Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Anti-Jo-1 LC

Facility

$246.00

Service Code	CPT 86235
Hospital Charge Code	1285794
Hospital Revenue Code	302
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$221.40
Rate for Payer: Aetna of AZ Commercial	$221.40
Rate for Payer: Bisbee Police All Plans	$63.96
Rate for Payer: Cash Price	$196.80
Rate for Payer: Self Pay Self Pay	$196.80

Anti-Jo-1 LC

Facility

$246.00

Service Code	CPT 86235
Hospital Charge Code	1285794
Hospital Revenue Code	302
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$221.40
Rate for Payer: Aetna of AZ Commercial	$221.40
Rate for Payer: Aetna of AZ Medicare	$68.88
Rate for Payer: Allwell Medicare	$39.36
Rate for Payer: Amerigroup Medicare	$39.36
Rate for Payer: APIPA Medicare/Medicaid	$91.88
Rate for Payer: AZCH Complete Medicare	$39.36
Rate for Payer: Banner UC Health Medicare	$39.36
Rate for Payer: Bisbee Police All Plans	$63.96
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$167.28
Rate for Payer: Cash Price	$196.80
Rate for Payer: Cigna of AZ Commercial	$159.90
Rate for Payer: Copperpoint Commercial	$60.88
Rate for Payer: Health Net of AZ Commercial	$147.60
Rate for Payer: Health Net of AZ Medicare	$68.88
Rate for Payer: Humana of AZ Medicare	$39.36
Rate for Payer: Self Pay Self Pay	$196.80
Rate for Payer: TriWest Medicare	$39.36
Rate for Payer: UnitedHealth Group of AZ Commercial	$143.42
Rate for Payer: UnitedHealth Group of AZ Medicare	$44.28

Anti-Mullerian Hormone LC

Facility

$355.00

Service Code	CPT 82397
Hospital Charge Code	3486207
Hospital Revenue Code	300
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$319.50
Rate for Payer: Aetna of AZ Commercial	$319.50
Rate for Payer: Bisbee Police All Plans	$92.30
Rate for Payer: Cash Price	$284.00
Rate for Payer: Self Pay Self Pay	$284.00

Anti-Mullerian Hormone LC

Facility

$355.00

Service Code	CPT 82397
Hospital Charge Code	3486207
Hospital Revenue Code	300
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$319.50
Rate for Payer: Aetna of AZ Commercial	$319.50
Rate for Payer: Aetna of AZ Medicare	$99.40
Rate for Payer: Allwell Medicare	$56.80
Rate for Payer: Amerigroup Medicare	$56.80
Rate for Payer: APIPA Medicare/Medicaid	$132.59
Rate for Payer: AZCH Complete Medicare	$56.80
Rate for Payer: Banner UC Health Medicare	$56.80
Rate for Payer: Bisbee Police All Plans	$92.30
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$241.40
Rate for Payer: Cash Price	$284.00
Rate for Payer: Cigna of AZ Commercial	$230.75
Rate for Payer: Copperpoint Commercial	$87.86
Rate for Payer: Health Net of AZ Commercial	$213.00
Rate for Payer: Health Net of AZ Medicare	$99.40
Rate for Payer: Humana of AZ Medicare	$56.80
Rate for Payer: Self Pay Self Pay	$284.00
Rate for Payer: TriWest Medicare	$56.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$206.97
Rate for Payer: UnitedHealth Group of AZ Medicare	$63.90

Antineutrophil Cytoplasmic Ab LC

Facility

$698.00

Service Code	CPT 86256
Hospital Charge Code	1285639
Hospital Revenue Code	302
Min. Negotiated Rate	$111.68
Max. Negotiated Rate	$628.20
Rate for Payer: Aetna of AZ Commercial	$628.20
Rate for Payer: Aetna of AZ Medicare	$195.44
Rate for Payer: Allwell Medicare	$111.68
Rate for Payer: Amerigroup Medicare	$111.68
Rate for Payer: APIPA Medicare/Medicaid	$260.70
Rate for Payer: AZCH Complete Medicare	$111.68
Rate for Payer: Banner UC Health Medicare	$111.68
Rate for Payer: Bisbee Police All Plans	$181.48
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$474.64
Rate for Payer: Cash Price	$558.40
Rate for Payer: Cigna of AZ Commercial	$453.70
Rate for Payer: Copperpoint Commercial	$172.75
Rate for Payer: Health Net of AZ Commercial	$418.80
Rate for Payer: Health Net of AZ Medicare	$195.44
Rate for Payer: Humana of AZ Medicare	$111.68
Rate for Payer: Self Pay Self Pay	$558.40
Rate for Payer: TriWest Medicare	$111.68
Rate for Payer: UnitedHealth Group of AZ Commercial	$406.93
Rate for Payer: UnitedHealth Group of AZ Medicare	$125.64

