Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$27,128.05

Service Code	APR-DRG 0494
Hospital Charge Code	APRDRG0494
Min. Negotiated Rate	$27,128.05
Max. Negotiated Rate	$27,128.05
Rate for Payer: AHCCCS Medicaid	$27,128.05
Rate for Payer: Allwell Medicaid	$27,128.05
Rate for Payer: AZCH Complete Medicaid	$27,128.05
Rate for Payer: Banner UC Health Medicaid	$27,128.05
Rate for Payer: Mercy Care Medicaid	$27,128.05

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$16,798.53

Service Code	APR-DRG 0493
Hospital Charge Code	APRDRG0494
Min. Negotiated Rate	$16,798.53
Max. Negotiated Rate	$16,798.53
Rate for Payer: AHCCCS Medicaid	$16,798.53
Rate for Payer: Allwell Medicaid	$16,798.53
Rate for Payer: AZCH Complete Medicaid	$16,798.53
Rate for Payer: Banner UC Health Medicaid	$16,798.53
Rate for Payer: Mercy Care Medicaid	$16,798.53

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$27,128.05

Service Code	APR-DRG 0494
Hospital Charge Code	APRDRG0491
Min. Negotiated Rate	$27,128.05
Max. Negotiated Rate	$27,128.05
Rate for Payer: AHCCCS Medicaid	$27,128.05
Rate for Payer: Allwell Medicaid	$27,128.05
Rate for Payer: AZCH Complete Medicaid	$27,128.05
Rate for Payer: Banner UC Health Medicaid	$27,128.05
Rate for Payer: Mercy Care Medicaid	$27,128.05

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$27,128.05

Service Code	APR-DRG 0494
Hospital Charge Code	APRDRG0492
Min. Negotiated Rate	$27,128.05
Max. Negotiated Rate	$27,128.05
Rate for Payer: AHCCCS Medicaid	$27,128.05
Rate for Payer: Allwell Medicaid	$27,128.05
Rate for Payer: AZCH Complete Medicaid	$27,128.05
Rate for Payer: Banner UC Health Medicaid	$27,128.05
Rate for Payer: Mercy Care Medicaid	$27,128.05

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$5,850.38

Service Code	APR-DRG 0491
Hospital Charge Code	APRDRG0491
Min. Negotiated Rate	$5,850.38
Max. Negotiated Rate	$5,850.38
Rate for Payer: AHCCCS Medicaid	$5,850.38
Rate for Payer: Allwell Medicaid	$5,850.38
Rate for Payer: AZCH Complete Medicaid	$5,850.38
Rate for Payer: Banner UC Health Medicaid	$5,850.38
Rate for Payer: Mercy Care Medicaid	$5,850.38

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$16,798.53

Service Code	APR-DRG 0493
Hospital Charge Code	APRDRG0492
Min. Negotiated Rate	$16,798.53
Max. Negotiated Rate	$16,798.53
Rate for Payer: AHCCCS Medicaid	$16,798.53
Rate for Payer: Allwell Medicaid	$16,798.53
Rate for Payer: AZCH Complete Medicaid	$16,798.53
Rate for Payer: Banner UC Health Medicaid	$16,798.53
Rate for Payer: Mercy Care Medicaid	$16,798.53

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$12,705.16

Service Code	APR-DRG 0492
Hospital Charge Code	APRDRG0493
Min. Negotiated Rate	$12,705.16
Max. Negotiated Rate	$12,705.16
Rate for Payer: AHCCCS Medicaid	$12,705.16
Rate for Payer: Allwell Medicaid	$12,705.16
Rate for Payer: AZCH Complete Medicaid	$12,705.16
Rate for Payer: Banner UC Health Medicaid	$12,705.16
Rate for Payer: Mercy Care Medicaid	$12,705.16

