|
Thyroid Stim Immunoglobulin LC
|
Facility
|
OP
|
$632.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
6780901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.86 |
| Max. Negotiated Rate |
$568.80 |
| Rate for Payer: Aetna of AZ Commercial |
$568.80
|
| Rate for Payer: Aetna of AZ Medicare |
$176.96
|
| Rate for Payer: AHCCCS Medicaid |
$50.86
|
| Rate for Payer: Allwell Medicaid |
$50.86
|
| Rate for Payer: Allwell Medicare |
$94.80
|
| Rate for Payer: Amerigroup Medicare |
$94.80
|
| Rate for Payer: APIPA Medicare/Medicaid |
$236.05
|
| Rate for Payer: AZCH Complete Medicaid |
$50.86
|
| Rate for Payer: AZCH Complete Medicare |
$94.80
|
| Rate for Payer: Banner UC Health Medicaid |
$50.86
|
| Rate for Payer: Banner UC Health Medicare |
$94.80
|
| Rate for Payer: Bisbee Police All Plans |
$164.32
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$429.76
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cigna of AZ Commercial |
$410.80
|
| Rate for Payer: Copperpoint Commercial |
$156.42
|
| Rate for Payer: Health Net of AZ Commercial |
$379.20
|
| Rate for Payer: Health Net of AZ Medicare |
$176.96
|
| Rate for Payer: Humana of AZ Medicare |
$94.80
|
| Rate for Payer: Mercy Care Medicaid |
$50.86
|
| Rate for Payer: Self Pay Self Pay |
$505.60
|
| Rate for Payer: TriWest Medicare |
$94.80
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$368.46
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$113.76
|
|
|
Thyroid Stim Immunoglobulin LC
|
Facility
|
IP
|
$632.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
6780901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$164.32 |
| Max. Negotiated Rate |
$568.80 |
| Rate for Payer: Aetna of AZ Commercial |
$568.80
|
| Rate for Payer: Bisbee Police All Plans |
$164.32
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Self Pay Self Pay |
$505.60
|
|
|
Thyroid Stimulating Hormone
|
Facility
|
IP
|
$243.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
633844
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.18 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Aetna of AZ Commercial |
$218.70
|
| Rate for Payer: Bisbee Police All Plans |
$63.18
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Self Pay Self Pay |
$194.40
|
|
|
Thyroid Stimulating Hormone
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
633844
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Aetna of AZ Commercial |
$218.70
|
| Rate for Payer: Aetna of AZ Medicare |
$68.04
|
| Rate for Payer: AHCCCS Medicaid |
$16.80
|
| Rate for Payer: Allwell Medicaid |
$16.80
|
| Rate for Payer: Allwell Medicare |
$36.45
|
| Rate for Payer: Amerigroup Medicare |
$36.45
|
| Rate for Payer: APIPA Medicare/Medicaid |
$90.76
|
| Rate for Payer: AZCH Complete Medicaid |
$16.80
|
| Rate for Payer: AZCH Complete Medicare |
$36.45
|
| Rate for Payer: Banner UC Health Medicaid |
$16.80
|
| Rate for Payer: Banner UC Health Medicare |
$36.45
|
| Rate for Payer: Bisbee Police All Plans |
$63.18
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$165.24
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna of AZ Commercial |
$157.95
|
| Rate for Payer: Copperpoint Commercial |
$60.14
|
| Rate for Payer: Health Net of AZ Commercial |
$145.80
|
| Rate for Payer: Health Net of AZ Medicare |
$68.04
|
| Rate for Payer: Humana of AZ Medicare |
$36.45
|
| Rate for Payer: Mercy Care Medicaid |
$16.80
|
| Rate for Payer: Self Pay Self Pay |
$194.40
|
| Rate for Payer: TriWest Medicare |
$36.45
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$141.67
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$43.74
|
|
|
THYROID STIMULATING IMMUNE GLOBULIN (TSI)
|
Facility
|
IP
|
$643.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
22491211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$167.18 |
| Max. Negotiated Rate |
$578.70 |
| Rate for Payer: Aetna of AZ Commercial |
$578.70
|
| Rate for Payer: Bisbee Police All Plans |
$167.18
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Self Pay Self Pay |
$514.40
|
|
|
THYROID STIMULATING IMMUNE GLOBULIN (TSI)
|
Facility
|
OP
|
$643.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
22491211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.86 |