Antineutrophil Cytoplasmic Ab LC

Facility

$698.00

Service Code	CPT 86256
Hospital Charge Code	1285639
Hospital Revenue Code	302
Min. Negotiated Rate	$181.48
Max. Negotiated Rate	$628.20
Rate for Payer: Aetna of AZ Commercial	$628.20
Rate for Payer: Bisbee Police All Plans	$181.48
Rate for Payer: Cash Price	$558.40
Rate for Payer: Self Pay Self Pay	$558.40

Antinuclear Antibodies Direct LC

Facility

$152.00

Service Code	CPT 86038
Hospital Charge Code	1285669
Hospital Revenue Code	300
Min. Negotiated Rate	$24.32
Max. Negotiated Rate	$136.80
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Aetna of AZ Medicare	$42.56
Rate for Payer: Allwell Medicare	$24.32
Rate for Payer: Amerigroup Medicare	$24.32
Rate for Payer: APIPA Medicare/Medicaid	$56.77
Rate for Payer: AZCH Complete Medicare	$24.32
Rate for Payer: Banner UC Health Medicare	$24.32
Rate for Payer: Bisbee Police All Plans	$39.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$103.36
Rate for Payer: Cash Price	$121.60
Rate for Payer: Cigna of AZ Commercial	$98.80
Rate for Payer: Copperpoint Commercial	$37.62
Rate for Payer: Health Net of AZ Commercial	$91.20
Rate for Payer: Health Net of AZ Medicare	$42.56
Rate for Payer: Humana of AZ Medicare	$24.32
Rate for Payer: Self Pay Self Pay	$121.60
Rate for Payer: TriWest Medicare	$24.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$88.62
Rate for Payer: UnitedHealth Group of AZ Medicare	$27.36

Antinuclear Antibodies Direct LC

Facility

$152.00

Service Code	CPT 86038
Hospital Charge Code	1285669
Hospital Revenue Code	300
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$136.80
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Bisbee Police All Plans	$39.52
Rate for Payer: Cash Price	$121.60
Rate for Payer: Self Pay Self Pay	$121.60

Antinuclear Antibodies, IFA LC

Facility

$152.00

Service Code	CPT 86038
Hospital Charge Code	1285670
Hospital Revenue Code	300
Min. Negotiated Rate	$24.32
Max. Negotiated Rate	$136.80
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Aetna of AZ Medicare	$42.56
Rate for Payer: Allwell Medicare	$24.32
Rate for Payer: Amerigroup Medicare	$24.32
Rate for Payer: APIPA Medicare/Medicaid	$56.77
Rate for Payer: AZCH Complete Medicare	$24.32
Rate for Payer: Banner UC Health Medicare	$24.32
Rate for Payer: Bisbee Police All Plans	$39.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$103.36
Rate for Payer: Cash Price	$121.60
Rate for Payer: Cigna of AZ Commercial	$98.80
Rate for Payer: Copperpoint Commercial	$37.62
Rate for Payer: Health Net of AZ Commercial	$91.20
Rate for Payer: Health Net of AZ Medicare	$42.56
Rate for Payer: Humana of AZ Medicare	$24.32
Rate for Payer: Self Pay Self Pay	$121.60
Rate for Payer: TriWest Medicare	$24.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$88.62
Rate for Payer: UnitedHealth Group of AZ Medicare	$27.36

Antinuclear Antibodies, IFA LC

Facility

$152.00

Service Code	CPT 86038
Hospital Charge Code	1285670
Hospital Revenue Code	300
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$136.80
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Bisbee Police All Plans	$39.52
Rate for Payer: Cash Price	$121.60
Rate for Payer: Self Pay Self Pay	$121.60

