Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$10,755.97

Service Code	APR-DRG 2343
Hospital Charge Code	APRDRG2342
Min. Negotiated Rate	$10,755.97
Max. Negotiated Rate	$10,755.97
Rate for Payer: AHCCCS Medicaid	$10,755.97
Rate for Payer: Allwell Medicaid	$10,755.97
Rate for Payer: AZCH Complete Medicaid	$10,755.97
Rate for Payer: Banner UC Health Medicaid	$10,755.97
Rate for Payer: Mercy Care Medicaid	$10,755.97

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$7,213.20

Service Code	APR-DRG 2342
Hospital Charge Code	APRDRG2342
Min. Negotiated Rate	$7,213.20
Max. Negotiated Rate	$7,213.20
Rate for Payer: AHCCCS Medicaid	$7,213.20
Rate for Payer: Allwell Medicaid	$7,213.20
Rate for Payer: AZCH Complete Medicaid	$7,213.20
Rate for Payer: Banner UC Health Medicaid	$7,213.20
Rate for Payer: Mercy Care Medicaid	$7,213.20

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$5,804.79

Service Code	APR-DRG 2341
Hospital Charge Code	APRDRG2341
Min. Negotiated Rate	$5,804.79
Max. Negotiated Rate	$5,804.79
Rate for Payer: AHCCCS Medicaid	$5,804.79
Rate for Payer: Allwell Medicaid	$5,804.79
Rate for Payer: AZCH Complete Medicaid	$5,804.79
Rate for Payer: Banner UC Health Medicaid	$5,804.79
Rate for Payer: Mercy Care Medicaid	$5,804.79

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$5,804.79

Service Code	APR-DRG 2341
Hospital Charge Code	APRDRG2344
Min. Negotiated Rate	$5,804.79
Max. Negotiated Rate	$5,804.79
Rate for Payer: AHCCCS Medicaid	$5,804.79
Rate for Payer: Allwell Medicaid	$5,804.79
Rate for Payer: AZCH Complete Medicaid	$5,804.79
Rate for Payer: Banner UC Health Medicaid	$5,804.79
Rate for Payer: Mercy Care Medicaid	$5,804.79

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$7,213.20

Service Code	APR-DRG 2342
Hospital Charge Code	APRDRG2341
Min. Negotiated Rate	$7,213.20
Max. Negotiated Rate	$7,213.20
Rate for Payer: AHCCCS Medicaid	$7,213.20
Rate for Payer: Allwell Medicaid	$7,213.20
Rate for Payer: AZCH Complete Medicaid	$7,213.20
Rate for Payer: Banner UC Health Medicaid	$7,213.20
Rate for Payer: Mercy Care Medicaid	$7,213.20

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$5,804.79

Service Code	APR-DRG 2341
Hospital Charge Code	APRDRG2342
Min. Negotiated Rate	$5,804.79
Max. Negotiated Rate	$5,804.79
Rate for Payer: AHCCCS Medicaid	$5,804.79
Rate for Payer: Allwell Medicaid	$5,804.79
Rate for Payer: AZCH Complete Medicaid	$5,804.79
Rate for Payer: Banner UC Health Medicaid	$5,804.79
Rate for Payer: Mercy Care Medicaid	$5,804.79

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$10,755.97

Service Code	APR-DRG 2343
Hospital Charge Code	APRDRG2341
Min. Negotiated Rate	$10,755.97
Max. Negotiated Rate	$10,755.97
Rate for Payer: AHCCCS Medicaid	$10,755.97
Rate for Payer: Allwell Medicaid	$10,755.97
Rate for Payer: AZCH Complete Medicaid	$10,755.97
Rate for Payer: Banner UC Health Medicaid	$10,755.97
Rate for Payer: Mercy Care Medicaid	$10,755.97

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$20,453.53

Service Code	APR-DRG 2344
Hospital Charge Code	APRDRG2342
Min. Negotiated Rate	$20,453.53
Max. Negotiated Rate	$20,453.53
Rate for Payer: AHCCCS Medicaid	$20,453.53
Rate for Payer: Allwell Medicaid	$20,453.53
Rate for Payer: AZCH Complete Medicaid	$20,453.53
Rate for Payer: Banner UC Health Medicaid	$20,453.53
Rate for Payer: Mercy Care Medicaid	$20,453.53

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$20,453.53

Service Code	APR-DRG 2344
Hospital Charge Code	APRDRG2344
Min. Negotiated Rate	$20,453.53
Max. Negotiated Rate	$20,453.53
Rate for Payer: AHCCCS Medicaid	$20,453.53
Rate for Payer: Allwell Medicaid	$20,453.53
Rate for Payer: AZCH Complete Medicaid	$20,453.53
Rate for Payer: Banner UC Health Medicaid	$20,453.53
Rate for Payer: Mercy Care Medicaid	$20,453.53

