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Charge Type Setting Price  
Service Code APR-DRG 1114
Hospital Charge Code APRDRG1112
Min. Negotiated Rate $6,980.33
Max. Negotiated Rate $6,980.33
Rate for Payer: AHCCCS Medicaid $6,980.33
Rate for Payer: Allwell Medicaid $6,980.33
Rate for Payer: AZCH Complete Medicaid $6,980.33
Rate for Payer: Banner UC Health Medicaid $6,980.33
Rate for Payer: Mercy Care Medicaid $6,980.33
Service Code APR-DRG 1111
Hospital Charge Code APRDRG1111
Min. Negotiated Rate $3,838.06
Max. Negotiated Rate $3,838.06
Rate for Payer: AHCCCS Medicaid $3,838.06
Rate for Payer: Allwell Medicaid $3,838.06
Rate for Payer: AZCH Complete Medicaid $3,838.06
Rate for Payer: Banner UC Health Medicaid $3,838.06
Rate for Payer: Mercy Care Medicaid $3,838.06
Service Code APR-DRG 1112
Hospital Charge Code APRDRG1111
Min. Negotiated Rate $4,238.56
Max. Negotiated Rate $4,238.56
Rate for Payer: AHCCCS Medicaid $4,238.56
Rate for Payer: Allwell Medicaid $4,238.56
Rate for Payer: AZCH Complete Medicaid $4,238.56
Rate for Payer: Banner UC Health Medicaid $4,238.56
Rate for Payer: Mercy Care Medicaid $4,238.56
Service Code APR-DRG 1114
Hospital Charge Code APRDRG1114
Min. Negotiated Rate $6,980.33
Max. Negotiated Rate $6,980.33
Rate for Payer: AHCCCS Medicaid $6,980.33
Rate for Payer: Allwell Medicaid $6,980.33
Rate for Payer: AZCH Complete Medicaid $6,980.33
Rate for Payer: Banner UC Health Medicaid $6,980.33
Rate for Payer: Mercy Care Medicaid $6,980.33
Service Code APR-DRG 1113
Hospital Charge Code APRDRG1113
Min. Negotiated Rate $5,340.46
Max. Negotiated Rate $5,340.46
Rate for Payer: AHCCCS Medicaid $5,340.46
Rate for Payer: Allwell Medicaid $5,340.46
Rate for Payer: AZCH Complete Medicaid $5,340.46
Rate for Payer: Banner UC Health Medicaid $5,340.46
Rate for Payer: Mercy Care Medicaid $5,340.46
Service Code APR-DRG 1113
Hospital Charge Code APRDRG1112
Min. Negotiated Rate $5,340.46
Max. Negotiated Rate $5,340.46
Rate for Payer: AHCCCS Medicaid $5,340.46
Rate for Payer: Allwell Medicaid $5,340.46
Rate for Payer: AZCH Complete Medicaid $5,340.46
Rate for Payer: Banner UC Health Medicaid $5,340.46
Rate for Payer: Mercy Care Medicaid $5,340.46
Service Code APR-DRG 1114
Hospital Charge Code APRDRG1111
Min. Negotiated Rate $6,980.33
Max. Negotiated Rate $6,980.33
Rate for Payer: AHCCCS Medicaid $6,980.33
Rate for Payer: Allwell Medicaid $6,980.33
Rate for Payer: AZCH Complete Medicaid $6,980.33
Rate for Payer: Banner UC Health Medicaid $6,980.33
Rate for Payer: Mercy Care Medicaid $6,980.33
Service Code APR-DRG 1112
Hospital Charge Code APRDRG1112
Min. Negotiated Rate $4,238.56
Max. Negotiated Rate $4,238.56
Rate for Payer: AHCCCS Medicaid $4,238.56
Rate for Payer: Allwell Medicaid $4,238.56
Rate for Payer: AZCH Complete Medicaid $4,238.56
Rate for Payer: Banner UC Health Medicaid $4,238.56
Rate for Payer: Mercy Care Medicaid $4,238.56
Service Code CPT 51900