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$12,705.16

Service Code	APR-DRG 0492
Hospital Charge Code	APRDRG0492
Min. Negotiated Rate	$12,705.16
Max. Negotiated Rate	$12,705.16
Rate for Payer: AHCCCS Medicaid	$12,705.16
Rate for Payer: Allwell Medicaid	$12,705.16
Rate for Payer: AZCH Complete Medicaid	$12,705.16
Rate for Payer: Banner UC Health Medicaid	$12,705.16
Rate for Payer: Mercy Care Medicaid	$12,705.16

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$16,798.53

Service Code	APR-DRG 0493
Hospital Charge Code	APRDRG0491
Min. Negotiated Rate	$16,798.53
Max. Negotiated Rate	$16,798.53
Rate for Payer: AHCCCS Medicaid	$16,798.53
Rate for Payer: Allwell Medicaid	$16,798.53
Rate for Payer: AZCH Complete Medicaid	$16,798.53
Rate for Payer: Banner UC Health Medicaid	$16,798.53
Rate for Payer: Mercy Care Medicaid	$16,798.53

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$5,850.38

Service Code	APR-DRG 0491
Hospital Charge Code	APRDRG0492
Min. Negotiated Rate	$5,850.38
Max. Negotiated Rate	$5,850.38
Rate for Payer: AHCCCS Medicaid	$5,850.38
Rate for Payer: Allwell Medicaid	$5,850.38
Rate for Payer: AZCH Complete Medicaid	$5,850.38
Rate for Payer: Banner UC Health Medicaid	$5,850.38
Rate for Payer: Mercy Care Medicaid	$5,850.38

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$5,850.38

Service Code	APR-DRG 0491
Hospital Charge Code	APRDRG0493
Min. Negotiated Rate	$5,850.38
Max. Negotiated Rate	$5,850.38
Rate for Payer: AHCCCS Medicaid	$5,850.38
Rate for Payer: Allwell Medicaid	$5,850.38
Rate for Payer: AZCH Complete Medicaid	$5,850.38
Rate for Payer: Banner UC Health Medicaid	$5,850.38
Rate for Payer: Mercy Care Medicaid	$5,850.38

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$12,705.16

Service Code	APR-DRG 0492
Hospital Charge Code	APRDRG0494
Min. Negotiated Rate	$12,705.16
Max. Negotiated Rate	$12,705.16
Rate for Payer: AHCCCS Medicaid	$12,705.16
Rate for Payer: Allwell Medicaid	$12,705.16
Rate for Payer: AZCH Complete Medicaid	$12,705.16
Rate for Payer: Banner UC Health Medicaid	$12,705.16
Rate for Payer: Mercy Care Medicaid	$12,705.16

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$5,850.38

Service Code	APR-DRG 0491
Hospital Charge Code	APRDRG0494
Min. Negotiated Rate	$5,850.38
Max. Negotiated Rate	$5,850.38
Rate for Payer: AHCCCS Medicaid	$5,850.38
Rate for Payer: Allwell Medicaid	$5,850.38
Rate for Payer: AZCH Complete Medicaid	$5,850.38
Rate for Payer: Banner UC Health Medicaid	$5,850.38
Rate for Payer: Mercy Care Medicaid	$5,850.38

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$16,798.53

Service Code	APR-DRG 0493
Hospital Charge Code	APRDRG0493
Min. Negotiated Rate	$16,798.53
Max. Negotiated Rate	$16,798.53
Rate for Payer: AHCCCS Medicaid	$16,798.53
Rate for Payer: Allwell Medicaid	$16,798.53
Rate for Payer: AZCH Complete Medicaid	$16,798.53
Rate for Payer: Banner UC Health Medicaid	$16,798.53
Rate for Payer: Mercy Care Medicaid	$16,798.53

Bacterial And Tuberculous Infections Of Nervous System

Facility

IP

$27,128.05

Service Code	APR-DRG 0494
Hospital Charge Code	APRDRG0493
Min. Negotiated Rate	$27,128.05
Max. Negotiated Rate	$27,128.05
Rate for Payer: AHCCCS Medicaid	$27,128.05
Rate for Payer: Allwell Medicaid	$27,128.05
Rate for Payer: AZCH Complete Medicaid	$27,128.05
Rate for Payer: Banner UC Health Medicaid	$27,128.05
Rate for Payer: Mercy Care Medicaid	$27,128.05

