Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$4,059.70

Service Code	APR-DRG 1982
Hospital Charge Code	APRDRG1981
Min. Negotiated Rate	$4,059.70
Max. Negotiated Rate	$4,059.70
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,059.70
Rate for Payer: Mercy Care Medicaid	$4,059.70
Rate for Payer: NaphCare Correctional Healthcare	$4,059.70

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$3,483.85

Service Code	APR-DRG 1981
Hospital Charge Code	APRDRG1983
Min. Negotiated Rate	$3,483.85
Max. Negotiated Rate	$3,483.85
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,483.85
Rate for Payer: Mercy Care Medicaid	$3,483.85
Rate for Payer: NaphCare Correctional Healthcare	$3,483.85

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$4,059.70

Service Code	APR-DRG 1982
Hospital Charge Code	APRDRG1984
Min. Negotiated Rate	$4,059.70
Max. Negotiated Rate	$4,059.70
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,059.70
Rate for Payer: Mercy Care Medicaid	$4,059.70
Rate for Payer: NaphCare Correctional Healthcare	$4,059.70

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$5,420.42

Service Code	APR-DRG 1983
Hospital Charge Code	APRDRG1984
Min. Negotiated Rate	$5,420.42
Max. Negotiated Rate	$5,420.42
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,420.42
Rate for Payer: Mercy Care Medicaid	$5,420.42
Rate for Payer: NaphCare Correctional Healthcare	$5,420.42

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$4,059.70

Service Code	APR-DRG 1982
Hospital Charge Code	APRDRG1983
Min. Negotiated Rate	$4,059.70
Max. Negotiated Rate	$4,059.70
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,059.70
Rate for Payer: Mercy Care Medicaid	$4,059.70
Rate for Payer: NaphCare Correctional Healthcare	$4,059.70

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$5,420.42

Service Code	APR-DRG 1983
Hospital Charge Code	APRDRG1983
Min. Negotiated Rate	$5,420.42
Max. Negotiated Rate	$5,420.42
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,420.42
Rate for Payer: Mercy Care Medicaid	$5,420.42
Rate for Payer: NaphCare Correctional Healthcare	$5,420.42

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$5,420.42

Service Code	APR-DRG 1983
Hospital Charge Code	APRDRG1982
Min. Negotiated Rate	$5,420.42
Max. Negotiated Rate	$5,420.42
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$5,420.42
Rate for Payer: Mercy Care Medicaid	$5,420.42
Rate for Payer: NaphCare Correctional Healthcare	$5,420.42

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$4,059.70

Service Code	APR-DRG 1982
Hospital Charge Code	APRDRG1982
Min. Negotiated Rate	$4,059.70
Max. Negotiated Rate	$4,059.70
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$4,059.70
Rate for Payer: Mercy Care Medicaid	$4,059.70
Rate for Payer: NaphCare Correctional Healthcare	$4,059.70

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$3,483.85

Service Code	APR-DRG 1981
Hospital Charge Code	APRDRG1982
Min. Negotiated Rate	$3,483.85
Max. Negotiated Rate	$3,483.85
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,483.85
Rate for Payer: Mercy Care Medicaid	$3,483.85
Rate for Payer: NaphCare Correctional Healthcare	$3,483.85

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$3,483.85

Service Code	APR-DRG 1981
Hospital Charge Code	APRDRG1984
Min. Negotiated Rate	$3,483.85
Max. Negotiated Rate	$3,483.85
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$3,483.85
Rate for Payer: Mercy Care Medicaid	$3,483.85
Rate for Payer: NaphCare Correctional Healthcare	$3,483.85

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$10,514.69

Service Code	APR-DRG 1984
Hospital Charge Code	APRDRG1983
Min. Negotiated Rate	$10,514.69
Max. Negotiated Rate	$10,514.69
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,514.69
Rate for Payer: Mercy Care Medicaid	$10,514.69
Rate for Payer: NaphCare Correctional Healthcare	$10,514.69

Angina Pectoris And Coronary Atherosclerosis

Facility

IP

$10,514.69

Service Code	APR-DRG 1984
Hospital Charge Code	APRDRG1982
Min. Negotiated Rate	$10,514.69
Max. Negotiated Rate	$10,514.69
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$10,514.69
Rate for Payer: Mercy Care Medicaid	$10,514.69
Rate for Payer: NaphCare Correctional Healthcare	$10,514.69

