Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

US Renal

Facility

$828.00

Service Code	CPT 76770
Hospital Charge Code	1007818
Hospital Revenue Code	402
Min. Negotiated Rate	$132.48
Max. Negotiated Rate	$745.20
Rate for Payer: Aetna of AZ Commercial	$745.20
Rate for Payer: Aetna of AZ Medicare	$231.84
Rate for Payer: Allwell Medicare	$132.48
Rate for Payer: Amerigroup Medicare	$132.48
Rate for Payer: APIPA Medicare/Medicaid	$309.26
Rate for Payer: AZCH Complete Medicare	$132.48
Rate for Payer: Banner UC Health Medicare	$132.48
Rate for Payer: Bisbee Police All Plans	$215.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$563.04
Rate for Payer: Cash Price	$662.40
Rate for Payer: Cigna of AZ Commercial	$579.60
Rate for Payer: Copperpoint Commercial	$204.93
Rate for Payer: Health Net of AZ Commercial	$496.80
Rate for Payer: Health Net of AZ Medicare	$231.84
Rate for Payer: Humana of AZ Medicare	$132.48
Rate for Payer: Self Pay Self Pay	$662.40
Rate for Payer: TriWest Medicare	$132.48
Rate for Payer: UnitedHealth Group of AZ Commercial	$482.72
Rate for Payer: UnitedHealth Group of AZ Medicare	$149.04

US Renal

Facility

$828.00

Service Code	CPT 76770
Hospital Charge Code	1007818
Hospital Revenue Code	402
Min. Negotiated Rate	$215.28
Max. Negotiated Rate	$745.20
Rate for Payer: Aetna of AZ Commercial	$745.20
Rate for Payer: Bisbee Police All Plans	$215.28
Rate for Payer: Cash Price	$662.40
Rate for Payer: Self Pay Self Pay	$662.40

US Retroperitoneal Complete

Facility

$1,474.00

Service Code	CPT 76775
Hospital Charge Code	823461
Hospital Revenue Code	402
Min. Negotiated Rate	$383.24
Max. Negotiated Rate	$1,326.60
Rate for Payer: Aetna of AZ Commercial	$1,326.60
Rate for Payer: Bisbee Police All Plans	$383.24
Rate for Payer: Cash Price	$1,179.20
Rate for Payer: Self Pay Self Pay	$1,179.20

US Retroperitoneal Complete

Facility

$1,474.00

Service Code	CPT 76775
Hospital Charge Code	823461
Hospital Revenue Code	402
Min. Negotiated Rate	$235.84
Max. Negotiated Rate	$1,326.60
Rate for Payer: Aetna of AZ Commercial	$1,326.60
Rate for Payer: Aetna of AZ Medicare	$412.72
Rate for Payer: Allwell Medicare	$235.84
Rate for Payer: Amerigroup Medicare	$235.84
Rate for Payer: APIPA Medicare/Medicaid	$550.54
Rate for Payer: AZCH Complete Medicare	$235.84
Rate for Payer: Banner UC Health Medicare	$235.84
Rate for Payer: Bisbee Police All Plans	$383.24
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,002.32
Rate for Payer: Cash Price	$1,179.20
Rate for Payer: Cigna of AZ Commercial	$1,031.80
Rate for Payer: Copperpoint Commercial	$364.81
Rate for Payer: Health Net of AZ Commercial	$884.40
Rate for Payer: Health Net of AZ Medicare	$412.72
Rate for Payer: Humana of AZ Medicare	$235.84
Rate for Payer: Self Pay Self Pay	$1,179.20
Rate for Payer: TriWest Medicare	$235.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$859.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$265.32

US Scrotum (Contents)

Facility

$1,011.00

Service Code	CPT 76870
Hospital Charge Code	823463
Hospital Revenue Code	402
Min. Negotiated Rate	$161.76
Max. Negotiated Rate	$909.90
Rate for Payer: Aetna of AZ Commercial	$909.90
Rate for Payer: Aetna of AZ Medicare	$283.08
Rate for Payer: Allwell Medicare	$161.76
Rate for Payer: Amerigroup Medicare	$161.76
Rate for Payer: APIPA Medicare/Medicaid	$377.61
Rate for Payer: AZCH Complete Medicare	$161.76
Rate for Payer: Banner UC Health Medicare	$161.76
Rate for Payer: Bisbee Police All Plans	$262.86
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$687.48
Rate for Payer: Cash Price	$808.80
Rate for Payer: Cigna of AZ Commercial	$707.70
Rate for Payer: Copperpoint Commercial	$250.22
Rate for Payer: Health Net of AZ Commercial	$606.60
Rate for Payer: Health Net of AZ Medicare	$283.08
Rate for Payer: Humana of AZ Medicare	$161.76
Rate for Payer: Self Pay Self Pay	$808.80
Rate for Payer: TriWest Medicare	$161.76
Rate for Payer: UnitedHealth Group of AZ Commercial	$589.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$181.98