Antipancreatic Islet Cells LC

Facility

$287.00

Service Code	CPT 86341
Hospital Charge Code	6780997
Hospital Revenue Code	302
Min. Negotiated Rate	$74.62
Max. Negotiated Rate	$258.30
Rate for Payer: Aetna of AZ Commercial	$258.30
Rate for Payer: Bisbee Police All Plans	$74.62
Rate for Payer: Cash Price	$229.60
Rate for Payer: Self Pay Self Pay	$229.60

Antipancreatic Islet Cells LC

Facility

$287.00

Service Code	CPT 86341
Hospital Charge Code	6780997
Hospital Revenue Code	302
Min. Negotiated Rate	$45.92
Max. Negotiated Rate	$258.30
Rate for Payer: Aetna of AZ Commercial	$258.30
Rate for Payer: Aetna of AZ Medicare	$80.36
Rate for Payer: Allwell Medicare	$45.92
Rate for Payer: Amerigroup Medicare	$45.92
Rate for Payer: APIPA Medicare/Medicaid	$107.19
Rate for Payer: AZCH Complete Medicare	$45.92
Rate for Payer: Banner UC Health Medicare	$45.92
Rate for Payer: Bisbee Police All Plans	$74.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$195.16
Rate for Payer: Cash Price	$229.60
Rate for Payer: Cigna of AZ Commercial	$186.55
Rate for Payer: Copperpoint Commercial	$71.03
Rate for Payer: Health Net of AZ Commercial	$172.20
Rate for Payer: Health Net of AZ Medicare	$80.36
Rate for Payer: Humana of AZ Medicare	$45.92
Rate for Payer: Self Pay Self Pay	$229.60
Rate for Payer: TriWest Medicare	$45.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$167.32
Rate for Payer: UnitedHealth Group of AZ Medicare	$51.66

.Antiribosomal P Abs LC

Facility

$1,420.00

Service Code	CPT 83516
Hospital Charge Code	22531163
Hospital Revenue Code	302
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

.Antiribosomal P Abs LC

Facility

$1,420.00

Service Code	CPT 83516
Hospital Charge Code	22531163
Hospital Revenue Code	302
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 RNP/SMITH

Facility

$213.00

Service Code	CPT 86235
Hospital Charge Code	22664811
Hospital Revenue Code	302
Min. Negotiated Rate	$55.38
Max. Negotiated Rate	$191.70
Rate for Payer: Aetna of AZ Commercial	$191.70
Rate for Payer: Bisbee Police All Plans	$55.38
Rate for Payer: Cash Price	$170.40
Rate for Payer: Self Pay Self Pay	$170.40

ANTI RNP/SMITH

Facility

$213.00

Service Code	CPT 86235
Hospital Charge Code	22664811
Hospital Revenue Code	302
Min. Negotiated Rate	$34.08
Max. Negotiated Rate	$191.70
Rate for Payer: Aetna of AZ Commercial	$191.70
Rate for Payer: Aetna of AZ Medicare	$59.64
Rate for Payer: Allwell Medicare	$34.08
Rate for Payer: Amerigroup Medicare	$34.08
Rate for Payer: APIPA Medicare/Medicaid	$79.56
Rate for Payer: AZCH Complete Medicare	$34.08
Rate for Payer: Banner UC Health Medicare	$34.08
Rate for Payer: Bisbee Police All Plans	$55.38
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$144.84
Rate for Payer: Cash Price	$170.40
Rate for Payer: Cigna of AZ Commercial	$138.45
Rate for Payer: Copperpoint Commercial	$52.72
Rate for Payer: Health Net of AZ Commercial	$127.80
Rate for Payer: Health Net of AZ Medicare	$59.64
Rate for Payer: Humana of AZ Medicare	$34.08
Rate for Payer: Self Pay Self Pay	$170.40
Rate for Payer: TriWest Medicare	$34.08
Rate for Payer: UnitedHealth Group of AZ Commercial	$124.18
Rate for Payer: UnitedHealth Group of AZ Medicare	$38.34

