Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

TPMT Genetic Test LC

Facility

OP

$1,788.00

Service Code	CPT 81401
Hospital Charge Code	22348727
Hospital Revenue Code	301
Min. Negotiated Rate	$137.00
Max. Negotiated Rate	$1,609.20
Rate for Payer: Aetna of AZ Commercial	$1,609.20
Rate for Payer: Aetna of AZ Medicare	$500.64
Rate for Payer: AHCCCS Medicaid	$137.00
Rate for Payer: Allwell Medicaid	$137.00
Rate for Payer: Allwell Medicare	$268.20
Rate for Payer: Amerigroup Medicare	$268.20
Rate for Payer: APIPA Medicare/Medicaid	$667.82
Rate for Payer: AZCH Complete Medicaid	$137.00
Rate for Payer: AZCH Complete Medicare	$268.20
Rate for Payer: Banner UC Health Medicaid	$137.00
Rate for Payer: Banner UC Health Medicare	$268.20
Rate for Payer: Bisbee Police All Plans	$464.88
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,215.84
Rate for Payer: Cash Price	$1,430.40
Rate for Payer: Cash Price	$1,430.40
Rate for Payer: Cigna of AZ Commercial	$1,162.20
Rate for Payer: Copperpoint Commercial	$442.53
Rate for Payer: Health Net of AZ Commercial	$1,072.80
Rate for Payer: Health Net of AZ Medicare	$500.64
Rate for Payer: Humana of AZ Medicare	$268.20
Rate for Payer: Mercy Care Medicaid	$137.00
Rate for Payer: Self Pay Self Pay	$1,430.40
Rate for Payer: TriWest Medicare	$268.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,042.40
Rate for Payer: UnitedHealth Group of AZ Medicare	$321.84

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$44,109.64

Service Code	APR-DRG 0041
Hospital Charge Code	APRDRG0041
Min. Negotiated Rate	$44,109.64
Max. Negotiated Rate	$44,109.64
Rate for Payer: AHCCCS Medicaid	$44,109.64
Rate for Payer: Allwell Medicaid	$44,109.64
Rate for Payer: AZCH Complete Medicaid	$44,109.64
Rate for Payer: Banner UC Health Medicaid	$44,109.64
Rate for Payer: Mercy Care Medicaid	$44,109.64

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$44,109.64

Service Code	APR-DRG 0041
Hospital Charge Code	APRDRG0042
Min. Negotiated Rate	$44,109.64
Max. Negotiated Rate	$44,109.64
Rate for Payer: AHCCCS Medicaid	$44,109.64
Rate for Payer: Allwell Medicaid	$44,109.64
Rate for Payer: AZCH Complete Medicaid	$44,109.64
Rate for Payer: Banner UC Health Medicaid	$44,109.64
Rate for Payer: Mercy Care Medicaid	$44,109.64

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$74,757.32

Service Code	APR-DRG 0043
Hospital Charge Code	APRDRG0042
Min. Negotiated Rate	$74,757.32
Max. Negotiated Rate	$74,757.32
Rate for Payer: AHCCCS Medicaid	$74,757.32
Rate for Payer: Allwell Medicaid	$74,757.32
Rate for Payer: AZCH Complete Medicaid	$74,757.32
Rate for Payer: Banner UC Health Medicaid	$74,757.32
Rate for Payer: Mercy Care Medicaid	$74,757.32

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$74,757.32

Service Code	APR-DRG 0043
Hospital Charge Code	APRDRG0041
Min. Negotiated Rate	$74,757.32
Max. Negotiated Rate	$74,757.32
Rate for Payer: AHCCCS Medicaid	$74,757.32
Rate for Payer: Allwell Medicaid	$74,757.32
Rate for Payer: AZCH Complete Medicaid	$74,757.32
Rate for Payer: Banner UC Health Medicaid	$74,757.32
Rate for Payer: Mercy Care Medicaid	$74,757.32

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$52,364.42

Service Code	APR-DRG 0042
Hospital Charge Code	APRDRG0044
Min. Negotiated Rate	$52,364.42
Max. Negotiated Rate	$52,364.42
Rate for Payer: AHCCCS Medicaid	$52,364.42
Rate for Payer: Allwell Medicaid	$52,364.42
Rate for Payer: AZCH Complete Medicaid	$52,364.42
Rate for Payer: Banner UC Health Medicaid	$52,364.42
Rate for Payer: Mercy Care Medicaid	$52,364.42

