Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

abatacept 250 mg REC [CQCH]

Facility

$1,338.50

Service Code	HCPCS J0129
Hospital Charge Code	220821185
Hospital Revenue Code	250
Min. Negotiated Rate	$1,204.65
Max. Negotiated Rate	$1,204.65
Rate for Payer: Aetna of AZ Commercial	$1,204.65
Rate for Payer: Cash Price	$1,070.80

Abdominal Pain

Facility

$4,198.58

Service Code	APR-DRG 2512
Hospital Charge Code	APRDRG2513
Min. Negotiated Rate	$4,198.58
Max. Negotiated Rate	$4,198.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,198.58
Rate for Payer: Mercy Care Medicaid	$4,198.58
Rate for Payer: NaphCare Correctional Healthcare	$4,198.58

Abdominal Pain

Facility

$10,527.31

Service Code	APR-DRG 2514
Hospital Charge Code	APRDRG2513
Min. Negotiated Rate	$10,527.31
Max. Negotiated Rate	$10,527.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,527.31
Rate for Payer: Mercy Care Medicaid	$10,527.31
Rate for Payer: NaphCare Correctional Healthcare	$10,527.31

Abdominal Pain

Facility

$3,504.19

Service Code	APR-DRG 2511
Hospital Charge Code	APRDRG2512
Min. Negotiated Rate	$3,504.19
Max. Negotiated Rate	$3,504.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,504.19
Rate for Payer: Mercy Care Medicaid	$3,504.19
Rate for Payer: NaphCare Correctional Healthcare	$3,504.19

Abdominal Pain

Facility

$10,527.31

Service Code	APR-DRG 2514
Hospital Charge Code	APRDRG2511
Min. Negotiated Rate	$10,527.31
Max. Negotiated Rate	$10,527.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,527.31
Rate for Payer: Mercy Care Medicaid	$10,527.31
Rate for Payer: NaphCare Correctional Healthcare	$10,527.31

Abdominal Pain

Facility

$3,504.19

Service Code	APR-DRG 2511
Hospital Charge Code	APRDRG2513
Min. Negotiated Rate	$3,504.19
Max. Negotiated Rate	$3,504.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,504.19
Rate for Payer: Mercy Care Medicaid	$3,504.19
Rate for Payer: NaphCare Correctional Healthcare	$3,504.19

Abdominal Pain

Facility

$5,578.94

Service Code	APR-DRG 2513
Hospital Charge Code	APRDRG2511
Min. Negotiated Rate	$5,578.94
Max. Negotiated Rate	$5,578.94
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,578.94
Rate for Payer: Mercy Care Medicaid	$5,578.94
Rate for Payer: NaphCare Correctional Healthcare	$5,578.94

Abdominal Pain

Facility

$5,578.94

Service Code	APR-DRG 2513
Hospital Charge Code	APRDRG2512
Min. Negotiated Rate	$5,578.94
Max. Negotiated Rate	$5,578.94
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,578.94
Rate for Payer: Mercy Care Medicaid	$5,578.94
Rate for Payer: NaphCare Correctional Healthcare	$5,578.94

Abdominal Pain

Facility

$4,198.58

Service Code	APR-DRG 2512
Hospital Charge Code	APRDRG2511
Min. Negotiated Rate	$4,198.58
Max. Negotiated Rate	$4,198.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,198.58
Rate for Payer: Mercy Care Medicaid	$4,198.58
Rate for Payer: NaphCare Correctional Healthcare	$4,198.58

Abdominal Pain

Facility

$3,504.19

Service Code	APR-DRG 2511
Hospital Charge Code	APRDRG2511
Min. Negotiated Rate	$3,504.19
Max. Negotiated Rate	$3,504.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,504.19
Rate for Payer: Mercy Care Medicaid	$3,504.19
Rate for Payer: NaphCare Correctional Healthcare	$3,504.19

Abdominal Pain

Facility

$3,504.19

Service Code	APR-DRG 2511
Hospital Charge Code	APRDRG2514
Min. Negotiated Rate	$3,504.19
Max. Negotiated Rate	$3,504.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,504.19
Rate for Payer: Mercy Care Medicaid	$3,504.19
Rate for Payer: NaphCare Correctional Healthcare	$3,504.19

