Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

TRANSURETHRAL PROCEDURES WITH MCC

Facility

$37,738.48

Service Code	MSDRG 668
Min. Negotiated Rate	$37,738.48
Max. Negotiated Rate	$37,738.48
Rate for Payer: Seven Corners Travel Insurance	$37,738.48

TRANSURETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$12,738.96

Service Code	MSDRG 670
Min. Negotiated Rate	$12,738.96
Max. Negotiated Rate	$12,738.96
Rate for Payer: Seven Corners Travel Insurance	$12,738.96

Transurethral Prostatectomy

Facility

$11,878.21

Service Code	APR-DRG 4823
Hospital Charge Code	APRDRG4823
Min. Negotiated Rate	$11,878.21
Max. Negotiated Rate	$11,878.21
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$11,878.21
Rate for Payer: Mercy Care Medicaid	$11,878.21
Rate for Payer: NaphCare Correctional Healthcare	$11,878.21

Transurethral Prostatectomy

Facility

$22,298.91

Service Code	APR-DRG 4824
Hospital Charge Code	APRDRG4822
Min. Negotiated Rate	$22,298.91
Max. Negotiated Rate	$22,298.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,298.91
Rate for Payer: Mercy Care Medicaid	$22,298.91
Rate for Payer: NaphCare Correctional Healthcare	$22,298.91

Transurethral Prostatectomy

Facility

$11,878.21

Service Code	APR-DRG 4823
Hospital Charge Code	APRDRG4824
Min. Negotiated Rate	$11,878.21
Max. Negotiated Rate	$11,878.21
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$11,878.21
Rate for Payer: Mercy Care Medicaid	$11,878.21
Rate for Payer: NaphCare Correctional Healthcare	$11,878.21

Transurethral Prostatectomy

Facility

$5,847.57

Service Code	APR-DRG 4822
Hospital Charge Code	APRDRG4822
Min. Negotiated Rate	$5,847.57
Max. Negotiated Rate	$5,847.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,847.57
Rate for Payer: Mercy Care Medicaid	$5,847.57
Rate for Payer: NaphCare Correctional Healthcare	$5,847.57

Transurethral Prostatectomy

Facility

$22,298.91

Service Code	APR-DRG 4824
Hospital Charge Code	APRDRG4824
Min. Negotiated Rate	$22,298.91
Max. Negotiated Rate	$22,298.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,298.91
Rate for Payer: Mercy Care Medicaid	$22,298.91
Rate for Payer: NaphCare Correctional Healthcare	$22,298.91

Transurethral Prostatectomy

Facility

$22,298.91

Service Code	APR-DRG 4824
Hospital Charge Code	APRDRG4821
Min. Negotiated Rate	$22,298.91
Max. Negotiated Rate	$22,298.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,298.91
Rate for Payer: Mercy Care Medicaid	$22,298.91
Rate for Payer: NaphCare Correctional Healthcare	$22,298.91

Transurethral Prostatectomy

Facility

$5,016.41

Service Code	APR-DRG 4821
Hospital Charge Code	APRDRG4823
Min. Negotiated Rate	$5,016.41
Max. Negotiated Rate	$5,016.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,016.41
Rate for Payer: Mercy Care Medicaid	$5,016.41
Rate for Payer: NaphCare Correctional Healthcare	$5,016.41

Transurethral Prostatectomy

Facility

$5,847.57

Service Code	APR-DRG 4822
Hospital Charge Code	APRDRG4824
Min. Negotiated Rate	$5,847.57
Max. Negotiated Rate	$5,847.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,847.57
Rate for Payer: Mercy Care Medicaid	$5,847.57
Rate for Payer: NaphCare Correctional Healthcare	$5,847.57

Transurethral Prostatectomy

Facility

$5,016.41

Service Code	APR-DRG 4821
Hospital Charge Code	APRDRG4824
Min. Negotiated Rate	$5,016.41
Max. Negotiated Rate	$5,016.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,016.41
Rate for Payer: Mercy Care Medicaid	$5,016.41
Rate for Payer: NaphCare Correctional Healthcare	$5,016.41

Transurethral Prostatectomy

Facility

$5,016.41

Service Code	APR-DRG 4821
Hospital Charge Code	APRDRG4821
Min. Negotiated Rate	$5,016.41
Max. Negotiated Rate	$5,016.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,016.41
Rate for Payer: Mercy Care Medicaid	$5,016.41
Rate for Payer: NaphCare Correctional Healthcare	$5,016.41

Transurethral Prostatectomy

Facility

$11,878.21

Service Code	APR-DRG 4823
Hospital Charge Code	APRDRG4822
Min. Negotiated Rate	$11,878.21
Max. Negotiated Rate	$11,878.21
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$11,878.21
Rate for Payer: Mercy Care Medicaid	$11,878.21
Rate for Payer: NaphCare Correctional Healthcare	$11,878.21

Transurethral Prostatectomy

Facility

$5,847.57

Service Code	APR-DRG 4822
Hospital Charge Code	APRDRG4821
Min. Negotiated Rate	$5,847.57
Max. Negotiated Rate	$5,847.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,847.57
Rate for Payer: Mercy Care Medicaid	$5,847.57
Rate for Payer: NaphCare Correctional Healthcare	$5,847.57

