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
|
|
Anticardiolipin Ab, IgG/M, Qn LC
|
Facility
|
IP
|
$366.00
|
|
Hospital Charge Code |
1285796
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$95.16 |
Max. Negotiated Rate |
$329.40 |
Rate for Payer: Aetna of AZ Commercial |
$329.40
|
Rate for Payer: Bisbee Police All Plans |
$95.16
|
Rate for Payer: Cash Price |
$292.80
|
Rate for Payer: Self Pay Self Pay |
$292.80
|
|
Anticardiolipin Ab, IgG/M, Qn LC
|
Facility
|
OP
|
$366.00
|
|
Hospital Charge Code |
1285796
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$58.56 |
Max. Negotiated Rate |
$329.40 |
Rate for Payer: Aetna of AZ Commercial |
$329.40
|
Rate for Payer: Aetna of AZ Medicare |
$102.48
|
Rate for Payer: Allwell Medicare |
$58.56
|
Rate for Payer: Amerigroup Medicare |
$58.56
|
Rate for Payer: APIPA Medicare/Medicaid |
$136.70
|
Rate for Payer: AZCH Complete Medicare |
$58.56
|
Rate for Payer: Banner UC Health Medicare |
$58.56
|
Rate for Payer: Bisbee Police All Plans |
$95.16
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$248.88
|
Rate for Payer: Cash Price |
$292.80
|
Rate for Payer: Cigna of AZ Commercial |
$237.90
|
Rate for Payer: Copperpoint Commercial |
$90.58
|
Rate for Payer: Health Net of AZ Commercial |
$219.60
|
Rate for Payer: Health Net of AZ Medicare |
$102.48
|
Rate for Payer: Humana of AZ Medicare |
$58.56
|
Rate for Payer: Self Pay Self Pay |
$292.80
|
Rate for Payer: TriWest Medicare |
$58.56
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$213.38
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$65.88
|
|
.Anti-Centromere B Abs LC
|
Facility
|
OP
|
$212.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531164
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$33.92 |
Max. Negotiated Rate |
$190.80 |
Rate for Payer: Aetna of AZ Commercial |
$190.80
|
Rate for Payer: Aetna of AZ Medicare |
$59.36
|
Rate for Payer: Allwell Medicare |
$33.92
|
Rate for Payer: Amerigroup Medicare |
$33.92
|
Rate for Payer: APIPA Medicare/Medicaid |
$79.18
|
Rate for Payer: AZCH Complete Medicare |
$33.92
|
Rate for Payer: Banner UC Health Medicare |
$33.92
|
Rate for Payer: Bisbee Police All Plans |
$55.12
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$144.16
|
Rate for Payer: Cash Price |
$169.60
|
Rate for Payer: Cigna of AZ Commercial |
$137.80
|
Rate for Payer: Copperpoint Commercial |
$52.47
|
Rate for Payer: Health Net of AZ Commercial |
$127.20
|
Rate for Payer: Health Net of AZ Medicare |
$59.36
|
Rate for Payer: Humana of AZ Medicare |
$33.92
|
Rate for Payer: Self Pay Self Pay |
$169.60
|
Rate for Payer: TriWest Medicare |
$33.92
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$123.60
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$38.16
|
|
.Anti-Centromere B Abs LC
|
Facility
|
IP
|
$212.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531164
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$55.12 |
Max. Negotiated Rate |
$190.80 |
Rate for Payer: Aetna of AZ Commercial |
$190.80
|
Rate for Payer: Bisbee Police All Plans |
$55.12
|
Rate for Payer: Cash Price |
$169.60
|
Rate for Payer: Self Pay Self Pay |
$169.60
|
|
Anti-Centromere B Antibodies LC
|
Facility
|
OP
|
$201.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
7328630
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$32.16 |
Max. Negotiated Rate |
$180.90 |
Rate for Payer: Aetna of AZ Commercial |
$180.90
|
Rate for Payer: Aetna of AZ Medicare |
$56.28
|
Rate for Payer: Allwell Medicare |
$32.16
|
Rate for Payer: Amerigroup Medicare |
$32.16
|
Rate for Payer: APIPA Medicare/Medicaid |
$75.07
|
Rate for Payer: AZCH Complete Medicare |
$32.16
|
Rate for Payer: Banner UC Health Medicare |
$32.16
|
Rate for Payer: Bisbee Police All Plans |
$52.26
