|
00930 ANES ORCHIOPEXY UNILAT OR BI ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00930
|
| Hospital Charge Code |
22406169
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00930 ANES ORCHIOPEXY UNILAT OR BI ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00930
|
| Hospital Charge Code |
22406169
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00930 ANES ORCHIOPEXY UNILAT OR BILAT ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00930
|
| Hospital Charge Code |
22406168
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00930 ANES ORCHIOPEXY UNILAT OR BILAT ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00930
|
| Hospital Charge Code |
22406168
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00938 ANES INSERTION OF PENILE PRO ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00938
|
| Hospital Charge Code |
22406172
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00938 ANES INSERTION OF PENILE PRO ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00938
|
| Hospital Charge Code |
22406172
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$44.70 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00938 ANES INSERTION OF PENILE PROSTH ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00938
|
| Hospital Charge Code |
22406171
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00938 ANES INSERTION OF PENILE PROSTH ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00938
|
| Hospital Charge Code |
22406171
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00940 ANES VAGINAL PROCEDURES ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406174
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00940 ANES VAGINAL PROCEDURES ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406174
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00940 ANES VAGINAL PROCEDURES ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406175
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00940 ANES VAGINAL PROCEDURES ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406175
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00940 ANES VAGINAL PROCEDURES BASE CHARGE AND 1ST MINUTE
|
Facility
IP
|
$746.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406173
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$193.96 |
| Max. Negotiated Rate |
$671.40 |
| Rate for Payer: Aetna of AZ Commercial |
$671.40
|
| Rate for Payer: Bisbee Police All Plans |
$193.96
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Self Pay Self Pay |
$596.80
|
|
|
00940 ANES VAGINAL PROCEDURES BASE CHARGE AND 1ST MINUTE
|
Facility
OP
|
$746.00
|
|
|
Service Code
|
CPT 00940
|
| Hospital Charge Code |
22406173
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$671.40 |
| Rate for Payer: Aetna of AZ Commercial |
$671.40
|
| Rate for Payer: Aetna of AZ Medicare |
$208.88
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$111.90
|
| Rate for Payer: Amerigroup Medicare |
$111.90
|
| Rate for Payer: APIPA Medicare/Medicaid |
$278.63
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$111.90
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$111.90
|
| Rate for Payer: Bisbee Police All Plans |
$193.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$507.28
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cash Price |
$596.80
|
| Rate for Payer: Cigna of AZ Commercial |
$522.20
|
| Rate for Payer: Copperpoint Commercial |
$184.64
|
| Rate for Payer: Health Net of AZ Commercial |
$447.60
|
| Rate for Payer: Health Net of AZ Medicare |
$208.88
|
| Rate for Payer: Humana of AZ Medicare |
$111.90
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$596.80
|
| Rate for Payer: TriWest Medicare |
$111.90
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$434.92
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$134.28
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
OP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597457
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Aetna of AZ Medicare |
$165.48
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$88.65
|
| Rate for Payer: Amerigroup Medicare |
$88.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$220.74
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$88.65
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$88.65
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$401.88
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cigna of AZ Commercial |
$384.15
|
| Rate for Payer: Copperpoint Commercial |
$146.27
|
| Rate for Payer: Health Net of AZ Commercial |
$354.60
|
| Rate for Payer: Health Net of AZ Medicare |
$165.48
|
| Rate for Payer: Humana of AZ Medicare |
$88.65
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
| Rate for Payer: TriWest Medicare |
$88.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$344.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$106.38
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
OP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597458
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Aetna of AZ Medicare |
$165.48
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$88.65
|
| Rate for Payer: Amerigroup Medicare |
$88.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$220.74
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$88.65
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$88.65
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$401.88
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cigna of AZ Commercial |