| Max. Negotiated Rate |
$578.70 |
| Rate for Payer: Aetna of AZ Commercial |
$578.70
|
| Rate for Payer: Aetna of AZ Medicare |
$180.04
|
| Rate for Payer: AHCCCS Medicaid |
$50.86
|
| Rate for Payer: Allwell Medicaid |
$50.86
|
| Rate for Payer: Allwell Medicare |
$96.45
|
| Rate for Payer: Amerigroup Medicare |
$96.45
|
| Rate for Payer: APIPA Medicare/Medicaid |
$240.16
|
| Rate for Payer: AZCH Complete Medicaid |
$50.86
|
| Rate for Payer: AZCH Complete Medicare |
$96.45
|
| Rate for Payer: Banner UC Health Medicaid |
$50.86
|
| Rate for Payer: Banner UC Health Medicare |
$96.45
|
| Rate for Payer: Bisbee Police All Plans |
$167.18
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$437.24
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cigna of AZ Commercial |
$417.95
|
| Rate for Payer: Copperpoint Commercial |
$159.14
|
| Rate for Payer: Health Net of AZ Commercial |
$385.80
|
| Rate for Payer: Health Net of AZ Medicare |
$180.04
|
| Rate for Payer: Humana of AZ Medicare |
$96.45
|
| Rate for Payer: Mercy Care Medicaid |
$50.86
|
| Rate for Payer: Self Pay Self Pay |
$514.40
|
| Rate for Payer: TriWest Medicare |
$96.45
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$374.87
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$115.74
|
|
|
Thyrotropin Receptor Ab, Serum LC
|
Facility
|
OP
|
$392.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
2087655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$352.80 |
| Rate for Payer: Aetna of AZ Commercial |
$352.80
|
| Rate for Payer: Aetna of AZ Medicare |
$109.76
|
| Rate for Payer: AHCCCS Medicaid |
$18.40
|
| Rate for Payer: Allwell Medicaid |
$18.40
|
| Rate for Payer: Allwell Medicare |
$58.80
|
| Rate for Payer: Amerigroup Medicare |
$58.80
|
| Rate for Payer: APIPA Medicare/Medicaid |
$146.41
|
| Rate for Payer: AZCH Complete Medicaid |
$18.40
|
| Rate for Payer: AZCH Complete Medicare |
$58.80
|
| Rate for Payer: Banner UC Health Medicaid |
$18.40
|
| Rate for Payer: Banner UC Health Medicare |
$58.80
|
| Rate for Payer: Bisbee Police All Plans |
$101.92
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$266.56
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cigna of AZ Commercial |
$254.80
|
| Rate for Payer: Copperpoint Commercial |
$97.02
|
| Rate for Payer: Health Net of AZ Commercial |
$235.20
|
| Rate for Payer: Health Net of AZ Medicare |
$109.76
|
| Rate for Payer: Humana of AZ Medicare |
$58.80
|
| Rate for Payer: Mercy Care Medicaid |
$18.40
|
| Rate for Payer: Self Pay Self Pay |
$313.60
|
| Rate for Payer: TriWest Medicare |
$58.80
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$228.54
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$70.56
|
|
|
Thyrotropin Receptor Ab, Serum LC
|
Facility
|
IP
|
$392.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
2087655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.92 |
| Max. Negotiated Rate |
$352.80 |
| Rate for Payer: Aetna of AZ Commercial |
$352.80
|
| Rate for Payer: Bisbee Police All Plans |
$101.92
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Self Pay Self Pay |
$313.60
|
|
|
Thyroxine Binding Globulin LC
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
6738642
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of AZ Commercial |
$90.00
|
| Rate for Payer: Aetna of AZ Medicare |
$28.00
|
| Rate for Payer: AHCCCS Medicaid |
$14.78
|
| Rate for Payer: Allwell Medicaid |
$14.78
|
| Rate for Payer: Allwell Medicare |
$15.00
|
| Rate for Payer: Amerigroup Medicare |
$15.00
|
| Rate for Payer: APIPA Medicare/Medicaid |
$37.35
|
| Rate for Payer: AZCH Complete Medicaid |
$14.78
|
| Rate for Payer: AZCH Complete Medicare |
$15.00
|
| Rate for Payer: Banner UC Health Medicaid |
$14.78
|
| Rate for Payer: Banner UC Health Medicare |
$15.00
|
| Rate for Payer: Bisbee Police All Plans |
$26.00
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$68.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna of AZ Commercial |
$65.00
|
| Rate for Payer: Copperpoint Commercial |
$24.75
|
| Rate for Payer: Health Net of AZ Commercial |
$60.00
|
| Rate for Payer: Health Net of AZ Medicare |
$28.00
|
| Rate for Payer: Humana of AZ Medicare |
$15.00
|