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$136.68
|
Rate for Payer: Cash Price |
$160.80
|
Rate for Payer: Cigna of AZ Commercial |
$130.65
|
Rate for Payer: Copperpoint Commercial |
$49.75
|
Rate for Payer: Health Net of AZ Commercial |
$120.60
|
Rate for Payer: Health Net of AZ Medicare |
$56.28
|
Rate for Payer: Humana of AZ Medicare |
$32.16
|
Rate for Payer: Self Pay Self Pay |
$160.80
|
Rate for Payer: TriWest Medicare |
$32.16
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$117.18
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$36.18
|
|
Anti-Centromere B Antibodies LC
|
Facility
|
IP
|
$201.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
7328630
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$52.26 |
Max. Negotiated Rate |
$180.90 |
Rate for Payer: Aetna of AZ Commercial |
$180.90
|
Rate for Payer: Bisbee Police All Plans |
$52.26
|
Rate for Payer: Cash Price |
$160.80
|
Rate for Payer: Self Pay Self Pay |
$160.80
|
|
.Antichromatin Abs LC
|
Facility
|
IP
|
$113.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531156
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$29.38 |
Max. Negotiated Rate |
$101.70 |
Rate for Payer: Aetna of AZ Commercial |
$101.70
|
Rate for Payer: Bisbee Police All Plans |
$29.38
|
Rate for Payer: Cash Price |
$90.40
|
Rate for Payer: Self Pay Self Pay |
$90.40
|
|
.Antichromatin Abs LC
|
Facility
|
OP
|
$113.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531156
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$18.08 |
Max. Negotiated Rate |
$101.70 |
Rate for Payer: Aetna of AZ Commercial |
$101.70
|
Rate for Payer: Aetna of AZ Medicare |
$31.64
|
Rate for Payer: Allwell Medicare |
$18.08
|
Rate for Payer: Amerigroup Medicare |
$18.08
|
Rate for Payer: APIPA Medicare/Medicaid |
$42.21
|
Rate for Payer: AZCH Complete Medicare |
$18.08
|
Rate for Payer: Banner UC Health Medicare |
$18.08
|
Rate for Payer: Bisbee Police All Plans |
$29.38
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$76.84
|
Rate for Payer: Cash Price |
$90.40
|
Rate for Payer: Cigna of AZ Commercial |
$73.45
|
Rate for Payer: Copperpoint Commercial |
$27.97
|
Rate for Payer: Health Net of AZ Commercial |
$67.80
|
Rate for Payer: Health Net of AZ Medicare |
$31.64
|
Rate for Payer: Humana of AZ Medicare |
$18.08
|
Rate for Payer: Self Pay Self Pay |
$90.40
|
Rate for Payer: TriWest Medicare |
$18.08
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$65.88
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$20.34
|
|
Anti-DNA(SS)IgG, Ab, Qn LC
|
Facility
|
IP
|
$317.00
|
|
Service Code
|
CPT 86226
|
Hospital Charge Code |
22311175
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$82.42 |
Max. Negotiated Rate |
$285.30 |
Rate for Payer: Aetna of AZ Commercial |
$285.30
|
Rate for Payer: Bisbee Police All Plans |
$82.42
|
Rate for Payer: Cash Price |
$253.60
|
Rate for Payer: Self Pay Self Pay |
$253.60
|
|
Anti-DNA(SS)IgG, Ab, Qn LC
|
Facility
|
OP
|
$317.00
|
|
Service Code
|
CPT 86226
|
Hospital Charge Code |
22311175
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$50.72 |
Max. Negotiated Rate |
$285.30 |
Rate for Payer: Aetna of AZ Commercial |
$285.30
|
Rate for Payer: Aetna of AZ Medicare |
$88.76
|
Rate for Payer: Allwell Medicare |
$50.72
|
Rate for Payer: Amerigroup Medicare |
$50.72
|
Rate for Payer: APIPA Medicare/Medicaid |
$118.40
|
Rate for Payer: AZCH Complete Medicare |
$50.72
|
Rate for Payer: Banner UC Health Medicare |
$50.72
|
Rate for Payer: Bisbee Police All Plans |
$82.42
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$215.56
|
Rate for Payer: Cash Price |
$253.60
|
Rate for Payer: Cigna of AZ Commercial |
$206.05
|
Rate for Payer: Copperpoint Commercial |
$78.46
|
Rate for Payer: Health Net of AZ Commercial |
$190.20
|
