|
TI6 DIGITAL SCREW 2MMX40MM
|
Facility
|
IP
|
$2,549.00
|
|
| Hospital Charge Code |
27567203
|
|
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 LOW PROFILE 3.0MMX22MM BONE SCREW
|
Facility
|
OP
|
$1,915.00
|
|
| Hospital Charge Code |
27519878
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$306.40 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Aetna of AZ Medicare |
$536.20
|
| Rate for Payer: Allwell Medicare |
$306.40
|
| Rate for Payer: Amerigroup Medicare |
$306.40
|
| Rate for Payer: APIPA Medicare/Medicaid |
$715.25
|
| Rate for Payer: AZCH Complete Medicare |
$306.40
|
| Rate for Payer: Banner UC Health Medicare |
$306.40
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,302.20
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,340.50
|
| Rate for Payer: Copperpoint Commercial |
$473.96
|
| Rate for Payer: Health Net of AZ Commercial |
$1,149.00
|
| Rate for Payer: Health Net of AZ Medicare |
$536.20
|
| Rate for Payer: Humana of AZ Medicare |
$306.40
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
| Rate for Payer: TriWest Medicare |
$306.40
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,116.44
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$344.70
|
|
|
TI6 LOW PROFILE 3.0MMX22MM BONE SCREW
|
Facility
|
IP
|
$1,915.00
|
|
| Hospital Charge Code |
27519878
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.90 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
|
|
TI6 LOW PROFILE 3.0MM X 24MM BONE SCREW
|
Facility
|
IP
|
$1,196.00
|
|
| Hospital Charge Code |
24127796
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$310.96 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
|
|
TI6 LOW PROFILE 3.0MM X 24MM BONE SCREW
|
Facility
|
OP
|
$1,196.00
|
|
| Hospital Charge Code |
24127796
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Aetna of AZ Medicare |
$334.88
|
| Rate for Payer: Allwell Medicare |
$191.36
|
| Rate for Payer: Amerigroup Medicare |
$191.36
|
| Rate for Payer: APIPA Medicare/Medicaid |
$446.71
|
| Rate for Payer: AZCH Complete Medicare |
$191.36
|
| Rate for Payer: Banner UC Health Medicare |
$191.36
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$813.28
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cigna of AZ Commercial |
$837.20
|
| Rate for Payer: Copperpoint Commercial |
$296.01
|
| Rate for Payer: Health Net of AZ Commercial |
$717.60
|
| Rate for Payer: Health Net of AZ Medicare |
$334.88
|
| Rate for Payer: Humana of AZ Medicare |
$191.36
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
| Rate for Payer: TriWest Medicare |
$191.36
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$697.27
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$215.28
|
|
|
TI6 LOW PROFILE 3.0MM X 28MM BONE SCREW
|
Facility
|
IP
|
$1,196.00
|
|
| Hospital Charge Code |
24127794
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$310.96 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
|
|
TI6 LOW PROFILE 3.0MM X 28MM BONE SCREW
|
Facility
|
OP
|
$1,196.00
|
|
| Hospital Charge Code |
24127794
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Aetna of AZ Medicare |
$334.88
|
| Rate for Payer: Allwell Medicare |
$191.36
|
| Rate for Payer: Amerigroup Medicare |
$191.36
|
| Rate for Payer: APIPA Medicare/Medicaid |
$446.71
|
| Rate for Payer: AZCH Complete Medicare |
$191.36
|
| Rate for Payer: Banner UC Health Medicare |
$191.36
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$813.28
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cigna of AZ Commercial |
$837.20
|
| Rate for Payer: Copperpoint Commercial |
$296.01
|
| Rate for Payer: Health Net of AZ Commercial |
$717.60
|
| Rate for Payer: Health Net of AZ Medicare |
$334.88
|
| Rate for Payer: Humana of AZ Medicare |
$191.36
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
| Rate for Payer: TriWest Medicare |
$191.36
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$697.27
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$215.28
|
|
|
TI6 LOW PROFILE 3.99MMX18MM BONE SCREW