ANTISCLERODERMA

Facility

$114.00

Service Code	CPT 86235
Hospital Charge Code	22664812
Hospital Revenue Code	302
Min. Negotiated Rate	$18.24
Max. Negotiated Rate	$102.60
Rate for Payer: Aetna of AZ Commercial	$102.60
Rate for Payer: Aetna of AZ Medicare	$31.92
Rate for Payer: Allwell Medicare	$18.24
Rate for Payer: Amerigroup Medicare	$18.24
Rate for Payer: APIPA Medicare/Medicaid	$42.58
Rate for Payer: AZCH Complete Medicare	$18.24
Rate for Payer: Banner UC Health Medicare	$18.24
Rate for Payer: Bisbee Police All Plans	$29.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$77.52
Rate for Payer: Cash Price	$91.20
Rate for Payer: Cigna of AZ Commercial	$74.10
Rate for Payer: Copperpoint Commercial	$28.21
Rate for Payer: Health Net of AZ Commercial	$68.40
Rate for Payer: Health Net of AZ Medicare	$31.92
Rate for Payer: Humana of AZ Medicare	$18.24
Rate for Payer: Self Pay Self Pay	$91.20
Rate for Payer: TriWest Medicare	$18.24
Rate for Payer: UnitedHealth Group of AZ Commercial	$66.46
Rate for Payer: UnitedHealth Group of AZ Medicare	$20.52

ANTISCLERODERMA

Facility

$114.00

Service Code	CPT 86235
Hospital Charge Code	22664812
Hospital Revenue Code	302
Min. Negotiated Rate	$29.64
Max. Negotiated Rate	$102.60
Rate for Payer: Aetna of AZ Commercial	$102.60
Rate for Payer: Bisbee Police All Plans	$29.64
Rate for Payer: Cash Price	$91.20
Rate for Payer: Self Pay Self Pay	$91.20

Antiscleroderma-70 Antibodies LC

Facility

$71.00

Service Code	CPT 86235
Hospital Charge Code	1905589
Hospital Revenue Code	302
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Cash Price	$56.80
Rate for Payer: Self Pay Self Pay	$56.80

Antiscleroderma-70 Antibodies LC

Facility

$71.00

Service Code	CPT 86235
Hospital Charge Code	1905589
Hospital Revenue Code	302
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Aetna of AZ Medicare	$19.88
Rate for Payer: Allwell Medicare	$11.36
Rate for Payer: Amerigroup Medicare	$11.36
Rate for Payer: APIPA Medicare/Medicaid	$26.52
Rate for Payer: AZCH Complete Medicare	$11.36
Rate for Payer: Banner UC Health Medicare	$11.36
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$48.28
Rate for Payer: Cash Price	$56.80
Rate for Payer: Cigna of AZ Commercial	$46.15
Rate for Payer: Copperpoint Commercial	$17.57
Rate for Payer: Health Net of AZ Commercial	$42.60
Rate for Payer: Health Net of AZ Medicare	$19.88
Rate for Payer: Humana of AZ Medicare	$11.36
Rate for Payer: Self Pay Self Pay	$56.80
Rate for Payer: TriWest Medicare	$11.36
Rate for Payer: UnitedHealth Group of AZ Commercial	$41.39
Rate for Payer: UnitedHealth Group of AZ Medicare	$12.78

Antistreptolysin O Ab LC

Facility

$227.00

Service Code	CPT 86060
Hospital Charge Code	1906788
Hospital Revenue Code	302
Min. Negotiated Rate	$36.32
Max. Negotiated Rate	$204.30
Rate for Payer: Aetna of AZ Commercial	$204.30
Rate for Payer: Aetna of AZ Medicare	$63.56
Rate for Payer: Allwell Medicare	$36.32
Rate for Payer: Amerigroup Medicare	$36.32
Rate for Payer: APIPA Medicare/Medicaid	$84.78
Rate for Payer: AZCH Complete Medicare	$36.32
Rate for Payer: Banner UC Health Medicare	$36.32
Rate for Payer: Bisbee Police All Plans	$59.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$154.36
Rate for Payer: Cash Price	$181.60
Rate for Payer: Cigna of AZ Commercial	$147.55
Rate for Payer: Copperpoint Commercial	$56.18
Rate for Payer: Health Net of AZ Commercial	$136.20
Rate for Payer: Health Net of AZ Medicare	$63.56
Rate for Payer: Humana of AZ Medicare	$36.32
Rate for Payer: Self Pay Self Pay	$181.60
Rate for Payer: TriWest Medicare	$36.32
Rate for Payer: UnitedHealth Group of AZ Commercial	$132.34
Rate for Payer: UnitedHealth Group of AZ Medicare	$40.86