Abdominal Pain

Facility

$10,527.31

Service Code	APR-DRG 2514
Hospital Charge Code	APRDRG2512
Min. Negotiated Rate	$10,527.31
Max. Negotiated Rate	$10,527.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,527.31
Rate for Payer: Mercy Care Medicaid	$10,527.31
Rate for Payer: NaphCare Correctional Healthcare	$10,527.31

Abdominal Pain

Facility

$4,198.58

Service Code	APR-DRG 2512
Hospital Charge Code	APRDRG2514
Min. Negotiated Rate	$4,198.58
Max. Negotiated Rate	$4,198.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,198.58
Rate for Payer: Mercy Care Medicaid	$4,198.58
Rate for Payer: NaphCare Correctional Healthcare	$4,198.58

Abdominal Pain

Facility

$4,198.58

Service Code	APR-DRG 2512
Hospital Charge Code	APRDRG2512
Min. Negotiated Rate	$4,198.58
Max. Negotiated Rate	$4,198.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,198.58
Rate for Payer: Mercy Care Medicaid	$4,198.58
Rate for Payer: NaphCare Correctional Healthcare	$4,198.58

Abdominal Pain

Facility

$5,578.94

Service Code	APR-DRG 2513
Hospital Charge Code	APRDRG2513
Min. Negotiated Rate	$5,578.94
Max. Negotiated Rate	$5,578.94
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,578.94
Rate for Payer: Mercy Care Medicaid	$5,578.94
Rate for Payer: NaphCare Correctional Healthcare	$5,578.94

Abdominal Pain

Facility

$5,578.94

Service Code	APR-DRG 2513
Hospital Charge Code	APRDRG2514
Min. Negotiated Rate	$5,578.94
Max. Negotiated Rate	$5,578.94
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,578.94
Rate for Payer: Mercy Care Medicaid	$5,578.94
Rate for Payer: NaphCare Correctional Healthcare	$5,578.94

Abdominal Pain

Facility

$10,527.31

Service Code	APR-DRG 2514
Hospital Charge Code	APRDRG2514
Min. Negotiated Rate	$10,527.31
Max. Negotiated Rate	$10,527.31
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,527.31
Rate for Payer: Mercy Care Medicaid	$10,527.31
Rate for Payer: NaphCare Correctional Healthcare	$10,527.31

Abdominal Paracentesis without Imaging

Facility

$371.00

Service Code	CPT 49082
Hospital Charge Code	22310102
Hospital Revenue Code	360
Min. Negotiated Rate	$58.77
Max. Negotiated Rate	$3,596.00
Rate for Payer: Aetna of AZ Commercial	$333.90
Rate for Payer: Arizona Complete Health Allwell	$59.36
Rate for Payer: Banner UC Health Medicare	$343.75
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$252.28
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$136.33
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$59.36
Rate for Payer: Care1st Health Plan Arizona Medicare	$59.36
Rate for Payer: Cash Price	$296.80
Rate for Payer: Cash Price	$296.80
Rate for Payer: Cash Price	$296.80
Rate for Payer: Cigna of AZ Commercial	$185.50
Rate for Payer: Devoted Health Medicare	$66.78
Rate for Payer: Humana of AZ Medicare	$59.36
Rate for Payer: Mercy Care Medicaid	$136.33
Rate for Payer: NaphCare Correctional Healthcare	$343.75
Rate for Payer: Seven Corners Travel Insurance	$1,403.35
Rate for Payer: Southwest Service Administrators UFCW	$252.28
Rate for Payer: TriWest Medicare	$59.36
Rate for Payer: United Healthcare Commercial	$3,596.00
Rate for Payer: United Healthcare Medicare	$59.36
Rate for Payer: Veterans Affairs TRICARE	$58.77

Abdominal Paracentesis without Imaging

Facility

$371.00

Service Code	CPT 49082
Hospital Charge Code	22310102
Hospital Revenue Code	360
Min. Negotiated Rate	$333.90
Max. Negotiated Rate	$333.90
Rate for Payer: Aetna of AZ Commercial	$333.90
Rate for Payer: Cash Price	$296.80