Angiotensin-Converting Enzyme LC

Facility

IP

$270.00

Service Code	CPT 82164
Hospital Charge Code	1905918
Hospital Revenue Code	301
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Cash Price	$216.00

Angiotensin-Converting Enzyme LC

Facility

OP

$270.00

Service Code	CPT 82164
Hospital Charge Code	1905918
Hospital Revenue Code	301
Min. Negotiated Rate	$21.17
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna of AZ Commercial	$243.00
Rate for Payer: Arizona Complete Health Allwell	$43.20
Rate for Payer: Banner UC Health Medicare	$43.20
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$183.60
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$43.20
Rate for Payer: Care1st Health Plan Arizona Medicare	$43.20
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cigna of AZ Commercial	$175.50
Rate for Payer: Devoted Health Medicare	$48.60
Rate for Payer: Humana of AZ Medicare	$43.20
Rate for Payer: Seven Corners Travel Insurance	$21.17
Rate for Payer: Southwest Service Administrators UFCW	$183.60
Rate for Payer: TriWest Medicare	$43.20
Rate for Payer: United Healthcare Commercial	$154.44
Rate for Payer: United Healthcare Medicare	$43.20
Rate for Payer: Veterans Affairs TRICARE	$42.77

ANGLED RESECTOR SHAVER BALDE F SERI

Facility

OP

$321.35

Hospital Charge Code	28083347
Hospital Revenue Code	270
Min. Negotiated Rate	$50.90
Max. Negotiated Rate	$289.21
Rate for Payer: Aetna of AZ Commercial	$289.21
Rate for Payer: Arizona Complete Health Allwell	$51.42
Rate for Payer: Banner UC Health Medicare	$51.42
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$218.52
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$51.42
Rate for Payer: Care1st Health Plan Arizona Medicare	$51.42
Rate for Payer: Cash Price	$257.08
Rate for Payer: Cigna of AZ Commercial	$224.94
Rate for Payer: Devoted Health Medicare	$57.84
Rate for Payer: Humana of AZ Medicare	$51.42
Rate for Payer: Southwest Service Administrators UFCW	$218.52
Rate for Payer: TriWest Medicare	$51.42
Rate for Payer: United Healthcare Commercial	$183.81
Rate for Payer: United Healthcare Medicare	$51.42
Rate for Payer: Veterans Affairs TRICARE	$50.90

ANGLED RESECTOR SHAVER BALDE F SERI

Facility

IP

$321.35

Hospital Charge Code	28083347
Hospital Revenue Code	270
Min. Negotiated Rate	$289.21
Max. Negotiated Rate	$289.21
Rate for Payer: Aetna of AZ Commercial	$289.21
Rate for Payer: Cash Price	$257.08

Annual Wellness Visit, Initial (AWV)

Facility

OP

$450.00

Service Code	HCPCS G0438
Hospital Charge Code	1298121
Hospital Revenue Code	521
Min. Negotiated Rate	$71.28
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Arizona Complete Health Allwell	$72.00
Rate for Payer: Banner UC Health Medicare	$72.00
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$306.00
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$72.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$72.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cigna of AZ Commercial	$315.00
Rate for Payer: Devoted Health Medicare	$81.00
Rate for Payer: Humana of AZ Medicare	$72.00
Rate for Payer: Southwest Service Administrators UFCW	$306.00
Rate for Payer: TriWest Medicare	$72.00
Rate for Payer: United Healthcare Commercial	$257.40
Rate for Payer: United Healthcare Medicare	$72.00
Rate for Payer: Veterans Affairs TRICARE	$71.28

Annual Wellness Visit, Initial (AWV)

Facility

IP

$450.00

Service Code	HCPCS G0438
Hospital Charge Code	1298121
Hospital Revenue Code	521
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Cash Price	$360.00

Annual Wellness Visit, Subsequent (AWV)

Facility

OP

$450.00

Service Code	HCPCS G0439
Hospital Charge Code	1298122
Hospital Revenue Code	521
Min. Negotiated Rate	$71.28
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Arizona Complete Health Allwell	$72.00
Rate for Payer: Banner UC Health Medicare	$72.00
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$306.00
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$72.00
Rate for Payer: Care1st Health Plan Arizona Medicare	$72.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cigna of AZ Commercial	$315.00
Rate for Payer: Devoted Health Medicare	$81.00
Rate for Payer: Humana of AZ Medicare	$72.00
Rate for Payer: Southwest Service Administrators UFCW	$306.00
Rate for Payer: TriWest Medicare	$72.00
Rate for Payer: United Healthcare Commercial	$257.40
Rate for Payer: United Healthcare Medicare	$72.00
Rate for Payer: Veterans Affairs TRICARE	$71.28

