|
00952 ANES HYSTEROSCOPY ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 00952
|
| Hospital Charge Code |
22406179
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
00955 INTRATHECAL INJECTION
|
Facility
OP
|
$1,318.00
|
|
|
Service Code
|
CPT 00955
|
| Hospital Charge Code |
23361647
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$224.06 |
| Max. Negotiated Rate |
$1,186.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$1,186.20
|
| Rate for Payer: Aetna Medicare |
$369.04
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$224.06
|
| Rate for Payer: Amerigroup Medicare |
$224.06
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$492.27
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$224.06
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$224.06
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$342.68
|
| Rate for Payer: Cigna All Products |
$856.70
|
| Rate for Payer: Copperpoint |
$369.70
|
| Rate for Payer: HealthNet Commercial |
$790.80
|
| Rate for Payer: HealthNet Medicare |
$369.04
|
| Rate for Payer: Humana Medicare |
$224.06
|
| Rate for Payer: SELF PAY |
$1,054.40
|
| Rate for Payer: Veterans (Triwest) |
$224.06
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$768.39
|
| Rate for Payer: United Healthcare Medicare |
$237.24
|
|
|
00955 INTRATHECAL INJECTION
|
Facility
IP
|
$1,318.00
|
|
|
Service Code
|
CPT 00955
|
| Hospital Charge Code |
23361647
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$224.06 |
| Max. Negotiated Rate |
$1,186.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$1,186.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$224.06
|
| Rate for Payer: Amerigroup Medicare |
$224.06
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$224.06
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$224.06
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$342.68
|
| Rate for Payer: Copperpoint |
$369.70
|
| Rate for Payer: Humana Medicare |
$224.06
|
| Rate for Payer: SELF PAY |
$1,054.40
|
| Rate for Payer: Veterans (Triwest) |
$224.06
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406182
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406182
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR ADDNL 30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406183
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR ADDNL 30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406183
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR BASE CHARGE AND 1ST MIN
|
Facility
IP
|
$851.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406180
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$144.67 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$765.90
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$144.67
|
| Rate for Payer: Amerigroup Medicare |
$144.67
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$144.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$144.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$221.26
|
| Rate for Payer: Copperpoint |
$238.71
|
| Rate for Payer: Humana Medicare |
$144.67
|
| Rate for Payer: SELF PAY |
$680.80
|
| Rate for Payer: Veterans (Triwest) |
$144.67
|
|
|
01360 ANES OPEN PROC LOWER 1/3 FEMUR BASE CHARGE AND 1ST MIN
|
Facility
OP
|
$851.00
|
|
|
Service Code
|
CPT 01360
|
| Hospital Charge Code |
22406180
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$144.67 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Aetna POS, PPO, HMO |
$765.90
|
| Rate for Payer: Aetna Medicare |
$238.28
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$144.67
|
| Rate for Payer: Amerigroup Medicare |
$144.67
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$317.85
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$144.67
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$144.67
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$221.26
|
| Rate for Payer: Cigna All Products |
$595.70
|
| Rate for Payer: Copperpoint |
$238.71
|
| Rate for Payer: HealthNet Commercial |
$510.60
|
| Rate for Payer: HealthNet Medicare |
$238.28
|
| Rate for Payer: Humana Medicare |
$144.67
|
| Rate for Payer: SELF PAY |
$680.80
|
| Rate for Payer: Veterans (Triwest) |
$144.67
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$496.13
|
| Rate for Payer: United Healthcare Medicare |
$153.18
|
|
|
01382 ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JO
|
Facility
OP
|
$563.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22889347
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Aetna Medicare |
$157.64
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$210.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Cigna All Products |
$365.95
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: HealthNet Commercial |
$337.80
|
| Rate for Payer: HealthNet Medicare |
$157.64
