01710 ANES NERVES;MUSCLE;TENDONS;U AR ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
Service Code
|
CPT 01710
|
Hospital Charge Code |
22406185
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Aetna Medicare |
$2.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Cigna All Products |
$5.85
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: HealthNet Commercial |
$5.40
|
Rate for Payer: HealthNet Medicare |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
Rate for Payer: United Healthcare Medicare |
$1.62
|
|
01710 ANES NERVES;MUSCLE;TENDONS;U AR ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
Service Code
|
CPT 01710
|
Hospital Charge Code |
22406185
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
|
01710 ANES NERVES; MUSCLE;TENDONS U ARM BASE CHG AND 1ST MIN
|
Facility
OP
|
$567.00
|
|
Service Code
|
CPT 01710
|
Hospital Charge Code |
22406184
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$96.39 |
Max. Negotiated Rate |
$510.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$510.30
|
Rate for Payer: Aetna Medicare |
$158.76
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$96.39
|
Rate for Payer: Amerigroup Medicare |
$96.39
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$211.77
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$96.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$96.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$147.42
|
Rate for Payer: Cigna All Products |
$396.90
|
Rate for Payer: Copperpoint |
$159.04
|
Rate for Payer: HealthNet Commercial |
$340.20
|
Rate for Payer: HealthNet Medicare |
$158.76
|
Rate for Payer: Humana Medicare |
$96.39
|
Rate for Payer: SELF PAY |
$453.60
|
Rate for Payer: Veterans (Triwest) |
$96.39
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$330.56
|
Rate for Payer: United Healthcare Medicare |
$102.06
|
|
01710 ANES NERVES; MUSCLE;TENDONS U ARM BASE CHG AND 1ST MIN
|
Facility
IP
|
$567.00
|
|
Service Code
|
CPT 01710
|
Hospital Charge Code |
22406184
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$96.39 |
Max. Negotiated Rate |
$510.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$510.30
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$96.39
|
Rate for Payer: Amerigroup Medicare |
$96.39
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$96.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$96.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$147.42
|
Rate for Payer: Copperpoint |
$159.04
|
Rate for Payer: Humana Medicare |
$96.39
|
Rate for Payer: SELF PAY |
$453.60
|
Rate for Payer: Veterans (Triwest) |
$96.39
|
|
01810 ANES PROCEDURES LOWER ARM ADDITIONAL MINUTES
|
Facility
IP
|
$9.00
|
|
Service Code
|
CPT 01810
|
Hospital Charge Code |
22406188
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
|
01810 ANES PROCEDURES LOWER ARM ADDITIONAL MINUTES
|
Facility
OP
|
$9.00
|
|
Service Code
|
CPT 01810
|
Hospital Charge Code |
22406188
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Aetna Medicare |
$2.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Cigna All Products |
$5.85
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: HealthNet Commercial |
$5.40
|
Rate for Payer: HealthNet Medicare |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
Rate for Payer: United Healthcare Medicare |
$1.62
|
|
01810 ANES PROCEDURES LOWER ARM ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
Service Code
|
CPT 01810
|
Hospital Charge Code |
22406189
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$48.28 |
Max. Negotiated Rate |
$255.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
Rate for Payer: Aetna Medicare |
$79.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
Rate for Payer: Amerigroup Medicare |
$48.28
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
Rate for Payer: Cigna All Products |
$184.60
|
Rate for Payer: Copperpoint |
$79.66
|
Rate for Payer: HealthNet Commercial |
$170.40
|
Rate for Payer: HealthNet Medicare |
$79.52
|
Rate for Payer: Humana Medicare |
$48.28
|
Rate for Payer: SELF PAY |
$227.20
|
Rate for Payer: Veterans (Triwest) |
$48.28
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
Rate for Payer: United Healthcare Medicare |
$51.12
|
|
01810 ANES PROCEDURES LOWER ARM ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
Service Code
|
CPT 01810
|
Hospital Charge Code |
22406189
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$48.28 |
Max. Negotiated Rate |