Antistreptolysin O Ab LC

Facility

$227.00

Service Code	CPT 86060
Hospital Charge Code	1906788
Hospital Revenue Code	302
Min. Negotiated Rate	$59.02
Max. Negotiated Rate	$204.30
Rate for Payer: Aetna of AZ Commercial	$204.30
Rate for Payer: Bisbee Police All Plans	$59.02
Rate for Payer: Cash Price	$181.60
Rate for Payer: Self Pay Self Pay	$181.60

Antithrombin Activity LC

Facility

$276.00

Service Code	CPT 85300
Hospital Charge Code	2029226
Hospital Revenue Code	305
Min. Negotiated Rate	$44.16
Max. Negotiated Rate	$248.40
Rate for Payer: Aetna of AZ Commercial	$248.40
Rate for Payer: Aetna of AZ Medicare	$77.28
Rate for Payer: Allwell Medicare	$44.16
Rate for Payer: Amerigroup Medicare	$44.16
Rate for Payer: APIPA Medicare/Medicaid	$103.09
Rate for Payer: AZCH Complete Medicare	$44.16
Rate for Payer: Banner UC Health Medicare	$44.16
Rate for Payer: Bisbee Police All Plans	$71.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$187.68
Rate for Payer: Cash Price	$220.80
Rate for Payer: Cigna of AZ Commercial	$179.40
Rate for Payer: Copperpoint Commercial	$68.31
Rate for Payer: Health Net of AZ Commercial	$165.60
Rate for Payer: Health Net of AZ Medicare	$77.28
Rate for Payer: Humana of AZ Medicare	$44.16
Rate for Payer: Self Pay Self Pay	$220.80
Rate for Payer: TriWest Medicare	$44.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$160.91
Rate for Payer: UnitedHealth Group of AZ Medicare	$49.68

Antithrombin Activity LC

Facility

$276.00

Service Code	CPT 85300
Hospital Charge Code	2029226
Hospital Revenue Code	305
Min. Negotiated Rate	$71.76
Max. Negotiated Rate	$248.40
Rate for Payer: Aetna of AZ Commercial	$248.40
Rate for Payer: Bisbee Police All Plans	$71.76
Rate for Payer: Cash Price	$220.80
Rate for Payer: Self Pay Self Pay	$220.80

Antithrombin Deficiency Profile LC

Facility

$444.00

Service Code	CPT 85300
Hospital Charge Code	22012108
Hospital Revenue Code	305
Min. Negotiated Rate	$71.04
Max. Negotiated Rate	$399.60
Rate for Payer: Aetna of AZ Commercial	$399.60
Rate for Payer: Aetna of AZ Medicare	$124.32
Rate for Payer: Allwell Medicare	$71.04
Rate for Payer: Amerigroup Medicare	$71.04
Rate for Payer: APIPA Medicare/Medicaid	$165.83
Rate for Payer: AZCH Complete Medicare	$71.04
Rate for Payer: Banner UC Health Medicare	$71.04
Rate for Payer: Bisbee Police All Plans	$115.44
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$301.92
Rate for Payer: Cash Price	$355.20
Rate for Payer: Cigna of AZ Commercial	$288.60
Rate for Payer: Copperpoint Commercial	$109.89
Rate for Payer: Health Net of AZ Commercial	$266.40
Rate for Payer: Health Net of AZ Medicare	$124.32
Rate for Payer: Humana of AZ Medicare	$71.04
Rate for Payer: Self Pay Self Pay	$355.20
Rate for Payer: TriWest Medicare	$71.04
Rate for Payer: UnitedHealth Group of AZ Commercial	$258.85
Rate for Payer: UnitedHealth Group of AZ Medicare	$79.92

Know your out-of-pocket cost for care.

All Charges