Transurethral Prostatectomy

Facility

$22,298.91

Service Code	APR-DRG 4824
Hospital Charge Code	APRDRG4823
Min. Negotiated Rate	$22,298.91
Max. Negotiated Rate	$22,298.91
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$22,298.91
Rate for Payer: Mercy Care Medicaid	$22,298.91
Rate for Payer: NaphCare Correctional Healthcare	$22,298.91

Transurethral Prostatectomy

Facility

$11,878.21

Service Code	APR-DRG 4823
Hospital Charge Code	APRDRG4821
Min. Negotiated Rate	$11,878.21
Max. Negotiated Rate	$11,878.21
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$11,878.21
Rate for Payer: Mercy Care Medicaid	$11,878.21
Rate for Payer: NaphCare Correctional Healthcare	$11,878.21

Transurethral Prostatectomy

Facility

$5,847.57

Service Code	APR-DRG 4822
Hospital Charge Code	APRDRG4823
Min. Negotiated Rate	$5,847.57
Max. Negotiated Rate	$5,847.57
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,847.57
Rate for Payer: Mercy Care Medicaid	$5,847.57
Rate for Payer: NaphCare Correctional Healthcare	$5,847.57

Transurethral Prostatectomy

Facility

$5,016.41

Service Code	APR-DRG 4821
Hospital Charge Code	APRDRG4822
Min. Negotiated Rate	$5,016.41
Max. Negotiated Rate	$5,016.41
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,016.41
Rate for Payer: Mercy Care Medicaid	$5,016.41
Rate for Payer: NaphCare Correctional Healthcare	$5,016.41

TRANSURETHRAL PROSTATECTOMY WITH CC/MCC

Facility

$19,430.13

Service Code	MSDRG 713
Min. Negotiated Rate	$19,430.13
Max. Negotiated Rate	$19,430.13
Rate for Payer: Seven Corners Travel Insurance	$19,430.13

TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC

Facility

$13,753.95

Service Code	MSDRG 714
Min. Negotiated Rate	$13,753.95
Max. Negotiated Rate	$13,753.95
Rate for Payer: Seven Corners Travel Insurance	$13,753.95

TRANSURETHRAL ROBOTIC ASSITED WATERJET RESECTION OF PROSTATE

Facility

$1,500.00

Service Code	CPT 52597
Hospital Charge Code	28254333
Hospital Revenue Code	360
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$14,647.16
Rate for Payer: Aetna of AZ Commercial	$1,350.00
Rate for Payer: Arizona Complete Health Allwell	$240.00
Rate for Payer: Banner UC Health Medicare	$5,976.45
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,020.00
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$240.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$240.00
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Cash Price	$1,200.00
Rate for Payer: Cigna of AZ Commercial	$750.00
Rate for Payer: Devoted Health Medicare	$270.00
Rate for Payer: Humana of AZ Medicare	$240.00
Rate for Payer: NaphCare Correctional Healthcare	$5,976.45
Rate for Payer: Seven Corners Travel Insurance	$14,647.16
Rate for Payer: Southwest Service Administrators UFCW	$1,020.00
Rate for Payer: TriWest Medicare	$240.00
Rate for Payer: United Healthcare Commercial	$3,373.00
Rate for Payer: United Healthcare Medicare	$240.00
Rate for Payer: Veterans Affairs TRICARE	$237.60

TRANSURETHRAL ROBOTIC ASSITED WATERJET RESECTION OF PROSTATE

Facility

$1,500.00

Service Code	CPT 52597
Hospital Charge Code	28254333
Hospital Revenue Code	360
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna of AZ Commercial	$1,350.00
Rate for Payer: Cash Price	$1,200.00

Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)

Facility

$2,671.00

Service Code	CPT 64488
Hospital Revenue Code	360
Min. Negotiated Rate	$67.30
Max. Negotiated Rate	$2,671.00
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$67.30
Rate for Payer: Mercy Care Medicaid	$67.30
Rate for Payer: NaphCare Correctional Healthcare	$67.30
Rate for Payer: United Healthcare Commercial	$2,671.00

TRAP SPECIMEN 80CC

Facility

$9.00

Hospital Charge Code	22926449
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Arizona Complete Health Allwell	$1.44
Rate for Payer: Banner UC Health Medicare	$1.44
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$6.12
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$1.44
Rate for Payer: Care1st Health Plan Arizona Medicare	$1.44
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna of AZ Commercial	$6.30
Rate for Payer: Devoted Health Medicare	$1.62
Rate for Payer: Humana of AZ Medicare	$1.44
Rate for Payer: Southwest Service Administrators UFCW	$6.12
Rate for Payer: TriWest Medicare	$1.44
Rate for Payer: United Healthcare Commercial	$5.15
Rate for Payer: United Healthcare Medicare	$1.44
Rate for Payer: Veterans Affairs TRICARE	$1.43

TRAP SPECIMEN 80CC

Facility

$9.00

Hospital Charge Code	22926449
Hospital Revenue Code	272
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Cash Price	$7.20

Know your out-of-pocket cost for care.

All Charges