Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,387.76

Service Code	APR-DRG 5412
Hospital Charge Code	APRDRG5411
Min. Negotiated Rate	$3,387.76
Max. Negotiated Rate	$3,387.76
Rate for Payer: AHCCCS Medicaid	$3,387.76
Rate for Payer: Allwell Medicaid	$3,387.76
Rate for Payer: AZCH Complete Medicaid	$3,387.76
Rate for Payer: Banner UC Health Medicaid	$3,387.76
Rate for Payer: Mercy Care Medicaid	$3,387.76

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,387.76

Service Code	APR-DRG 5412
Hospital Charge Code	APRDRG5413
Min. Negotiated Rate	$3,387.76
Max. Negotiated Rate	$3,387.76
Rate for Payer: AHCCCS Medicaid	$3,387.76
Rate for Payer: Allwell Medicaid	$3,387.76
Rate for Payer: AZCH Complete Medicaid	$3,387.76
Rate for Payer: Banner UC Health Medicaid	$3,387.76
Rate for Payer: Mercy Care Medicaid	$3,387.76

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$4,552.09

Service Code	APR-DRG 5413
Hospital Charge Code	APRDRG5413
Min. Negotiated Rate	$4,552.09
Max. Negotiated Rate	$4,552.09
Rate for Payer: AHCCCS Medicaid	$4,552.09
Rate for Payer: Allwell Medicaid	$4,552.09
Rate for Payer: AZCH Complete Medicaid	$4,552.09
Rate for Payer: Banner UC Health Medicaid	$4,552.09
Rate for Payer: Mercy Care Medicaid	$4,552.09

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,387.76

Service Code	APR-DRG 5412
Hospital Charge Code	APRDRG5412
Min. Negotiated Rate	$3,387.76
Max. Negotiated Rate	$3,387.76
Rate for Payer: AHCCCS Medicaid	$3,387.76
Rate for Payer: Allwell Medicaid	$3,387.76
Rate for Payer: AZCH Complete Medicaid	$3,387.76
Rate for Payer: Banner UC Health Medicaid	$3,387.76
Rate for Payer: Mercy Care Medicaid	$3,387.76

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$4,552.09

Service Code	APR-DRG 5413
Hospital Charge Code	APRDRG5414
Min. Negotiated Rate	$4,552.09
Max. Negotiated Rate	$4,552.09
Rate for Payer: AHCCCS Medicaid	$4,552.09
Rate for Payer: Allwell Medicaid	$4,552.09
Rate for Payer: AZCH Complete Medicaid	$4,552.09
Rate for Payer: Banner UC Health Medicaid	$4,552.09
Rate for Payer: Mercy Care Medicaid	$4,552.09

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$4,552.09

Service Code	APR-DRG 5413
Hospital Charge Code	APRDRG5412
Min. Negotiated Rate	$4,552.09
Max. Negotiated Rate	$4,552.09
Rate for Payer: AHCCCS Medicaid	$4,552.09
Rate for Payer: Allwell Medicaid	$4,552.09
Rate for Payer: AZCH Complete Medicaid	$4,552.09
Rate for Payer: Banner UC Health Medicaid	$4,552.09
Rate for Payer: Mercy Care Medicaid	$4,552.09

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$7,378.73

Service Code	APR-DRG 5414
Hospital Charge Code	APRDRG5414
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$7,378.73

Service Code	APR-DRG 5414
Hospital Charge Code	APRDRG5413
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,387.76

Service Code	APR-DRG 5412
Hospital Charge Code	APRDRG5414
Min. Negotiated Rate	$3,387.76
Max. Negotiated Rate	$3,387.76
Rate for Payer: AHCCCS Medicaid	$3,387.76
Rate for Payer: Allwell Medicaid	$3,387.76
Rate for Payer: AZCH Complete Medicaid	$3,387.76
Rate for Payer: Banner UC Health Medicaid	$3,387.76
Rate for Payer: Mercy Care Medicaid	$3,387.76

