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Charge Type Setting Price  
Service Code APR-DRG 4464
Hospital Charge Code APRDRG4462
Min. Negotiated Rate $20,260.64
Max. Negotiated Rate $20,260.64
Rate for Payer: AHCCCS Medicaid $20,260.64
Rate for Payer: Allwell Medicaid $20,260.64
Rate for Payer: AZCH Complete Medicaid $20,260.64
Rate for Payer: Banner UC Health Medicaid $20,260.64
Rate for Payer: Mercy Care Medicaid $20,260.64
Service Code APR-DRG 4463
Hospital Charge Code APRDRG4464
Min. Negotiated Rate $11,218.19
Max. Negotiated Rate $11,218.19
Rate for Payer: AHCCCS Medicaid $11,218.19
Rate for Payer: Allwell Medicaid $11,218.19
Rate for Payer: AZCH Complete Medicaid $11,218.19
Rate for Payer: Banner UC Health Medicaid $11,218.19
Rate for Payer: Mercy Care Medicaid $11,218.19
Service Code APR-DRG 4463
Hospital Charge Code APRDRG4462
Min. Negotiated Rate $11,218.19
Max. Negotiated Rate $11,218.19
Rate for Payer: AHCCCS Medicaid $11,218.19
Rate for Payer: Allwell Medicaid $11,218.19
Rate for Payer: AZCH Complete Medicaid $11,218.19
Rate for Payer: Banner UC Health Medicaid $11,218.19
Rate for Payer: Mercy Care Medicaid $11,218.19
Service Code APR-DRG 4462
Hospital Charge Code APRDRG4462
Min. Negotiated Rate $6,668.21
Max. Negotiated Rate $6,668.21
Rate for Payer: AHCCCS Medicaid $6,668.21
Rate for Payer: Allwell Medicaid $6,668.21
Rate for Payer: AZCH Complete Medicaid $6,668.21
Rate for Payer: Banner UC Health Medicaid $6,668.21
Rate for Payer: Mercy Care Medicaid $6,668.21
Service Code APR-DRG 4464
Hospital Charge Code APRDRG4464
Min. Negotiated Rate $20,260.64
Max. Negotiated Rate $20,260.64
Rate for Payer: AHCCCS Medicaid $20,260.64
Rate for Payer: Allwell Medicaid $20,260.64
Rate for Payer: AZCH Complete Medicaid $20,260.64
Rate for Payer: Banner UC Health Medicaid $20,260.64
Rate for Payer: Mercy Care Medicaid $20,260.64
Service Code APR-DRG 4463
Hospital Charge Code APRDRG4463
Min. Negotiated Rate $11,218.19
Max. Negotiated Rate $11,218.19
Rate for Payer: AHCCCS Medicaid $11,218.19
Rate for Payer: Allwell Medicaid $11,218.19
Rate for Payer: AZCH Complete Medicaid $11,218.19
Rate for Payer: Banner UC Health Medicaid $11,218.19
Rate for Payer: Mercy Care Medicaid $11,218.19
Service Code APR-DRG 4462
Hospital Charge Code APRDRG4461
Min. Negotiated Rate $6,668.21
Max. Negotiated Rate $6,668.21
Rate for Payer: AHCCCS Medicaid $6,668.21
Rate for Payer: Allwell Medicaid $6,668.21
Rate for Payer: AZCH Complete Medicaid $6,668.21
Rate for Payer: Banner UC Health Medicaid $6,668.21
Rate for Payer: Mercy Care Medicaid $6,668.21
Service Code APR-DRG 4464
Hospital Charge Code APRDRG4463
Min. Negotiated Rate $20,260.64
Max. Negotiated Rate $20,260.64
Rate for Payer: AHCCCS Medicaid $20,260.64
Rate for Payer: Allwell Medicaid $20,260.64
Rate for Payer: AZCH Complete Medicaid $20,260.64
Rate for Payer: Banner UC Health Medicaid $20,260.64
Rate for Payer: Mercy Care Medicaid $20,260.64
Service Code APR-DRG 4461
Hospital Charge Code APRDRG4462
Min. Negotiated Rate $5,397.97
Max. Negotiated Rate $5,397.97
Rate for Payer: AHCCCS Medicaid $5,397.97
Rate for Payer: Allwell Medicaid $5,397.97
Rate for Payer: AZCH Complete Medicaid $5,397.97
Rate for Payer: Banner UC Health Medicaid $5,397.97
Rate for Payer: Mercy Care Medicaid $5,397.97
Service Code APR-DRG 4464
Hospital Charge Code APRDRG4461
Min. Negotiated Rate $20,260.64
