Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$16,776.79

Service Code	APR-DRG 5113
Hospital Charge Code	APRDRG5114
Min. Negotiated Rate	$16,776.79
Max. Negotiated Rate	$16,776.79
Rate for Payer: AHCCCS Medicaid	$16,776.79
Rate for Payer: Allwell Medicaid	$16,776.79
Rate for Payer: AZCH Complete Medicaid	$16,776.79
Rate for Payer: Banner UC Health Medicaid	$16,776.79
Rate for Payer: Mercy Care Medicaid	$16,776.79

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$30,793.56

Service Code	APR-DRG 5114
Hospital Charge Code	APRDRG5113
Min. Negotiated Rate	$30,793.56
Max. Negotiated Rate	$30,793.56
Rate for Payer: AHCCCS Medicaid	$30,793.56
Rate for Payer: Allwell Medicaid	$30,793.56
Rate for Payer: AZCH Complete Medicaid	$30,793.56
Rate for Payer: Banner UC Health Medicaid	$30,793.56
Rate for Payer: Mercy Care Medicaid	$30,793.56

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$10,628.31

Service Code	APR-DRG 5112
Hospital Charge Code	APRDRG5112
Min. Negotiated Rate	$10,628.31
Max. Negotiated Rate	$10,628.31
Rate for Payer: AHCCCS Medicaid	$10,628.31
Rate for Payer: Allwell Medicaid	$10,628.31
Rate for Payer: AZCH Complete Medicaid	$10,628.31
Rate for Payer: Banner UC Health Medicaid	$10,628.31
Rate for Payer: Mercy Care Medicaid	$10,628.31

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$16,776.79

Service Code	APR-DRG 5113
Hospital Charge Code	APRDRG5112
Min. Negotiated Rate	$16,776.79
Max. Negotiated Rate	$16,776.79
Rate for Payer: AHCCCS Medicaid	$16,776.79
Rate for Payer: Allwell Medicaid	$16,776.79
Rate for Payer: AZCH Complete Medicaid	$16,776.79
Rate for Payer: Banner UC Health Medicaid	$16,776.79
Rate for Payer: Mercy Care Medicaid	$16,776.79

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$8,883.93

Service Code	APR-DRG 5111
Hospital Charge Code	APRDRG5111
Min. Negotiated Rate	$8,883.93
Max. Negotiated Rate	$8,883.93
Rate for Payer: AHCCCS Medicaid	$8,883.93
Rate for Payer: Allwell Medicaid	$8,883.93
Rate for Payer: AZCH Complete Medicaid	$8,883.93
Rate for Payer: Banner UC Health Medicaid	$8,883.93
Rate for Payer: Mercy Care Medicaid	$8,883.93

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$16,776.79

Service Code	APR-DRG 5113
Hospital Charge Code	APRDRG5111
Min. Negotiated Rate	$16,776.79
Max. Negotiated Rate	$16,776.79
Rate for Payer: AHCCCS Medicaid	$16,776.79
Rate for Payer: Allwell Medicaid	$16,776.79
Rate for Payer: AZCH Complete Medicaid	$16,776.79
Rate for Payer: Banner UC Health Medicaid	$16,776.79
Rate for Payer: Mercy Care Medicaid	$16,776.79

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$30,793.56

Service Code	APR-DRG 5114
Hospital Charge Code	APRDRG5114
Min. Negotiated Rate	$30,793.56
Max. Negotiated Rate	$30,793.56
Rate for Payer: AHCCCS Medicaid	$30,793.56
Rate for Payer: Allwell Medicaid	$30,793.56
Rate for Payer: AZCH Complete Medicaid	$30,793.56
Rate for Payer: Banner UC Health Medicaid	$30,793.56
Rate for Payer: Mercy Care Medicaid	$30,793.56

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$30,793.56

Service Code	APR-DRG 5114
Hospital Charge Code	APRDRG5112
Min. Negotiated Rate	$30,793.56
Max. Negotiated Rate	$30,793.56
Rate for Payer: AHCCCS Medicaid	$30,793.56
Rate for Payer: Allwell Medicaid	$30,793.56
Rate for Payer: AZCH Complete Medicaid	$30,793.56
Rate for Payer: Banner UC Health Medicaid	$30,793.56
Rate for Payer: Mercy Care Medicaid	$30,793.56

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$16,776.79

Service Code	APR-DRG 5113
Hospital Charge Code	APRDRG5113
Min. Negotiated Rate	$16,776.79
Max. Negotiated Rate	$16,776.79
Rate for Payer: AHCCCS Medicaid	$16,776.79
Rate for Payer: Allwell Medicaid	$16,776.79
Rate for Payer: AZCH Complete Medicaid	$16,776.79
Rate for Payer: Banner UC Health Medicaid	$16,776.79
Rate for Payer: Mercy Care Medicaid	$16,776.79