Rate for Payer: Health Net of AZ Medicare |
$88.76
|
Rate for Payer: Humana of AZ Medicare |
$50.72
|
Rate for Payer: Self Pay Self Pay |
$253.60
|
Rate for Payer: TriWest Medicare |
$50.72
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$184.81
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$57.06
|
|
.Anti-dsDNA Antibodies LC
|
Facility
|
IP
|
$119.00
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
3033504
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$30.94 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: Aetna of AZ Commercial |
$107.10
|
Rate for Payer: Bisbee Police All Plans |
$30.94
|
Rate for Payer: Cash Price |
$95.20
|
Rate for Payer: Self Pay Self Pay |
$95.20
|
|
.Anti-dsDNA Antibodies LC
|
Facility
|
OP
|
$119.00
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
3033504
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$19.04 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: Aetna of AZ Commercial |
$107.10
|
Rate for Payer: Aetna of AZ Medicare |
$33.32
|
Rate for Payer: Allwell Medicare |
$19.04
|
Rate for Payer: Amerigroup Medicare |
$19.04
|
Rate for Payer: APIPA Medicare/Medicaid |
$44.45
|
Rate for Payer: AZCH Complete Medicare |
$19.04
|
Rate for Payer: Banner UC Health Medicare |
$19.04
|
Rate for Payer: Bisbee Police All Plans |
$30.94
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$80.92
|
Rate for Payer: Cash Price |
$95.20
|
Rate for Payer: Cigna of AZ Commercial |
$77.35
|
Rate for Payer: Copperpoint Commercial |
$29.45
|
Rate for Payer: Health Net of AZ Commercial |
$71.40
|
Rate for Payer: Health Net of AZ Medicare |
$33.32
|
Rate for Payer: Humana of AZ Medicare |
$19.04
|
Rate for Payer: Self Pay Self Pay |
$95.20
|
Rate for Payer: TriWest Medicare |
$19.04
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$69.38
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$21.42
|
|
Anti-dsDNA Antibodies LC
|
Facility
|
IP
|
$155.00
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
1905934
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$40.30 |
Max. Negotiated Rate |
$139.50 |
Rate for Payer: Aetna of AZ Commercial |
$139.50
|
Rate for Payer: Bisbee Police All Plans |
$40.30
|
Rate for Payer: Cash Price |
$124.00
|
Rate for Payer: Self Pay Self Pay |
$124.00
|
|
Anti-dsDNA Antibodies LC
|
Facility
|
OP
|
$155.00
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
1905934
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$24.80 |
Max. Negotiated Rate |
$139.50 |
Rate for Payer: Aetna of AZ Commercial |
$139.50
|
Rate for Payer: Aetna of AZ Medicare |
$43.40
|
Rate for Payer: Allwell Medicare |
$24.80
|
Rate for Payer: Amerigroup Medicare |
$24.80
|
Rate for Payer: APIPA Medicare/Medicaid |
$57.89
|
Rate for Payer: AZCH Complete Medicare |
$24.80
|
Rate for Payer: Banner UC Health Medicare |
$24.80
|
Rate for Payer: Bisbee Police All Plans |
$40.30
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$105.40
|
Rate for Payer: Cash Price |
$124.00
|
Rate for Payer: Cigna of AZ Commercial |
$100.75
|
Rate for Payer: Copperpoint Commercial |
$38.36
|
Rate for Payer: Health Net of AZ Commercial |
$93.00
|
Rate for Payer: Health Net of AZ Medicare |
$43.40
|
Rate for Payer: Humana of AZ Medicare |
$24.80
|
Rate for Payer: Self Pay Self Pay |
$124.00
|
Rate for Payer: TriWest Medicare |
$24.80
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$90.36
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$27.90
|
|
Antigen Type
|
Facility
|
IP
|
$158.00
|
|
Service Code
|
CPT 86902
|
Hospital Charge Code |
22245939
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$41.08 |
Max. Negotiated Rate |
$142.20 |
Rate for Payer: Aetna of AZ Commercial |
$142.20
|
Rate for Payer: Bisbee Police All Plans |
$41.08