Hospital Charge Code 27267834
Hospital Revenue Code 360
Min. Negotiated Rate $1,157.52
Max. Negotiated Rate $4,006.80
Rate for Payer: Aetna of AZ Commercial $4,006.80
Rate for Payer: Bisbee Police All Plans $1,157.52
Rate for Payer: Cash Price $3,561.60
Rate for Payer: Self Pay Self Pay $3,561.60
Service Code CPT 51900
Hospital Charge Code 27267834
Hospital Revenue Code 360
Min. Negotiated Rate $0.13
Max. Negotiated Rate $4,006.80
Rate for Payer: Aetna of AZ Commercial $4,006.80
Rate for Payer: Aetna of AZ Medicare $1,246.56
Rate for Payer: AHCCCS Medicaid $0.13
Rate for Payer: Allwell Medicaid $0.13
Rate for Payer: Allwell Medicare $667.80
Rate for Payer: Amerigroup Medicare $667.80
Rate for Payer: APIPA Medicare/Medicaid $1,662.82
Rate for Payer: AZCH Complete Medicaid $0.13
Rate for Payer: AZCH Complete Medicare $667.80
Rate for Payer: Banner UC Health Medicaid $0.13
Rate for Payer: Banner UC Health Medicare $667.80
Rate for Payer: Bisbee Police All Plans $1,157.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $3,027.36
Rate for Payer: Cash Price $3,561.60
Rate for Payer: Cash Price $3,561.60
Rate for Payer: Cigna of AZ Commercial $2,226.00
Rate for Payer: Copperpoint Commercial $1,101.87
Rate for Payer: Health Net of AZ Commercial $2,671.20
Rate for Payer: Health Net of AZ Medicare $1,246.56
Rate for Payer: Humana of AZ Medicare $667.80
Rate for Payer: Mercy Care Medicaid $0.13
Rate for Payer: Self Pay Self Pay $3,561.60
Rate for Payer: TriWest Medicare $667.80
Rate for Payer: UnitedHealth Group of AZ Commercial $3,914.00
Rate for Payer: UnitedHealth Group of AZ Medicare $801.36
Service Code CPT 57320
Hospital Charge Code 27291798
Hospital Revenue Code 360
Min. Negotiated Rate $433.50
Max. Negotiated Rate $6,393.84
Rate for Payer: Aetna of AZ Commercial $2,601.00
Rate for Payer: Aetna of AZ Medicare $809.20
Rate for Payer: AHCCCS Medicaid $6,393.84
Rate for Payer: Allwell Medicaid $6,393.84
Rate for Payer: Allwell Medicare $433.50
Rate for Payer: Amerigroup Medicare $433.50
Rate for Payer: APIPA Medicare/Medicaid $1,079.42
Rate for Payer: AZCH Complete Medicaid $6,393.84
Rate for Payer: AZCH Complete Medicare $433.50
Rate for Payer: Banner UC Health Medicaid $6,393.84
Rate for Payer: Banner UC Health Medicare $433.50
Rate for Payer: Bisbee Police All Plans $751.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,965.20
Rate for Payer: Cash Price $2,312.00
Rate for Payer: Cash Price $2,312.00
Rate for Payer: Cigna of AZ Commercial $1,445.00
Rate for Payer: Copperpoint Commercial $715.28
Rate for Payer: Health Net of AZ Commercial $1,734.00
Rate for Payer: Health Net of AZ Medicare $809.20
Rate for Payer: Humana of AZ Medicare $433.50
Rate for Payer: Mercy Care Medicaid $6,393.84
Rate for Payer: Self Pay Self Pay $2,312.00
Rate for Payer: TriWest Medicare $433.50
Rate for Payer: UnitedHealth Group of AZ Commercial $3,914.00