| Rate for Payer: Mercy Care Medicaid |
$14.78
|
| Rate for Payer: Self Pay Self Pay |
$80.00
|
| Rate for Payer: TriWest Medicare |
$15.00
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$58.30
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$18.00
|
|
|
Thyroxine Binding Globulin LC
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
6738642
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of AZ Commercial |
$90.00
|
| Rate for Payer: Bisbee Police All Plans |
$26.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Self Pay Self Pay |
$80.00
|
|
|
THYROXINE BINDING GLOBULIN (TBG)
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
22949892
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of AZ Commercial |
$90.00
|
| Rate for Payer: Aetna of AZ Medicare |
$28.00
|
| Rate for Payer: AHCCCS Medicaid |
$14.78
|
| Rate for Payer: Allwell Medicaid |
$14.78
|
| Rate for Payer: Allwell Medicare |
$15.00
|
| Rate for Payer: Amerigroup Medicare |
$15.00
|
| Rate for Payer: APIPA Medicare/Medicaid |
$37.35
|
| Rate for Payer: AZCH Complete Medicaid |
$14.78
|
| Rate for Payer: AZCH Complete Medicare |
$15.00
|
| Rate for Payer: Banner UC Health Medicaid |
$14.78
|
| Rate for Payer: Banner UC Health Medicare |
$15.00
|
| Rate for Payer: Bisbee Police All Plans |
$26.00
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$68.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cigna of AZ Commercial |
$65.00
|
| Rate for Payer: Copperpoint Commercial |
$24.75
|
| Rate for Payer: Health Net of AZ Commercial |
$60.00
|
| Rate for Payer: Health Net of AZ Medicare |
$28.00
|
| Rate for Payer: Humana of AZ Medicare |
$15.00
|
| Rate for Payer: Mercy Care Medicaid |
$14.78
|
| Rate for Payer: Self Pay Self Pay |
$80.00
|
| Rate for Payer: TriWest Medicare |
$15.00
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$58.30
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$18.00
|
|
|
THYROXINE BINDING GLOBULIN (TBG)
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
22949892
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna of AZ Commercial |
$90.00
|
| Rate for Payer: Bisbee Police All Plans |
$26.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Self Pay Self Pay |
$80.00
|
|
|
.Thyroxine (T4) Free, Direct H LC
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
22531068
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Aetna of AZ Commercial |
$336.60
|
| Rate for Payer: Aetna of AZ Medicare |
$104.72
|
| Rate for Payer: AHCCCS Medicaid |
$9.02
|
| Rate for Payer: Allwell Medicaid |
$9.02
|
| Rate for Payer: Allwell Medicare |
$56.10
|
| Rate for Payer: Amerigroup Medicare |
$56.10
|
| Rate for Payer: APIPA Medicare/Medicaid |
$139.69
|
| Rate for Payer: AZCH Complete Medicaid |
$9.02
|
| Rate for Payer: AZCH Complete Medicare |
$56.10
|
| Rate for Payer: Banner UC Health Medicaid |
$9.02
|
| Rate for Payer: Banner UC Health Medicare |
$56.10
|
| Rate for Payer: Bisbee Police All Plans |
$97.24
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$254.32
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cigna of AZ Commercial |
$243.10
|
| Rate for Payer: Copperpoint Commercial |
$92.56
|
| Rate for Payer: Health Net of AZ Commercial |
$224.40
|
| Rate for Payer: Health Net of AZ Medicare |
$104.72
|
| Rate for Payer: Humana of AZ Medicare |
$56.10
|
| Rate for Payer: Mercy Care Medicaid |
$9.02
|
| Rate for Payer: Self Pay Self Pay |
$299.20
|
| Rate for Payer: TriWest Medicare |
$56.10
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$218.04
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$67.32
|
|
|
.Thyroxine (T4) Free, Direct H LC
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
22531068
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$97.24 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Aetna of AZ Commercial |
$336.60
|
| Rate for Payer: Bisbee Police All Plans |
$97.24
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Self Pay Self Pay |
$299.20
|
|
|
Thyroxine (T4) Free, Direct, LC
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
1285539
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Aetna of AZ Commercial |
$336.60
|
| Rate for Payer: Aetna of AZ Medicare |