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$7,213.20

Service Code	APR-DRG 2342
Hospital Charge Code	APRDRG2344
Min. Negotiated Rate	$7,213.20
Max. Negotiated Rate	$7,213.20
Rate for Payer: AHCCCS Medicaid	$7,213.20
Rate for Payer: Allwell Medicaid	$7,213.20
Rate for Payer: AZCH Complete Medicaid	$7,213.20
Rate for Payer: Banner UC Health Medicaid	$7,213.20
Rate for Payer: Mercy Care Medicaid	$7,213.20

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$5,804.79

Service Code	APR-DRG 2341
Hospital Charge Code	APRDRG2343
Min. Negotiated Rate	$5,804.79
Max. Negotiated Rate	$5,804.79
Rate for Payer: AHCCCS Medicaid	$5,804.79
Rate for Payer: Allwell Medicaid	$5,804.79
Rate for Payer: AZCH Complete Medicaid	$5,804.79
Rate for Payer: Banner UC Health Medicaid	$5,804.79
Rate for Payer: Mercy Care Medicaid	$5,804.79

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$7,213.20

Service Code	APR-DRG 2342
Hospital Charge Code	APRDRG2343
Min. Negotiated Rate	$7,213.20
Max. Negotiated Rate	$7,213.20
Rate for Payer: AHCCCS Medicaid	$7,213.20
Rate for Payer: Allwell Medicaid	$7,213.20
Rate for Payer: AZCH Complete Medicaid	$7,213.20
Rate for Payer: Banner UC Health Medicaid	$7,213.20
Rate for Payer: Mercy Care Medicaid	$7,213.20

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$10,755.97

Service Code	APR-DRG 2343
Hospital Charge Code	APRDRG2344
Min. Negotiated Rate	$10,755.97
Max. Negotiated Rate	$10,755.97
Rate for Payer: AHCCCS Medicaid	$10,755.97
Rate for Payer: Allwell Medicaid	$10,755.97
Rate for Payer: AZCH Complete Medicaid	$10,755.97
Rate for Payer: Banner UC Health Medicaid	$10,755.97
Rate for Payer: Mercy Care Medicaid	$10,755.97

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$20,453.53

Service Code	APR-DRG 2344
Hospital Charge Code	APRDRG2343
Min. Negotiated Rate	$20,453.53
Max. Negotiated Rate	$20,453.53
Rate for Payer: AHCCCS Medicaid	$20,453.53
Rate for Payer: Allwell Medicaid	$20,453.53
Rate for Payer: AZCH Complete Medicaid	$20,453.53
Rate for Payer: Banner UC Health Medicaid	$20,453.53
Rate for Payer: Mercy Care Medicaid	$20,453.53

Appendectomy Without Complex Principal Diagnosis

Facility

IP

$10,755.97

Service Code	APR-DRG 2343
Hospital Charge Code	APRDRG2343
Min. Negotiated Rate	$10,755.97
Max. Negotiated Rate	$10,755.97
Rate for Payer: AHCCCS Medicaid	$10,755.97
Rate for Payer: Allwell Medicaid	$10,755.97
Rate for Payer: AZCH Complete Medicaid	$10,755.97
Rate for Payer: Banner UC Health Medicaid	$10,755.97
Rate for Payer: Mercy Care Medicaid	$10,755.97

APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG (BELOW KNEE) INCLUDING ANKLE

Facility

IP

$137.00

Service Code	CPT 29581
Hospital Charge Code	24043307
Hospital Revenue Code	360
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$123.30
Rate for Payer: Aetna of AZ Commercial	$123.30
Rate for Payer: Bisbee Police All Plans	$35.62
Rate for Payer: Cash Price	$109.60
Rate for Payer: Self Pay Self Pay	$109.60

APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG (BELOW KNEE) INCLUDING ANKLE