|
Facility
|
IP
|
$1,196.00
|
|
| Hospital Charge Code |
24127772
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$310.96 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
|
|
TI6 LOW PROFILE 3.99MMX18MM BONE SCREW
|
Facility
|
OP
|
$1,196.00
|
|
| Hospital Charge Code |
24127772
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna of AZ Commercial |
$1,076.40
|
| Rate for Payer: Aetna of AZ Medicare |
$334.88
|
| Rate for Payer: Allwell Medicare |
$191.36
|
| Rate for Payer: Amerigroup Medicare |
$191.36
|
| Rate for Payer: APIPA Medicare/Medicaid |
$446.71
|
| Rate for Payer: AZCH Complete Medicare |
$191.36
|
| Rate for Payer: Banner UC Health Medicare |
$191.36
|
| Rate for Payer: Bisbee Police All Plans |
$310.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$813.28
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cigna of AZ Commercial |
$837.20
|
| Rate for Payer: Copperpoint Commercial |
$296.01
|
| Rate for Payer: Health Net of AZ Commercial |
$717.60
|
| Rate for Payer: Health Net of AZ Medicare |
$334.88
|
| Rate for Payer: Humana of AZ Medicare |
$191.36
|
| Rate for Payer: Self Pay Self Pay |
$956.80
|
| Rate for Payer: TriWest Medicare |
$191.36
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$697.27
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$215.28
|
|
|
TI6 LOW PROFILE 3MMX16MM BONE SCREW
|
Facility
|
IP
|
$1,915.00
|
|
| Hospital Charge Code |
24358104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.90 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
|
|
TI6 LOW PROFILE 3MMX16MM BONE SCREW
|
Facility
|
OP
|
$1,915.00
|
|
| Hospital Charge Code |
24358104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$306.40 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Aetna of AZ Medicare |
$536.20
|
| Rate for Payer: Allwell Medicare |
$306.40
|
| Rate for Payer: Amerigroup Medicare |
$306.40
|
| Rate for Payer: APIPA Medicare/Medicaid |
$715.25
|
| Rate for Payer: AZCH Complete Medicare |
$306.40
|
| Rate for Payer: Banner UC Health Medicare |
$306.40
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,302.20
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,340.50
|
| Rate for Payer: Copperpoint Commercial |
$473.96
|
| Rate for Payer: Health Net of AZ Commercial |
$1,149.00
|
| Rate for Payer: Health Net of AZ Medicare |
$536.20
|
| Rate for Payer: Humana of AZ Medicare |
$306.40
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
| Rate for Payer: TriWest Medicare |
$306.40
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,116.44
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$344.70
|
|
|
TI6 LOW PROFILE 3MMX20MM BONE SCREW
|
Facility
|
IP
|
$1,915.00
|
|
| Hospital Charge Code |
24358110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.90 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
|
|
TI6 LOW PROFILE 3MMX20MM BONE SCREW
|
Facility
|
OP
|
$1,915.00
|
|
| Hospital Charge Code |
24358110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$306.40 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Aetna of AZ Medicare |
$536.20
|
| Rate for Payer: Allwell Medicare |
$306.40
|
| Rate for Payer: Amerigroup Medicare |
$306.40
|
| Rate for Payer: APIPA Medicare/Medicaid |
$715.25
|
| Rate for Payer: AZCH Complete Medicare |
$306.40
|
| Rate for Payer: Banner UC Health Medicare |
$306.40
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,302.20
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,340.50
|
| Rate for Payer: Copperpoint Commercial |
$473.96
|
| Rate for Payer: Health Net of AZ Commercial |
$1,149.00
|
| Rate for Payer: Health Net of AZ Medicare |
$536.20
|
| Rate for Payer: Humana of AZ Medicare |
$306.40
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
| Rate for Payer: TriWest Medicare |
$306.40
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,116.44
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$344.70
|
|
|
TI6 LOW PROFILE 3X14 BONE SCREW
|
Facility
|
IP
|
$1,915.00
|
|
| Hospital Charge Code |