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$109,327.92

Service Code	APR-DRG 0044
Hospital Charge Code	APRDRG0041
Min. Negotiated Rate	$109,327.92
Max. Negotiated Rate	$109,327.92
Rate for Payer: AHCCCS Medicaid	$109,327.92
Rate for Payer: Allwell Medicaid	$109,327.92
Rate for Payer: AZCH Complete Medicaid	$109,327.92
Rate for Payer: Banner UC Health Medicaid	$109,327.92
Rate for Payer: Mercy Care Medicaid	$109,327.92

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$52,364.42

Service Code	APR-DRG 0042
Hospital Charge Code	APRDRG0043
Min. Negotiated Rate	$52,364.42
Max. Negotiated Rate	$52,364.42
Rate for Payer: AHCCCS Medicaid	$52,364.42
Rate for Payer: Allwell Medicaid	$52,364.42
Rate for Payer: AZCH Complete Medicaid	$52,364.42
Rate for Payer: Banner UC Health Medicaid	$52,364.42
Rate for Payer: Mercy Care Medicaid	$52,364.42

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$44,109.64

Service Code	APR-DRG 0041
Hospital Charge Code	APRDRG0043
Min. Negotiated Rate	$44,109.64
Max. Negotiated Rate	$44,109.64
Rate for Payer: AHCCCS Medicaid	$44,109.64
Rate for Payer: Allwell Medicaid	$44,109.64
Rate for Payer: AZCH Complete Medicaid	$44,109.64
Rate for Payer: Banner UC Health Medicaid	$44,109.64
Rate for Payer: Mercy Care Medicaid	$44,109.64

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$74,757.32

Service Code	APR-DRG 0043
Hospital Charge Code	APRDRG0044
Min. Negotiated Rate	$74,757.32
Max. Negotiated Rate	$74,757.32
Rate for Payer: AHCCCS Medicaid	$74,757.32
Rate for Payer: Allwell Medicaid	$74,757.32
Rate for Payer: AZCH Complete Medicaid	$74,757.32
Rate for Payer: Banner UC Health Medicaid	$74,757.32
Rate for Payer: Mercy Care Medicaid	$74,757.32

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$52,364.42

Service Code	APR-DRG 0042
Hospital Charge Code	APRDRG0042
Min. Negotiated Rate	$52,364.42
Max. Negotiated Rate	$52,364.42
Rate for Payer: AHCCCS Medicaid	$52,364.42
Rate for Payer: Allwell Medicaid	$52,364.42
Rate for Payer: AZCH Complete Medicaid	$52,364.42
Rate for Payer: Banner UC Health Medicaid	$52,364.42
Rate for Payer: Mercy Care Medicaid	$52,364.42

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$109,327.92

Service Code	APR-DRG 0044
Hospital Charge Code	APRDRG0044
Min. Negotiated Rate	$109,327.92
Max. Negotiated Rate	$109,327.92
Rate for Payer: AHCCCS Medicaid	$109,327.92
Rate for Payer: Allwell Medicaid	$109,327.92
Rate for Payer: AZCH Complete Medicaid	$109,327.92
Rate for Payer: Banner UC Health Medicaid	$109,327.92
Rate for Payer: Mercy Care Medicaid	$109,327.92

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$109,327.92

Service Code	APR-DRG 0044
Hospital Charge Code	APRDRG0042
Min. Negotiated Rate	$109,327.92
Max. Negotiated Rate	$109,327.92
Rate for Payer: AHCCCS Medicaid	$109,327.92
Rate for Payer: Allwell Medicaid	$109,327.92
Rate for Payer: AZCH Complete Medicaid	$109,327.92
Rate for Payer: Banner UC Health Medicaid	$109,327.92
Rate for Payer: Mercy Care Medicaid	$109,327.92