$104.72
|
| Rate for Payer: AHCCCS Medicaid |
$9.02
|
| Rate for Payer: Allwell Medicaid |
$9.02
|
| Rate for Payer: Allwell Medicare |
$56.10
|
| Rate for Payer: Amerigroup Medicare |
$56.10
|
| Rate for Payer: APIPA Medicare/Medicaid |
$139.69
|
| Rate for Payer: AZCH Complete Medicaid |
$9.02
|
| Rate for Payer: AZCH Complete Medicare |
$56.10
|
| Rate for Payer: Banner UC Health Medicaid |
$9.02
|
| Rate for Payer: Banner UC Health Medicare |
$56.10
|
| Rate for Payer: Bisbee Police All Plans |
$97.24
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$254.32
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cigna of AZ Commercial |
$243.10
|
| Rate for Payer: Copperpoint Commercial |
$92.56
|
| Rate for Payer: Health Net of AZ Commercial |
$224.40
|
| Rate for Payer: Health Net of AZ Medicare |
$104.72
|
| Rate for Payer: Humana of AZ Medicare |
$56.10
|
| Rate for Payer: Mercy Care Medicaid |
$9.02
|
| Rate for Payer: Self Pay Self Pay |
$299.20
|
| Rate for Payer: TriWest Medicare |
$56.10
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$218.04
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$67.32
|
|
|
Thyroxine (T4) Free, Direct, LC
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
1285539
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.24 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Aetna of AZ Commercial |
$336.60
|
| Rate for Payer: Bisbee Police All Plans |
$97.24
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Self Pay Self Pay |
$299.20
|
|
|
TI6 DIGITAL SCREW 2.0 X 36MM
|
Facility
|
OP
|
$1,591.00
|
|
| Hospital Charge Code |
24127797
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$238.65 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Aetna of AZ Medicare |
$445.48
|
| Rate for Payer: Allwell Medicare |
$238.65
|
| Rate for Payer: Amerigroup Medicare |
$238.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$594.24
|
| Rate for Payer: AZCH Complete Medicare |
$238.65
|
| Rate for Payer: Banner UC Health Medicare |
$238.65
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,081.88
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cigna of AZ Commercial |
$1,113.70
|
| Rate for Payer: Copperpoint Commercial |
$393.77
|
| Rate for Payer: Health Net of AZ Commercial |
$954.60
|
| Rate for Payer: Health Net of AZ Medicare |
$445.48
|
| Rate for Payer: Humana of AZ Medicare |
$238.65
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
| Rate for Payer: TriWest Medicare |
$238.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$927.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$286.38
|
|
|
TI6 DIGITAL SCREW 2.0 X 36MM
|
Facility
|
IP
|
$1,591.00
|
|
| Hospital Charge Code |
24127797
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$413.66 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
|
|
TI6 DIGITAL SCREW 2.0 X 46MM
|
Facility
|
OP
|
$1,591.00
|
|
| Hospital Charge Code |
24127800
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$238.65 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Aetna of AZ Medicare |
$445.48
|
| Rate for Payer: Allwell Medicare |
$238.65
|
| Rate for Payer: Amerigroup Medicare |
$238.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$594.24
|
| Rate for Payer: AZCH Complete Medicare |
$238.65
|
| Rate for Payer: Banner UC Health Medicare |
$238.65
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,081.88
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cigna of AZ Commercial |
$1,113.70
|
| Rate for Payer: Copperpoint Commercial |
$393.77
|
| Rate for Payer: Health Net of AZ Commercial |
$954.60
|
| Rate for Payer: Health Net of AZ Medicare |
$445.48
|
| Rate for Payer: Humana of AZ Medicare |
$238.65
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
| Rate for Payer: TriWest Medicare |
$238.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$927.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$286.38
|
|
|
TI6 DIGITAL SCREW 2.0 X 46MM
|
Facility
|
IP
|
$1,591.00
|
|
| Hospital Charge Code |
24127800
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$413.66 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
|
|
TI6 DIGITAL SCREW 2.0 X 48MM
|
Facility
|
OP
|
$1,591.00
|
|
