Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Antepartum Without O.R. Procedure

Facility

IP

$8,013.50

Service Code	APR-DRG 5664
Hospital Charge Code	APRDRG5662
Min. Negotiated Rate	$8,013.50
Max. Negotiated Rate	$8,013.50
Rate for Payer: AHCCCS Medicaid	$8,013.50
Rate for Payer: Allwell Medicaid	$8,013.50
Rate for Payer: AZCH Complete Medicaid	$8,013.50
Rate for Payer: Banner UC Health Medicaid	$8,013.50
Rate for Payer: Mercy Care Medicaid	$8,013.50

Antepartum Without O.R. Procedure

Facility

IP

$1,894.48

Service Code	APR-DRG 5661
Hospital Charge Code	APRDRG5663
Min. Negotiated Rate	$1,894.48
Max. Negotiated Rate	$1,894.48
Rate for Payer: AHCCCS Medicaid	$1,894.48
Rate for Payer: Allwell Medicaid	$1,894.48
Rate for Payer: AZCH Complete Medicaid	$1,894.48
Rate for Payer: Banner UC Health Medicaid	$1,894.48
Rate for Payer: Mercy Care Medicaid	$1,894.48

Antepartum Without O.R. Procedure

Facility

IP

$2,480.15

Service Code	APR-DRG 5662
Hospital Charge Code	APRDRG5664
Min. Negotiated Rate	$2,480.15
Max. Negotiated Rate	$2,480.15
Rate for Payer: AHCCCS Medicaid	$2,480.15
Rate for Payer: Allwell Medicaid	$2,480.15
Rate for Payer: AZCH Complete Medicaid	$2,480.15
Rate for Payer: Banner UC Health Medicaid	$2,480.15
Rate for Payer: Mercy Care Medicaid	$2,480.15

Antepartum Without O.R. Procedure

Facility

IP

$2,480.15

Service Code	APR-DRG 5662
Hospital Charge Code	APRDRG5662
Min. Negotiated Rate	$2,480.15
Max. Negotiated Rate	$2,480.15
Rate for Payer: AHCCCS Medicaid	$2,480.15
Rate for Payer: Allwell Medicaid	$2,480.15
Rate for Payer: AZCH Complete Medicaid	$2,480.15
Rate for Payer: Banner UC Health Medicaid	$2,480.15
Rate for Payer: Mercy Care Medicaid	$2,480.15

Antepartum Without O.R. Procedure

Facility

IP

$1,894.48

Service Code	APR-DRG 5661
Hospital Charge Code	APRDRG5662
Min. Negotiated Rate	$1,894.48
Max. Negotiated Rate	$1,894.48
Rate for Payer: AHCCCS Medicaid	$1,894.48
Rate for Payer: Allwell Medicaid	$1,894.48
Rate for Payer: AZCH Complete Medicaid	$1,894.48
Rate for Payer: Banner UC Health Medicaid	$1,894.48
Rate for Payer: Mercy Care Medicaid	$1,894.48

Antepartum Without O.R. Procedure

Facility

IP

$2,480.15

Service Code	APR-DRG 5662
Hospital Charge Code	APRDRG5663
Min. Negotiated Rate	$2,480.15
Max. Negotiated Rate	$2,480.15
Rate for Payer: AHCCCS Medicaid	$2,480.15
Rate for Payer: Allwell Medicaid	$2,480.15
Rate for Payer: AZCH Complete Medicaid	$2,480.15
Rate for Payer: Banner UC Health Medicaid	$2,480.15
Rate for Payer: Mercy Care Medicaid	$2,480.15

Antepartum Without O.R. Procedure

Facility

IP

$8,013.50

Service Code	APR-DRG 5664
Hospital Charge Code	APRDRG5661
Min. Negotiated Rate	$8,013.50
Max. Negotiated Rate	$8,013.50
Rate for Payer: AHCCCS Medicaid	$8,013.50
Rate for Payer: Allwell Medicaid	$8,013.50
Rate for Payer: AZCH Complete Medicaid	$8,013.50
Rate for Payer: Banner UC Health Medicaid	$8,013.50
Rate for Payer: Mercy Care Medicaid	$8,013.50

Antepartum Without O.R. Procedure

Facility

IP

$1,894.48

Service Code	APR-DRG 5661
Hospital Charge Code	APRDRG5661
Min. Negotiated Rate	$1,894.48
Max. Negotiated Rate	$1,894.48
Rate for Payer: AHCCCS Medicaid	$1,894.48
Rate for Payer: Allwell Medicaid	$1,894.48
Rate for Payer: AZCH Complete Medicaid	$1,894.48
Rate for Payer: Banner UC Health Medicaid	$1,894.48
Rate for Payer: Mercy Care Medicaid	$1,894.48