27738159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.90 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
|
|
TI6 LOW PROFILE 3X14 BONE SCREW
|
Facility
|
OP
|
$1,915.00
|
|
| Hospital Charge Code |
27738159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$306.40 |
| Max. Negotiated Rate |
$1,723.50 |
| Rate for Payer: Aetna of AZ Commercial |
$1,723.50
|
| Rate for Payer: Aetna of AZ Medicare |
$536.20
|
| Rate for Payer: Allwell Medicare |
$306.40
|
| Rate for Payer: Amerigroup Medicare |
$306.40
|
| Rate for Payer: APIPA Medicare/Medicaid |
$715.25
|
| Rate for Payer: AZCH Complete Medicare |
$306.40
|
| Rate for Payer: Banner UC Health Medicare |
$306.40
|
| Rate for Payer: Bisbee Police All Plans |
$497.90
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$1,302.20
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cigna of AZ Commercial |
$1,340.50
|
| Rate for Payer: Copperpoint Commercial |
$473.96
|
| Rate for Payer: Health Net of AZ Commercial |
$1,149.00
|
| Rate for Payer: Health Net of AZ Medicare |
$536.20
|
| Rate for Payer: Humana of AZ Medicare |
$306.40
|
| Rate for Payer: Self Pay Self Pay |
$1,532.00
|
| Rate for Payer: TriWest Medicare |
$306.40
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$1,116.44
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$344.70
|
|
|
TI6 QUICKSNAP 2.0MM S 14MM SCREW
|
Facility
|
IP
|
$1,377.00
|
|
| Hospital Charge Code |
24127775
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
|
|
TI6 QUICKSNAP 2.0MM S 14MM SCREW
|
Facility
|
OP
|
$1,377.00
|
|
| Hospital Charge Code |
24127775
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$220.32 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Aetna of AZ Medicare |
$385.56
|
| Rate for Payer: Allwell Medicare |
$220.32
|
| Rate for Payer: Amerigroup Medicare |
$220.32
|
| Rate for Payer: APIPA Medicare/Medicaid |
$514.31
|
| Rate for Payer: AZCH Complete Medicare |
$220.32
|
| Rate for Payer: Banner UC Health Medicare |
$220.32
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$936.36
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cigna of AZ Commercial |
$963.90
|
| Rate for Payer: Copperpoint Commercial |
$340.81
|
| Rate for Payer: Health Net of AZ Commercial |
$826.20
|
| Rate for Payer: Health Net of AZ Medicare |
$385.56
|
| Rate for Payer: Humana of AZ Medicare |
$220.32
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
| Rate for Payer: TriWest Medicare |
$220.32
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$802.79
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$247.86
|
|
|
TI6 QUICKSNAP 2.0MM X 10MM SCREW
|
Facility
|
IP
|
$1,377.00
|
|
| Hospital Charge Code |
24127795
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
|
|
TI6 QUICKSNAP 2.0MM X 10MM SCREW
|
Facility
|
OP
|
$1,377.00
|
|
| Hospital Charge Code |
24127795
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$220.32 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Aetna of AZ Medicare |
$385.56
|
| Rate for Payer: Allwell Medicare |
$220.32
|
| Rate for Payer: Amerigroup Medicare |
$220.32
|
| Rate for Payer: APIPA Medicare/Medicaid |
$514.31
|
| Rate for Payer: AZCH Complete Medicare |
$220.32
|
| Rate for Payer: Banner UC Health Medicare |
$220.32
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$936.36
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cigna of AZ Commercial |
$963.90
|
| Rate for Payer: Copperpoint Commercial |
$340.81
|
| Rate for Payer: Health Net of AZ Commercial |
$826.20
|
| Rate for Payer: Health Net of AZ Medicare |
$385.56
|
| Rate for Payer: Humana of AZ Medicare |
$220.32
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
| Rate for Payer: TriWest Medicare |
$220.32
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$802.79
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$247.86
|
|
|
TI6 QUICKSNAP 2.0MM X 11MM SCREW
|
Facility
|
IP
|
$1,377.00
|
|
| Hospital Charge Code |
24127787
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
|
|
TI6 QUICKSNAP 2.0MM X 11MM SCREW
|
Facility