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Self Pay Self Pay |
$126.40
|
|
Antigen Type
|
Facility
|
OP
|
$158.00
|
|
Service Code
|
CPT 86902
|
Hospital Charge Code |
22245939
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$25.28 |
Max. Negotiated Rate |
$142.20 |
Rate for Payer: Aetna of AZ Commercial |
$142.20
|
Rate for Payer: Aetna of AZ Medicare |
$44.24
|
Rate for Payer: Allwell Medicare |
$25.28
|
Rate for Payer: Amerigroup Medicare |
$25.28
|
Rate for Payer: APIPA Medicare/Medicaid |
$59.01
|
Rate for Payer: AZCH Complete Medicare |
$25.28
|
Rate for Payer: Banner UC Health Medicare |
$25.28
|
Rate for Payer: Bisbee Police All Plans |
$41.08
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$107.44
|
Rate for Payer: Cash Price |
$126.40
|
Rate for Payer: Cigna of AZ Commercial |
$102.70
|
Rate for Payer: Copperpoint Commercial |
$39.10
|
Rate for Payer: Health Net of AZ Commercial |
$94.80
|
Rate for Payer: Health Net of AZ Medicare |
$44.24
|
Rate for Payer: Humana of AZ Medicare |
$25.28
|
Rate for Payer: Self Pay Self Pay |
$126.40
|
Rate for Payer: TriWest Medicare |
$25.28
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$92.11
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$28.44
|
|
Antigen Type w/ Charge
|
Facility
|
IP
|
$237.00
|
|
Service Code
|
CPT 86885
|
Hospital Charge Code |
22172090
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$61.62 |
Max. Negotiated Rate |
$213.30 |
Rate for Payer: Aetna of AZ Commercial |
$213.30
|
Rate for Payer: Bisbee Police All Plans |
$61.62
|
Rate for Payer: Cash Price |
$189.60
|
Rate for Payer: Self Pay Self Pay |
$189.60
|
|
Antigen Type w/ Charge
|
Facility
|
OP
|
$237.00
|
|
Service Code
|
CPT 86885
|
Hospital Charge Code |
22172090
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$37.92 |
Max. Negotiated Rate |
$213.30 |
Rate for Payer: Aetna of AZ Commercial |
$213.30
|
Rate for Payer: Aetna of AZ Medicare |
$66.36
|
Rate for Payer: Allwell Medicare |
$37.92
|
Rate for Payer: Amerigroup Medicare |
$37.92
|
Rate for Payer: APIPA Medicare/Medicaid |
$88.52
|
Rate for Payer: AZCH Complete Medicare |
$37.92
|
Rate for Payer: Banner UC Health Medicare |
$37.92
|
Rate for Payer: Bisbee Police All Plans |
$61.62
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$161.16
|
Rate for Payer: Cash Price |
$189.60
|
Rate for Payer: Cigna of AZ Commercial |
$154.05
|
Rate for Payer: Copperpoint Commercial |
$58.66
|
Rate for Payer: Health Net of AZ Commercial |
$142.20
|
Rate for Payer: Health Net of AZ Medicare |
$66.36
|
Rate for Payer: Humana of AZ Medicare |
$37.92
|
Rate for Payer: Self Pay Self Pay |
$189.60
|
Rate for Payer: TriWest Medicare |
$37.92
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$138.17
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$42.66
|
|
ANTI GLIADIN AB IGG
|
Facility
|
OP
|
$1,422.00
|
|
Service Code
|
CPT 83516
|
Hospital Charge Code |
22481459
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$227.52 |
Max. Negotiated Rate |
$1,279.80 |
Rate for Payer: Aetna of AZ Commercial |
$1,279.80
|
Rate for Payer: Aetna of AZ Medicare |
$398.16
|
Rate for Payer: Allwell Medicare |
$227.52
|
Rate for Payer: Amerigroup Medicare |
$227.52
|
Rate for Payer: APIPA Medicare/Medicaid |
$531.12
|
Rate for Payer: AZCH Complete Medicare |
$227.52
|
Rate for Payer: Banner UC Health Medicare |
$227.52
|
Rate for Payer: Bisbee Police All Plans |
$369.72
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$966.96
|
Rate for Payer: Cash Price |
$1,137.60
|
Rate for Payer: Cigna of AZ Commercial |
$924.30
|
Rate for Payer: Copperpoint Commercial |
$351.94
|
Rate for Payer: Health Net of AZ Commercial |
$853.20
|
Rate for Payer: Health Net of AZ Medicare |
$398.16
|
Rate for Payer: Humana of AZ Medicare |
$227.52
|