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$10,628.31

Service Code	APR-DRG 5112
Hospital Charge Code	APRDRG5114
Min. Negotiated Rate	$10,628.31
Max. Negotiated Rate	$10,628.31
Rate for Payer: AHCCCS Medicaid	$10,628.31
Rate for Payer: Allwell Medicaid	$10,628.31
Rate for Payer: AZCH Complete Medicaid	$10,628.31
Rate for Payer: Banner UC Health Medicaid	$10,628.31
Rate for Payer: Mercy Care Medicaid	$10,628.31

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$10,628.31

Service Code	APR-DRG 5112
Hospital Charge Code	APRDRG5111
Min. Negotiated Rate	$10,628.31
Max. Negotiated Rate	$10,628.31
Rate for Payer: AHCCCS Medicaid	$10,628.31
Rate for Payer: Allwell Medicaid	$10,628.31
Rate for Payer: AZCH Complete Medicaid	$10,628.31
Rate for Payer: Banner UC Health Medicaid	$10,628.31
Rate for Payer: Mercy Care Medicaid	$10,628.31

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$8,883.93

Service Code	APR-DRG 5111
Hospital Charge Code	APRDRG5114
Min. Negotiated Rate	$8,883.93
Max. Negotiated Rate	$8,883.93
Rate for Payer: AHCCCS Medicaid	$8,883.93
Rate for Payer: Allwell Medicaid	$8,883.93
Rate for Payer: AZCH Complete Medicaid	$8,883.93
Rate for Payer: Banner UC Health Medicaid	$8,883.93
Rate for Payer: Mercy Care Medicaid	$8,883.93

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$30,793.56

Service Code	APR-DRG 5114
Hospital Charge Code	APRDRG5111
Min. Negotiated Rate	$30,793.56
Max. Negotiated Rate	$30,793.56
Rate for Payer: AHCCCS Medicaid	$30,793.56
Rate for Payer: Allwell Medicaid	$30,793.56
Rate for Payer: AZCH Complete Medicaid	$30,793.56
Rate for Payer: Banner UC Health Medicaid	$30,793.56
Rate for Payer: Mercy Care Medicaid	$30,793.56

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$8,883.93

Service Code	APR-DRG 5111
Hospital Charge Code	APRDRG5112
Min. Negotiated Rate	$8,883.93
Max. Negotiated Rate	$8,883.93
Rate for Payer: AHCCCS Medicaid	$8,883.93
Rate for Payer: Allwell Medicaid	$8,883.93
Rate for Payer: AZCH Complete Medicaid	$8,883.93
Rate for Payer: Banner UC Health Medicaid	$8,883.93
Rate for Payer: Mercy Care Medicaid	$8,883.93

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$8,883.93

Service Code	APR-DRG 5111
Hospital Charge Code	APRDRG5113
Min. Negotiated Rate	$8,883.93
Max. Negotiated Rate	$8,883.93
Rate for Payer: AHCCCS Medicaid	$8,883.93
Rate for Payer: Allwell Medicaid	$8,883.93
Rate for Payer: AZCH Complete Medicaid	$8,883.93
Rate for Payer: Banner UC Health Medicaid	$8,883.93
Rate for Payer: Mercy Care Medicaid	$8,883.93

Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy

Facility

IP

$10,628.31

Service Code	APR-DRG 5112
Hospital Charge Code	APRDRG5113
Min. Negotiated Rate	$10,628.31
Max. Negotiated Rate	$10,628.31
Rate for Payer: AHCCCS Medicaid	$10,628.31
Rate for Payer: Allwell Medicaid	$10,628.31
Rate for Payer: AZCH Complete Medicaid	$10,628.31
Rate for Payer: Banner UC Health Medicaid	$10,628.31
Rate for Payer: Mercy Care Medicaid	$10,628.31

Uterine Suspension

Facility

IP

$2,510.00

Service Code	CPT 58400
Hospital Charge Code	22754022
Hospital Revenue Code	360
Min. Negotiated Rate	$652.60
Max. Negotiated Rate	$2,259.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Self Pay Self Pay	$2,008.00