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$328.23
|
| Rate for Payer: United Healthcare Medicare |
$101.34
|
|
|
01382 ANES FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JO
|
Facility
IP
|
$563.00
|
|
|
Service Code
|
CPT 01382
|
| Hospital Charge Code |
22889347
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$95.71 |
| Max. Negotiated Rate |
$506.70 |
| Rate for Payer: Aetna POS, PPO, HMO |
$506.70
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$95.71
|
| Rate for Payer: Amerigroup Medicare |
$95.71
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$95.71
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$95.71
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$146.38
|
| Rate for Payer: Copperpoint |
$157.92
|
| Rate for Payer: Humana Medicare |
$95.71
|
| Rate for Payer: SELF PAY |
$450.40
|
| Rate for Payer: Veterans (Triwest) |
$95.71
|
|
|
01462 Anesthesia for all closed procedures on lower leg, ank
|
Facility
OP
|
$8.00
|
|
|
Service Code
|
CPT 01462
|
| Hospital Charge Code |
24062579
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$7.20
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.36
|
| Rate for Payer: Amerigroup Medicare |
$1.36
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$2.99
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.36
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.08
|
| Rate for Payer: Cigna All Products |
$5.20
|
| Rate for Payer: Copperpoint |
$2.24
|
| Rate for Payer: HealthNet Commercial |
$4.80
|
| Rate for Payer: HealthNet Medicare |
$2.24
|
| Rate for Payer: Humana Medicare |
$1.36
|
| Rate for Payer: SELF PAY |
$6.40
|
| Rate for Payer: Veterans (Triwest) |
$1.36
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$4.66
|
| Rate for Payer: United Healthcare Medicare |
$1.44
|
|
|
01462 Anesthesia for all closed procedures on lower leg, ank
|
Facility
IP
|
$8.00
|
|
|
Service Code
|
CPT 01462
|
| Hospital Charge Code |
24062579
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna POS, PPO, HMO |
$7.20
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.36
|
| Rate for Payer: Amerigroup Medicare |
$1.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.36
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.36
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.08
|
| Rate for Payer: Copperpoint |
$2.24
|
| Rate for Payer: Humana Medicare |
$1.36
|
| Rate for Payer: SELF PAY |
$6.40
|
| Rate for Payer: Veterans (Triwest) |
$1.36
|
|
|
01462 ANESTHESIA LOWER LEG ANKLE FOOT FMC CHARGE
|
Facility
OP
|
$546.00
|
|
|
Service Code
|
CPT 01462
|
| Hospital Charge Code |
22385160
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$92.82 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$491.40
|
| Rate for Payer: Aetna Medicare |
$152.88
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$92.82
|
| Rate for Payer: Amerigroup Medicare |
$92.82
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$203.93
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$92.82
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$92.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$141.96
|
| Rate for Payer: Cigna All Products |
$382.20
|
| Rate for Payer: Copperpoint |
$153.15
|
| Rate for Payer: HealthNet Commercial |
$327.60
|
| Rate for Payer: HealthNet Medicare |
$152.88
|
| Rate for Payer: Humana Medicare |
$92.82
|
| Rate for Payer: SELF PAY |
$436.80
|
| Rate for Payer: Veterans (Triwest) |
$92.82
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$318.32
|
| Rate for Payer: United Healthcare Medicare |
$98.28
|
|
|
01462 ANESTHESIA LOWER LEG ANKLE FOOT FMC CHARGE
|
Facility
IP
|
$546.00
|
|
|
Service Code
|
CPT 01462
|
| Hospital Charge Code |
22385160
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$92.82 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna POS, PPO, HMO |
$491.40
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$92.82
|
| Rate for Payer: Amerigroup Medicare |
$92.82
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$92.82
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$92.82
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$141.96
|
| Rate for Payer: Copperpoint |
$153.15
|
| Rate for Payer: Humana Medicare |
$92.82
|
| Rate for Payer: SELF PAY |
$436.80
|
| Rate for Payer: Veterans (Triwest) |
$92.82
|
|
|
01470 ANES OPEN FOOT ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406202
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
01470 ANES OPEN FOOT ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406202
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
01470 ANES OPEN FOOT ADDTNL 0:30 CHARGE
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406205
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
|
|
01470 ANES OPEN FOOT ADDTNL 0:30 CHARGE
|
Facility