Facility

OP

$137.00

Service Code	CPT 29581
Hospital Charge Code	24043307
Hospital Revenue Code	360
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$123.30
Rate for Payer: Aetna of AZ Medicare	$38.36
Rate for Payer: AHCCCS Medicaid	$204.72
Rate for Payer: Allwell Medicaid	$204.72
Rate for Payer: Allwell Medicare	$20.55
Rate for Payer: Amerigroup Medicare	$20.55
Rate for Payer: APIPA Medicare/Medicaid	$51.17
Rate for Payer: AZCH Complete Medicaid	$204.72
Rate for Payer: AZCH Complete Medicare	$20.55
Rate for Payer: Banner UC Health Medicaid	$204.72
Rate for Payer: Banner UC Health Medicare	$20.55
Rate for Payer: Bisbee Police All Plans	$35.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$93.16
Rate for Payer: Cash Price	$109.60
Rate for Payer: Cash Price	$109.60
Rate for Payer: Cigna of AZ Commercial	$68.50
Rate for Payer: Copperpoint Commercial	$33.91
Rate for Payer: Health Net of AZ Commercial	$82.20
Rate for Payer: Health Net of AZ Medicare	$38.36
Rate for Payer: Humana of AZ Medicare	$20.55
Rate for Payer: Mercy Care Medicaid	$204.72
Rate for Payer: Self Pay Self Pay	$109.60
Rate for Payer: TriWest Medicare	$20.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$24.66

APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS

Facility

IP

$4,586.00

Service Code	CPT 15275
Hospital Charge Code	23922976
Hospital Revenue Code	761
Min. Negotiated Rate	$1,192.36
Max. Negotiated Rate	$4,127.40
Rate for Payer: Aetna of AZ Commercial	$4,127.40
Rate for Payer: Bisbee Police All Plans	$1,192.36
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Self Pay Self Pay	$3,668.80

APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS

Facility

OP

$4,586.00

Service Code	CPT 15275
Hospital Charge Code	23922976
Hospital Revenue Code	761
Min. Negotiated Rate	$687.90
Max. Negotiated Rate	$4,127.40
Rate for Payer: Aetna of AZ Commercial	$4,127.40
Rate for Payer: Aetna of AZ Medicare	$1,284.08
Rate for Payer: AHCCCS Medicaid	$2,487.28
Rate for Payer: Allwell Medicaid	$2,487.28
Rate for Payer: Allwell Medicare	$687.90
Rate for Payer: Amerigroup Medicare	$687.90
Rate for Payer: APIPA Medicare/Medicaid	$1,712.87
Rate for Payer: AZCH Complete Medicaid	$2,487.28
Rate for Payer: AZCH Complete Medicare	$687.90
Rate for Payer: Banner UC Health Medicaid	$2,487.28
Rate for Payer: Banner UC Health Medicare	$687.90
Rate for Payer: Bisbee Police All Plans	$1,192.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,118.48
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Cigna of AZ Commercial	$3,210.20
Rate for Payer: Copperpoint Commercial	$1,135.04
Rate for Payer: Health Net of AZ Commercial	$2,751.60
Rate for Payer: Health Net of AZ Medicare	$1,284.08
Rate for Payer: Humana of AZ Medicare	$687.90
Rate for Payer: Mercy Care Medicaid	$2,487.28
Rate for Payer: Self Pay Self Pay	$3,668.80
Rate for Payer: TriWest Medicare	$687.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$825.48

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, T

Facility

OP

$989.00

Service Code	CPT 15273
Hospital Charge Code	24049290
Hospital Revenue Code	760
Min. Negotiated Rate	$148.35
Max. Negotiated Rate	$5,107.12
Rate for Payer: Aetna of AZ Commercial	$890.10
Rate for Payer: Aetna of AZ Medicare	$276.92
Rate for Payer: AHCCCS Medicaid	$5,107.12
Rate for Payer: Allwell Medicaid	$5,107.12
Rate for Payer: Allwell Medicare	$148.35
Rate for Payer: Amerigroup Medicare	$148.35
Rate for Payer: APIPA Medicare/Medicaid	$369.39
Rate for Payer: AZCH Complete Medicaid	$5,107.12
Rate for Payer: AZCH Complete Medicare	$148.35
Rate for Payer: Banner UC Health Medicaid	$5,107.12
Rate for Payer: Banner UC Health Medicare	$148.35
Rate for Payer: Bisbee Police All Plans	$257.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$672.52
Rate for Payer: Cash Price	$791.20
Rate for Payer: Cash Price	$791.20
Rate for Payer: Cigna of AZ Commercial	$692.30
Rate for Payer: Copperpoint Commercial	$244.78
Rate for Payer: Health Net of AZ Commercial	$593.40
Rate for Payer: Health Net of AZ Medicare	$276.92
Rate for Payer: Humana of AZ Medicare	$148.35
Rate for Payer: Mercy Care Medicaid	$5,107.12
Rate for Payer: Self Pay Self Pay	$791.20
Rate for Payer: TriWest Medicare	$148.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$3,914.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$178.02

