Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

Anal Procedures

Facility

$7,831.83

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG2261
Min. Negotiated Rate	$7,831.83
Max. Negotiated Rate	$7,831.83
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,831.83
Rate for Payer: Mercy Care Medicaid	$7,831.83
Rate for Payer: NaphCare Correctional Healthcare	$7,831.83

Anal Procedures

Facility

$5,699.58

Service Code	APR-DRG 2261
Hospital Charge Code	APRDRG2263
Min. Negotiated Rate	$5,699.58
Max. Negotiated Rate	$5,699.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,699.58
Rate for Payer: Mercy Care Medicaid	$5,699.58
Rate for Payer: NaphCare Correctional Healthcare	$5,699.58

Anal Procedures

Facility

$26,716.33

Service Code	APR-DRG 2264
Hospital Charge Code	APRDRG2261
Min. Negotiated Rate	$26,716.33
Max. Negotiated Rate	$26,716.33
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$26,716.33
Rate for Payer: Mercy Care Medicaid	$26,716.33
Rate for Payer: NaphCare Correctional Healthcare	$26,716.33

Anal Procedures

Facility

$5,699.58

Service Code	APR-DRG 2261
Hospital Charge Code	APRDRG2261
Min. Negotiated Rate	$5,699.58
Max. Negotiated Rate	$5,699.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,699.58
Rate for Payer: Mercy Care Medicaid	$5,699.58
Rate for Payer: NaphCare Correctional Healthcare	$5,699.58

Anal Procedures

Facility

$7,831.83

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG2263
Min. Negotiated Rate	$7,831.83
Max. Negotiated Rate	$7,831.83
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,831.83
Rate for Payer: Mercy Care Medicaid	$7,831.83
Rate for Payer: NaphCare Correctional Healthcare	$7,831.83

Anal Procedures

Facility

$11,389.33

Service Code	APR-DRG 2263
Hospital Charge Code	APRDRG2261
Min. Negotiated Rate	$11,389.33
Max. Negotiated Rate	$11,389.33
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$11,389.33
Rate for Payer: Mercy Care Medicaid	$11,389.33
Rate for Payer: NaphCare Correctional Healthcare	$11,389.33

Anal Procedures

Facility

$5,699.58

Service Code	APR-DRG 2261
Hospital Charge Code	APRDRG2262
Min. Negotiated Rate	$5,699.58
Max. Negotiated Rate	$5,699.58
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,699.58
Rate for Payer: Mercy Care Medicaid	$5,699.58
Rate for Payer: NaphCare Correctional Healthcare	$5,699.58

Anal Procedures

Facility

$7,831.83

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG2264
Min. Negotiated Rate	$7,831.83
Max. Negotiated Rate	$7,831.83
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,831.83
Rate for Payer: Mercy Care Medicaid	$7,831.83
Rate for Payer: NaphCare Correctional Healthcare	$7,831.83

Anal Procedures

Facility

$7,831.83

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG2262
Min. Negotiated Rate	$7,831.83
Max. Negotiated Rate	$7,831.83
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$7,831.83
Rate for Payer: Mercy Care Medicaid	$7,831.83
Rate for Payer: NaphCare Correctional Healthcare	$7,831.83

Anal Sphincteroplasty

Facility

$3,900.00

Service Code	CPT 46750
Hospital Charge Code	27281896
Hospital Revenue Code	360
Min. Negotiated Rate	$617.76
Max. Negotiated Rate	$4,838.00
Rate for Payer: Aetna of AZ Commercial	$3,510.00
Rate for Payer: Arizona Complete Health Allwell	$624.00
Rate for Payer: Banner UC Health Medicare	$913.45
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$2,652.00
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$624.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$624.00
Rate for Payer: Cash Price	$3,120.00
Rate for Payer: Cash Price	$3,120.00
Rate for Payer: Cash Price	$3,120.00
Rate for Payer: Cigna of AZ Commercial	$1,950.00
Rate for Payer: Devoted Health Medicare	$702.00
Rate for Payer: Humana of AZ Medicare	$624.00
Rate for Payer: NaphCare Correctional Healthcare	$913.45
Rate for Payer: Seven Corners Travel Insurance	$4,294.70
Rate for Payer: Southwest Service Administrators UFCW	$2,652.00
Rate for Payer: TriWest Medicare	$624.00
Rate for Payer: United Healthcare Commercial	$4,838.00
Rate for Payer: United Healthcare Medicare	$624.00
Rate for Payer: Veterans Affairs TRICARE	$617.76

