Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

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

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0052
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

$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

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0053
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

$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

$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	APRDRG0054
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

$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

TRACH MASK

Facility

OP

$14.00

Hospital Charge Code	22355568
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Aetna of AZ Medicare	$3.92
Rate for Payer: Allwell Medicare	$2.10
Rate for Payer: Amerigroup Medicare	$2.10
Rate for Payer: APIPA Medicare/Medicaid	$5.23
Rate for Payer: AZCH Complete Medicare	$2.10
Rate for Payer: Banner UC Health Medicare	$2.10
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$9.52
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cigna of AZ Commercial	$9.80
Rate for Payer: Copperpoint Commercial	$3.46
Rate for Payer: Health Net of AZ Commercial	$8.40
Rate for Payer: Health Net of AZ Medicare	$3.92
Rate for Payer: Humana of AZ Medicare	$2.10
Rate for Payer: Self Pay Self Pay	$11.20
Rate for Payer: TriWest Medicare	$2.10
Rate for Payer: UnitedHealth Group of AZ Commercial	$8.16
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.52

TRACH MASK

Facility

IP

$14.00

Hospital Charge Code	22355568
Hospital Revenue Code	270
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Bisbee Police All Plans	$3.64
Rate for Payer: Cash Price	$11.20
Rate for Payer: Self Pay Self Pay	$11.20

TRACH STRAP CHILD ADULT HOOK AND L

Facility

OP

$13.00

Hospital Charge Code	23549206
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Aetna of AZ Medicare	$3.64
Rate for Payer: Allwell Medicare	$1.95
Rate for Payer: Amerigroup Medicare	$1.95
Rate for Payer: APIPA Medicare/Medicaid	$4.86
Rate for Payer: AZCH Complete Medicare	$1.95
Rate for Payer: Banner UC Health Medicare	$1.95
Rate for Payer: Bisbee Police All Plans	$3.38
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$8.84
Rate for Payer: Cash Price	$10.40
Rate for Payer: Cigna of AZ Commercial	$9.10
Rate for Payer: Copperpoint Commercial	$3.22
Rate for Payer: Health Net of AZ Commercial	$7.80
Rate for Payer: Health Net of AZ Medicare	$3.64
Rate for Payer: Humana of AZ Medicare	$1.95
Rate for Payer: Self Pay Self Pay	$10.40
Rate for Payer: TriWest Medicare	$1.95
Rate for Payer: UnitedHealth Group of AZ Commercial	$7.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$2.34

TRACH STRAP CHILD ADULT HOOK AND L

Facility

IP

$13.00

Hospital Charge Code	23549206
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Bisbee Police All Plans	$3.38
Rate for Payer: Cash Price	$10.40
Rate for Payer: Self Pay Self Pay	$10.40

traMADol 50 mg Tab [CQCH]

Facility

OP

$0.06

Service Code	NDC 904636561
Hospital Charge Code	105944199
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Aetna of AZ Medicare	$0.02
Rate for Payer: Allwell Medicare	$0.01
Rate for Payer: Amerigroup Medicare	$0.01
Rate for Payer: APIPA Medicare/Medicaid	$0.02
Rate for Payer: AZCH Complete Medicare	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.04
Rate for Payer: Cash Price	$0.05
Rate for Payer: Cigna of AZ Commercial	$0.04
Rate for Payer: Copperpoint Commercial	$0.01
Rate for Payer: Health Net of AZ Commercial	$0.04
Rate for Payer: Health Net of AZ Medicare	$0.02
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Self Pay Self Pay	$0.05
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.03
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.01

traMADol 50 mg Tab [CQCH]

Facility

IP

$0.06

Service Code	NDC 904636561
Hospital Charge Code	105944199
Hospital Revenue Code	251
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Bisbee Police All Plans	$0.02
Rate for Payer: Cash Price	$0.05
Rate for Payer: Self Pay Self Pay	$0.05

tranexamic acid 100 mg/mL 10 ml inj[CQCH]

Facility

OP

$0.21

Service Code	NDC 81284061110
Hospital Charge Code	241912544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Aetna of AZ Medicare	$0.06
Rate for Payer: Allwell Medicare	$0.03
Rate for Payer: Amerigroup Medicare	$0.03
Rate for Payer: APIPA Medicare/Medicaid	$0.08
Rate for Payer: AZCH Complete Medicare	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Bisbee Police All Plans	$0.05
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.14
Rate for Payer: Cash Price	$0.17
Rate for Payer: Cigna of AZ Commercial	$0.14
Rate for Payer: Copperpoint Commercial	$0.05
Rate for Payer: Health Net of AZ Commercial	$0.13
Rate for Payer: Health Net of AZ Medicare	$0.06
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Self Pay Self Pay	$0.17
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.12
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.04

tranexamic acid 100 mg/mL 10 ml inj[CQCH]

Facility

IP

$0.21

Service Code	NDC 81284061110
Hospital Charge Code	241912544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Bisbee Police All Plans	$0.05
Rate for Payer: Cash Price	$0.17
Rate for Payer: Self Pay Self Pay	$0.17

tranexamic acid 10 mg/mL-NaCl 0.7% Sol[CQCH]

Facility

IP

$0.01

Service Code	NDC 51754010803
Hospital Charge Code	197259247
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Self Pay Self Pay	$0.01

tranexamic acid 10 mg/mL-NaCl 0.7% Sol[CQCH]