|
OP
|
$1,377.00
|
|
| Hospital Charge Code |
24127787
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$220.32 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna of AZ Commercial |
$1,239.30
|
| Rate for Payer: Aetna of AZ Medicare |
$385.56
|
| Rate for Payer: Allwell Medicare |
$220.32
|
| Rate for Payer: Amerigroup Medicare |
$220.32
|
| Rate for Payer: APIPA Medicare/Medicaid |
$514.31
|
| Rate for Payer: AZCH Complete Medicare |
$220.32
|
| Rate for Payer: Banner UC Health Medicare |
$220.32
|
| Rate for Payer: Bisbee Police All Plans |
$358.02
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$936.36
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cigna of AZ Commercial |
$963.90
|
| Rate for Payer: Copperpoint Commercial |
$340.81
|
| Rate for Payer: Health Net of AZ Commercial |
$826.20
|
| Rate for Payer: Health Net of AZ Medicare |
$385.56
|
| Rate for Payer: Humana of AZ Medicare |
$220.32
|
| Rate for Payer: Self Pay Self Pay |
$1,101.60
|
| Rate for Payer: TriWest Medicare |
$220.32
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$802.79
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$247.86
|
|
|
TI6 TC SERIES KWIRE 3.0/4.0 (1.1X120MM)
|
Facility
|
IP
|
$98.00
|
|
| Hospital Charge Code |
24127773
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna of AZ Commercial |
$88.20
|
| Rate for Payer: Bisbee Police All Plans |
$25.48
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Self Pay Self Pay |
$78.40
|
|
|
TI6 TC SERIES KWIRE 3.0/4.0 (1.1X120MM)
|
Facility
|
OP
|
$98.00
|
|
| Hospital Charge Code |
24127773
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna of AZ Commercial |
$88.20
|
| Rate for Payer: Aetna of AZ Medicare |
$27.44
|
| Rate for Payer: Allwell Medicare |
$15.68
|
| Rate for Payer: Amerigroup Medicare |
$15.68
|
| Rate for Payer: APIPA Medicare/Medicaid |
$36.60
|
| Rate for Payer: AZCH Complete Medicare |
$15.68
|
| Rate for Payer: Banner UC Health Medicare |
$15.68
|
| Rate for Payer: Bisbee Police All Plans |
$25.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$66.64
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cigna of AZ Commercial |
$68.60
|
| Rate for Payer: Copperpoint Commercial |
$24.25
|
| Rate for Payer: Health Net of AZ Commercial |
$58.80
|
| Rate for Payer: Health Net of AZ Medicare |
$27.44
|
| Rate for Payer: Humana of AZ Medicare |
$15.68
|
| Rate for Payer: Self Pay Self Pay |
$78.40
|
| Rate for Payer: TriWest Medicare |
$15.68
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$57.13
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.64
|
|
|
TI6 TH SERIES KWIRE 0.80 x 70MM
|
Facility
|
IP
|
$98.00
|
|
| Hospital Charge Code |
24358108
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna of AZ Commercial |
$88.20
|
| Rate for Payer: Bisbee Police All Plans |
$25.48
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Self Pay Self Pay |
$78.40
|
|
|
TI6 TH SERIES KWIRE 0.80 x 70MM
|
Facility
|
OP
|
$98.00
|
|
| Hospital Charge Code |
24358108
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna of AZ Commercial |
$88.20
|
| Rate for Payer: Aetna of AZ Medicare |
$27.44
|
| Rate for Payer: Allwell Medicare |
$15.68
|
| Rate for Payer: Amerigroup Medicare |
$15.68
|
| Rate for Payer: APIPA Medicare/Medicaid |
$36.60
|
| Rate for Payer: AZCH Complete Medicare |
$15.68
|
| Rate for Payer: Banner UC Health Medicare |
$15.68
|
| Rate for Payer: Bisbee Police All Plans |
$25.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$66.64
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cigna of AZ Commercial |
$68.60
|
| Rate for Payer: Copperpoint Commercial |
$24.25
|
| Rate for Payer: Health Net of AZ Commercial |
$58.80
|
| Rate for Payer: Health Net of AZ Medicare |
$27.44
|
| Rate for Payer: Humana of AZ Medicare |
$15.68
|
| Rate for Payer: Self Pay Self Pay |
$78.40
|
| Rate for Payer: TriWest Medicare |
$15.68
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$57.13
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$17.64
|
|