$384.15
|
| Rate for Payer: Copperpoint Commercial |
$146.27
|
| Rate for Payer: Health Net of AZ Commercial |
$354.60
|
| Rate for Payer: Health Net of AZ Medicare |
$165.48
|
| Rate for Payer: Humana of AZ Medicare |
$88.65
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
| Rate for Payer: TriWest Medicare |
$88.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$344.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$106.38
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
OP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597459
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Aetna of AZ Medicare |
$165.48
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$88.65
|
| Rate for Payer: Amerigroup Medicare |
$88.65
|
| Rate for Payer: APIPA Medicare/Medicaid |
$220.74
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$88.65
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$88.65
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$401.88
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cigna of AZ Commercial |
$384.15
|
| Rate for Payer: Copperpoint Commercial |
$146.27
|
| Rate for Payer: Health Net of AZ Commercial |
$354.60
|
| Rate for Payer: Health Net of AZ Medicare |
$165.48
|
| Rate for Payer: Humana of AZ Medicare |
$88.65
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
| Rate for Payer: TriWest Medicare |
$88.65
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$344.55
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$106.38
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
IP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597457
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$153.66 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
IP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597458
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$153.66 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
|
|
00944 ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF
|
Facility
IP
|
$591.00
|
|
|
Service Code
|
CPT 00944
|
| Hospital Charge Code |
23597459
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$153.66 |
| Max. Negotiated Rate |
$531.90 |
| Rate for Payer: Aetna of AZ Commercial |
$531.90
|
| Rate for Payer: Bisbee Police All Plans |
$153.66
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Self Pay Self Pay |
$472.80
|
|
|
00952 ANES HYSTEROSCOPY ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 00952
|
| Hospital Charge Code |
22406177
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Aetna of AZ Medicare |
$2.52
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$1.35
|
| Rate for Payer: Amerigroup Medicare |
$1.35
|
| Rate for Payer: APIPA Medicare/Medicaid |
$3.36
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$1.35
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$1.35
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of AZ Commercial |
$5.85
|
| Rate for Payer: Copperpoint Commercial |
$2.23
|
| Rate for Payer: Health Net of AZ Commercial |
$5.40
|
| Rate for Payer: Health Net of AZ Medicare |
$2.52
|
| Rate for Payer: Humana of AZ Medicare |
$1.35
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
| Rate for Payer: TriWest Medicare |
$1.35
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$5.25
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.62
|
|
|
00952 ANES HYSTEROSCOPY ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 00952
|
| Hospital Charge Code |
22406177
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna of AZ Commercial |
$8.10
|
| Rate for Payer: Bisbee Police All Plans |
$2.34
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Self Pay Self Pay |
$7.20
|
|
|
00952 ANES HYSTEROSCOPY ADDTNL 0:30 CHARGE
|
Facility
IP
|
$298.00
|
|
|
Service Code
|
CPT 00952
|
| Hospital Charge Code |
22406179
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
|
|
00952 ANES HYSTEROSCOPY ADDTNL 0:30 CHARGE
|
Facility
OP
|
$298.00
|
|
|
Service Code
|
CPT 00952
|
| Hospital Charge Code |
22406179
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$268.20 |
| Rate for Payer: Aetna of AZ Commercial |
$268.20
|
| Rate for Payer: Aetna of AZ Medicare |
$83.44
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$44.70
|
| Rate for Payer: Amerigroup Medicare |
$44.70
|
| Rate for Payer: APIPA Medicare/Medicaid |
$111.30
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$44.70
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$44.70
|
| Rate for Payer: Bisbee Police All Plans |
$77.48
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$202.64
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cigna of AZ Commercial |
$193.70
|
| Rate for Payer: Copperpoint Commercial |
$73.76
|
| Rate for Payer: Health Net of AZ Commercial |
$178.80
|
| Rate for Payer: Health Net of AZ Medicare |
$83.44
|
| Rate for Payer: Humana of AZ Medicare |
$44.70
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$238.40
|
| Rate for Payer: TriWest Medicare |
$44.70
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$173.73
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$53.64
|
|
|
00955 INTRATHECAL INJECTION
|
Facility
IP
|
$1,384.00
|
|
|
Service Code
|
CPT 00955
|
| Hospital Charge Code |
23361647
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$359.84 |
| Max. Negotiated Rate |
$1,245.60 |
| Rate for Payer: Aetna of AZ Commercial |
$1,245.60
|
| Rate for Payer: Bisbee Police All Plans |
$359.84
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Self Pay Self Pay |
$1,107.20
|
|