Max. Negotiated Rate $20,260.64
Rate for Payer: AHCCCS Medicaid $20,260.64
Rate for Payer: Allwell Medicaid $20,260.64
Rate for Payer: AZCH Complete Medicaid $20,260.64
Rate for Payer: Banner UC Health Medicaid $20,260.64
Rate for Payer: Mercy Care Medicaid $20,260.64
Service Code APR-DRG 4462
Hospital Charge Code APRDRG4463
Min. Negotiated Rate $6,668.21
Max. Negotiated Rate $6,668.21
Rate for Payer: AHCCCS Medicaid $6,668.21
Rate for Payer: Allwell Medicaid $6,668.21
Rate for Payer: AZCH Complete Medicaid $6,668.21
Rate for Payer: Banner UC Health Medicaid $6,668.21
Rate for Payer: Mercy Care Medicaid $6,668.21
Service Code APR-DRG 4461
Hospital Charge Code APRDRG4463
Min. Negotiated Rate $5,397.97
Max. Negotiated Rate $5,397.97
Rate for Payer: AHCCCS Medicaid $5,397.97
Rate for Payer: Allwell Medicaid $5,397.97
Rate for Payer: AZCH Complete Medicaid $5,397.97
Rate for Payer: Banner UC Health Medicaid $5,397.97
Rate for Payer: Mercy Care Medicaid $5,397.97
Service Code APR-DRG 4463
Hospital Charge Code APRDRG4461
Min. Negotiated Rate $11,218.19
Max. Negotiated Rate $11,218.19
Rate for Payer: AHCCCS Medicaid $11,218.19
Rate for Payer: Allwell Medicaid $11,218.19
Rate for Payer: AZCH Complete Medicaid $11,218.19
Rate for Payer: Banner UC Health Medicaid $11,218.19
Rate for Payer: Mercy Care Medicaid $11,218.19
Service Code APR-DRG 4461
Hospital Charge Code APRDRG4461
Min. Negotiated Rate $5,397.97
Max. Negotiated Rate $5,397.97
Rate for Payer: AHCCCS Medicaid $5,397.97
Rate for Payer: Allwell Medicaid $5,397.97
Rate for Payer: AZCH Complete Medicaid $5,397.97
Rate for Payer: Banner UC Health Medicaid $5,397.97
Rate for Payer: Mercy Care Medicaid $5,397.97
Service Code APR-DRG 4461
Hospital Charge Code APRDRG4464
Min. Negotiated Rate $5,397.97
Max. Negotiated Rate $5,397.97
Rate for Payer: AHCCCS Medicaid $5,397.97
Rate for Payer: Allwell Medicaid $5,397.97
Rate for Payer: AZCH Complete Medicaid $5,397.97
Rate for Payer: Banner UC Health Medicaid $5,397.97
Rate for Payer: Mercy Care Medicaid $5,397.97
Service Code CPT 53265
Hospital Charge Code 27291801
Hospital Revenue Code 360
Min. Negotiated Rate $152.85
Max. Negotiated Rate $3,373.00
Rate for Payer: Aetna of AZ Commercial $917.10
Rate for Payer: Aetna of AZ Medicare $285.32
Rate for Payer: AHCCCS Medicaid $2,599.84
Rate for Payer: Allwell Medicaid $2,599.84
Rate for Payer: Allwell Medicare $152.85
Rate for Payer: Amerigroup Medicare $152.85
Rate for Payer: APIPA Medicare/Medicaid $380.60
Rate for Payer: AZCH Complete Medicaid $2,599.84
Rate for Payer: AZCH Complete Medicare $152.85
Rate for Payer: Banner UC Health Medicaid $2,599.84
Rate for Payer: Banner UC Health Medicare $152.85
Rate for Payer: Bisbee Police All Plans $264.94
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $692.92
Rate for Payer: Cash Price $815.20
Rate for Payer: Cash Price $815.20
Rate for Payer: Cigna of AZ Commercial $509.50
Rate for Payer: Copperpoint Commercial $252.20
Rate for Payer: Health Net of AZ Commercial $611.40
Rate for Payer: Health Net of AZ Medicare $285.32
Rate for Payer: Humana of AZ Medicare $152.85
Rate for Payer: Mercy Care Medicaid $2,599.84
Rate for Payer: Self Pay Self Pay $815.20
Rate for Payer: TriWest Medicare $152.85
Rate for Payer: UnitedHealth Group of AZ Commercial $3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare $183.42
Service Code CPT 53265
Hospital Charge Code 27291801
