Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Acute Kidney Injury

Facility

$4,072.33

Service Code	APR-DRG 4692
Hospital Charge Code	APRDRG4691
Min. Negotiated Rate	$4,072.33
Max. Negotiated Rate	$4,072.33
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,072.33
Rate for Payer: Mercy Care Medicaid	$4,072.33
Rate for Payer: NaphCare Correctional Healthcare	$4,072.33

Acute Kidney Injury

Facility

$6,575.63

Service Code	APR-DRG 4693
Hospital Charge Code	APRDRG4692
Min. Negotiated Rate	$6,575.63
Max. Negotiated Rate	$6,575.63
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$6,575.63
Rate for Payer: Mercy Care Medicaid	$6,575.63
Rate for Payer: NaphCare Correctional Healthcare	$6,575.63

Acute Leukemia

Facility

$8,829.92

Service Code	APR-DRG 6901
Hospital Charge Code	APRDRG6903
Min. Negotiated Rate	$8,829.92
Max. Negotiated Rate	$8,829.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,829.92
Rate for Payer: Mercy Care Medicaid	$8,829.92
Rate for Payer: NaphCare Correctional Healthcare	$8,829.92

Acute Leukemia

Facility

$48,504.62

Service Code	APR-DRG 6904
Hospital Charge Code	APRDRG6903
Min. Negotiated Rate	$48,504.62
Max. Negotiated Rate	$48,504.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$48,504.62
Rate for Payer: Mercy Care Medicaid	$48,504.62
Rate for Payer: NaphCare Correctional Healthcare	$48,504.62

Acute Leukemia

Facility

$14,831.80

Service Code	APR-DRG 6902
Hospital Charge Code	APRDRG6903
Min. Negotiated Rate	$14,831.80
Max. Negotiated Rate	$14,831.80
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,831.80
Rate for Payer: Mercy Care Medicaid	$14,831.80
Rate for Payer: NaphCare Correctional Healthcare	$14,831.80

Acute Leukemia

Facility

$48,504.62

Service Code	APR-DRG 6904
Hospital Charge Code	APRDRG6902
Min. Negotiated Rate	$48,504.62
Max. Negotiated Rate	$48,504.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$48,504.62
Rate for Payer: Mercy Care Medicaid	$48,504.62
Rate for Payer: NaphCare Correctional Healthcare	$48,504.62

Acute Leukemia

Facility

$14,831.80

Service Code	APR-DRG 6902
Hospital Charge Code	APRDRG6902
Min. Negotiated Rate	$14,831.80
Max. Negotiated Rate	$14,831.80
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,831.80
Rate for Payer: Mercy Care Medicaid	$14,831.80
Rate for Payer: NaphCare Correctional Healthcare	$14,831.80

Acute Leukemia

Facility

$30,254.19

Service Code	APR-DRG 6903
Hospital Charge Code	APRDRG6902
Min. Negotiated Rate	$30,254.19
Max. Negotiated Rate	$30,254.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,254.19
Rate for Payer: Mercy Care Medicaid	$30,254.19
Rate for Payer: NaphCare Correctional Healthcare	$30,254.19

Acute Leukemia

Facility

$30,254.19

Service Code	APR-DRG 6903
Hospital Charge Code	APRDRG6901
Min. Negotiated Rate	$30,254.19
Max. Negotiated Rate	$30,254.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,254.19
Rate for Payer: Mercy Care Medicaid	$30,254.19
Rate for Payer: NaphCare Correctional Healthcare	$30,254.19

Acute Leukemia

Facility

$14,831.80

Service Code	APR-DRG 6902
Hospital Charge Code	APRDRG6904
Min. Negotiated Rate	$14,831.80
Max. Negotiated Rate	$14,831.80
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,831.80
Rate for Payer: Mercy Care Medicaid	$14,831.80
Rate for Payer: NaphCare Correctional Healthcare	$14,831.80

Acute Leukemia

Facility

$8,829.92

Service Code	APR-DRG 6901
Hospital Charge Code	APRDRG6901
Min. Negotiated Rate	$8,829.92
Max. Negotiated Rate	$8,829.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,829.92
Rate for Payer: Mercy Care Medicaid	$8,829.92
Rate for Payer: NaphCare Correctional Healthcare	$8,829.92