Antepartum Without O.R. Procedure

Facility

IP

$1,894.48

Service Code	APR-DRG 5661
Hospital Charge Code	APRDRG5664
Min. Negotiated Rate	$1,894.48
Max. Negotiated Rate	$1,894.48
Rate for Payer: AHCCCS Medicaid	$1,894.48
Rate for Payer: Allwell Medicaid	$1,894.48
Rate for Payer: AZCH Complete Medicaid	$1,894.48
Rate for Payer: Banner UC Health Medicaid	$1,894.48
Rate for Payer: Mercy Care Medicaid	$1,894.48

Antepartum Without O.R. Procedure

Facility

IP

$3,676.74

Service Code	APR-DRG 5663
Hospital Charge Code	APRDRG5661
Min. Negotiated Rate	$3,676.74
Max. Negotiated Rate	$3,676.74
Rate for Payer: AHCCCS Medicaid	$3,676.74
Rate for Payer: Allwell Medicaid	$3,676.74
Rate for Payer: AZCH Complete Medicaid	$3,676.74
Rate for Payer: Banner UC Health Medicaid	$3,676.74
Rate for Payer: Mercy Care Medicaid	$3,676.74

Antepartum Without O.R. Procedure

Facility

IP

$2,480.15

Service Code	APR-DRG 5662
Hospital Charge Code	APRDRG5661
Min. Negotiated Rate	$2,480.15
Max. Negotiated Rate	$2,480.15
Rate for Payer: AHCCCS Medicaid	$2,480.15
Rate for Payer: Allwell Medicaid	$2,480.15
Rate for Payer: AZCH Complete Medicaid	$2,480.15
Rate for Payer: Banner UC Health Medicaid	$2,480.15
Rate for Payer: Mercy Care Medicaid	$2,480.15

Antepartum Without O.R. Procedure

Facility

IP

$3,676.74

Service Code	APR-DRG 5663
Hospital Charge Code	APRDRG5663
Min. Negotiated Rate	$3,676.74
Max. Negotiated Rate	$3,676.74
Rate for Payer: AHCCCS Medicaid	$3,676.74
Rate for Payer: Allwell Medicaid	$3,676.74
Rate for Payer: AZCH Complete Medicaid	$3,676.74
Rate for Payer: Banner UC Health Medicaid	$3,676.74
Rate for Payer: Mercy Care Medicaid	$3,676.74

Anterior Repair with graft

Facility

OP

$1,305.00

Service Code	CPT 57267
Hospital Charge Code	27267805
Hospital Revenue Code	360
Min. Negotiated Rate	$208.80
Max. Negotiated Rate	$2,545.21
Rate for Payer: Aetna of AZ Commercial	$1,174.50
Rate for Payer: Aetna of AZ Medicare	$365.40
Rate for Payer: AHCCCS Medicaid	$2,545.21
Rate for Payer: Allwell Medicaid	$2,545.21
Rate for Payer: Allwell Medicare	$208.80
Rate for Payer: Amerigroup Medicare	$208.80
Rate for Payer: APIPA Medicare/Medicaid	$487.42
Rate for Payer: AZCH Complete Medicaid	$2,545.21
Rate for Payer: AZCH Complete Medicare	$208.80
Rate for Payer: Banner UC Health Medicaid	$2,545.21
Rate for Payer: Banner UC Health Medicare	$208.80
Rate for Payer: Bisbee Police All Plans	$339.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$887.40
Rate for Payer: Cash Price	$1,044.00
Rate for Payer: Cash Price	$1,044.00
Rate for Payer: Cigna of AZ Commercial	$652.50
Rate for Payer: Copperpoint Commercial	$322.99
Rate for Payer: Health Net of AZ Commercial	$783.00
Rate for Payer: Health Net of AZ Medicare	$365.40
Rate for Payer: Humana of AZ Medicare	$208.80
Rate for Payer: Mercy Care Medicaid	$2,545.21
Rate for Payer: Self Pay Self Pay	$1,044.00
Rate for Payer: TriWest Medicare	$208.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$234.90

Anterior Repair with graft

Facility

IP

$1,305.00

Service Code	CPT 57267
Hospital Charge Code	27267805
Hospital Revenue Code	360
Min. Negotiated Rate	$339.30
Max. Negotiated Rate	$1,174.50
Rate for Payer: Aetna of AZ Commercial	$1,174.50
Rate for Payer: Bisbee Police All Plans	$339.30
Rate for Payer: Cash Price	$1,044.00
Rate for Payer: Self Pay Self Pay	$1,044.00

