Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0051
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57
Rate for Payer: NaphCare Correctional Healthcare	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57
Rate for Payer: NaphCare Correctional Healthcare	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$39,671.18
Max. Negotiated Rate	$39,671.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$39,671.18
Rate for Payer: Mercy Care Medicaid	$39,671.18
Rate for Payer: NaphCare Correctional Healthcare	$39,671.18

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92
Rate for Payer: NaphCare Correctional Healthcare	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57
Rate for Payer: NaphCare Correctional Healthcare	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92
Rate for Payer: NaphCare Correctional Healthcare	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0051
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92
Rate for Payer: NaphCare Correctional Healthcare	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27
Rate for Payer: NaphCare Correctional Healthcare	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27
Rate for Payer: NaphCare Correctional Healthcare	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$71,753.92

Service Code	APR-DRG 0054
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$71,753.92
Max. Negotiated Rate	$71,753.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$71,753.92
Rate for Payer: Mercy Care Medicaid	$71,753.92
Rate for Payer: NaphCare Correctional Healthcare	$71,753.92

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0051
Min. Negotiated Rate	$39,671.18
Max. Negotiated Rate	$39,671.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$39,671.18
Rate for Payer: Mercy Care Medicaid	$39,671.18
Rate for Payer: NaphCare Correctional Healthcare	$39,671.18

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0051
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27
Rate for Payer: NaphCare Correctional Healthcare	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$29,144.57

Service Code	APR-DRG 0051
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$29,144.57
Max. Negotiated Rate	$29,144.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$29,144.57
Rate for Payer: Mercy Care Medicaid	$29,144.57
Rate for Payer: NaphCare Correctional Healthcare	$29,144.57

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$50,436.27

Service Code	APR-DRG 0053
Hospital Charge Code	APRDRG0053
Min. Negotiated Rate	$50,436.27
Max. Negotiated Rate	$50,436.27
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$50,436.27
Rate for Payer: Mercy Care Medicaid	$50,436.27
Rate for Payer: NaphCare Correctional Healthcare	$50,436.27

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0052
Min. Negotiated Rate	$39,671.18
Max. Negotiated Rate	$39,671.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$39,671.18
Rate for Payer: Mercy Care Medicaid	$39,671.18
Rate for Payer: NaphCare Correctional Healthcare	$39,671.18

Tracheostomy With Mv >96 Hours Without Extensive Procedure

Facility

IP

$39,671.18

Service Code	APR-DRG 0052
Hospital Charge Code	APRDRG0054
Min. Negotiated Rate	$39,671.18
Max. Negotiated Rate	$39,671.18
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$39,671.18
Rate for Payer: Mercy Care Medicaid	$39,671.18
Rate for Payer: NaphCare Correctional Healthcare	$39,671.18

TRACH MASK

Facility

OP

$14.00

Hospital Charge Code	22355568
Hospital Revenue Code	270
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Arizona Complete Health Allwell	$2.24
Rate for Payer: Banner UC Health Medicare	$2.24
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$9.52
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$2.24
Rate for Payer: Care1st Health Plan Arizona Medicare	$2.24
Rate for Payer: Cash Price	$11.20
Rate for Payer: Cigna of AZ Commercial	$9.80
Rate for Payer: Devoted Health Medicare	$2.52
Rate for Payer: Humana of AZ Medicare	$2.24
Rate for Payer: Southwest Service Administrators UFCW	$9.52
Rate for Payer: TriWest Medicare	$2.24
Rate for Payer: United Healthcare Commercial	$8.01
Rate for Payer: United Healthcare Medicare	$2.24
Rate for Payer: Veterans Affairs TRICARE	$2.22

TRACH MASK

Facility

IP

$14.00

Hospital Charge Code	22355568
Hospital Revenue Code	270
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna of AZ Commercial	$12.60
Rate for Payer: Cash Price	$11.20