Hospital Revenue Code 360
Min. Negotiated Rate $264.94
Max. Negotiated Rate $917.10
Rate for Payer: Aetna of AZ Commercial $917.10
Rate for Payer: Bisbee Police All Plans $264.94
Rate for Payer: Cash Price $815.20
Rate for Payer: Self Pay Self Pay $815.20
Service Code CPT 53230
Hospital Charge Code 27332470
Hospital Revenue Code 360
Min. Negotiated Rate $495.30
Max. Negotiated Rate $6,400.16
Rate for Payer: Aetna of AZ Commercial $2,971.80
Rate for Payer: Aetna of AZ Medicare $924.56
Rate for Payer: AHCCCS Medicaid $6,400.16
Rate for Payer: Allwell Medicaid $6,400.16
Rate for Payer: Allwell Medicare $495.30
Rate for Payer: Amerigroup Medicare $495.30
Rate for Payer: APIPA Medicare/Medicaid $1,233.30
Rate for Payer: AZCH Complete Medicaid $6,400.16
Rate for Payer: AZCH Complete Medicare $495.30
Rate for Payer: Banner UC Health Medicaid $6,400.16
Rate for Payer: Banner UC Health Medicare $495.30
Rate for Payer: Bisbee Police All Plans $858.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $2,245.36
Rate for Payer: Cash Price $2,641.60
Rate for Payer: Cash Price $2,641.60
Rate for Payer: Cigna of AZ Commercial $1,651.00
Rate for Payer: Copperpoint Commercial $817.24
Rate for Payer: Health Net of AZ Commercial $1,981.20
Rate for Payer: Health Net of AZ Medicare $924.56
Rate for Payer: Humana of AZ Medicare $495.30
Rate for Payer: Mercy Care Medicaid $6,400.16
Rate for Payer: Self Pay Self Pay $2,641.60
Rate for Payer: TriWest Medicare $495.30
Rate for Payer: UnitedHealth Group of AZ Commercial $3,914.00
Rate for Payer: UnitedHealth Group of AZ Medicare $594.36
Service Code CPT 53230
Hospital Charge Code 27332470
Hospital Revenue Code 360
Min. Negotiated Rate $858.52
Max. Negotiated Rate $2,971.80
Rate for Payer: Aetna of AZ Commercial $2,971.80
Rate for Payer: Bisbee Police All Plans $858.52
Rate for Payer: Cash Price $2,641.60
Rate for Payer: Self Pay Self Pay $2,641.60
Service Code CPT 53260
Hospital Charge Code 27267825
Hospital Revenue Code 360
Min. Negotiated Rate $147.30
Max. Negotiated Rate $4,460.70
Rate for Payer: Aetna of AZ Commercial $883.80
Rate for Payer: Aetna of AZ Medicare $274.96
Rate for Payer: AHCCCS Medicaid $4,460.70
Rate for Payer: Allwell Medicaid $4,460.70
Rate for Payer: Allwell Medicare $147.30
Rate for Payer: Amerigroup Medicare $147.30
Rate for Payer: APIPA Medicare/Medicaid $366.78
Rate for Payer: AZCH Complete Medicaid $4,460.70
Rate for Payer: AZCH Complete Medicare $147.30
Rate for Payer: Banner UC Health Medicaid $4,460.70
Rate for Payer: Banner UC Health Medicare $147.30
Rate for Payer: Bisbee Police All Plans $255.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $667.76
Rate for Payer: Cash Price $785.60
Rate for Payer: Cash Price $785.60
Rate for Payer: Cigna of AZ Commercial $491.00
Rate for Payer: Copperpoint Commercial $243.04
Rate for Payer: Health Net of AZ Commercial $589.20
Rate for Payer: Health Net of AZ Medicare $274.96
Rate for Payer: Humana of AZ Medicare $147.30
Rate for Payer: Mercy Care Medicaid $4,460.70
Rate for Payer: Self Pay Self Pay $785.60
Rate for Payer: TriWest Medicare $147.30
Rate for Payer: UnitedHealth Group of AZ Commercial $3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare $176.76
Service Code CPT 53260
Hospital Charge Code 27267825
Hospital Revenue Code 360
Min. Negotiated Rate $255.32
Max. Negotiated Rate $883.80
Rate for Payer: Aetna of AZ Commercial $883.80