Facility

OP

$0.01

Service Code	NDC 51754010803
Hospital Charge Code	197259247
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Aetna of AZ Medicare	$0.00
Rate for Payer: Allwell Medicare	$0.00
Rate for Payer: Amerigroup Medicare	$0.00
Rate for Payer: APIPA Medicare/Medicaid	$0.00
Rate for Payer: AZCH Complete Medicare	$0.00
Rate for Payer: Banner UC Health Medicare	$0.00
Rate for Payer: Bisbee Police All Plans	$0.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.01
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of AZ Commercial	$0.01
Rate for Payer: Copperpoint Commercial	$0.00
Rate for Payer: Health Net of AZ Commercial	$0.01
Rate for Payer: Health Net of AZ Medicare	$0.00
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Self Pay Self Pay	$0.01
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.01
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.00

Transferrin LC

Facility

OP

$199.00

Service Code	CPT 84466
Hospital Charge Code	1909569
Hospital Revenue Code	301
Min. Negotiated Rate	$12.76
Max. Negotiated Rate	$179.10
Rate for Payer: Aetna of AZ Commercial	$179.10
Rate for Payer: Aetna of AZ Medicare	$55.72
Rate for Payer: AHCCCS Medicaid	$12.76
Rate for Payer: Allwell Medicaid	$12.76
Rate for Payer: Allwell Medicare	$29.85
Rate for Payer: Amerigroup Medicare	$29.85
Rate for Payer: APIPA Medicare/Medicaid	$74.33
Rate for Payer: AZCH Complete Medicaid	$12.76
Rate for Payer: AZCH Complete Medicare	$29.85
Rate for Payer: Banner UC Health Medicaid	$12.76
Rate for Payer: Banner UC Health Medicare	$29.85
Rate for Payer: Bisbee Police All Plans	$51.74
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$135.32
Rate for Payer: Cash Price	$159.20
Rate for Payer: Cash Price	$159.20
Rate for Payer: Cigna of AZ Commercial	$129.35
Rate for Payer: Copperpoint Commercial	$49.25
Rate for Payer: Health Net of AZ Commercial	$119.40
Rate for Payer: Health Net of AZ Medicare	$55.72
Rate for Payer: Humana of AZ Medicare	$29.85
Rate for Payer: Mercy Care Medicaid	$12.76
Rate for Payer: Self Pay Self Pay	$159.20
Rate for Payer: TriWest Medicare	$29.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$116.02
Rate for Payer: UnitedHealth Group of AZ Medicare	$35.82

Transferrin LC

Facility

IP

$199.00

Service Code	CPT 84466
Hospital Charge Code	1909569
Hospital Revenue Code	301
Min. Negotiated Rate	$51.74
Max. Negotiated Rate	$179.10
Rate for Payer: Aetna of AZ Commercial	$179.10
Rate for Payer: Bisbee Police All Plans	$51.74
Rate for Payer: Cash Price	$159.20
Rate for Payer: Self Pay Self Pay	$159.20

Transient Ischemia

Facility

IP

$11,383.72

Service Code	APR-DRG 0474
Hospital Charge Code	APRDRG0474
Min. Negotiated Rate	$11,383.72
Max. Negotiated Rate	$11,383.72
Rate for Payer: AHCCCS Medicaid	$11,383.72
Rate for Payer: Allwell Medicaid	$11,383.72
Rate for Payer: AZCH Complete Medicaid	$11,383.72
Rate for Payer: Banner UC Health Medicaid	$11,383.72
Rate for Payer: Mercy Care Medicaid	$11,383.72

Transient Ischemia

Facility

IP

$6,159.69

Service Code	APR-DRG 0473
Hospital Charge Code	APRDRG0474
Min. Negotiated Rate	$6,159.69
Max. Negotiated Rate	$6,159.69
Rate for Payer: AHCCCS Medicaid	$6,159.69
Rate for Payer: Allwell Medicaid	$6,159.69
Rate for Payer: AZCH Complete Medicaid	$6,159.69
Rate for Payer: Banner UC Health Medicaid	$6,159.69
Rate for Payer: Mercy Care Medicaid	$6,159.69

Transient Ischemia

Facility

IP

$6,159.69

Service Code	APR-DRG 0473
Hospital Charge Code	APRDRG0473
Min. Negotiated Rate	$6,159.69
Max. Negotiated Rate	$6,159.69
Rate for Payer: AHCCCS Medicaid	$6,159.69
Rate for Payer: Allwell Medicaid	$6,159.69
Rate for Payer: AZCH Complete Medicaid	$6,159.69
Rate for Payer: Banner UC Health Medicaid	$6,159.69
Rate for Payer: Mercy Care Medicaid	$6,159.69

Transient Ischemia

Facility

IP

$4,300.98

Service Code	APR-DRG 0471
Hospital Charge Code	APRDRG0472
Min. Negotiated Rate	$4,300.98
Max. Negotiated Rate	$4,300.98
Rate for Payer: AHCCCS Medicaid	$4,300.98
Rate for Payer: Allwell Medicaid	$4,300.98
Rate for Payer: AZCH Complete Medicaid	$4,300.98
Rate for Payer: Banner UC Health Medicaid	$4,300.98
Rate for Payer: Mercy Care Medicaid	$4,300.98

Transient Ischemia

Facility

IP

$11,383.72

Service Code	APR-DRG 0474
Hospital Charge Code	APRDRG0472
Min. Negotiated Rate	$11,383.72
Max. Negotiated Rate	$11,383.72
Rate for Payer: AHCCCS Medicaid	$11,383.72
Rate for Payer: Allwell Medicaid	$11,383.72
Rate for Payer: AZCH Complete Medicaid	$11,383.72
Rate for Payer: Banner UC Health Medicaid	$11,383.72
Rate for Payer: Mercy Care Medicaid	$11,383.72

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