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,226.44

Service Code	APR-DRG 5411
Hospital Charge Code	APRDRG5412
Min. Negotiated Rate	$3,226.44
Max. Negotiated Rate	$3,226.44
Rate for Payer: AHCCCS Medicaid	$3,226.44
Rate for Payer: Allwell Medicaid	$3,226.44
Rate for Payer: AZCH Complete Medicaid	$3,226.44
Rate for Payer: Banner UC Health Medicaid	$3,226.44
Rate for Payer: Mercy Care Medicaid	$3,226.44

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,226.44

Service Code	APR-DRG 5411
Hospital Charge Code	APRDRG5413
Min. Negotiated Rate	$3,226.44
Max. Negotiated Rate	$3,226.44
Rate for Payer: AHCCCS Medicaid	$3,226.44
Rate for Payer: Allwell Medicaid	$3,226.44
Rate for Payer: AZCH Complete Medicaid	$3,226.44
Rate for Payer: Banner UC Health Medicaid	$3,226.44
Rate for Payer: Mercy Care Medicaid	$3,226.44

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,226.44

Service Code	APR-DRG 5411
Hospital Charge Code	APRDRG5414
Min. Negotiated Rate	$3,226.44
Max. Negotiated Rate	$3,226.44
Rate for Payer: AHCCCS Medicaid	$3,226.44
Rate for Payer: Allwell Medicaid	$3,226.44
Rate for Payer: AZCH Complete Medicaid	$3,226.44
Rate for Payer: Banner UC Health Medicaid	$3,226.44
Rate for Payer: Mercy Care Medicaid	$3,226.44

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$7,378.73

Service Code	APR-DRG 5414
Hospital Charge Code	APRDRG5411
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$4,552.09

Service Code	APR-DRG 5413
Hospital Charge Code	APRDRG5411
Min. Negotiated Rate	$4,552.09
Max. Negotiated Rate	$4,552.09
Rate for Payer: AHCCCS Medicaid	$4,552.09
Rate for Payer: Allwell Medicaid	$4,552.09
Rate for Payer: AZCH Complete Medicaid	$4,552.09
Rate for Payer: Banner UC Health Medicaid	$4,552.09
Rate for Payer: Mercy Care Medicaid	$4,552.09

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$7,378.73

Service Code	APR-DRG 5414
Hospital Charge Code	APRDRG5412
Min. Negotiated Rate	$7,378.73
Max. Negotiated Rate	$7,378.73
Rate for Payer: AHCCCS Medicaid	$7,378.73
Rate for Payer: Allwell Medicaid	$7,378.73
Rate for Payer: AZCH Complete Medicaid	$7,378.73
Rate for Payer: Banner UC Health Medicaid	$7,378.73
Rate for Payer: Mercy Care Medicaid	$7,378.73

Vaginal Delivery With Sterilization And/Or D&C

Facility

IP

$3,226.44

Service Code	APR-DRG 5411
Hospital Charge Code	APRDRG5411
Min. Negotiated Rate	$3,226.44
Max. Negotiated Rate	$3,226.44
Rate for Payer: AHCCCS Medicaid	$3,226.44
Rate for Payer: Allwell Medicaid	$3,226.44
Rate for Payer: AZCH Complete Medicaid	$3,226.44
Rate for Payer: Banner UC Health Medicaid	$3,226.44
Rate for Payer: Mercy Care Medicaid	$3,226.44

Vaginectomy (complete)

Facility

IP

$4,935.00

Service Code	CPT 57110
Hospital Charge Code	27281895
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$4,441.50
Rate for Payer: Aetna of AZ Commercial	$4,441.50
Rate for Payer: Bisbee Police All Plans	$1,283.10
Rate for Payer: Cash Price	$3,948.00
Rate for Payer: Self Pay Self Pay	$3,948.00

Vaginectomy (complete)