ANTI 68 KD

Facility

OP

$408.00

Service Code	CPT 84181
Hospital Charge Code	23298042
Hospital Revenue Code	301
Min. Negotiated Rate	$65.28
Max. Negotiated Rate	$367.20
Rate for Payer: Aetna of AZ Commercial	$367.20
Rate for Payer: Aetna of AZ Medicare	$114.24
Rate for Payer: Allwell Medicare	$65.28
Rate for Payer: Amerigroup Medicare	$65.28
Rate for Payer: APIPA Medicare/Medicaid	$152.39
Rate for Payer: AZCH Complete Medicare	$65.28
Rate for Payer: Banner UC Health Medicare	$65.28
Rate for Payer: Bisbee Police All Plans	$106.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$277.44
Rate for Payer: Cash Price	$326.40
Rate for Payer: Cigna of AZ Commercial	$265.20
Rate for Payer: Copperpoint Commercial	$100.98
Rate for Payer: Health Net of AZ Commercial	$244.80
Rate for Payer: Health Net of AZ Medicare	$114.24
Rate for Payer: Humana of AZ Medicare	$65.28
Rate for Payer: Self Pay Self Pay	$326.40
Rate for Payer: TriWest Medicare	$65.28
Rate for Payer: UnitedHealth Group of AZ Commercial	$237.86
Rate for Payer: UnitedHealth Group of AZ Medicare	$73.44

ANTI 68 KD

Facility

IP

$408.00

Service Code	CPT 84181
Hospital Charge Code	23298042
Hospital Revenue Code	301
Min. Negotiated Rate	$106.08
Max. Negotiated Rate	$367.20
Rate for Payer: Aetna of AZ Commercial	$367.20
Rate for Payer: Bisbee Police All Plans	$106.08
Rate for Payer: Cash Price	$326.40
Rate for Payer: Self Pay Self Pay	$326.40

Antibody Screen Tube

Facility

IP

$117.00

Service Code	CPT 86850
Hospital Charge Code	1137983
Hospital Revenue Code	302
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$105.30
Rate for Payer: Aetna of AZ Commercial	$105.30
Rate for Payer: Bisbee Police All Plans	$30.42
Rate for Payer: Cash Price	$93.60
Rate for Payer: Self Pay Self Pay	$93.60

Antibody Screen Tube

Facility

OP

$117.00

Service Code	CPT 86850
Hospital Charge Code	1137983
Hospital Revenue Code	302
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$105.30
Rate for Payer: Aetna of AZ Commercial	$105.30
Rate for Payer: Aetna of AZ Medicare	$32.76
Rate for Payer: Allwell Medicare	$18.72
Rate for Payer: Amerigroup Medicare	$18.72
Rate for Payer: APIPA Medicare/Medicaid	$43.70
Rate for Payer: AZCH Complete Medicare	$18.72
Rate for Payer: Banner UC Health Medicare	$18.72
Rate for Payer: Bisbee Police All Plans	$30.42
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$79.56
Rate for Payer: Cash Price	$93.60
Rate for Payer: Cigna of AZ Commercial	$76.05
Rate for Payer: Copperpoint Commercial	$28.96
Rate for Payer: Health Net of AZ Commercial	$70.20
Rate for Payer: Health Net of AZ Medicare	$32.76
Rate for Payer: Humana of AZ Medicare	$18.72
Rate for Payer: Self Pay Self Pay	$93.60
Rate for Payer: TriWest Medicare	$18.72
Rate for Payer: UnitedHealth Group of AZ Commercial	$68.21
Rate for Payer: UnitedHealth Group of AZ Medicare	$21.06

ANTICARD IGA

Facility

OP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481460
Hospital Revenue Code	302
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Aetna of AZ Medicare	$117.04
Rate for Payer: Allwell Medicare	$66.88
Rate for Payer: Amerigroup Medicare	$66.88
Rate for Payer: APIPA Medicare/Medicaid	$156.12
Rate for Payer: AZCH Complete Medicare	$66.88
Rate for Payer: Banner UC Health Medicare	$66.88
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$284.24
Rate for Payer: Cash Price	$334.40
Rate for Payer: Cigna of AZ Commercial	$271.70
Rate for Payer: Copperpoint Commercial	$103.45
Rate for Payer: Health Net of AZ Commercial	$250.80
Rate for Payer: Health Net of AZ Medicare	$117.04
Rate for Payer: Humana of AZ Medicare	$66.88
Rate for Payer: Self Pay Self Pay	$334.40
Rate for Payer: TriWest Medicare	$66.88
Rate for Payer: UnitedHealth Group of AZ Commercial	$243.69
Rate for Payer: UnitedHealth Group of AZ Medicare	$75.24