Anal Sphincteroplasty

Facility

$3,900.00

Service Code	CPT 46750
Hospital Charge Code	27281896
Hospital Revenue Code	360
Min. Negotiated Rate	$3,510.00
Max. Negotiated Rate	$3,510.00
Rate for Payer: Aetna of AZ Commercial	$3,510.00
Rate for Payer: Cash Price	$3,120.00

ANA REFL, SM RNP AB

Facility

$108.00

Service Code	CPT 86235
Hospital Charge Code	22664813
Hospital Revenue Code	302
Min. Negotiated Rate	$17.11
Max. Negotiated Rate	$97.20
Rate for Payer: Aetna of AZ Commercial	$97.20
Rate for Payer: Arizona Complete Health Allwell	$17.28
Rate for Payer: Banner UC Health Medicare	$17.28
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$73.44
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$17.28
Rate for Payer: Care1st Health Plan Arizona Medicare	$17.28
Rate for Payer: Cash Price	$86.40
Rate for Payer: Cash Price	$86.40
Rate for Payer: Cigna of AZ Commercial	$70.20
Rate for Payer: Devoted Health Medicare	$19.44
Rate for Payer: Humana of AZ Medicare	$17.28
Rate for Payer: Seven Corners Travel Insurance	$26.00
Rate for Payer: Southwest Service Administrators UFCW	$73.44
Rate for Payer: TriWest Medicare	$17.28
Rate for Payer: United Healthcare Commercial	$61.78
Rate for Payer: United Healthcare Medicare	$17.28
Rate for Payer: Veterans Affairs TRICARE	$17.11

ANA REFL, SM RNP AB

Facility

$108.00

Service Code	CPT 86235
Hospital Charge Code	22664813
Hospital Revenue Code	302
Min. Negotiated Rate	$97.20
Max. Negotiated Rate	$97.20
Rate for Payer: Aetna of AZ Commercial	$97.20
Rate for Payer: Cash Price	$86.40

ANA w/Reflex if Positive LC

Facility

$160.00

Service Code	CPT 86038
Hospital Charge Code	7328631
Hospital Revenue Code	300
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$144.00
Rate for Payer: Aetna of AZ Commercial	$144.00
Rate for Payer: Cash Price	$128.00

ANA w/Reflex if Positive LC

Facility

$160.00

Service Code	CPT 86038
Hospital Charge Code	7328631
Hospital Revenue Code	300
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$144.00
Rate for Payer: Aetna of AZ Commercial	$144.00
Rate for Payer: Arizona Complete Health Allwell	$25.60
Rate for Payer: Banner UC Health Medicare	$25.60
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$108.80
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$25.60
Rate for Payer: Care1st Health Plan Arizona Medicare	$25.60
Rate for Payer: Cash Price	$128.00
Rate for Payer: Cash Price	$128.00
Rate for Payer: Cigna of AZ Commercial	$104.00
Rate for Payer: Devoted Health Medicare	$28.80
Rate for Payer: Humana of AZ Medicare	$25.60
Rate for Payer: Seven Corners Travel Insurance	$17.53
Rate for Payer: Southwest Service Administrators UFCW	$108.80
Rate for Payer: TriWest Medicare	$25.60
Rate for Payer: United Healthcare Commercial	$91.52
Rate for Payer: United Healthcare Medicare	$25.60
Rate for Payer: Veterans Affairs TRICARE	$25.34