Annual Wellness Visit, Subsequent (AWV)

Facility

IP

$450.00

Service Code	HCPCS G0439
Hospital Charge Code	1298122
Hospital Revenue Code	521
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna of AZ Commercial	$405.00
Rate for Payer: Cash Price	$360.00

ANOSCOPY

Facility

IP

$243.00

Hospital Charge Code	2263852
Hospital Revenue Code	750
Min. Negotiated Rate	$218.70
Max. Negotiated Rate	$218.70
Rate for Payer: Aetna of AZ Commercial	$218.70
Rate for Payer: Cash Price	$194.40

ANOSCOPY

Facility

OP

$243.00

Hospital Charge Code	2263852
Hospital Revenue Code	750
Min. Negotiated Rate	$38.49
Max. Negotiated Rate	$3,373.00
Rate for Payer: Aetna of AZ Commercial	$218.70
Rate for Payer: Arizona Complete Health Allwell	$38.88
Rate for Payer: Banner UC Health Medicare	$38.88
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$165.24
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$38.88
Rate for Payer: Care1st Health Plan Arizona Medicare	$38.88
Rate for Payer: Cash Price	$194.40
Rate for Payer: Cash Price	$194.40
Rate for Payer: Cigna of AZ Commercial	$170.10
Rate for Payer: Devoted Health Medicare	$43.74
Rate for Payer: Humana of AZ Medicare	$38.88
Rate for Payer: Southwest Service Administrators UFCW	$165.24
Rate for Payer: TriWest Medicare	$38.88
Rate for Payer: United Healthcare Commercial	$3,373.00
Rate for Payer: United Healthcare Medicare	$38.88
Rate for Payer: United Healthcare New Mexico Commercial	$46.17
Rate for Payer: Veterans Affairs TRICARE	$38.49

Anoscopy; With Dilation (Eg, Balloon, Guide Wire, Bougie)

Facility

IP

$1,322.00

Service Code	CPT 46604
Hospital Charge Code	1303582
Hospital Revenue Code	521
Min. Negotiated Rate	$1,189.80
Max. Negotiated Rate	$1,189.80
Rate for Payer: Aetna of AZ Commercial	$1,189.80
Rate for Payer: Cash Price	$1,057.60

Anoscopy; With Dilation (Eg, Balloon, Guide Wire, Bougie)

Facility

OP

$1,322.00

Service Code	CPT 46604
Hospital Charge Code	1303582
Hospital Revenue Code	521
Min. Negotiated Rate	$209.40
Max. Negotiated Rate	$1,851.53
Rate for Payer: Aetna of AZ Commercial	$1,189.80
Rate for Payer: Arizona Complete Health Allwell	$211.52
Rate for Payer: Banner UC Health Medicare	$211.52
Rate for Payer: Blue Cross Blue Shield of Arizona Commercial	$898.96
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$555.08
Rate for Payer: Blue Cross Blue Shield of Arizona Medicare	$211.52
Rate for Payer: Care1st Health Plan Arizona Medicare	$211.52
Rate for Payer: Cash Price	$1,057.60
Rate for Payer: Cash Price	$1,057.60
Rate for Payer: Cigna of AZ Commercial	$925.40
Rate for Payer: Devoted Health Medicare	$237.96
Rate for Payer: Humana of AZ Medicare	$211.52
Rate for Payer: Mercy Care Medicaid	$555.08
Rate for Payer: NaphCare Correctional Healthcare	$555.08
Rate for Payer: Seven Corners Travel Insurance	$1,851.53
Rate for Payer: Southwest Service Administrators UFCW	$898.96
Rate for Payer: TriWest Medicare	$211.52
Rate for Payer: United Healthcare Commercial	$756.18
Rate for Payer: United Healthcare Medicare	$211.52
Rate for Payer: Veterans Affairs TRICARE	$209.40

Anoxic And Other Severe Brain Damage

Facility

IP

$15,379.60

Service Code	APR-DRG 0594
Hospital Charge Code	APRDRG0594
Min. Negotiated Rate	$15,379.60
Max. Negotiated Rate	$15,379.60
Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice	$15,379.60
Rate for Payer: Mercy Care Medicaid	$15,379.60
Rate for Payer: NaphCare Correctional Healthcare	$15,379.60

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