$255.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
Rate for Payer: Amerigroup Medicare |
$48.28
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
Rate for Payer: Copperpoint |
$79.66
|
Rate for Payer: Humana Medicare |
$48.28
|
Rate for Payer: SELF PAY |
$227.20
|
Rate for Payer: Veterans (Triwest) |
$48.28
|
|
01922 ANES NON INVASIVE IMAG OR RAD THER ADDITONAL MINUTES
|
Facility
OP
|
$9.00
|
|
Service Code
|
CPT 01922
|
Hospital Charge Code |
22406191
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Aetna Medicare |
$2.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Cigna All Products |
$5.85
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: HealthNet Commercial |
$5.40
|
Rate for Payer: HealthNet Medicare |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
Rate for Payer: United Healthcare Medicare |
$1.62
|
|
01922 ANES NON INVASIVE IMAG OR RAD THER ADDITONAL MINUTES
|
Facility
IP
|
$9.00
|
|
Service Code
|
CPT 01922
|
Hospital Charge Code |
22406191
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
|
01922 ANES NON INVASIVE IMAG OR RAD THER ADDTNL 0:30 CHARGE
|
Facility
IP
|
$284.00
|
|
Service Code
|
CPT 01922
|
Hospital Charge Code |
22406192
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$48.28 |
Max. Negotiated Rate |
$255.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
Rate for Payer: Amerigroup Medicare |
$48.28
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
Rate for Payer: Copperpoint |
$79.66
|
Rate for Payer: Humana Medicare |
$48.28
|
Rate for Payer: SELF PAY |
$227.20
|
Rate for Payer: Veterans (Triwest) |
$48.28
|
|
01922 ANES NON INVASIVE IMAG OR RAD THER ADDTNL 0:30 CHARGE
|
Facility
OP
|
$284.00
|
|
Service Code
|
CPT 01922
|
Hospital Charge Code |
22406192
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$48.28 |
Max. Negotiated Rate |
$255.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$255.60
|
Rate for Payer: Aetna Medicare |
$79.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$48.28
|
Rate for Payer: Amerigroup Medicare |
$48.28
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$106.07
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$48.28
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$48.28
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$73.84
|
Rate for Payer: Cigna All Products |
$184.60
|
Rate for Payer: Copperpoint |
$79.66
|
Rate for Payer: HealthNet Commercial |
$170.40
|
Rate for Payer: HealthNet Medicare |
$79.52
|
Rate for Payer: Humana Medicare |
$48.28
|
Rate for Payer: SELF PAY |
$227.20
|
Rate for Payer: Veterans (Triwest) |
$48.28
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$165.57
|
Rate for Payer: United Healthcare Medicare |
$51.12
|
|
01999 ANES UNLISTED ANESTHESIA PRO ADDTNL 0:30 CHARGE
|
Facility
IP
|
$567.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406197
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$96.39 |
Max. Negotiated Rate |
$510.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$510.30
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$96.39
|
Rate for Payer: Amerigroup Medicare |
$96.39
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$96.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$96.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$147.42
|
Rate for Payer: Copperpoint |
$159.04
|
Rate for Payer: Humana Medicare |
$96.39
|
Rate for Payer: SELF PAY |
$453.60
|
Rate for Payer: Veterans (Triwest) |
$96.39
|
|
01999 ANES UNLISTED ANESTHESIA PRO ADDTNL 0:30 CHARGE
|
Facility
OP
|
$567.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406197
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$96.39 |
Max. Negotiated Rate |
$510.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$510.30
|
Rate for Payer: Aetna Medicare |
$158.76
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$96.39
|
Rate for Payer: Amerigroup Medicare |
$96.39
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$211.77
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$96.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$96.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$147.42
|
Rate for Payer: Cigna All Products |
$368.55
|
Rate for Payer: Copperpoint |
$159.04
|
Rate for Payer: HealthNet Commercial |
$340.20
|
Rate for Payer: HealthNet Medicare |
$158.76
|
Rate for Payer: Humana Medicare |
$96.39
|
Rate for Payer: SELF PAY |
$453.60
|
Rate for Payer: Veterans (Triwest) |
$96.39
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$330.56
