility

$23,362.23

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

Spinal Disorders And Injuries

Facility

$9,300.56

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

Spinal Disorders And Injuries

Facility

$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

Spinal Disorders And Injuries

Facility

$6,868.11

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

Spinal Disorders And Injuries

Facility

$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

Spinal Disorders And Injuries

Facility

$9,300.56

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

Spinal Disorders And Injuries

Facility

$13,968.38

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

Spinal Disorders And Injuries

Facility

$13,968.38

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

Spinal Disorders And Injuries

Facility

$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

Spinal Procedures

Facility

$40,597.73

Service Code	APR-DRG 0234
Hospital Charge Code	APRDRG0234
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

Spinal Procedures

Facility

$25,776.45

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

Spinal Procedures

Facility

$25,776.45

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

Spinal Procedures

Facility

$14,480.40

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

Spinal Procedures

Facility

$14,480.40

Service Code	APR-DRG 0232
Hospital Charge Code	APRDRG0232
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

Spinal Procedures

Facility

$40,597.73

Service Code	APR-DRG 0234
Hospital Charge Code	APRDRG0231
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

Know your out-of-pocket cost for care.

All Charges