Rate for Payer: UnitedHealth Group of AZ Medicare $520.20
Service Code CPT 57320
Hospital Charge Code 27291798
Hospital Revenue Code 360
Min. Negotiated Rate $751.40
Max. Negotiated Rate $2,601.00
Rate for Payer: Aetna of AZ Commercial $2,601.00
Rate for Payer: Bisbee Police All Plans $751.40
Rate for Payer: Cash Price $2,312.00
Rate for Payer: Self Pay Self Pay $2,312.00
Service Code CPT 87252
Hospital Charge Code 2029221
Hospital Revenue Code 306
Min. Negotiated Rate $116.22
Max. Negotiated Rate $402.30
Rate for Payer: Aetna of AZ Commercial $402.30
Rate for Payer: Bisbee Police All Plans $116.22
Rate for Payer: Cash Price $357.60
Rate for Payer: Self Pay Self Pay $357.60
Service Code CPT 87252
Hospital Charge Code 2029221
Hospital Revenue Code 306
Min. Negotiated Rate $26.07
Max. Negotiated Rate $402.30
Rate for Payer: Aetna of AZ Commercial $402.30
Rate for Payer: Aetna of AZ Medicare $125.16
Rate for Payer: AHCCCS Medicaid $26.07
Rate for Payer: Allwell Medicaid $26.07
Rate for Payer: Allwell Medicare $67.05
Rate for Payer: Amerigroup Medicare $67.05
Rate for Payer: APIPA Medicare/Medicaid $166.95
Rate for Payer: AZCH Complete Medicaid $26.07
Rate for Payer: AZCH Complete Medicare $67.05
Rate for Payer: Banner UC Health Medicaid $26.07
Rate for Payer: Banner UC Health Medicare $67.05
Rate for Payer: Bisbee Police All Plans $116.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $303.96
Rate for Payer: Cash Price $357.60
Rate for Payer: Cash Price $357.60
Rate for Payer: Cigna of AZ Commercial $290.55
Rate for Payer: Copperpoint Commercial $110.63
Rate for Payer: Health Net of AZ Commercial $268.20
Rate for Payer: Health Net of AZ Medicare $125.16
Rate for Payer: Humana of AZ Medicare $67.05
Rate for Payer: Mercy Care Medicaid $26.07
Rate for Payer: Self Pay Self Pay $357.60
Rate for Payer: TriWest Medicare $67.05
Rate for Payer: UnitedHealth Group of AZ Commercial $260.60
Rate for Payer: UnitedHealth Group of AZ Medicare $80.46
Service Code APR-DRG 7234
Hospital Charge Code APRDRG7232
Min. Negotiated Rate $13,657.66
Max. Negotiated Rate $13,657.66
Rate for Payer: AHCCCS Medicaid $13,657.66
Rate for Payer: Allwell Medicaid $13,657.66
Rate for Payer: AZCH Complete Medicaid $13,657.66
Rate for Payer: Banner UC Health Medicaid $13,657.66
Rate for Payer: Mercy Care Medicaid $13,657.66
Service Code APR-DRG 7232
Hospital Charge Code APRDRG7233
Min. Negotiated Rate $3,679.54
Max. Negotiated Rate $3,679.54
Rate for Payer: AHCCCS Medicaid $3,679.54
Rate for Payer: Allwell Medicaid $3,679.54
Rate for Payer: AZCH Complete Medicaid $3,679.54
Rate for Payer: Banner UC Health Medicaid $3,679.54
Rate for Payer: Mercy Care Medicaid $3,679.54
Service Code APR-DRG 7232
Hospital Charge Code APRDRG7231
Min. Negotiated Rate $3,679.54
Max. Negotiated Rate $3,679.54
Rate for Payer: AHCCCS Medicaid $3,679.54
Rate for Payer: Allwell Medicaid $3,679.54
Rate for Payer: AZCH Complete Medicaid $3,679.54
