Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Z GUIDE WIRE 1.5MMX80MM

Facility

$2,125.00

Hospital Charge Code	27887272
Hospital Revenue Code	270
Min. Negotiated Rate	$1,912.50
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna of AZ Commercial	$1,912.50
Rate for Payer: Cash Price	$1,700.00

Zika Test

Facility

$151.00

Service Code	CPT 86790
Hospital Charge Code	22875060
Hospital Revenue Code	301
Min. Negotiated Rate	$135.90
Max. Negotiated Rate	$135.90
Rate for Payer: Aetna of AZ Commercial	$135.90
Rate for Payer: Cash Price	$120.80

Zika Test

Facility

$151.00

Service Code	CPT 86790
Hospital Charge Code	22875060
Hospital Revenue Code	301
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$135.90
Rate for Payer: Aetna of AZ Commercial	$135.90
Rate for Payer: Arizona Complete Health Allwell	$24.16
Rate for Payer: Banner UC Health Medicare	$24.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$102.68
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$24.16
Rate for Payer: Care1st Health Plan Arizona Medicare	$24.16
Rate for Payer: Cash Price	$120.80
Rate for Payer: Cash Price	$120.80
Rate for Payer: Cigna of AZ Commercial	$98.15
Rate for Payer: Devoted Health Medicare	$27.18
Rate for Payer: Humana of AZ Medicare	$24.16
Rate for Payer: Seven Corners Travel Insurance	$18.68
Rate for Payer: Southwest Service Administrators UFCW	$102.68
Rate for Payer: TriWest Medicare	$24.16
Rate for Payer: United Healthcare Commercial	$86.37
Rate for Payer: United Healthcare Medicare	$24.16
Rate for Payer: Veterans Affairs TRICARE	$23.92

Zika Viru NAA

Facility

$449.00

Service Code	CPT 87798
Hospital Charge Code	22929297
Hospital Revenue Code	306
Min. Negotiated Rate	$50.88
Max. Negotiated Rate	$404.10
Rate for Payer: Aetna of AZ Commercial	$404.10
Rate for Payer: Arizona Complete Health Allwell	$71.84
Rate for Payer: Banner UC Health Medicare	$71.84
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$305.32
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$71.84
Rate for Payer: Care1st Health Plan Arizona Medicare	$71.84
Rate for Payer: Cash Price	$359.20
Rate for Payer: Cash Price	$359.20
Rate for Payer: Cigna of AZ Commercial	$291.85
Rate for Payer: Devoted Health Medicare	$80.82
Rate for Payer: Humana of AZ Medicare	$71.84
Rate for Payer: Seven Corners Travel Insurance	$50.88
Rate for Payer: Southwest Service Administrators UFCW	$305.32
Rate for Payer: TriWest Medicare	$71.84
Rate for Payer: United Healthcare Commercial	$256.83
Rate for Payer: United Healthcare Medicare	$71.84
Rate for Payer: Veterans Affairs TRICARE	$71.12

Zika Viru NAA

Facility

$449.00

Service Code	CPT 87798
Hospital Charge Code	22929297
Hospital Revenue Code	306
Min. Negotiated Rate	$404.10
Max. Negotiated Rate	$404.10
Rate for Payer: Aetna of AZ Commercial	$404.10
Rate for Payer: Cash Price	$359.20

Zika Virus Antibody, IgM LC

Facility

$84.00

Service Code	CPT 86794
Hospital Charge Code	28265609
Hospital Revenue Code	301
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Arizona Complete Health Allwell	$13.44
Rate for Payer: Banner UC Health Medicare	$13.44
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$57.12
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$13.44
Rate for Payer: Care1st Health Plan Arizona Medicare	$13.44
Rate for Payer: Cash Price	$67.20
Rate for Payer: Cash Price	$67.20
Rate for Payer: Cigna of AZ Commercial	$54.60
Rate for Payer: Devoted Health Medicare	$15.12
Rate for Payer: Humana of AZ Medicare	$13.44
Rate for Payer: Seven Corners Travel Insurance	$24.43
Rate for Payer: Southwest Service Administrators UFCW	$57.12
Rate for Payer: TriWest Medicare	$13.44
Rate for Payer: United Healthcare Commercial	$48.05
Rate for Payer: United Healthcare Medicare	$13.44
Rate for Payer: Veterans Affairs TRICARE	$13.31