TRACH STRAP CHILD ADULT HOOK AND L

Facility

OP

$13.00

Hospital Charge Code	23549206
Hospital Revenue Code	270
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Arizona Complete Health Allwell	$2.08
Rate for Payer: Banner UC Health Medicare	$2.08
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$8.84
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$2.08
Rate for Payer: Care1st Health Plan Arizona Medicare	$2.08
Rate for Payer: Cash Price	$10.40
Rate for Payer: Cigna of AZ Commercial	$9.10
Rate for Payer: Devoted Health Medicare	$2.34
Rate for Payer: Humana of AZ Medicare	$2.08
Rate for Payer: Southwest Service Administrators UFCW	$8.84
Rate for Payer: TriWest Medicare	$2.08
Rate for Payer: United Healthcare Commercial	$7.44
Rate for Payer: United Healthcare Medicare	$2.08
Rate for Payer: Veterans Affairs TRICARE	$2.06

TRACH STRAP CHILD ADULT HOOK AND L

Facility

IP

$13.00

Hospital Charge Code	23549206
Hospital Revenue Code	270
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of AZ Commercial	$11.70
Rate for Payer: Cash Price	$10.40

traMADol 50 mg Tab [CQCH]

Facility

OP

$0.06

Service Code	NDC 904636561
Hospital Charge Code	105944199
Hospital Revenue Code	251
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Arizona Complete Health Allwell	$0.01
Rate for Payer: Banner UC Health Medicare	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$0.04
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.01
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.01
Rate for Payer: Cash Price	$0.05
Rate for Payer: Cigna of AZ Commercial	$0.04
Rate for Payer: Devoted Health Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Southwest Service Administrators UFCW	$0.04
Rate for Payer: TriWest Medicare	$0.01
Rate for Payer: United Healthcare Commercial	$0.03
Rate for Payer: United Healthcare Medicare	$0.01
Rate for Payer: Veterans Affairs TRICARE	$0.01

traMADol 50 mg Tab [CQCH]

Facility

IP

$0.06

Service Code	NDC 904636561
Hospital Charge Code	105944199
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna of AZ Commercial	$0.05
Rate for Payer: Cash Price	$0.05

tranexamic acid 100 mg/mL 10 ml inj[CQCH]

Facility

IP

$0.21

Service Code	NDC 81284061110
Hospital Charge Code	241912544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Cash Price	$0.17

tranexamic acid 100 mg/mL 10 ml inj[CQCH]

Facility

OP

$0.21

Service Code	NDC 81284061110
Hospital Charge Code	241912544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.19
Rate for Payer: Aetna of AZ Commercial	$0.19
Rate for Payer: Arizona Complete Health Allwell	$0.03
Rate for Payer: Banner UC Health Medicare	$0.03
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$0.14
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.03
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.03
Rate for Payer: Cash Price	$0.17
Rate for Payer: Cigna of AZ Commercial	$0.14
Rate for Payer: Devoted Health Medicare	$0.04
Rate for Payer: Humana of AZ Medicare	$0.03
Rate for Payer: Southwest Service Administrators UFCW	$0.14
Rate for Payer: TriWest Medicare	$0.03
Rate for Payer: United Healthcare Commercial	$0.12
Rate for Payer: United Healthcare Medicare	$0.03
Rate for Payer: Veterans Affairs TRICARE	$0.03

tranexamic acid 10 mg/mL-NaCl 0.7% Sol[CQCH]

Facility

OP

$0.01

Service Code	NDC 51754010803
Hospital Charge Code	197259247
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna of AZ Commercial	$0.01
Rate for Payer: Arizona Complete Health Allwell	$0.00
Rate for Payer: Banner UC Health Medicare	$0.00
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$0.01
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.00
Rate for Payer: Cash Price	$0.01
Rate for Payer: Cigna of AZ Commercial	$0.01
Rate for Payer: Devoted Health Medicare	$0.00
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Southwest Service Administrators UFCW	$0.01
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: United Healthcare Commercial	$0.01
Rate for Payer: United Healthcare Medicare	$0.00
Rate for Payer: Veterans Affairs TRICARE	$0.00

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