Rate for Payer: Banner UC Health Medicaid $3,679.54
Rate for Payer: Mercy Care Medicaid $3,679.54
Service Code APR-DRG 7233
Hospital Charge Code APRDRG7231
Min. Negotiated Rate $5,933.14
Max. Negotiated Rate $5,933.14
Rate for Payer: AHCCCS Medicaid $5,933.14
Rate for Payer: Allwell Medicaid $5,933.14
Rate for Payer: AZCH Complete Medicaid $5,933.14
Rate for Payer: Banner UC Health Medicaid $5,933.14
Rate for Payer: Mercy Care Medicaid $5,933.14
Service Code APR-DRG 7234
Hospital Charge Code APRDRG7233
Min. Negotiated Rate $13,657.66
Max. Negotiated Rate $13,657.66
Rate for Payer: AHCCCS Medicaid $13,657.66
Rate for Payer: Allwell Medicaid $13,657.66
Rate for Payer: AZCH Complete Medicaid $13,657.66
Rate for Payer: Banner UC Health Medicaid $13,657.66
Rate for Payer: Mercy Care Medicaid $13,657.66
Service Code APR-DRG 7231
Hospital Charge Code APRDRG7234
Min. Negotiated Rate $2,594.48
Max. Negotiated Rate $2,594.48
Rate for Payer: AHCCCS Medicaid $2,594.48
Rate for Payer: Allwell Medicaid $2,594.48
Rate for Payer: AZCH Complete Medicaid $2,594.48
Rate for Payer: Banner UC Health Medicaid $2,594.48
Rate for Payer: Mercy Care Medicaid $2,594.48
Service Code APR-DRG 7232
Hospital Charge Code APRDRG7234
Min. Negotiated Rate $3,679.54
Max. Negotiated Rate $3,679.54
Rate for Payer: AHCCCS Medicaid $3,679.54
Rate for Payer: Allwell Medicaid $3,679.54
Rate for Payer: AZCH Complete Medicaid $3,679.54
Rate for Payer: Banner UC Health Medicaid $3,679.54
Rate for Payer: Mercy Care Medicaid $3,679.54
Service Code APR-DRG 7231
Hospital Charge Code APRDRG7232
Min. Negotiated Rate $2,594.48
Max. Negotiated Rate $2,594.48
Rate for Payer: AHCCCS Medicaid $2,594.48
Rate for Payer: Allwell Medicaid $2,594.48
Rate for Payer: AZCH Complete Medicaid $2,594.48
Rate for Payer: Banner UC Health Medicaid $2,594.48
Rate for Payer: Mercy Care Medicaid $2,594.48
Service Code APR-DRG 7233
Hospital Charge Code APRDRG7234
Min. Negotiated Rate $5,933.14
Max. Negotiated Rate $5,933.14
Rate for Payer: AHCCCS Medicaid $5,933.14
Rate for Payer: Allwell Medicaid $5,933.14
Rate for Payer: AZCH Complete Medicaid $5,933.14
Rate for Payer: Banner UC Health Medicaid $5,933.14
Rate for Payer: Mercy Care Medicaid $5,933.14
Service Code APR-DRG 7233
Hospital Charge Code APRDRG7232
Min. Negotiated Rate $5,933.14
Max. Negotiated Rate $5,933.14
Rate for Payer: AHCCCS Medicaid $5,933.14
Rate for Payer: Allwell Medicaid $5,933.14
Rate for Payer: AZCH Complete Medicaid $5,933.14
Rate for Payer: Banner UC Health Medicaid $5,933.14
Rate for Payer: Mercy Care Medicaid $5,933.14
Service Code APR-DRG 7234
Hospital Charge Code APRDRG7231
Min. Negotiated Rate $13,657.66
Max. Negotiated Rate $13,657.66
Rate for Payer: AHCCCS Medicaid $13,657.66
Rate for Payer: Allwell Medicaid $13,657.66
Rate for Payer: AZCH Complete Medicaid $13,657.66
Rate for Payer: Banner UC Health Medicaid $13,657.66
Rate for Payer: Mercy Care Medicaid $13,657.66