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$74,757.32

Service Code	APR-DRG 0043
Hospital Charge Code	APRDRG0043
Min. Negotiated Rate	$74,757.32
Max. Negotiated Rate	$74,757.32
Rate for Payer: AHCCCS Medicaid	$74,757.32
Rate for Payer: Allwell Medicaid	$74,757.32
Rate for Payer: AZCH Complete Medicaid	$74,757.32
Rate for Payer: Banner UC Health Medicaid	$74,757.32
Rate for Payer: Mercy Care Medicaid	$74,757.32

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$109,327.92

Service Code	APR-DRG 0044
Hospital Charge Code	APRDRG0043
Min. Negotiated Rate	$109,327.92
Max. Negotiated Rate	$109,327.92
Rate for Payer: AHCCCS Medicaid	$109,327.92
Rate for Payer: Allwell Medicaid	$109,327.92
Rate for Payer: AZCH Complete Medicaid	$109,327.92
Rate for Payer: Banner UC Health Medicaid	$109,327.92
Rate for Payer: Mercy Care Medicaid	$109,327.92

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$52,364.42

Service Code	APR-DRG 0042
Hospital Charge Code	APRDRG0041
Min. Negotiated Rate	$52,364.42
Max. Negotiated Rate	$52,364.42
Rate for Payer: AHCCCS Medicaid	$52,364.42
Rate for Payer: Allwell Medicaid	$52,364.42
Rate for Payer: AZCH Complete Medicaid	$52,364.42
Rate for Payer: Banner UC Health Medicaid	$52,364.42
Rate for Payer: Mercy Care Medicaid	$52,364.42

Tracheostomy With Mv >96 Hours With Extensive Procedure

Facility

IP

$44,109.64

Service Code	APR-DRG 0041
Hospital Charge Code	APRDRG0044
Min. Negotiated Rate	$44,109.64
Max. Negotiated Rate	$44,109.64
Rate for Payer: AHCCCS Medicaid	$44,109.64
Rate for Payer: Allwell Medicaid	$44,109.64
Rate for Payer: AZCH Complete Medicaid	$44,109.64
Rate for Payer: Banner UC Health Medicaid	$44,109.64
Rate for Payer: Mercy Care Medicaid	$44,109.64

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: AHCCCS Medicaid	$29,144.57
Rate for Payer: Allwell Medicaid	$29,144.57
Rate for Payer: AZCH Complete Medicaid	$29,144.57
Rate for Payer: Banner UC Health Medicaid	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: AHCCCS Medicaid	$29,144.57
Rate for Payer: Allwell Medicaid	$29,144.57
Rate for Payer: AZCH Complete Medicaid	$29,144.57
Rate for Payer: Banner UC Health Medicaid	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$39,671.18
Max. Negotiated Rate	$39,671.18
Rate for Payer: AHCCCS Medicaid	$39,671.18
Rate for Payer: Allwell Medicaid	$39,671.18
Rate for Payer: AZCH Complete Medicaid	$39,671.18
Rate for Payer: Banner UC Health Medicaid	$39,671.18
Rate for Payer: Mercy Care Medicaid	$39,671.18

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0051
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: AHCCCS Medicaid	$50,436.27
Rate for Payer: Allwell Medicaid	$50,436.27
Rate for Payer: AZCH Complete Medicaid	$50,436.27
Rate for Payer: Banner UC Health Medicaid	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: AHCCCS Medicaid	$71,753.92
Rate for Payer: Allwell Medicaid	$71,753.92
Rate for Payer: AZCH Complete Medicaid	$71,753.92
Rate for Payer: Banner UC Health Medicaid	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: AHCCCS Medicaid	$50,436.27
Rate for Payer: Allwell Medicaid	$50,436.27
Rate for Payer: AZCH Complete Medicaid	$50,436.27
Rate for Payer: Banner UC Health Medicaid	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: AHCCCS Medicaid	$71,753.92
Rate for Payer: Allwell Medicaid	$71,753.92
Rate for Payer: AZCH Complete Medicaid	$71,753.92
Rate for Payer: Banner UC Health Medicaid	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: AHCCCS Medicaid	$71,753.92
Rate for Payer: Allwell Medicaid	$71,753.92
Rate for Payer: AZCH Complete Medicaid	$71,753.92
Rate for Payer: Banner UC Health Medicaid	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92

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