US Scrotum (Contents)

Facility

$1,011.00

Service Code	CPT 76870
Hospital Charge Code	823463
Hospital Revenue Code	402
Min. Negotiated Rate	$262.86
Max. Negotiated Rate	$909.90
Rate for Payer: Aetna of AZ Commercial	$909.90
Rate for Payer: Bisbee Police All Plans	$262.86
Rate for Payer: Cash Price	$808.80
Rate for Payer: Self Pay Self Pay	$808.80

US Spleen

Facility

$870.00

Service Code	CPT 76700
Hospital Charge Code	2214236
Hospital Revenue Code	402
Min. Negotiated Rate	$139.20
Max. Negotiated Rate	$783.00
Rate for Payer: Aetna of AZ Commercial	$783.00
Rate for Payer: Aetna of AZ Medicare	$243.60
Rate for Payer: Allwell Medicare	$139.20
Rate for Payer: Amerigroup Medicare	$139.20
Rate for Payer: APIPA Medicare/Medicaid	$324.94
Rate for Payer: AZCH Complete Medicare	$139.20
Rate for Payer: Banner UC Health Medicare	$139.20
Rate for Payer: Bisbee Police All Plans	$226.20
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$591.60
Rate for Payer: Cash Price	$696.00
Rate for Payer: Cigna of AZ Commercial	$609.00
Rate for Payer: Copperpoint Commercial	$215.32
Rate for Payer: Health Net of AZ Commercial	$522.00
Rate for Payer: Health Net of AZ Medicare	$243.60
Rate for Payer: Humana of AZ Medicare	$139.20
Rate for Payer: Self Pay Self Pay	$696.00
Rate for Payer: TriWest Medicare	$139.20
Rate for Payer: UnitedHealth Group of AZ Commercial	$507.21
Rate for Payer: UnitedHealth Group of AZ Medicare	$156.60

US Spleen

Facility

$870.00

Service Code	CPT 76700
Hospital Charge Code	2214236
Hospital Revenue Code	402
Min. Negotiated Rate	$226.20
Max. Negotiated Rate	$783.00
Rate for Payer: Aetna of AZ Commercial	$783.00
Rate for Payer: Bisbee Police All Plans	$226.20
Rate for Payer: Cash Price	$696.00
Rate for Payer: Self Pay Self Pay	$696.00

US Superficial Mass

Facility

$740.00

Service Code	CPT 76881
Hospital Charge Code	1319948
Hospital Revenue Code	402
Min. Negotiated Rate	$192.40
Max. Negotiated Rate	$666.00
Rate for Payer: Aetna of AZ Commercial	$666.00
Rate for Payer: Bisbee Police All Plans	$192.40
Rate for Payer: Cash Price	$592.00
Rate for Payer: Self Pay Self Pay	$592.00

US Superficial Mass

Facility

$740.00

Service Code	CPT 76881
Hospital Charge Code	1319948
Hospital Revenue Code	402
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$666.00
Rate for Payer: Aetna of AZ Commercial	$666.00
Rate for Payer: Aetna of AZ Medicare	$207.20
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$118.40
Rate for Payer: Amerigroup Medicare	$118.40
Rate for Payer: APIPA Medicare/Medicaid	$276.39
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$118.40
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$118.40
Rate for Payer: Bisbee Police All Plans	$192.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$503.20
Rate for Payer: Cash Price	$592.00
Rate for Payer: Cash Price	$592.00
Rate for Payer: Cigna of AZ Commercial	$518.00
Rate for Payer: Copperpoint Commercial	$183.15
Rate for Payer: Health Net of AZ Commercial	$444.00
Rate for Payer: Health Net of AZ Medicare	$207.20
Rate for Payer: Humana of AZ Medicare	$118.40
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$592.00
Rate for Payer: TriWest Medicare	$118.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$431.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$133.20