ANA w/Reflex LC

Facility

$203.00

Service Code	CPT 86038
Hospital Charge Code	1285800
Hospital Revenue Code	300
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$182.70
Rate for Payer: Aetna of AZ Commercial	$182.70
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Arizona Complete Health Allwell	$24.32
Rate for Payer: Arizona Complete Health Allwell	$32.48
Rate for Payer: Banner UC Health Medicare	$24.32
Rate for Payer: Banner UC Health Medicare	$32.48
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$138.04
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$103.36
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$24.32
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$32.48
Rate for Payer: Care1st Health Plan Arizona Medicare	$24.32
Rate for Payer: Care1st Health Plan Arizona Medicare	$32.48
Rate for Payer: Cash Price	$162.40
Rate for Payer: Cash Price	$121.60
Rate for Payer: Cash Price	$162.40
Rate for Payer: Cash Price	$121.60
Rate for Payer: Cigna of AZ Commercial	$131.95
Rate for Payer: Cigna of AZ Commercial	$98.80
Rate for Payer: Devoted Health Medicare	$36.54
Rate for Payer: Devoted Health Medicare	$27.36
Rate for Payer: Humana of AZ Medicare	$24.32
Rate for Payer: Humana of AZ Medicare	$32.48
Rate for Payer: Seven Corners Travel Insurance	$17.53
Rate for Payer: Seven Corners Travel Insurance	$17.53
Rate for Payer: Southwest Service Administrators UFCW	$103.36
Rate for Payer: Southwest Service Administrators UFCW	$138.04
Rate for Payer: TriWest Medicare	$24.32
Rate for Payer: TriWest Medicare	$32.48
Rate for Payer: United Healthcare Commercial	$116.12
Rate for Payer: United Healthcare Commercial	$86.94
Rate for Payer: United Healthcare Medicare	$24.32
Rate for Payer: United Healthcare Medicare	$32.48
Rate for Payer: Veterans Affairs TRICARE	$32.16
Rate for Payer: Veterans Affairs TRICARE	$24.08

ANA w/Reflex LC

Facility

$152.00

Service Code	CPT 86038
Hospital Charge Code	1285800
Hospital Revenue Code	300
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$136.80
Rate for Payer: Aetna of AZ Commercial	$136.80
Rate for Payer: Aetna of AZ Commercial	$182.70
Rate for Payer: Cash Price	$121.60
Rate for Payer: Cash Price	$162.40

ANCA PANEL LC

Facility

$1,495.00

Service Code	CPT 83516
Hospital Charge Code	2269466
Hospital Revenue Code	301
Min. Negotiated Rate	$1,345.50
Max. Negotiated Rate	$1,345.50
Rate for Payer: Aetna of AZ Commercial	$1,345.50
Rate for Payer: Cash Price	$1,196.00

ANCA PANEL LC

Facility

$1,495.00

Service Code	CPT 83516
Hospital Charge Code	2269466
Hospital Revenue Code	301
Min. Negotiated Rate	$16.72
Max. Negotiated Rate	$1,345.50
Rate for Payer: Aetna of AZ Commercial	$1,345.50
Rate for Payer: Arizona Complete Health Allwell	$239.20
Rate for Payer: Banner UC Health Medicare	$239.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,016.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$239.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$239.20
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Cash Price	$1,196.00
Rate for Payer: Cigna of AZ Commercial	$971.75
Rate for Payer: Devoted Health Medicare	$269.10
Rate for Payer: Humana of AZ Medicare	$239.20
Rate for Payer: Seven Corners Travel Insurance	$16.72
Rate for Payer: Southwest Service Administrators UFCW	$1,016.60
Rate for Payer: TriWest Medicare	$239.20
Rate for Payer: United Healthcare Commercial	$855.14
Rate for Payer: United Healthcare Medicare	$239.20
Rate for Payer: Veterans Affairs TRICARE	$236.81

ANCA PROFILE (RDL) LC

Facility

$1,488.00

Service Code	CPT 83516
Hospital Charge Code	27469671
Hospital Revenue Code	301
Min. Negotiated Rate	$1,339.20
Max. Negotiated Rate	$1,339.20
Rate for Payer: Aetna of AZ Commercial	$1,339.20
Rate for Payer: Cash Price	$1,190.40