Zika Virus Antibody, IgM LC

Facility

$84.00

Service Code	CPT 86794
Hospital Charge Code	28265609
Hospital Revenue Code	301
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$75.60
Rate for Payer: Aetna of AZ Commercial	$75.60
Rate for Payer: Cash Price	$67.20

Zika Virus Comprehensive Profile, NAA, Serum and Urine LC

Facility

$270.00

Service Code	CPT 87798
Hospital Charge Code	22955748
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Cash Price	$216.00

Zika Virus Comprehensive Profile, NAA, Serum and Urine LC

Facility

$270.00

Service Code	CPT 87798
Hospital Charge Code	22955748
Min. Negotiated Rate	$42.77
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Arizona Complete Health Allwell	$43.20
Rate for Payer: Banner UC Health Medicare	$43.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$183.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$43.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$43.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cigna of AZ Commercial	$189.00
Rate for Payer: Devoted Health Medicare	$48.60
Rate for Payer: Humana of AZ Medicare	$43.20
Rate for Payer: Seven Corners Travel Insurance	$50.88
Rate for Payer: Southwest Service Administrators UFCW	$183.60
Rate for Payer: TriWest Medicare	$43.20
Rate for Payer: United Healthcare Commercial	$154.44
Rate for Payer: United Healthcare Medicare	$43.20
Rate for Payer: Veterans Affairs TRICARE	$42.77

zinc oxide Top Oint 56.7gm [CQCH]

Facility

$0.05

Service Code	NDC 168006202
Hospital Charge Code	105945790
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	$0.03
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	$0.04
Rate for Payer: Cigna of AZ Commercial	$0.03
Rate for Payer: Devoted Health Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.01
Rate for Payer: Southwest Service Administrators UFCW	$0.03
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

zinc oxide Top Oint 56.7gm [CQCH]

Facility

$0.05

Service Code	NDC 168006202
Hospital Charge Code	105945790
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	$0.04

Zinc, Plasma or Serum LC

Facility

$362.00

Service Code	CPT 84630
Hospital Charge Code	1285555
Hospital Revenue Code	301
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$325.80
Rate for Payer: Aetna of AZ Commercial	$325.80
Rate for Payer: Aetna of AZ Commercial	$224.10
Rate for Payer: Arizona Complete Health Allwell	$39.84
Rate for Payer: Arizona Complete Health Allwell	$57.92
Rate for Payer: Banner UC Health Medicare	$39.84
Rate for Payer: Banner UC Health Medicare	$57.92
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$246.16
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$169.32
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$39.84
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$57.92
Rate for Payer: Care1st Health Plan Arizona Medicare	$39.84
Rate for Payer: Care1st Health Plan Arizona Medicare	$57.92
Rate for Payer: Cash Price	$289.60
Rate for Payer: Cash Price	$199.20
Rate for Payer: Cash Price	$289.60
Rate for Payer: Cash Price	$199.20
Rate for Payer: Cigna of AZ Commercial	$235.30
Rate for Payer: Cigna of AZ Commercial	$161.85
Rate for Payer: Devoted Health Medicare	$65.16
Rate for Payer: Devoted Health Medicare	$44.82
Rate for Payer: Humana of AZ Medicare	$39.84
Rate for Payer: Humana of AZ Medicare	$57.92
Rate for Payer: Seven Corners Travel Insurance	$16.52
Rate for Payer: Seven Corners Travel Insurance	$16.52
Rate for Payer: Southwest Service Administrators UFCW	$169.32
Rate for Payer: Southwest Service Administrators UFCW	$246.16
Rate for Payer: TriWest Medicare	$39.84
Rate for Payer: TriWest Medicare	$57.92
Rate for Payer: United Healthcare Commercial	$207.06
Rate for Payer: United Healthcare Commercial	$142.43
Rate for Payer: United Healthcare Medicare	$39.84
Rate for Payer: United Healthcare Medicare	$57.92
Rate for Payer: Veterans Affairs TRICARE	$57.34
Rate for Payer: Veterans Affairs TRICARE	$39.44