|
Rate for Payer: United Healthcare Medicare |
$102.06
|
|
01999 ANES UNLISTED ANESTHESIA PROCED ADDITONAL MINUTES
|
Facility
OP
|
$9.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406194
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Aetna Medicare |
$2.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$3.36
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Cigna All Products |
$5.85
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: HealthNet Commercial |
$5.40
|
Rate for Payer: HealthNet Medicare |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$5.25
|
Rate for Payer: United Healthcare Medicare |
$1.62
|
|
01999 ANES UNLISTED ANESTHESIA PROCED ADDITONAL MINUTES
|
Facility
IP
|
$9.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406194
|
Hospital Revenue Code
|
370
|
Min. Negotiated Rate |
$1.53 |
Max. Negotiated Rate |
$8.10 |
Rate for Payer: Aetna POS, PPO, HMO |
$8.10
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$1.53
|
Rate for Payer: Amerigroup Medicare |
$1.53
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$1.53
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$1.53
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$2.34
|
Rate for Payer: Copperpoint |
$2.52
|
Rate for Payer: Humana Medicare |
$1.53
|
Rate for Payer: SELF PAY |
$7.20
|
Rate for Payer: Veterans (Triwest) |
$1.53
|
|
01999 ANES UNLISTED ANESTHESIA PROCEDURE BASE CHG AND 1ST MI
|
Facility
IP
|
$467.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406193
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$79.39 |
Max. Negotiated Rate |
$420.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
Rate for Payer: Amerigroup Medicare |
$79.39
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
Rate for Payer: Copperpoint |
$130.99
|
Rate for Payer: Humana Medicare |
$79.39
|
Rate for Payer: SELF PAY |
$373.60
|
Rate for Payer: Veterans (Triwest) |
$79.39
|
|
01999 ANES UNLISTED ANESTHESIA PROCEDURE BASE CHG AND 1ST MI
|
Facility
OP
|
$467.00
|
|
Service Code
|
CPT 01999
|
Hospital Charge Code |
22406193
|
Hospital Revenue Code
|
964
|
Min. Negotiated Rate |
$79.39 |
Max. Negotiated Rate |
$420.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$420.30
|
Rate for Payer: Aetna Medicare |
$130.76
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$79.39
|
Rate for Payer: Amerigroup Medicare |
$79.39
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$174.42
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$79.39
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$79.39
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$121.42
|
Rate for Payer: Cigna All Products |
$326.90
|
Rate for Payer: Copperpoint |
$130.99
|
Rate for Payer: HealthNet Commercial |
$280.20
|
Rate for Payer: HealthNet Medicare |
$130.76
|
Rate for Payer: Humana Medicare |
$79.39
|
Rate for Payer: SELF PAY |
$373.60
|
Rate for Payer: Veterans (Triwest) |
$79.39
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$272.26
|
Rate for Payer: United Healthcare Medicare |
$84.06
|
|
0 Ethibond Excel CT-0
|
Facility
IP
|
$81.00
|
|
Hospital Charge Code |
22926434
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$13.77 |
Max. Negotiated Rate |
$72.90 |
Rate for Payer: Aetna POS, PPO, HMO |
$72.90
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$13.77
|
Rate for Payer: Amerigroup Medicare |
$13.77
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$13.77
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$13.77
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$21.06
|
Rate for Payer: Copperpoint |
$22.72
|
Rate for Payer: Humana Medicare |
$13.77
|
Rate for Payer: SELF PAY |
$64.80
|
Rate for Payer: Veterans (Triwest) |
$13.77
|
|
0 Ethibond Excel CT-0
|
Facility
OP
|
$81.00
|
|
Hospital Charge Code |
22926434
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$13.77 |
Max. Negotiated Rate |
$72.90 |
Rate for Payer: Aetna POS, PPO, HMO |
$72.90
|
Rate for Payer: Aetna Medicare |
$22.68
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$13.77
|
Rate for Payer: Amerigroup Medicare |
$13.77
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$30.25
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$13.77
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$13.77
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$21.06
|
Rate for Payer: Cigna All Products |
$56.70
|
Rate for Payer: Copperpoint |
$22.72
|
Rate for Payer: HealthNet Commercial |
$48.60