Facility

OP

$4,935.00

Service Code	CPT 57110
Hospital Charge Code	27281895
Hospital Revenue Code	360
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$4,441.50
Rate for Payer: Aetna of AZ Commercial	$4,441.50
Rate for Payer: Aetna of AZ Medicare	$1,381.80
Rate for Payer: AHCCCS Medicaid	$0.13
Rate for Payer: Allwell Medicaid	$0.13
Rate for Payer: Allwell Medicare	$740.25
Rate for Payer: Amerigroup Medicare	$740.25
Rate for Payer: APIPA Medicare/Medicaid	$1,843.22
Rate for Payer: AZCH Complete Medicaid	$0.13
Rate for Payer: AZCH Complete Medicare	$740.25
Rate for Payer: Banner UC Health Medicaid	$0.13
Rate for Payer: Banner UC Health Medicare	$740.25
Rate for Payer: Bisbee Police All Plans	$1,283.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,355.80
Rate for Payer: Cash Price	$3,948.00
Rate for Payer: Cash Price	$3,948.00
Rate for Payer: Cigna of AZ Commercial	$2,467.50
Rate for Payer: Copperpoint Commercial	$1,221.41
Rate for Payer: Health Net of AZ Commercial	$2,961.00
Rate for Payer: Health Net of AZ Medicare	$1,381.80
Rate for Payer: Humana of AZ Medicare	$740.25
Rate for Payer: Mercy Care Medicaid	$0.13
Rate for Payer: Self Pay Self Pay	$3,948.00
Rate for Payer: TriWest Medicare	$740.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$888.30

Vaginectomy (partial vaginal apex revision)

Facility

IP

$2,740.00

Service Code	CPT 57106
Hospital Charge Code	27291799
Hospital Revenue Code	360
Min. Negotiated Rate	$712.40
Max. Negotiated Rate	$2,466.00
Rate for Payer: Aetna of AZ Commercial	$2,466.00
Rate for Payer: Bisbee Police All Plans	$712.40
Rate for Payer: Cash Price	$2,192.00
Rate for Payer: Self Pay Self Pay	$2,192.00

Vaginectomy (partial vaginal apex revision)

Facility

OP

$2,740.00

Service Code	CPT 57106
Hospital Charge Code	27291799
Hospital Revenue Code	360
Min. Negotiated Rate	$411.00
Max. Negotiated Rate	$3,803.66
Rate for Payer: Aetna of AZ Commercial	$2,466.00
Rate for Payer: Aetna of AZ Medicare	$767.20
Rate for Payer: AHCCCS Medicaid	$3,803.66
Rate for Payer: Allwell Medicaid	$3,803.66
Rate for Payer: Allwell Medicare	$411.00
Rate for Payer: Amerigroup Medicare	$411.00
Rate for Payer: APIPA Medicare/Medicaid	$1,023.39
Rate for Payer: AZCH Complete Medicaid	$3,803.66
Rate for Payer: AZCH Complete Medicare	$411.00
Rate for Payer: Banner UC Health Medicaid	$3,803.66
Rate for Payer: Banner UC Health Medicare	$411.00
Rate for Payer: Bisbee Police All Plans	$712.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,863.20
Rate for Payer: Cash Price	$2,192.00
Rate for Payer: Cash Price	$2,192.00
Rate for Payer: Cigna of AZ Commercial	$1,370.00
Rate for Payer: Copperpoint Commercial	$678.15
Rate for Payer: Health Net of AZ Commercial	$1,644.00
Rate for Payer: Health Net of AZ Medicare	$767.20
Rate for Payer: Humana of AZ Medicare	$411.00
Rate for Payer: Mercy Care Medicaid	$3,803.66
Rate for Payer: Self Pay Self Pay	$2,192.00
Rate for Payer: TriWest Medicare	$411.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,373.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$493.20

Valproic Acid Level

Facility

IP

$252.00

Service Code	CPT 80164
Hospital Charge Code	633867
Hospital Revenue Code	301
Min. Negotiated Rate	$65.52
Max. Negotiated Rate	$226.80
Rate for Payer: Aetna of AZ Commercial	$226.80
Rate for Payer: Bisbee Police All Plans	$65.52
Rate for Payer: Cash Price	$201.60
Rate for Payer: Self Pay Self Pay	$201.60

