|
ANES ANESTHESIA PRONE POSITION CHARGE BASE AND 1ST MINUTE
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 01992
|
| Hospital Charge Code |
22625272
|
|
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
|
|
|
ANES ANESTHESIA PRONE POSITION CHARGE BASE AND 1ST MINUTE
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 01992
|
| Hospital Charge Code |
22625272
|
|
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
|
|
|
ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT 1S
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22625273
|
|
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
|
|
|
ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT 1S
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22625273
|
|
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
|
|
|
ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT AD
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22625274
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna of AZ Commercial |
$35.10
|
| Rate for Payer: Bisbee Police All Plans |
$10.14
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Self Pay Self Pay |
$31.20
|
|
|
ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT AD
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22625274
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna of AZ Commercial |
$35.10
|
| Rate for Payer: Aetna of AZ Medicare |
$10.92
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$5.85
|
| Rate for Payer: Amerigroup Medicare |
$5.85
|
| Rate for Payer: APIPA Medicare/Medicaid |
$14.57
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$5.85
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$5.85
|
| Rate for Payer: Bisbee Police All Plans |
$10.14
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$26.52
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cigna of AZ Commercial |
$25.35
|
| Rate for Payer: Copperpoint Commercial |
$9.65
|
| Rate for Payer: Health Net of AZ Commercial |
$23.40
|
| Rate for Payer: Health Net of AZ Medicare |
$10.92
|
| Rate for Payer: Humana of AZ Medicare |
$5.85
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$31.20
|
| Rate for Payer: TriWest Medicare |
$5.85
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$22.74
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$7.02
|
|
|
Anes Forearm Wrist and Hand Addtnl 0:30 charge
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT 01810
|
| Hospital Charge Code |
23788219
|
|
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
|
|
|
Anes Forearm Wrist and Hand Addtnl 0:30 charge
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT 01810
|
| Hospital Charge Code |
23788219
|
|
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
|
|
|
ANES FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPE
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 00635
|
| Hospital Charge Code |
22625439
|
|
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
|
|
|
ANES FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPE
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 00635
|
| Hospital Charge Code |
22625438
|
|
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
|
|
|
ANES FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPE
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 00635
|
| Hospital Charge Code |
22625439
|
|
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
|
|
|
ANES FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPE
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 00635
|
| Hospital Charge Code |
22625438
|
|
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
|
|
|
ANES NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FIL
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 00862
|
| Hospital Charge Code |
22625436
|
|
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
|
|
|
ANES NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FIL
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 00862
|
| Hospital Charge Code |
22625437
|
|
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
|
|
|
ANES NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FIL
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 00862
|
| Hospital Charge Code |
22625437
|
|
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
|
|
|
ANES NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FIL
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 00862
|
| Hospital Charge Code |
22625436
|
|
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
|
|
|
ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION 1ST 0:30
|
Facility
|
IP
|
$591.00
|
|
|
Service Code
|
CPT 00532
|
| Hospital Charge Code |
22825334
|
|
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
|
|
|
ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION 1ST 0:30
|
Facility
|
OP
|
$591.00
|
|
|
Service Code
|
CPT 00532
|
| Hospital Charge Code |
22825334
|
|
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
|
|
|
Anesthesia for Access to Central Venous Circulation Addtnl 0
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
CPT 00532
|
| Hospital Charge Code |
22825335
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna of AZ Commercial |
$506.70
|
| Rate for Payer: Aetna of AZ Medicare |
$157.64
|
| Rate for Payer: AHCCCS Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicaid |
$0.13
|
| Rate for Payer: Allwell Medicare |
$84.45
|
| Rate for Payer: Amerigroup Medicare |
$84.45
|
| Rate for Payer: APIPA Medicare/Medicaid |
$210.28
|
| Rate for Payer: AZCH Complete Medicaid |
$0.13
|
| Rate for Payer: AZCH Complete Medicare |
$84.45
|
| Rate for Payer: Banner UC Health Medicaid |
$0.13
|
| Rate for Payer: Banner UC Health Medicare |
$84.45
|
| Rate for Payer: Bisbee Police All Plans |
$146.38
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$382.84
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cigna of AZ Commercial |
$365.95
|
| Rate for Payer: Copperpoint Commercial |
$139.34
|
| Rate for Payer: Health Net of AZ Commercial |
$337.80
|
| Rate for Payer: Health Net of AZ Medicare |
$157.64
|
| Rate for Payer: Humana of AZ Medicare |
$84.45
|
| Rate for Payer: Mercy Care Medicaid |
$0.13
|
| Rate for Payer: Self Pay Self Pay |
$450.40
|
| Rate for Payer: TriWest Medicare |
$84.45
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$328.23
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$101.34
|
|
|
Anesthesia for Access to Central Venous Circulation Addtnl 0
|
Facility
|
IP
|
$563.00
|
|
|
Service Code
|
CPT 00532
|
| Hospital Charge Code |
22825335
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$146.38 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna of AZ Commercial |
$506.70
|
| Rate for Payer: Bisbee Police All Plans |
$146.38
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Self Pay Self Pay |
$450.40
|
|
|
Anesthesia for transurethral procedures (including urethroCY
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 00918
|
| Hospital Charge Code |
22406156
|
|
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
|
|
|
Anesthesia for transurethral procedures (including urethroCY
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 00918
|
| Hospital Charge Code |
22406156
|
|
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
|
|
|
ANESTHESIA MASK
|
Facility
|
IP
|
$8.00
|
|
| Hospital Charge Code |
22355433
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna of AZ Commercial |
$7.20
|
| Rate for Payer: Bisbee Police All Plans |
$2.08
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Self Pay Self Pay |
$6.40
|
|
|
ANESTHESIA MASK
|
Facility
|
OP
|
$8.00
|
|
| Hospital Charge Code |
22355433
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna of AZ Commercial |
$7.20
|
| Rate for Payer: Aetna of AZ Medicare |
$2.24
|
| Rate for Payer: Allwell Medicare |
$1.20
|
| Rate for Payer: Amerigroup Medicare |
$1.20
|
| Rate for Payer: APIPA Medicare/Medicaid |
$2.99
|
| Rate for Payer: AZCH Complete Medicare |
$1.20
|
| Rate for Payer: Banner UC Health Medicare |
$1.20
|
| Rate for Payer: Bisbee Police All Plans |
$2.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$5.44
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cigna of AZ Commercial |
$5.60
|
| Rate for Payer: Copperpoint Commercial |
$1.98
|
| Rate for Payer: Health Net of AZ Commercial |
$4.80
|
| Rate for Payer: Health Net of AZ Medicare |
$2.24
|
| Rate for Payer: Humana of AZ Medicare |
$1.20
|
| Rate for Payer: Self Pay Self Pay |
$6.40
|
| Rate for Payer: TriWest Medicare |
$1.20
|
| Rate for Payer: UnitedHealth Group of AZ Commercial |
$4.66
|
| Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.44
|
|
|
ANESTHESIA SET
|
Facility
|
IP
|
$19.00
|
|
| Hospital Charge Code |
22355691
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$17.10 |
| Rate for Payer: Aetna of AZ Commercial |
$17.10
|
| Rate for Payer: Bisbee Police All Plans |
$4.94
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Self Pay Self Pay |
$15.20
|
|