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, T

Facility

IP

$4,586.00

Service Code	CPT 15271
Hospital Charge Code	23922975
Hospital Revenue Code	761
Min. Negotiated Rate	$1,192.36
Max. Negotiated Rate	$4,127.40
Rate for Payer: Aetna of AZ Commercial	$4,127.40
Rate for Payer: Bisbee Police All Plans	$1,192.36
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Self Pay Self Pay	$3,668.80

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, T

Facility

OP

$4,586.00

Service Code	CPT 15271
Hospital Charge Code	23922975
Hospital Revenue Code	761
Min. Negotiated Rate	$687.90
Max. Negotiated Rate	$4,127.40
Rate for Payer: Aetna of AZ Commercial	$4,127.40
Rate for Payer: Aetna of AZ Medicare	$1,284.08
Rate for Payer: AHCCCS Medicaid	$2,487.28
Rate for Payer: Allwell Medicaid	$2,487.28
Rate for Payer: Allwell Medicare	$687.90
Rate for Payer: Amerigroup Medicare	$687.90
Rate for Payer: APIPA Medicare/Medicaid	$1,712.87
Rate for Payer: AZCH Complete Medicaid	$2,487.28
Rate for Payer: AZCH Complete Medicare	$687.90
Rate for Payer: Banner UC Health Medicaid	$2,487.28
Rate for Payer: Banner UC Health Medicare	$687.90
Rate for Payer: Bisbee Police All Plans	$1,192.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,118.48
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Cash Price	$3,668.80
Rate for Payer: Cigna of AZ Commercial	$3,210.20
Rate for Payer: Copperpoint Commercial	$1,135.04
Rate for Payer: Health Net of AZ Commercial	$2,751.60
Rate for Payer: Health Net of AZ Medicare	$1,284.08
Rate for Payer: Humana of AZ Medicare	$687.90
Rate for Payer: Mercy Care Medicaid	$2,487.28
Rate for Payer: Self Pay Self Pay	$3,668.80
Rate for Payer: TriWest Medicare	$687.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,909.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$825.48

APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, T

Facility

IP

$989.00

Service Code	CPT 15273
Hospital Charge Code	24049290
Hospital Revenue Code	760
Min. Negotiated Rate	$257.14
Max. Negotiated Rate	$890.10
Rate for Payer: Aetna of AZ Commercial	$890.10
Rate for Payer: Bisbee Police All Plans	$257.14
Rate for Payer: Cash Price	$791.20
Rate for Payer: Self Pay Self Pay	$791.20

AP with culdoplasty

Facility

OP

$4,525.00

Service Code	CPT 57265
Hospital Charge Code	27291785
Hospital Revenue Code	360
Min. Negotiated Rate	$678.75
Max. Negotiated Rate	$6,393.84
Rate for Payer: Aetna of AZ Commercial	$4,072.50
Rate for Payer: Aetna of AZ Medicare	$1,267.00
Rate for Payer: AHCCCS Medicaid	$6,393.84
Rate for Payer: Allwell Medicaid	$6,393.84
Rate for Payer: Allwell Medicare	$678.75
Rate for Payer: Amerigroup Medicare	$678.75
Rate for Payer: APIPA Medicare/Medicaid	$1,690.09
Rate for Payer: AZCH Complete Medicaid	$6,393.84
Rate for Payer: AZCH Complete Medicare	$678.75
Rate for Payer: Banner UC Health Medicaid	$6,393.84
Rate for Payer: Banner UC Health Medicare	$678.75
Rate for Payer: Bisbee Police All Plans	$1,176.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$3,077.00
Rate for Payer: Cash Price	$3,620.00
Rate for Payer: Cash Price	$3,620.00
Rate for Payer: Cigna of AZ Commercial	$2,262.50
Rate for Payer: Copperpoint Commercial	$1,119.94
Rate for Payer: Health Net of AZ Commercial	$2,715.00
Rate for Payer: Health Net of AZ Medicare	$1,267.00
Rate for Payer: Humana of AZ Medicare	$678.75
Rate for Payer: Mercy Care Medicaid	$6,393.84
Rate for Payer: Self Pay Self Pay	$3,620.00
Rate for Payer: TriWest Medicare	$678.75
Rate for Payer: UnitedHealth Group of AZ Commercial	$4,540.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$814.50

AP with culdoplasty

Facility

IP

$4,525.00

Service Code	CPT 57265
Hospital Charge Code	27291785
Hospital Revenue Code	360
Min. Negotiated Rate	$1,176.50
Max. Negotiated Rate	$4,072.50
Rate for Payer: Aetna of AZ Commercial	$4,072.50
Rate for Payer: Bisbee Police All Plans	$1,176.50
Rate for Payer: Cash Price	$3,620.00
Rate for Payer: Self Pay Self Pay	$3,620.00

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