ANCA PROFILE (RDL) LC

Facility

$1,488.00

Service Code	CPT 83516
Hospital Charge Code	27469671
Hospital Revenue Code	301
Min. Negotiated Rate	$16.72
Max. Negotiated Rate	$1,339.20
Rate for Payer: Aetna of AZ Commercial	$1,339.20
Rate for Payer: Arizona Complete Health Allwell	$238.08
Rate for Payer: Banner UC Health Medicare	$238.08
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$1,011.84
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$238.08
Rate for Payer: Care1st Health Plan Arizona Medicare	$238.08
Rate for Payer: Cash Price	$1,190.40
Rate for Payer: Cash Price	$1,190.40
Rate for Payer: Cigna of AZ Commercial	$967.20
Rate for Payer: Devoted Health Medicare	$267.84
Rate for Payer: Humana of AZ Medicare	$238.08
Rate for Payer: Seven Corners Travel Insurance	$16.72
Rate for Payer: Southwest Service Administrators UFCW	$1,011.84
Rate for Payer: TriWest Medicare	$238.08
Rate for Payer: United Healthcare Commercial	$851.14
Rate for Payer: United Healthcare Medicare	$238.08
Rate for Payer: Veterans Affairs TRICARE	$235.70

Androstenedione LC

Facility

$365.00

Service Code	CPT 82157
Hospital Charge Code	6738648
Hospital Revenue Code	301
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$328.50
Rate for Payer: Aetna of AZ Commercial	$328.50
Rate for Payer: Arizona Complete Health Allwell	$58.40
Rate for Payer: Banner UC Health Medicare	$58.40
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$248.20
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$58.40
Rate for Payer: Care1st Health Plan Arizona Medicare	$58.40
Rate for Payer: Cash Price	$292.00
Rate for Payer: Cash Price	$292.00
Rate for Payer: Cigna of AZ Commercial	$237.25
Rate for Payer: Devoted Health Medicare	$65.70
Rate for Payer: Humana of AZ Medicare	$58.40
Rate for Payer: Seven Corners Travel Insurance	$42.46
Rate for Payer: Southwest Service Administrators UFCW	$248.20
Rate for Payer: TriWest Medicare	$58.40
Rate for Payer: United Healthcare Commercial	$208.78
Rate for Payer: United Healthcare Medicare	$58.40
Rate for Payer: Veterans Affairs TRICARE	$57.82

Androstenedione LC

Facility

$365.00

Service Code	CPT 82157
Hospital Charge Code	6738648
Hospital Revenue Code	301
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$328.50
Rate for Payer: Aetna of AZ Commercial	$328.50
Rate for Payer: Cash Price	$292.00

ANES ANESTHESIA PRONE POSITION 1ST 0:30

Facility

$591.00

Service Code	CPT 01992
Hospital Charge Code	22495017
Hospital Revenue Code	370
Min. Negotiated Rate	$93.61
Max. Negotiated Rate	$531.90
Rate for Payer: Aetna of AZ Commercial	$531.90
Rate for Payer: Arizona Complete Health Allwell	$94.56
Rate for Payer: Banner UC Health Medicare	$94.56
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$401.88
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$94.56
Rate for Payer: Care1st Health Plan Arizona Medicare	$94.56
Rate for Payer: Cash Price	$472.80
Rate for Payer: Cigna of AZ Commercial	$384.15
Rate for Payer: Devoted Health Medicare	$106.38
Rate for Payer: Humana of AZ Medicare	$94.56
Rate for Payer: Southwest Service Administrators UFCW	$401.88
Rate for Payer: TriWest Medicare	$94.56
Rate for Payer: United Healthcare Commercial	$338.05
Rate for Payer: United Healthcare Medicare	$94.56
Rate for Payer: Veterans Affairs TRICARE	$93.61

ANES ANESTHESIA PRONE POSITION 1ST 0:30

Facility

$591.00

Service Code	CPT 01992
Hospital Charge Code	22495017
Hospital Revenue Code	370
Min. Negotiated Rate	$531.90
Max. Negotiated Rate	$531.90
Rate for Payer: Aetna of AZ Commercial	$531.90
Rate for Payer: Cash Price	$472.80

Know your out-of-pocket cost for care.

All Charges