Uterine Suspension

Facility

OP

$2,510.00

Service Code	CPT 58400
Hospital Charge Code	22754022
Hospital Revenue Code	360
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$2,259.00
Rate for Payer: Aetna of AZ Medicare	$702.80
Rate for Payer: AHCCCS Medicaid	$0.13
Rate for Payer: Allwell Medicaid	$0.13
Rate for Payer: Allwell Medicare	$376.50
Rate for Payer: Amerigroup Medicare	$376.50
Rate for Payer: APIPA Medicare/Medicaid	$937.48
Rate for Payer: AZCH Complete Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$376.50
Rate for Payer: Banner UC Health Medicaid	$0.13
Rate for Payer: Banner UC Health Medicare	$376.50
Rate for Payer: Bisbee Police All Plans	$652.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,706.80
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cash Price	$2,008.00
Rate for Payer: Cigna of AZ Commercial	$1,255.00
Rate for Payer: Copperpoint Commercial	$621.22
Rate for Payer: Health Net of AZ Commercial	$1,506.00
Rate for Payer: Health Net of AZ Medicare	$702.80
Rate for Payer: Humana of AZ Medicare	$376.50
Rate for Payer: Mercy Care Medicaid	$0.13
Rate for Payer: Self Pay Self Pay	$2,008.00
Rate for Payer: TriWest Medicare	$376.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$451.80

Vaginal Delivery

Facility

IP

$3,306.40

Service Code	APR-DRG 5603
Hospital Charge Code	APRDRG5604
Min. Negotiated Rate	$3,306.40
Max. Negotiated Rate	$3,306.40
Rate for Payer: AHCCCS Medicaid	$3,306.40
Rate for Payer: Allwell Medicaid	$3,306.40
Rate for Payer: AZCH Complete Medicaid	$3,306.40
Rate for Payer: Banner UC Health Medicaid	$3,306.40
Rate for Payer: Mercy Care Medicaid	$3,306.40

Vaginal Delivery

Facility

IP

$2,095.78

Service Code	APR-DRG 5601
Hospital Charge Code	APRDRG5601
Min. Negotiated Rate	$2,095.78
Max. Negotiated Rate	$2,095.78
Rate for Payer: AHCCCS Medicaid	$2,095.78
Rate for Payer: Allwell Medicaid	$2,095.78
Rate for Payer: AZCH Complete Medicaid	$2,095.78
Rate for Payer: Banner UC Health Medicaid	$2,095.78
Rate for Payer: Mercy Care Medicaid	$2,095.78

Vaginal Delivery

Facility

IP

$2,362.32

Service Code	APR-DRG 5602
Hospital Charge Code	APRDRG5601
Min. Negotiated Rate	$2,362.32
Max. Negotiated Rate	$2,362.32
Rate for Payer: AHCCCS Medicaid	$2,362.32
Rate for Payer: Allwell Medicaid	$2,362.32
Rate for Payer: AZCH Complete Medicaid	$2,362.32
Rate for Payer: Banner UC Health Medicaid	$2,362.32
Rate for Payer: Mercy Care Medicaid	$2,362.32

Vaginal Delivery

Facility

IP

$2,362.32

Service Code	APR-DRG 5602
Hospital Charge Code	APRDRG5602
Min. Negotiated Rate	$2,362.32
Max. Negotiated Rate	$2,362.32
Rate for Payer: AHCCCS Medicaid	$2,362.32
Rate for Payer: Allwell Medicaid	$2,362.32
Rate for Payer: AZCH Complete Medicaid	$2,362.32
Rate for Payer: Banner UC Health Medicaid	$2,362.32
Rate for Payer: Mercy Care Medicaid	$2,362.32

Vaginal Delivery

Facility

IP

$2,095.78

Service Code	APR-DRG 5601
Hospital Charge Code	APRDRG5602
Min. Negotiated Rate	$2,095.78
Max. Negotiated Rate	$2,095.78
Rate for Payer: AHCCCS Medicaid	$2,095.78
Rate for Payer: Allwell Medicaid	$2,095.78
Rate for Payer: AZCH Complete Medicaid	$2,095.78
Rate for Payer: Banner UC Health Medicaid	$2,095.78
Rate for Payer: Mercy Care Medicaid	$2,095.78

Vaginal Delivery

Facility

IP

$2,095.78

Service Code	APR-DRG 5601
Hospital Charge Code	APRDRG5604
Min. Negotiated Rate	$2,095.78
Max. Negotiated Rate	$2,095.78
Rate for Payer: AHCCCS Medicaid	$2,095.78
Rate for Payer: Allwell Medicaid	$2,095.78
Rate for Payer: AZCH Complete Medicaid	$2,095.78
Rate for Payer: Banner UC Health Medicaid	$2,095.78
Rate for Payer: Mercy Care Medicaid	$2,095.78

Vaginal Delivery

Facility

IP

$3,306.40

Service Code	APR-DRG 5603
Hospital Charge Code	APRDRG5601
Min. Negotiated Rate	$3,306.40
Max. Negotiated Rate	$3,306.40
Rate for Payer: AHCCCS Medicaid	$3,306.40
Rate for Payer: Allwell Medicaid	$3,306.40
Rate for Payer: AZCH Complete Medicaid	$3,306.40
Rate for Payer: Banner UC Health Medicaid	$3,306.40
Rate for Payer: Mercy Care Medicaid	$3,306.40

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