US Thyroid

Facility

$1,291.00

Service Code	CPT 76536
Hospital Charge Code	1007837
Hospital Revenue Code	402
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$1,161.90
Rate for Payer: Aetna of AZ Commercial	$1,161.90
Rate for Payer: Aetna of AZ Medicare	$361.48
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$206.56
Rate for Payer: Amerigroup Medicare	$206.56
Rate for Payer: APIPA Medicare/Medicaid	$482.19
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$206.56
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$206.56
Rate for Payer: Bisbee Police All Plans	$335.66
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$877.88
Rate for Payer: Cash Price	$1,032.80
Rate for Payer: Cash Price	$1,032.80
Rate for Payer: Cigna of AZ Commercial	$903.70
Rate for Payer: Copperpoint Commercial	$319.52
Rate for Payer: Health Net of AZ Commercial	$774.60
Rate for Payer: Health Net of AZ Medicare	$361.48
Rate for Payer: Humana of AZ Medicare	$206.56
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$1,032.80
Rate for Payer: TriWest Medicare	$206.56
Rate for Payer: UnitedHealth Group of AZ Commercial	$752.65
Rate for Payer: UnitedHealth Group of AZ Medicare	$232.38

US Thyroid

Facility

$1,291.00

Service Code	CPT 76536
Hospital Charge Code	1007837
Hospital Revenue Code	402
Min. Negotiated Rate	$335.66
Max. Negotiated Rate	$1,161.90
Rate for Payer: Aetna of AZ Commercial	$1,161.90
Rate for Payer: Bisbee Police All Plans	$335.66
Rate for Payer: Cash Price	$1,032.80
Rate for Payer: Self Pay Self Pay	$1,032.80

US Transvaginal

Facility

$964.00

Service Code	CPT 76830
Hospital Charge Code	823467
Hospital Revenue Code	402
Min. Negotiated Rate	$250.64
Max. Negotiated Rate	$867.60
Rate for Payer: Aetna of AZ Commercial	$867.60
Rate for Payer: Bisbee Police All Plans	$250.64
Rate for Payer: Cash Price	$771.20
Rate for Payer: Self Pay Self Pay	$771.20

US Transvaginal

Facility

$964.00

Service Code	CPT 76830
Hospital Charge Code	823467
Hospital Revenue Code	402
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$867.60
Rate for Payer: Aetna of AZ Commercial	$867.60
Rate for Payer: Aetna of AZ Medicare	$269.92
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$154.24
Rate for Payer: Amerigroup Medicare	$154.24
Rate for Payer: APIPA Medicare/Medicaid	$360.05
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$154.24
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$154.24
Rate for Payer: Bisbee Police All Plans	$250.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$655.52
Rate for Payer: Cash Price	$771.20
Rate for Payer: Cash Price	$771.20
Rate for Payer: Cigna of AZ Commercial	$674.80
Rate for Payer: Copperpoint Commercial	$238.59
Rate for Payer: Health Net of AZ Commercial	$578.40
Rate for Payer: Health Net of AZ Medicare	$269.92
Rate for Payer: Humana of AZ Medicare	$154.24
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$771.20
Rate for Payer: TriWest Medicare	$154.24
Rate for Payer: UnitedHealth Group of AZ Commercial	$562.01
Rate for Payer: UnitedHealth Group of AZ Medicare	$173.52

US UE Arterial Duplex Bilateral

Facility

$1,807.00

Service Code	CPT 93930
Hospital Charge Code	823471
Hospital Revenue Code	921
Min. Negotiated Rate	$166.84
Max. Negotiated Rate	$1,626.30
Rate for Payer: Aetna of AZ Commercial	$1,626.30
Rate for Payer: Aetna of AZ Medicare	$505.96
Rate for Payer: AHCCCS Medicaid	$166.84
Rate for Payer: Allwell Medicaid	$166.84
Rate for Payer: Allwell Medicare	$289.12
Rate for Payer: Amerigroup Medicare	$289.12
Rate for Payer: APIPA Medicare/Medicaid	$674.91
Rate for Payer: AZCH Complete Medicaid	$166.84
Rate for Payer: AZCH Complete Medicare	$289.12
Rate for Payer: Banner UC Health Medicaid	$166.84
Rate for Payer: Banner UC Health Medicare	$289.12
Rate for Payer: Bisbee Police All Plans	$469.82
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,228.76
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Cigna of AZ Commercial	$1,264.90
Rate for Payer: Copperpoint Commercial	$447.23
Rate for Payer: Health Net of AZ Commercial	$1,084.20
Rate for Payer: Health Net of AZ Medicare	$505.96
Rate for Payer: Humana of AZ Medicare	$289.12
Rate for Payer: Mercy Care Medicaid	$166.84
Rate for Payer: Self Pay Self Pay	$1,445.60
Rate for Payer: TriWest Medicare	$289.12
Rate for Payer: UnitedHealth Group of AZ Commercial	$1,053.48
Rate for Payer: UnitedHealth Group of AZ Medicare	$325.26