Zinc, Plasma or Serum LC

Facility

$249.00

Service Code	CPT 84630
Hospital Charge Code	1285555
Hospital Revenue Code	301
Min. Negotiated Rate	$224.10
Max. Negotiated Rate	$224.10
Rate for Payer: Aetna of AZ Commercial	$224.10
Rate for Payer: Aetna of AZ Commercial	$325.80
Rate for Payer: Cash Price	$199.20
Rate for Payer: Cash Price	$289.60

Zinc, Whole Blood LC

Facility

$142.00

Service Code	CPT 84630
Hospital Charge Code	22242095
Hospital Revenue Code	301
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$127.80
Rate for Payer: Aetna of AZ Commercial	$127.80
Rate for Payer: Arizona Complete Health Allwell	$22.72
Rate for Payer: Banner UC Health Medicare	$22.72
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$96.56
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$22.72
Rate for Payer: Care1st Health Plan Arizona Medicare	$22.72
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cash Price	$113.60
Rate for Payer: Cigna of AZ Commercial	$92.30
Rate for Payer: Devoted Health Medicare	$25.56
Rate for Payer: Humana of AZ Medicare	$22.72
Rate for Payer: Seven Corners Travel Insurance	$16.52
Rate for Payer: Southwest Service Administrators UFCW	$96.56
Rate for Payer: TriWest Medicare	$22.72
Rate for Payer: United Healthcare Commercial	$81.22
Rate for Payer: United Healthcare Medicare	$22.72
Rate for Payer: Veterans Affairs TRICARE	$22.49

Zinc, Whole Blood LC

Facility

$142.00

Service Code	CPT 84630
Hospital Charge Code	22242095
Hospital Revenue Code	301
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$127.80
Rate for Payer: Aetna of AZ Commercial	$127.80
Rate for Payer: Cash Price	$113.60

ziprasidone 40 mg Cap [CQCH]

Facility

$2.25

Service Code	NDC 904627045
Hospital Charge Code	105945855
Hospital Revenue Code	251
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna of AZ Commercial	$2.02
Rate for Payer: Arizona Complete Health Allwell	$0.36
Rate for Payer: Banner UC Health Medicare	$0.36
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1.53
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.36
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.36
Rate for Payer: Cash Price	$1.80
Rate for Payer: Cigna of AZ Commercial	$1.46
Rate for Payer: Devoted Health Medicare	$0.41
Rate for Payer: Humana of AZ Medicare	$0.36
Rate for Payer: Southwest Service Administrators UFCW	$1.53
Rate for Payer: TriWest Medicare	$0.36
Rate for Payer: United Healthcare Commercial	$1.29
Rate for Payer: United Healthcare Medicare	$0.36
Rate for Payer: Veterans Affairs TRICARE	$0.36

ziprasidone 40 mg Cap [CQCH]

Facility

$2.25

Service Code	NDC 904627045
Hospital Charge Code	105945855
Hospital Revenue Code	251
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna of AZ Commercial	$2.02
Rate for Payer: Cash Price	$1.80

zoledronic acid 4 mg/100 mL IVPB [CQCH]

Facility

$0.24

Service Code	HCPCS J3489
Hospital Charge Code	105945920
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.22
Rate for Payer: Aetna of AZ Commercial	$0.22
Rate for Payer: Arizona Complete Health Allwell	$0.04
Rate for Payer: Banner UC Health Medicare	$0.04
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$0.16
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.04
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.04
Rate for Payer: Cash Price	$0.19
Rate for Payer: Cigna of AZ Commercial	$0.16
Rate for Payer: Devoted Health Medicare	$0.04
Rate for Payer: Humana of AZ Medicare	$0.04
Rate for Payer: Southwest Service Administrators UFCW	$0.16
Rate for Payer: TriWest Medicare	$0.04
Rate for Payer: United Healthcare Commercial	$0.14
Rate for Payer: United Healthcare Medicare	$0.04
Rate for Payer: Veterans Affairs TRICARE	$0.04

zoledronic acid 4 mg/100 mL IVPB [CQCH]