ABG STICK

Facility

$347.00

Service Code	CPT 36600
Hospital Charge Code	2280035
Hospital Revenue Code	460
Min. Negotiated Rate	$13.25
Max. Negotiated Rate	$312.30
Rate for Payer: Aetna of AZ Commercial	$312.30
Rate for Payer: Arizona Complete Health Allwell	$55.52
Rate for Payer: Banner UC Health Medicare	$55.52
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$235.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13.25
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$55.52
Rate for Payer: Care1st Health Plan Arizona Medicare	$55.52
Rate for Payer: Cash Price	$277.60
Rate for Payer: Cash Price	$277.60
Rate for Payer: Cigna of AZ Commercial	$242.90
Rate for Payer: Devoted Health Medicare	$62.46
Rate for Payer: Humana of AZ Medicare	$55.52
Rate for Payer: Mercy Care Medicaid	$13.25
Rate for Payer: NaphCare Correctional Healthcare	$13.25
Rate for Payer: Seven Corners Travel Insurance	$205.86
Rate for Payer: Southwest Service Administrators UFCW	$235.96
Rate for Payer: TriWest Medicare	$55.52
Rate for Payer: United Healthcare Commercial	$198.48
Rate for Payer: United Healthcare Medicare	$55.52
Rate for Payer: United Healthcare New Mexico Commercial	$65.93
Rate for Payer: Veterans Affairs TRICARE	$54.96

ABG STICK

Facility

$347.00

Service Code	CPT 36600
Hospital Charge Code	2280035
Hospital Revenue Code	460
Min. Negotiated Rate	$312.30
Max. Negotiated Rate	$312.30
Rate for Payer: Aetna of AZ Commercial	$312.30
Rate for Payer: Cash Price	$277.60

ABORh

Facility

$89.00

Service Code	CPT 86900
Hospital Charge Code	1481849
Hospital Revenue Code	302
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$80.10
Rate for Payer: Aetna of AZ Commercial	$80.10
Rate for Payer: Arizona Complete Health Allwell	$14.24
Rate for Payer: Banner UC Health Medicare	$14.24
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$60.52
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$14.24
Rate for Payer: Care1st Health Plan Arizona Medicare	$14.24
Rate for Payer: Cash Price	$71.20
Rate for Payer: Cash Price	$71.20
Rate for Payer: Cigna of AZ Commercial	$57.85
Rate for Payer: Devoted Health Medicare	$16.02
Rate for Payer: Humana of AZ Medicare	$14.24
Rate for Payer: Seven Corners Travel Insurance	$4.34
Rate for Payer: Southwest Service Administrators UFCW	$60.52
Rate for Payer: TriWest Medicare	$14.24
Rate for Payer: United Healthcare Commercial	$50.91
Rate for Payer: United Healthcare Medicare	$14.24
Rate for Payer: Veterans Affairs TRICARE	$14.10

ABORh

Facility

$89.00

Service Code	CPT 86900
Hospital Charge Code	1481849
Hospital Revenue Code	302
Min. Negotiated Rate	$80.10
Max. Negotiated Rate	$80.10
Rate for Payer: Aetna of AZ Commercial	$80.10
Rate for Payer: Cash Price	$71.20

Abortion With D&C, Aspiration Curettage Or Hysterotomy

Facility

$3,385.66

Service Code	APR-DRG 5431
Hospital Charge Code	APRDRG5433
Min. Negotiated Rate	$3,385.66
Max. Negotiated Rate	$3,385.66
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,385.66
Rate for Payer: Mercy Care Medicaid	$3,385.66
Rate for Payer: NaphCare Correctional Healthcare	$3,385.66

Abortion With D&C, Aspiration Curettage Or Hysterotomy

Facility

$13,229.11

Service Code	APR-DRG 5434
Hospital Charge Code	APRDRG5434
Min. Negotiated Rate	$13,229.11
Max. Negotiated Rate	$13,229.11
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$13,229.11
Rate for Payer: Mercy Care Medicaid	$13,229.11
Rate for Payer: NaphCare Correctional Healthcare	$13,229.11

Know your out-of-pocket cost for care.

All Charges