| Hospital Charge Code |
24127798
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$238.65 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Aetna of AZ Medicare |
$445.48
|
| Rate for Payer: Allwell Medicare |
$238.65
|
| Rate for Payer: Amerigroup Medicare |
$238.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$594.24
|
| Rate for Payer: AZCH Complete Medicare |
$238.65
|
| Rate for Payer: Banner UC Health Medicare |
$238.65
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,081.88
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cigna of AZ Commercial |
$1,113.70
|
| Rate for Payer: Copperpoint Commercial |
$393.77
|
| Rate for Payer: Health Net of AZ Commercial |
$954.60
|
| Rate for Payer: Health Net of AZ Medicare |
$445.48
|
| Rate for Payer: Humana of AZ Medicare |
$238.65
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
| Rate for Payer: TriWest Medicare |
$238.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$927.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$286.38
|
|
|
TI6 DIGITAL SCREW 2.0 X 48MM
|
Facility
|
IP
|
$1,591.00
|
|
| Hospital Charge Code |
24127798
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$413.66 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna of AZ Commercial |
$1,431.90
|
| Rate for Payer: Bisbee Police All Plans |
$413.66
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Self Pay Self Pay |
$1,272.80
|
|
|
TI6 DIGITAL SCREW 2MMX38MM
|
Facility
|
IP
|
$2,549.00
|
|
| Hospital Charge Code |
27567204
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$662.74 |
| Max. Negotiated Rate |
$2,294.10 |
| Rate for Payer: Aetna of AZ Commercial |
$2,294.10
|
| Rate for Payer: Bisbee Police All Plans |
$662.74
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Self Pay Self Pay |
$2,039.20
|
|
|
TI6 DIGITAL SCREW 2MMX38MM
|
Facility
|
OP
|
$2,549.00
|
|
| Hospital Charge Code |
27567204
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$382.35 |
| Max. Negotiated Rate |
$2,294.10 |
| Rate for Payer: Aetna of AZ Commercial |
$2,294.10
|
| Rate for Payer: Aetna of AZ Medicare |
$713.72
|
| Rate for Payer: Allwell Medicare |
$382.35
|
| Rate for Payer: Amerigroup Medicare |
$382.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$952.05
|
| Rate for Payer: AZCH Complete Medicare |
$382.35
|
| Rate for Payer: Banner UC Health Medicare |
$382.35
|
| Rate for Payer: Bisbee Police All Plans |
$662.74
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,733.32
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cigna of AZ Commercial |
$1,784.30
|
| Rate for Payer: Copperpoint Commercial |
$630.88
|
| Rate for Payer: Health Net of AZ Commercial |
$1,529.40
|
| Rate for Payer: Health Net of AZ Medicare |
$713.72
|
| Rate for Payer: Humana of AZ Medicare |
$382.35
|
| Rate for Payer: Self Pay Self Pay |
$2,039.20
|
| Rate for Payer: TriWest Medicare |
$382.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,486.07
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$458.82
|
|
|
TI6 DIGITAL SCREW 2MMX40MM
|
Facility
|
OP
|
$2,549.00
|
|
| Hospital Charge Code |
27567203
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$382.35 |
| Max. Negotiated Rate |
$2,294.10 |
| Rate for Payer: Aetna of AZ Commercial |
$2,294.10
|
| Rate for Payer: Aetna of AZ Medicare |
$713.72
|
| Rate for Payer: Allwell Medicare |
$382.35
|
| Rate for Payer: Amerigroup Medicare |
$382.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$952.05
|
| Rate for Payer: AZCH Complete Medicare |
$382.35
|
| Rate for Payer: Banner UC Health Medicare |
$382.35
|
| Rate for Payer: Bisbee Police All Plans |
$662.74
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,733.32
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cigna of AZ Commercial |
$1,784.30
|
| Rate for Payer: Copperpoint Commercial |
$630.88
|
| Rate for Payer: Health Net of AZ Commercial |
$1,529.40
|
| Rate for Payer: Health Net of AZ Medicare |
$713.72
|
| Rate for Payer: Humana of AZ Medicare |
$382.35
|
| Rate for Payer: Self Pay Self Pay |
$2,039.20
|
| Rate for Payer: TriWest Medicare |
$382.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,486.07
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$458.82
|
|