IP
|
$520.00
|
|
| Hospital Charge Code |
22524462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$468.00
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$88.40
|
| Rate for Payer: Amerigroup Medicare |
$88.40
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$88.40
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$88.40
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$135.20
|
| Rate for Payer: Copperpoint |
$145.86
|
| Rate for Payer: Humana Medicare |
$88.40
|
| Rate for Payer: SELF PAY |
$416.00
|
| Rate for Payer: Veterans (Triwest) |
$88.40
|
|
|
01470 ANES OPEN FOOT ADDTNL 0:30 CHARGE
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406205
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
| Rate for Payer: Aetna Medicare |
$2.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
| Rate for Payer: Amerigroup Medicare |
$1.53
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
| Rate for Payer: Cigna All Products |
$5.85
|
| Rate for Payer: Copperpoint |
$2.52
|
| Rate for Payer: HealthNet Commercial |
$5.40
|
| Rate for Payer: HealthNet Medicare |
$2.52
|
| Rate for Payer: Humana Medicare |
$1.53
|
| Rate for Payer: SELF PAY |
$7.20
|
| Rate for Payer: Veterans (Triwest) |
$1.53
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
| Rate for Payer: United Healthcare Medicare |
$1.62
|
|
|
01470 ANES OPEN FOOT ADDTNL 0:30 CHARGE
|
Facility
OP
|
$520.00
|
|
| Hospital Charge Code |
22524462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna POS, PPO, HMO |
$468.00
|
| Rate for Payer: Aetna Medicare |
$145.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$88.40
|
| Rate for Payer: Amerigroup Medicare |
$88.40
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$194.22
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$88.40
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$88.40
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$135.20
|
| Rate for Payer: Cigna All Products |
$364.00
|
| Rate for Payer: Copperpoint |
$145.86
|
| Rate for Payer: HealthNet Commercial |
$312.00
|
| Rate for Payer: HealthNet Medicare |
$145.60
|
| Rate for Payer: Humana Medicare |
$88.40
|
| Rate for Payer: SELF PAY |
$416.00
|
| Rate for Payer: Veterans (Triwest) |
$88.40
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$303.16
|
| Rate for Payer: United Healthcare Medicare |
$93.60
|
|
|
01470 ANES OPEN FOOT PROCEDURE BASE CHARGE AND 1ST MINUTE
|
Facility
IP
|
$467.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406199
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
|
|
01470 ANES OPEN FOOT PROCEDURE BASE CHARGE AND 1ST MINUTE
|
Facility
OP
|
$467.00
|
|
|
Service Code
|
CPT 01470
|
| Hospital Charge Code |
22406199
|
|
Hospital Revenue Code
|
964
|
| Min. Negotiated Rate |
$79.39 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
| Rate for Payer: Aetna Medicare |
$130.76
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
| Rate for Payer: Amerigroup Medicare |
$79.39
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$174.42
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
| Rate for Payer: Cigna All Products |
$326.90
|
| Rate for Payer: Copperpoint |
$130.99
|
| Rate for Payer: HealthNet Commercial |
$280.20
|
| Rate for Payer: HealthNet Medicare |
$130.76
|
| Rate for Payer: Humana Medicare |
$79.39
|
| Rate for Payer: SELF PAY |
$373.60
|
| Rate for Payer: Veterans (Triwest) |
$79.39
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$272.26
|
| Rate for Payer: United Healthcare Medicare |
$84.06
|
|
|
01710 ANES NERVES;MUSCLE;TENDONS;U ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
|
Service Code
|
CPT 01710
|
| Hospital Charge Code |
22406186
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
|
|
01710 ANES NERVES;MUSCLE;TENDONS;U ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
|
Service Code
|
CPT 01710
|
| Hospital Charge Code |
22406186
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.28 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
| Rate for Payer: Aetna Medicare |
$79.52
|
| Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
| Rate for Payer: Amerigroup Medicare |
$48.28
|
| Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
| Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
| Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
| Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
| Rate for Payer: Cigna All Products |
$184.60
|
| Rate for Payer: Copperpoint |
$79.66
|
| Rate for Payer: HealthNet Commercial |
$170.40
|
| Rate for Payer: HealthNet Medicare |
$79.52
|
| Rate for Payer: Humana Medicare |
$48.28
|
| Rate for Payer: SELF PAY |
$227.20
|
| Rate for Payer: Veterans (Triwest) |
$48.28
|
| Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
| Rate for Payer: United Healthcare Medicare |
$51.12
|
|