Rate for Payer: Self Pay Self Pay |
$1,137.60
|
Rate for Payer: TriWest Medicare |
$227.52
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$829.03
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$255.96
|
|
ANTI GLIADIN AB IGG
|
Facility
|
IP
|
$1,422.00
|
|
Service Code
|
CPT 83516
|
Hospital Charge Code |
22481459
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$369.72 |
Max. Negotiated Rate |
$1,279.80 |
Rate for Payer: Aetna of AZ Commercial |
$1,279.80
|
Rate for Payer: Bisbee Police All Plans |
$369.72
|
Rate for Payer: Cash Price |
$1,137.60
|
Rate for Payer: Self Pay Self Pay |
$1,137.60
|
|
Antihistone Antibodies LC
|
Facility
|
OP
|
$1,420.00
|
|
Service Code
|
CPT 83516
|
Hospital Charge Code |
16937587
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$227.20 |
Max. Negotiated Rate |
$1,278.00 |
Rate for Payer: Aetna of AZ Commercial |
$1,278.00
|
Rate for Payer: Aetna of AZ Medicare |
$397.60
|
Rate for Payer: Allwell Medicare |
$227.20
|
Rate for Payer: Amerigroup Medicare |
$227.20
|
Rate for Payer: APIPA Medicare/Medicaid |
$530.37
|
Rate for Payer: AZCH Complete Medicare |
$227.20
|
Rate for Payer: Banner UC Health Medicare |
$227.20
|
Rate for Payer: Bisbee Police All Plans |
$369.20
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$965.60
|
Rate for Payer: Cash Price |
$1,136.00
|
Rate for Payer: Cigna of AZ Commercial |
$923.00
|
Rate for Payer: Copperpoint Commercial |
$351.45
|
Rate for Payer: Health Net of AZ Commercial |
$852.00
|
Rate for Payer: Health Net of AZ Medicare |
$397.60
|
Rate for Payer: Humana of AZ Medicare |
$227.20
|
Rate for Payer: Self Pay Self Pay |
$1,136.00
|
Rate for Payer: TriWest Medicare |
$227.20
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$827.86
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$255.60
|
|
Antihistone Antibodies LC
|
Facility
|
IP
|
$1,420.00
|
|
Service Code
|
CPT 83516
|
Hospital Charge Code |
16937587
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$369.20 |
Max. Negotiated Rate |
$1,278.00 |
Rate for Payer: Aetna of AZ Commercial |
$1,278.00
|
Rate for Payer: Bisbee Police All Plans |
$369.20
|
Rate for Payer: Cash Price |
$1,136.00
|
Rate for Payer: Self Pay Self Pay |
$1,136.00
|
|
.Anti-Jo-1 LC
|
Facility
|
OP
|
$259.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531162
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$41.44 |
Max. Negotiated Rate |
$233.10 |
Rate for Payer: Aetna of AZ Commercial |
$233.10
|
Rate for Payer: Aetna of AZ Medicare |
$72.52
|
Rate for Payer: Allwell Medicare |
$41.44
|
Rate for Payer: Amerigroup Medicare |
$41.44
|
Rate for Payer: APIPA Medicare/Medicaid |
$96.74
|
Rate for Payer: AZCH Complete Medicare |
$41.44
|
Rate for Payer: Banner UC Health Medicare |
$41.44
|
Rate for Payer: Bisbee Police All Plans |
$67.34
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$176.12
|
Rate for Payer: Cash Price |
$207.20
|
Rate for Payer: Cigna of AZ Commercial |
$168.35
|
Rate for Payer: Copperpoint Commercial |
$64.10
|
Rate for Payer: Health Net of AZ Commercial |
$155.40
|
Rate for Payer: Health Net of AZ Medicare |
$72.52
|
Rate for Payer: Humana of AZ Medicare |
$41.44
|
Rate for Payer: Self Pay Self Pay |
$207.20
|
Rate for Payer: TriWest Medicare |
$41.44
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$151.00
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$46.62
|
|
.Anti-Jo-1 LC
|
Facility
|
IP
|
$259.00
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
22531162
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$67.34 |
Max. Negotiated Rate |
$233.10 |
Rate for Payer: Aetna of AZ Commercial |
$233.10
|
Rate for Payer: Bisbee Police All Plans |
$67.34
|
Rate for Payer: Cash Price |
$207.20
|
Rate for Payer: Self Pay Self Pay |
$207.20
|
|