BAG AMBU CHILD

Facility

OP

$59.00

Hospital Charge Code	22355238
Hospital Revenue Code	271
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna of AZ Commercial	$53.10
Rate for Payer: Aetna of AZ Medicare	$16.52
Rate for Payer: Allwell Medicare	$8.85
Rate for Payer: Amerigroup Medicare	$8.85
Rate for Payer: APIPA Medicare/Medicaid	$22.04
Rate for Payer: AZCH Complete Medicare	$8.85
Rate for Payer: Banner UC Health Medicare	$8.85
Rate for Payer: Bisbee Police All Plans	$15.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$40.12
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cigna of AZ Commercial	$41.30
Rate for Payer: Copperpoint Commercial	$14.60
Rate for Payer: Health Net of AZ Commercial	$35.40
Rate for Payer: Health Net of AZ Medicare	$16.52
Rate for Payer: Humana of AZ Medicare	$8.85
Rate for Payer: Self Pay Self Pay	$47.20
Rate for Payer: TriWest Medicare	$8.85
Rate for Payer: UnitedHealth Group of AZ Commercial	$34.40
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.62

BAG AMBU CHILD

Facility

IP

$59.00

Hospital Charge Code	22355238
Hospital Revenue Code	271
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna of AZ Commercial	$53.10
Rate for Payer: Bisbee Police All Plans	$15.34
Rate for Payer: Cash Price	$47.20
Rate for Payer: Self Pay Self Pay	$47.20

BAG BILE

Facility

OP

$58.00

Hospital Charge Code	22355157
Hospital Revenue Code	270
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of AZ Commercial	$52.20
Rate for Payer: Aetna of AZ Medicare	$16.24
Rate for Payer: Allwell Medicare	$8.70
Rate for Payer: Amerigroup Medicare	$8.70
Rate for Payer: APIPA Medicare/Medicaid	$21.66
Rate for Payer: AZCH Complete Medicare	$8.70
Rate for Payer: Banner UC Health Medicare	$8.70
Rate for Payer: Bisbee Police All Plans	$15.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$39.44
Rate for Payer: Cash Price	$46.40
Rate for Payer: Cigna of AZ Commercial	$40.60
Rate for Payer: Copperpoint Commercial	$14.36
Rate for Payer: Health Net of AZ Commercial	$34.80
Rate for Payer: Health Net of AZ Medicare	$16.24
Rate for Payer: Humana of AZ Medicare	$8.70
Rate for Payer: Self Pay Self Pay	$46.40
Rate for Payer: TriWest Medicare	$8.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$33.81
Rate for Payer: UnitedHealth Group of AZ Medicare	$10.44

BAG BILE

Facility

IP

$58.00

Hospital Charge Code	22355157
Hospital Revenue Code	270
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of AZ Commercial	$52.20
Rate for Payer: Bisbee Police All Plans	$15.08
Rate for Payer: Cash Price	$46.40
Rate for Payer: Self Pay Self Pay	$46.40