|
Rate for Payer: HealthNet Medicare |
$22.68
|
Rate for Payer: Humana Medicare |
$13.77
|
Rate for Payer: SELF PAY |
$64.80
|
Rate for Payer: Veterans (Triwest) |
$13.77
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$47.22
|
Rate for Payer: United Healthcare Medicare |
$14.58
|
|
0 Ethibond Excel OS-4
|
Facility
OP
|
$17.00
|
|
Hospital Charge Code |
22926436
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.89 |
Max. Negotiated Rate |
$15.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$15.30
|
Rate for Payer: Aetna Medicare |
$4.76
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$2.89
|
Rate for Payer: Amerigroup Medicare |
$2.89
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$6.35
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$2.89
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$2.89
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$4.42
|
Rate for Payer: Cigna All Products |
$11.90
|
Rate for Payer: Copperpoint |
$4.77
|
Rate for Payer: HealthNet Commercial |
$10.20
|
Rate for Payer: HealthNet Medicare |
$4.76
|
Rate for Payer: Humana Medicare |
$2.89
|
Rate for Payer: SELF PAY |
$13.60
|
Rate for Payer: Veterans (Triwest) |
$2.89
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$9.91
|
Rate for Payer: United Healthcare Medicare |
$3.06
|
|
0 Ethibond Excel OS-4
|
Facility
IP
|
$17.00
|
|
Hospital Charge Code |
22926436
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2.89 |
Max. Negotiated Rate |
$15.30 |
Rate for Payer: Aetna POS, PPO, HMO |
$15.30
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$2.89
|
Rate for Payer: Amerigroup Medicare |
$2.89
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$2.89
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$2.89
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$4.42
|
Rate for Payer: Copperpoint |
$4.77
|
Rate for Payer: Humana Medicare |
$2.89
|
Rate for Payer: SELF PAY |
$13.60
|
Rate for Payer: Veterans (Triwest) |
$2.89
|
|
0 Surgigut GS-23
|
Facility
IP
|
$34.00
|
|
Hospital Charge Code |
22926443
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.78 |
Max. Negotiated Rate |
$30.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$30.60
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$5.78
|
Rate for Payer: Amerigroup Medicare |
$5.78
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$5.78
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$5.78
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$8.84
|
Rate for Payer: Copperpoint |
$9.54
|
Rate for Payer: Humana Medicare |
$5.78
|
Rate for Payer: SELF PAY |
$27.20
|
Rate for Payer: Veterans (Triwest) |
$5.78
|
|
0 Surgigut GS-23
|
Facility
OP
|
$34.00
|
|
Hospital Charge Code |
22926443
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.78 |
Max. Negotiated Rate |
$30.60 |
Rate for Payer: Aetna POS, PPO, HMO |
$30.60
|
Rate for Payer: Aetna Medicare |
$9.52
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$5.78
|
Rate for Payer: Amerigroup Medicare |
$5.78
|
Rate for Payer: Arizona Physicians IPA (APIPA) Medicare and Medicaid |
$12.70
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$5.78
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$5.78
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$8.84
|
Rate for Payer: Cigna All Products |
$23.80
|
Rate for Payer: Copperpoint |
$9.54
|
Rate for Payer: HealthNet Commercial |
$20.40
|
Rate for Payer: HealthNet Medicare |
$9.52
|
Rate for Payer: Humana Medicare |
$5.78
|
Rate for Payer: SELF PAY |
$27.20
|
Rate for Payer: Veterans (Triwest) |
$5.78
|
Rate for Payer: United Healthcare (PPO, HMO, HMO, POS) |
$19.82
|
Rate for Payer: United Healthcare Medicare |
$6.12
|
|
10060 I D ABSCESS
|
Facility
IP
|
$412.00
|
|
Service Code
|
CPT 10060
|
Hospital Charge Code |
22273442
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$70.04 |
Max. Negotiated Rate |
$370.80 |
Rate for Payer: Aetna POS, PPO, HMO |
$370.80
|
Rate for Payer: Allwell from Arizona Complete Health Medicare Advantage |
$70.04
|
Rate for Payer: Amerigroup Medicare |
$70.04
|
Rate for Payer: Arizona Complete Care Health Medicare Advantage |
$70.04
|
Rate for Payer: Banner University Care Advantage Health Maintenance Organization |
$70.04
|
Rate for Payer: City of Bisbee Police Bisbee Police |
$107.12
|
Rate for Payer: Copperpoint |
$115.57
|
Rate for Payer: Humana Medicare |
$70.04
|
Rate for Payer: SELF PAY |
$329.60
|
Rate for Payer: Veterans (Triwest) |
$70.04
|
|