US UE Arterial Duplex Bilateral

Facility

$1,807.00

Service Code	CPT 93930
Hospital Charge Code	823471
Hospital Revenue Code	921
Min. Negotiated Rate	$469.82
Max. Negotiated Rate	$1,626.30
Rate for Payer: Aetna of AZ Commercial	$1,626.30
Rate for Payer: Bisbee Police All Plans	$469.82
Rate for Payer: Cash Price	$1,445.60
Rate for Payer: Self Pay Self Pay	$1,445.60

US UE Arterial Duplex Left

Facility

$1,050.00

Service Code	CPT 93931
Hospital Charge Code	823473
Hospital Revenue Code	921
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna of AZ Commercial	$945.00
Rate for Payer: Aetna of AZ Medicare	$294.00
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$168.00
Rate for Payer: Amerigroup Medicare	$168.00
Rate for Payer: APIPA Medicare/Medicaid	$392.18
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$168.00
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$168.00
Rate for Payer: Bisbee Police All Plans	$273.00
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$714.00
Rate for Payer: Cash Price	$840.00
Rate for Payer: Cash Price	$840.00
Rate for Payer: Cigna of AZ Commercial	$735.00
Rate for Payer: Copperpoint Commercial	$259.88
Rate for Payer: Health Net of AZ Commercial	$630.00
Rate for Payer: Health Net of AZ Medicare	$294.00
Rate for Payer: Humana of AZ Medicare	$168.00
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$840.00
Rate for Payer: TriWest Medicare	$168.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$612.15
Rate for Payer: UnitedHealth Group of AZ Medicare	$189.00

US UE Arterial Duplex Left

Facility

$1,050.00

Service Code	CPT 93931
Hospital Charge Code	823473
Hospital Revenue Code	921
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna of AZ Commercial	$945.00
Rate for Payer: Bisbee Police All Plans	$273.00
Rate for Payer: Cash Price	$840.00
Rate for Payer: Self Pay Self Pay	$840.00

US UE Arterial Duplex Right

Facility

$778.00

Service Code	CPT 93931
Hospital Charge Code	823475
Hospital Revenue Code	921
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$700.20
Rate for Payer: Aetna of AZ Commercial	$700.20
Rate for Payer: Aetna of AZ Medicare	$217.84
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$124.48
Rate for Payer: Amerigroup Medicare	$124.48
Rate for Payer: APIPA Medicare/Medicaid	$290.58
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$124.48
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$124.48
Rate for Payer: Bisbee Police All Plans	$202.28
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$529.04
Rate for Payer: Cash Price	$622.40
Rate for Payer: Cash Price	$622.40
Rate for Payer: Cigna of AZ Commercial	$544.60
Rate for Payer: Copperpoint Commercial	$192.56
Rate for Payer: Health Net of AZ Commercial	$466.80
Rate for Payer: Health Net of AZ Medicare	$217.84
Rate for Payer: Humana of AZ Medicare	$124.48
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$622.40
Rate for Payer: TriWest Medicare	$124.48
Rate for Payer: UnitedHealth Group of AZ Commercial	$453.57
Rate for Payer: UnitedHealth Group of AZ Medicare	$140.04

US UE Arterial Duplex Right

Facility

$778.00

Service Code	CPT 93931
Hospital Charge Code	823475
Hospital Revenue Code	921
Min. Negotiated Rate	$202.28
Max. Negotiated Rate	$700.20
Rate for Payer: Aetna of AZ Commercial	$700.20
Rate for Payer: Bisbee Police All Plans	$202.28
Rate for Payer: Cash Price	$622.40
Rate for Payer: Self Pay Self Pay	$622.40