Acute Leukemia

Facility

$14,831.80

Service Code	APR-DRG 6902
Hospital Charge Code	APRDRG6901
Min. Negotiated Rate	$14,831.80
Max. Negotiated Rate	$14,831.80
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$14,831.80
Rate for Payer: Mercy Care Medicaid	$14,831.80
Rate for Payer: NaphCare Correctional Healthcare	$14,831.80

Acute Leukemia

Facility

$8,829.92

Service Code	APR-DRG 6901
Hospital Charge Code	APRDRG6904
Min. Negotiated Rate	$8,829.92
Max. Negotiated Rate	$8,829.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,829.92
Rate for Payer: Mercy Care Medicaid	$8,829.92
Rate for Payer: NaphCare Correctional Healthcare	$8,829.92

Acute Leukemia

Facility

$48,504.62

Service Code	APR-DRG 6904
Hospital Charge Code	APRDRG6904
Min. Negotiated Rate	$48,504.62
Max. Negotiated Rate	$48,504.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$48,504.62
Rate for Payer: Mercy Care Medicaid	$48,504.62
Rate for Payer: NaphCare Correctional Healthcare	$48,504.62

Acute Leukemia

Facility

$48,504.62

Service Code	APR-DRG 6904
Hospital Charge Code	APRDRG6901
Min. Negotiated Rate	$48,504.62
Max. Negotiated Rate	$48,504.62
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$48,504.62
Rate for Payer: Mercy Care Medicaid	$48,504.62
Rate for Payer: NaphCare Correctional Healthcare	$48,504.62

Acute Leukemia

Facility

$30,254.19

Service Code	APR-DRG 6903
Hospital Charge Code	APRDRG6904
Min. Negotiated Rate	$30,254.19
Max. Negotiated Rate	$30,254.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,254.19
Rate for Payer: Mercy Care Medicaid	$30,254.19
Rate for Payer: NaphCare Correctional Healthcare	$30,254.19

Acute Leukemia

Facility

$30,254.19

Service Code	APR-DRG 6903
Hospital Charge Code	APRDRG6903
Min. Negotiated Rate	$30,254.19
Max. Negotiated Rate	$30,254.19
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$30,254.19
Rate for Payer: Mercy Care Medicaid	$30,254.19
Rate for Payer: NaphCare Correctional Healthcare	$30,254.19

Acute Leukemia

Facility

$8,829.92

Service Code	APR-DRG 6901
Hospital Charge Code	APRDRG6902
Min. Negotiated Rate	$8,829.92
Max. Negotiated Rate	$8,829.92
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$8,829.92
Rate for Payer: Mercy Care Medicaid	$8,829.92
Rate for Payer: NaphCare Correctional Healthcare	$8,829.92

ACUTE LEUKEMIA WITH CC

Facility

$26,957.18

Service Code	MSDRG 835
Min. Negotiated Rate	$26,957.18
Max. Negotiated Rate	$26,957.18
Rate for Payer: Seven Corners Travel Insurance	$26,957.18

ACUTE LEUKEMIA WITH MCC

Facility

$70,952.23

Service Code	MSDRG 834
Min. Negotiated Rate	$70,952.23
Max. Negotiated Rate	$70,952.23
Rate for Payer: Seven Corners Travel Insurance	$70,952.23

ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$111,916.60

Service Code	MSDRG 850
Min. Negotiated Rate	$111,916.60
Max. Negotiated Rate	$111,916.60
Rate for Payer: Seven Corners Travel Insurance	$111,916.60

ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$15,807.96

Service Code	MSDRG 836
Min. Negotiated Rate	$15,807.96
Max. Negotiated Rate	$15,807.96
Rate for Payer: Seven Corners Travel Insurance	$15,807.96

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$15,095.81

Service Code	MSDRG 121
Min. Negotiated Rate	$15,095.81
Max. Negotiated Rate	$15,095.81
Rate for Payer: Seven Corners Travel Insurance	$15,095.81

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$10,312.44

Service Code	MSDRG 122
Min. Negotiated Rate	$10,312.44
Max. Negotiated Rate	$10,312.44
Rate for Payer: Seven Corners Travel Insurance	$10,312.44

Acute Measles Panel, IgM Antibody and PCR LC

Facility

$76.00

Service Code	CPT 86765
Hospital Charge Code	28059749
Hospital Revenue Code	302
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Aetna of AZ Commercial	$68.40
Rate for Payer: Cash Price	$60.80

Know your out-of-pocket cost for care.

All Charges