Valproic Acid Level

Facility

OP

$252.00

Service Code	CPT 80164
Hospital Charge Code	633867
Hospital Revenue Code	301
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$226.80
Rate for Payer: Aetna of AZ Commercial	$226.80
Rate for Payer: Aetna of AZ Medicare	$70.56
Rate for Payer: AHCCCS Medicaid	$13.54
Rate for Payer: Allwell Medicaid	$13.54
Rate for Payer: Allwell Medicare	$37.80
Rate for Payer: Amerigroup Medicare	$37.80
Rate for Payer: APIPA Medicare/Medicaid	$94.12
Rate for Payer: AZCH Complete Medicaid	$13.54
Rate for Payer: AZCH Complete Medicare	$37.80
Rate for Payer: Banner UC Health Medicaid	$13.54
Rate for Payer: Banner UC Health Medicare	$37.80
Rate for Payer: Bisbee Police All Plans	$65.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$171.36
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cigna of AZ Commercial	$163.80
Rate for Payer: Copperpoint Commercial	$62.37
Rate for Payer: Health Net of AZ Commercial	$151.20
Rate for Payer: Health Net of AZ Medicare	$70.56
Rate for Payer: Humana of AZ Medicare	$37.80
Rate for Payer: Mercy Care Medicaid	$13.54
Rate for Payer: Self Pay Self Pay	$201.60
Rate for Payer: TriWest Medicare	$37.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$146.92
Rate for Payer: UnitedHealth Group of AZ Medicare	$45.36

valsartan 80 mg Tab [CQCH]

Facility

OP

$1.00

Service Code	NDC 60687012801
Hospital Charge Code	105944531
Hospital Revenue Code	251
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.90
Rate for Payer: Aetna of AZ Commercial	$0.90
Rate for Payer: Aetna of AZ Medicare	$0.28
Rate for Payer: Allwell Medicare	$0.15
Rate for Payer: Amerigroup Medicare	$0.15
Rate for Payer: APIPA Medicare/Medicaid	$0.37
Rate for Payer: AZCH Complete Medicare	$0.15
Rate for Payer: Banner UC Health Medicare	$0.15
Rate for Payer: Bisbee Police All Plans	$0.26
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$0.68
Rate for Payer: Cash Price	$0.80
Rate for Payer: Cigna of AZ Commercial	$0.65
Rate for Payer: Copperpoint Commercial	$0.25
Rate for Payer: Health Net of AZ Commercial	$0.60
Rate for Payer: Health Net of AZ Medicare	$0.28
Rate for Payer: Humana of AZ Medicare	$0.15
Rate for Payer: Self Pay Self Pay	$0.80
Rate for Payer: TriWest Medicare	$0.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$0.58
Rate for Payer: UnitedHealth Group of AZ Medicare	$0.18

valsartan 80 mg Tab [CQCH]

Facility

IP

$1.00

Service Code	NDC 60687012801
Hospital Charge Code	105944531
Hospital Revenue Code	251
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.90
Rate for Payer: Aetna of AZ Commercial	$0.90
Rate for Payer: Bisbee Police All Plans	$0.26
Rate for Payer: Cash Price	$0.80
Rate for Payer: Self Pay Self Pay	$0.80

VALVE ANTI-REFLUX

Facility

OP

$41.00

Hospital Charge Code	22355083
Hospital Revenue Code	272
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$36.90
Rate for Payer: Aetna of AZ Commercial	$36.90
Rate for Payer: Aetna of AZ Medicare	$11.48
Rate for Payer: Allwell Medicare	$6.15
Rate for Payer: Amerigroup Medicare	$6.15
Rate for Payer: APIPA Medicare/Medicaid	$15.31
Rate for Payer: AZCH Complete Medicare	$6.15
Rate for Payer: Banner UC Health Medicare	$6.15
Rate for Payer: Bisbee Police All Plans	$10.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$27.88
Rate for Payer: Cash Price	$32.80
Rate for Payer: Cigna of AZ Commercial	$28.70
Rate for Payer: Copperpoint Commercial	$10.15
Rate for Payer: Health Net of AZ Commercial	$24.60
Rate for Payer: Health Net of AZ Medicare	$11.48
Rate for Payer: Humana of AZ Medicare	$6.15
Rate for Payer: Self Pay Self Pay	$32.80
Rate for Payer: TriWest Medicare	$6.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$23.90
Rate for Payer: UnitedHealth Group of AZ Medicare	$7.38

<<
<
494
495
496
497
498
499
500
501
502
503
>
>>