BAG CLOSED DRNG

Facility

OP

$36.00

Service Code	CPT A4357
Hospital Charge Code	22355306
Hospital Revenue Code	270
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of AZ Commercial	$32.40
Rate for Payer: Aetna of AZ Medicare	$10.08
Rate for Payer: AHCCCS Medicaid	$17.42
Rate for Payer: Allwell Medicaid	$17.42
Rate for Payer: Allwell Medicare	$5.40
Rate for Payer: Amerigroup Medicare	$5.40
Rate for Payer: APIPA Medicare/Medicaid	$13.45
Rate for Payer: AZCH Complete Medicaid	$17.42
Rate for Payer: AZCH Complete Medicare	$5.40
Rate for Payer: Banner UC Health Medicaid	$17.42
Rate for Payer: Banner UC Health Medicare	$5.40
Rate for Payer: Bisbee Police All Plans	$9.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$24.48
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cigna of AZ Commercial	$25.20
Rate for Payer: Copperpoint Commercial	$8.91
Rate for Payer: Health Net of AZ Commercial	$21.60
Rate for Payer: Health Net of AZ Medicare	$10.08
Rate for Payer: Humana of AZ Medicare	$5.40
Rate for Payer: Mercy Care Medicaid	$17.42
Rate for Payer: Self Pay Self Pay	$28.80
Rate for Payer: TriWest Medicare	$5.40
Rate for Payer: UnitedHealth Group of AZ Commercial	$20.99
Rate for Payer: UnitedHealth Group of AZ Medicare	$6.48

BAG CLOSED DRNG

Facility

IP

$36.00

Service Code	CPT A4357
Hospital Charge Code	22355306
Hospital Revenue Code	270
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of AZ Commercial	$32.40
Rate for Payer: Bisbee Police All Plans	$9.36
Rate for Payer: Cash Price	$28.80
Rate for Payer: Self Pay Self Pay	$28.80

BAG FLATUS

Facility

OP

$20.00

Hospital Charge Code	22355620
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna of AZ Commercial	$18.00
Rate for Payer: Aetna of AZ Medicare	$5.60
Rate for Payer: Allwell Medicare	$3.00
Rate for Payer: Amerigroup Medicare	$3.00
Rate for Payer: APIPA Medicare/Medicaid	$7.47
Rate for Payer: AZCH Complete Medicare	$3.00
Rate for Payer: Banner UC Health Medicare	$3.00
Rate for Payer: Bisbee Police All Plans	$5.20
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$13.60
Rate for Payer: Cash Price	$16.00
Rate for Payer: Cigna of AZ Commercial	$14.00
Rate for Payer: Copperpoint Commercial	$4.95
Rate for Payer: Health Net of AZ Commercial	$12.00
Rate for Payer: Health Net of AZ Medicare	$5.60
Rate for Payer: Humana of AZ Medicare	$3.00
Rate for Payer: Self Pay Self Pay	$16.00
Rate for Payer: TriWest Medicare	$3.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$11.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$3.60

BAG FLATUS

Facility

IP

$20.00

Hospital Charge Code	22355620
Hospital Revenue Code	272
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna of AZ Commercial	$18.00
Rate for Payer: Bisbee Police All Plans	$5.20
Rate for Payer: Cash Price	$16.00
Rate for Payer: Self Pay Self Pay	$16.00

BAG ICE DISP

Facility

IP

$9.00

Hospital Charge Code	22355402
Hospital Revenue Code	270
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Cash Price	$7.20
Rate for Payer: Self Pay Self Pay	$7.20

BAG ICE DISP

Facility

OP

$9.00

Hospital Charge Code	22355402
Hospital Revenue Code	270
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$8.10
Rate for Payer: Aetna of AZ Commercial	$8.10
Rate for Payer: Aetna of AZ Medicare	$2.52
Rate for Payer: Allwell Medicare	$1.35
Rate for Payer: Amerigroup Medicare	$1.35
Rate for Payer: APIPA Medicare/Medicaid	$3.36
Rate for Payer: AZCH Complete Medicare	$1.35
Rate for Payer: Banner UC Health Medicare	$1.35
Rate for Payer: Bisbee Police All Plans	$2.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$6.12
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna of AZ Commercial	$6.30
Rate for Payer: Copperpoint Commercial	$2.23
Rate for Payer: Health Net of AZ Commercial	$5.40
Rate for Payer: Health Net of AZ Medicare	$2.52
Rate for Payer: Humana of AZ Medicare	$1.35
Rate for Payer: Self Pay Self Pay	$7.20
Rate for Payer: TriWest Medicare	$1.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$5.25
Rate for Payer: UnitedHealth Group of AZ Medicare	$1.62

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