US UE Venous Duplex Bilateral

Facility

$1,516.00

Service Code	CPT 93970
Hospital Charge Code	823477
Hospital Revenue Code	921
Min. Negotiated Rate	$166.84
Max. Negotiated Rate	$1,364.40
Rate for Payer: Aetna of AZ Commercial	$1,364.40
Rate for Payer: Aetna of AZ Medicare	$424.48
Rate for Payer: AHCCCS Medicaid	$166.84
Rate for Payer: Allwell Medicaid	$166.84
Rate for Payer: Allwell Medicare	$242.56
Rate for Payer: Amerigroup Medicare	$242.56
Rate for Payer: APIPA Medicare/Medicaid	$566.23
Rate for Payer: AZCH Complete Medicaid	$166.84
Rate for Payer: AZCH Complete Medicare	$242.56
Rate for Payer: Banner UC Health Medicaid	$166.84
Rate for Payer: Banner UC Health Medicare	$242.56
Rate for Payer: Bisbee Police All Plans	$394.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$1,030.88
Rate for Payer: Cash Price	$1,212.80
Rate for Payer: Cash Price	$1,212.80
Rate for Payer: Cigna of AZ Commercial	$1,061.20
Rate for Payer: Copperpoint Commercial	$375.21
Rate for Payer: Health Net of AZ Commercial	$909.60
Rate for Payer: Health Net of AZ Medicare	$424.48
Rate for Payer: Humana of AZ Medicare	$242.56
Rate for Payer: Mercy Care Medicaid	$166.84
Rate for Payer: Self Pay Self Pay	$1,212.80
Rate for Payer: TriWest Medicare	$242.56
Rate for Payer: UnitedHealth Group of AZ Commercial	$883.83
Rate for Payer: UnitedHealth Group of AZ Medicare	$272.88

US UE Venous Duplex Bilateral

Facility

$1,516.00

Service Code	CPT 93970
Hospital Charge Code	823477
Hospital Revenue Code	921
Min. Negotiated Rate	$394.16
Max. Negotiated Rate	$1,364.40
Rate for Payer: Aetna of AZ Commercial	$1,364.40
Rate for Payer: Bisbee Police All Plans	$394.16
Rate for Payer: Cash Price	$1,212.80
Rate for Payer: Self Pay Self Pay	$1,212.80

US UE Venous Duplex Left

Facility

$862.00

Service Code	CPT 93971
Hospital Charge Code	823479
Hospital Revenue Code	921
Min. Negotiated Rate	$224.12
Max. Negotiated Rate	$775.80
Rate for Payer: Aetna of AZ Commercial	$775.80
Rate for Payer: Bisbee Police All Plans	$224.12
Rate for Payer: Cash Price	$689.60
Rate for Payer: Self Pay Self Pay	$689.60

US UE Venous Duplex Left

Facility

$862.00

Service Code	CPT 93971
Hospital Charge Code	823479
Hospital Revenue Code	921
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$775.80
Rate for Payer: Aetna of AZ Commercial	$775.80
Rate for Payer: Aetna of AZ Medicare	$241.36
Rate for Payer: AHCCCS Medicaid	$79.00
Rate for Payer: Allwell Medicaid	$79.00
Rate for Payer: Allwell Medicare	$137.92
Rate for Payer: Amerigroup Medicare	$137.92
Rate for Payer: APIPA Medicare/Medicaid	$321.96
Rate for Payer: AZCH Complete Medicaid	$79.00
Rate for Payer: AZCH Complete Medicare	$137.92
Rate for Payer: Banner UC Health Medicaid	$79.00
Rate for Payer: Banner UC Health Medicare	$137.92
Rate for Payer: Bisbee Police All Plans	$224.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$586.16
Rate for Payer: Cash Price	$689.60
Rate for Payer: Cash Price	$689.60
Rate for Payer: Cigna of AZ Commercial	$603.40
Rate for Payer: Copperpoint Commercial	$213.34
Rate for Payer: Health Net of AZ Commercial	$517.20
Rate for Payer: Health Net of AZ Medicare	$241.36
Rate for Payer: Humana of AZ Medicare	$137.92
Rate for Payer: Mercy Care Medicaid	$79.00
Rate for Payer: Self Pay Self Pay	$689.60
Rate for Payer: TriWest Medicare	$137.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$502.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$155.16

US UE Venous Duplex Right

Facility

$862.00

Service Code	CPT 93971
Hospital Charge Code	823481
Hospital Revenue Code	921
Min. Negotiated Rate	$224.12
Max. Negotiated Rate	$775.80
Rate for Payer: Aetna of AZ Commercial	$775.80
Rate for Payer: Bisbee Police All Plans	$224.12
Rate for Payer: Cash Price	$689.60
Rate for Payer: Self Pay Self Pay	$689.60

Know your out-of-pocket cost for care.

All Charges