Facility

$0.24

Service Code	HCPCS J3489
Hospital Charge Code	105945920
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Aetna of AZ Commercial	$0.22
Rate for Payer: Cash Price	$0.19

zoledronic acid 5 mg/100 mL IVPB[CQCH]

Facility

$0.29

Service Code	HCPCS J3489
Hospital Charge Code	223969697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Aetna of AZ Commercial	$0.26
Rate for Payer: Cash Price	$0.23

zoledronic acid 5 mg/100 mL IVPB[CQCH]

Facility

$0.29

Service Code	HCPCS J3489
Hospital Charge Code	223969697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.26
Rate for Payer: Aetna of AZ Commercial	$0.26
Rate for Payer: Arizona Complete Health Allwell	$0.05
Rate for Payer: Banner UC Health Medicare	$0.05
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$0.20
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$0.05
Rate for Payer: Care1st Health Plan Arizona Medicare	$0.05
Rate for Payer: Cash Price	$0.23
Rate for Payer: Cigna of AZ Commercial	$0.19
Rate for Payer: Devoted Health Medicare	$0.05
Rate for Payer: Humana of AZ Medicare	$0.05
Rate for Payer: Southwest Service Administrators UFCW	$0.20
Rate for Payer: TriWest Medicare	$0.05
Rate for Payer: United Healthcare Commercial	$0.17
Rate for Payer: United Healthcare Medicare	$0.05
Rate for Payer: Veterans Affairs TRICARE	$0.05

zolpidem 5 mg Tab [CQCH]

Facility

$0.03

Service Code	NDC 16714062101
Hospital Charge Code	105945989
Hospital Revenue Code	251
Max. Negotiated Rate	$0.03
Rate for Payer: Aetna of AZ Commercial	$0.03
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	$0.02
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	$0.03
Rate for Payer: Cigna of AZ Commercial	$0.02
Rate for Payer: Devoted Health Medicare	$0.01
Rate for Payer: Humana of AZ Medicare	$0.00
Rate for Payer: Southwest Service Administrators UFCW	$0.02
Rate for Payer: TriWest Medicare	$0.00
Rate for Payer: United Healthcare Commercial	$0.02
Rate for Payer: United Healthcare Medicare	$0.00
Rate for Payer: Veterans Affairs TRICARE	$0.00

zolpidem 5 mg Tab [CQCH]

Facility

$0.03

Service Code	NDC 16714062101
Hospital Charge Code	105945989
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Aetna of AZ Commercial	$0.03
Rate for Payer: Cash Price	$0.03

Zonisamide(Zonegran), Serum LC

Facility

$343.00

Service Code	CPT 82542
Hospital Charge Code	1285611
Hospital Revenue Code	301
Min. Negotiated Rate	$34.93
Max. Negotiated Rate	$308.70
Rate for Payer: Aetna of AZ Commercial	$308.70
Rate for Payer: Arizona Complete Health Allwell	$54.88
Rate for Payer: Banner UC Health Medicare	$54.88
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$233.24
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$54.88
Rate for Payer: Care1st Health Plan Arizona Medicare	$54.88
Rate for Payer: Cash Price	$274.40
Rate for Payer: Cash Price	$274.40
Rate for Payer: Cigna of AZ Commercial	$222.95
Rate for Payer: Devoted Health Medicare	$61.74
Rate for Payer: Humana of AZ Medicare	$54.88
Rate for Payer: Seven Corners Travel Insurance	$34.93
Rate for Payer: Southwest Service Administrators UFCW	$233.24
Rate for Payer: TriWest Medicare	$54.88
Rate for Payer: United Healthcare Commercial	$196.20
Rate for Payer: United Healthcare Medicare	$54.88
Rate for Payer: Veterans Affairs TRICARE	$54.33

Zonisamide(Zonegran), Serum LC

Facility

$343.00

Service Code	CPT 82542
Hospital Charge Code	1285611
Hospital Revenue Code	301
Min. Negotiated Rate	$308.70
Max. Negotiated Rate	$308.70
Rate for Payer: Aetna of AZ Commercial	$308.70
Rate for Payer: Cash Price	$274.40

Know your out-of-pocket cost for care.

All Charges