ANTICARD IGA

Facility

IP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481460
Hospital Revenue Code	302
Min. Negotiated Rate	$108.68
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Cash Price	$334.40
Rate for Payer: Self Pay Self Pay	$334.40

ANTICARD IGG

Facility

IP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481461
Hospital Revenue Code	302
Min. Negotiated Rate	$108.68
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Cash Price	$334.40
Rate for Payer: Self Pay Self Pay	$334.40

ANTICARD IGG

Facility

OP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481461
Hospital Revenue Code	302
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Aetna of AZ Medicare	$117.04
Rate for Payer: Allwell Medicare	$66.88
Rate for Payer: Amerigroup Medicare	$66.88
Rate for Payer: APIPA Medicare/Medicaid	$156.12
Rate for Payer: AZCH Complete Medicare	$66.88
Rate for Payer: Banner UC Health Medicare	$66.88
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$284.24
Rate for Payer: Cash Price	$334.40
Rate for Payer: Cigna of AZ Commercial	$271.70
Rate for Payer: Copperpoint Commercial	$103.45
Rate for Payer: Health Net of AZ Commercial	$250.80
Rate for Payer: Health Net of AZ Medicare	$117.04
Rate for Payer: Humana of AZ Medicare	$66.88
Rate for Payer: Self Pay Self Pay	$334.40
Rate for Payer: TriWest Medicare	$66.88
Rate for Payer: UnitedHealth Group of AZ Commercial	$243.69
Rate for Payer: UnitedHealth Group of AZ Medicare	$75.24

ANTICARD IGM

Facility

IP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481462
Hospital Revenue Code	302
Min. Negotiated Rate	$108.68
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Cash Price	$334.40
Rate for Payer: Self Pay Self Pay	$334.40

ANTICARD IGM

Facility

OP

$418.00

Service Code	CPT 86147
Hospital Charge Code	22481462
Hospital Revenue Code	302
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$376.20
Rate for Payer: Aetna of AZ Commercial	$376.20
Rate for Payer: Aetna of AZ Medicare	$117.04
Rate for Payer: Allwell Medicare	$66.88
Rate for Payer: Amerigroup Medicare	$66.88
Rate for Payer: APIPA Medicare/Medicaid	$156.12
Rate for Payer: AZCH Complete Medicare	$66.88
Rate for Payer: Banner UC Health Medicare	$66.88
Rate for Payer: Bisbee Police All Plans	$108.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$284.24
Rate for Payer: Cash Price	$334.40
Rate for Payer: Cigna of AZ Commercial	$271.70
Rate for Payer: Copperpoint Commercial	$103.45
Rate for Payer: Health Net of AZ Commercial	$250.80
Rate for Payer: Health Net of AZ Medicare	$117.04
Rate for Payer: Humana of AZ Medicare	$66.88
Rate for Payer: Self Pay Self Pay	$334.40
Rate for Payer: TriWest Medicare	$66.88
Rate for Payer: UnitedHealth Group of AZ Commercial	$243.69
Rate for Payer: UnitedHealth Group of AZ Medicare	$75.24

Anticardiolip Ab, IgA/G/M, Qn LC

Facility

OP

$397.00

Service Code	CPT 86147
Hospital Charge Code	1905982
Hospital Revenue Code	302
Min. Negotiated Rate	$63.52
Max. Negotiated Rate	$357.30
Rate for Payer: Aetna of AZ Commercial	$357.30
Rate for Payer: Aetna of AZ Medicare	$111.16
Rate for Payer: Allwell Medicare	$63.52
Rate for Payer: Amerigroup Medicare	$63.52
Rate for Payer: APIPA Medicare/Medicaid	$148.28
Rate for Payer: AZCH Complete Medicare	$63.52
Rate for Payer: Banner UC Health Medicare	$63.52
Rate for Payer: Bisbee Police All Plans	$103.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$269.96
Rate for Payer: Cash Price	$317.60
Rate for Payer: Cigna of AZ Commercial	$258.05
Rate for Payer: Copperpoint Commercial	$98.26
Rate for Payer: Health Net of AZ Commercial	$238.20
Rate for Payer: Health Net of AZ Medicare	$111.16
Rate for Payer: Humana of AZ Medicare	$63.52
Rate for Payer: Self Pay Self Pay	$317.60
Rate for Payer: TriWest Medicare	$63.52
Rate for Payer: UnitedHealth Group of AZ Commercial	$231.45
Rate for Payer: UnitedHealth Group of AZ Medicare	$71.46

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