Rate for Payer: Bisbee Police All Plans $255.32
Rate for Payer: Cash Price $785.60
Rate for Payer: Self Pay Self Pay $785.60
Service Code CPT 51727
Hospital Charge Code 27281883
Hospital Revenue Code 360
Min. Negotiated Rate $514.54
Max. Negotiated Rate $1,781.10
Rate for Payer: Aetna of AZ Commercial $1,781.10
Rate for Payer: Bisbee Police All Plans $514.54
Rate for Payer: Cash Price $1,583.20
Rate for Payer: Self Pay Self Pay $1,583.20
Service Code CPT 51727
Hospital Charge Code 27281883
Hospital Revenue Code 360
Min. Negotiated Rate $296.85
Max. Negotiated Rate $2,507.00
Rate for Payer: Aetna of AZ Commercial $1,781.10
Rate for Payer: Aetna of AZ Medicare $554.12
Rate for Payer: AHCCCS Medicaid $833.42
Rate for Payer: Allwell Medicaid $833.42
Rate for Payer: Allwell Medicare $296.85
Rate for Payer: Amerigroup Medicare $296.85
Rate for Payer: APIPA Medicare/Medicaid $739.16
Rate for Payer: AZCH Complete Medicaid $833.42
Rate for Payer: AZCH Complete Medicare $296.85
Rate for Payer: Banner UC Health Medicaid $833.42
Rate for Payer: Banner UC Health Medicare $296.85
Rate for Payer: Bisbee Police All Plans $514.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,345.72
Rate for Payer: Cash Price $1,583.20
Rate for Payer: Cash Price $1,583.20
Rate for Payer: Cigna of AZ Commercial $989.50
Rate for Payer: Copperpoint Commercial $489.80
Rate for Payer: Health Net of AZ Commercial $1,187.40
Rate for Payer: Health Net of AZ Medicare $554.12
Rate for Payer: Humana of AZ Medicare $296.85
Rate for Payer: Mercy Care Medicaid $833.42
Rate for Payer: Self Pay Self Pay $1,583.20
Rate for Payer: TriWest Medicare $296.85
Rate for Payer: UnitedHealth Group of AZ Commercial $2,507.00
Rate for Payer: UnitedHealth Group of AZ Medicare $356.22
Service Code CPT 53275
Hospital Charge Code 27267826
Hospital Revenue Code 360
Min. Negotiated Rate $369.98
Max. Negotiated Rate $1,280.70
Rate for Payer: Aetna of AZ Commercial $1,280.70
Rate for Payer: Bisbee Police All Plans $369.98
Rate for Payer: Cash Price $1,138.40
Rate for Payer: Self Pay Self Pay $1,138.40
Service Code CPT 53275
Hospital Charge Code 27267826
Hospital Revenue Code 360
Min. Negotiated Rate $213.45
Max. Negotiated Rate $4,460.70
Rate for Payer: Aetna of AZ Commercial $1,280.70
Rate for Payer: Aetna of AZ Medicare $398.44
Rate for Payer: AHCCCS Medicaid $4,460.70
Rate for Payer: Allwell Medicaid $4,460.70
Rate for Payer: Allwell Medicare $213.45
Rate for Payer: Amerigroup Medicare $213.45
Rate for Payer: APIPA Medicare/Medicaid $531.49
Rate for Payer: AZCH Complete Medicaid $4,460.70
Rate for Payer: AZCH Complete Medicare $213.45
Rate for Payer: Banner UC Health Medicaid $4,460.70
Rate for Payer: Banner UC Health Medicare $213.45
Rate for Payer: Bisbee Police All Plans $369.98
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $967.64
Rate for Payer: Cash Price $1,138.40
Rate for Payer: Cash Price $1,138.40
Rate for Payer: Cigna of AZ Commercial $711.50
Rate for Payer: Copperpoint Commercial $352.19
Rate for Payer: Health Net of AZ Commercial $853.80
Rate for Payer: Health Net of AZ Medicare $398.44
Rate for Payer: Humana of AZ Medicare $213.45
Rate for Payer: Mercy Care Medicaid $4,460.70
Rate for Payer: Self Pay Self Pay $1,138.40
Rate for Payer: TriWest Medicare $213.45
Rate for Payer: UnitedHealth Group of AZ Commercial $3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare $256.14