Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

BLADE GLIDESCOPE SML

Facility

$109.00

Hospital Charge Code	22354971
Hospital Revenue Code	270
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$98.10
Rate for Payer: Aetna of AZ Commercial	$98.10
Rate for Payer: Aetna of AZ Medicare	$30.52
Rate for Payer: Allwell Medicare	$16.35
Rate for Payer: Amerigroup Medicare	$16.35
Rate for Payer: APIPA Medicare/Medicaid	$40.71
Rate for Payer: AZCH Complete Medicare	$16.35
Rate for Payer: Banner UC Health Medicare	$16.35
Rate for Payer: Bisbee Police All Plans	$28.34
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$74.12
Rate for Payer: Cash Price	$87.20
Rate for Payer: Cigna of AZ Commercial	$76.30
Rate for Payer: Copperpoint Commercial	$26.98
Rate for Payer: Health Net of AZ Commercial	$65.40
Rate for Payer: Health Net of AZ Medicare	$30.52
Rate for Payer: Humana of AZ Medicare	$16.35
Rate for Payer: Self Pay Self Pay	$87.20
Rate for Payer: TriWest Medicare	$16.35
Rate for Payer: UnitedHealth Group of AZ Commercial	$63.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$19.62

BLADE LARYNGASCOPE #3

Facility

$222.00

Hospital Charge Code	22354256
Hospital Revenue Code	270
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna of AZ Commercial	$199.80
Rate for Payer: Aetna of AZ Medicare	$62.16
Rate for Payer: Allwell Medicare	$33.30
Rate for Payer: Amerigroup Medicare	$33.30
Rate for Payer: APIPA Medicare/Medicaid	$82.92
Rate for Payer: AZCH Complete Medicare	$33.30
Rate for Payer: Banner UC Health Medicare	$33.30
Rate for Payer: Bisbee Police All Plans	$57.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$150.96
Rate for Payer: Cash Price	$177.60
Rate for Payer: Cigna of AZ Commercial	$155.40
Rate for Payer: Copperpoint Commercial	$54.94
Rate for Payer: Health Net of AZ Commercial	$133.20
Rate for Payer: Health Net of AZ Medicare	$62.16
Rate for Payer: Humana of AZ Medicare	$33.30
Rate for Payer: Self Pay Self Pay	$177.60
Rate for Payer: TriWest Medicare	$33.30
Rate for Payer: UnitedHealth Group of AZ Commercial	$129.43
Rate for Payer: UnitedHealth Group of AZ Medicare	$39.96

BLADE LARYNGASCOPE #3

Facility

$222.00

Hospital Charge Code	22354256
Hospital Revenue Code	270
Min. Negotiated Rate	$57.72
Max. Negotiated Rate	$199.80
Rate for Payer: Aetna of AZ Commercial	$199.80
Rate for Payer: Bisbee Police All Plans	$57.72
Rate for Payer: Cash Price	$177.60
Rate for Payer: Self Pay Self Pay	$177.60

BLADE SM62 PODIATRY

Facility

$18.00

Hospital Charge Code	22926423
Hospital Revenue Code	272
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of AZ Commercial	$16.20
Rate for Payer: Bisbee Police All Plans	$4.68
Rate for Payer: Cash Price	$14.40
Rate for Payer: Self Pay Self Pay	$14.40

BLADE SM62 PODIATRY

Facility

$18.00

Hospital Charge Code	22926423
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of AZ Commercial	$16.20
Rate for Payer: Aetna of AZ Medicare	$5.04
Rate for Payer: Allwell Medicare	$2.70
Rate for Payer: Amerigroup Medicare	$2.70
Rate for Payer: APIPA Medicare/Medicaid	$6.72
Rate for Payer: AZCH Complete Medicare	$2.70
Rate for Payer: Banner UC Health Medicare	$2.70
Rate for Payer: Bisbee Police All Plans	$4.68
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$12.24
Rate for Payer: Cash Price	$14.40
Rate for Payer: Cigna of AZ Commercial	$12.60
Rate for Payer: Copperpoint Commercial	$4.46
Rate for Payer: Health Net of AZ Commercial	$10.80
Rate for Payer: Health Net of AZ Medicare	$5.04
Rate for Payer: Humana of AZ Medicare	$2.70
Rate for Payer: Self Pay Self Pay	$14.40
Rate for Payer: TriWest Medicare	$2.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$10.49
Rate for Payer: UnitedHealth Group of AZ Medicare	$3.24

Blood Admininstration

Facility

$958.00

Service Code	CPT 36430
Hospital Charge Code	22349429
Hospital Revenue Code	391
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$862.20
Rate for Payer: Aetna of AZ Commercial	$862.20
Rate for Payer: Bisbee Police All Plans	$249.08
Rate for Payer: Cash Price	$766.40
Rate for Payer: Self Pay Self Pay	$766.40

Blood Admininstration

Facility

$958.00

Service Code	CPT 36430
Hospital Charge Code	22349429
Hospital Revenue Code	391
Min. Negotiated Rate	$143.70
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$862.20
Rate for Payer: Aetna of AZ Medicare	$268.24
Rate for Payer: AHCCCS Medicaid	$575.74
Rate for Payer: Allwell Medicaid	$575.74
Rate for Payer: Allwell Medicare	$143.70
Rate for Payer: Amerigroup Medicare	$143.70
Rate for Payer: APIPA Medicare/Medicaid	$357.81
Rate for Payer: AZCH Complete Medicaid	$575.74
Rate for Payer: AZCH Complete Medicare	$143.70
Rate for Payer: Banner UC Health Medicaid	$575.74
Rate for Payer: Banner UC Health Medicare	$143.70
Rate for Payer: Bisbee Police All Plans	$249.08
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$651.44
Rate for Payer: Cash Price	$766.40
Rate for Payer: Cash Price	$766.40
Rate for Payer: Cigna of AZ Commercial	$670.60
Rate for Payer: Copperpoint Commercial	$237.10
Rate for Payer: Health Net of AZ Commercial	$574.80
Rate for Payer: Health Net of AZ Medicare	$268.24
Rate for Payer: Humana of AZ Medicare	$143.70
Rate for Payer: Mercy Care Medicaid	$575.74
Rate for Payer: Self Pay Self Pay	$766.40
Rate for Payer: TriWest Medicare	$143.70
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$172.44

Blood Administration

Facility

$912.00

Service Code	CPT 36430
Hospital Charge Code	609598
Hospital Revenue Code	391
Min. Negotiated Rate	$237.12
Max. Negotiated Rate	$820.80
Rate for Payer: Aetna of AZ Commercial	$820.80
Rate for Payer: Bisbee Police All Plans	$237.12
Rate for Payer: Cash Price	$729.60
Rate for Payer: Self Pay Self Pay	$729.60

Blood Administration

Facility

$912.00

Service Code	CPT 36430
Hospital Charge Code	609598
Hospital Revenue Code	391
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$2,161.00
Rate for Payer: Aetna of AZ Commercial	$820.80
Rate for Payer: Aetna of AZ Medicare	$255.36
Rate for Payer: AHCCCS Medicaid	$575.74
Rate for Payer: Allwell Medicaid	$575.74
Rate for Payer: Allwell Medicare	$136.80
Rate for Payer: Amerigroup Medicare	$136.80
Rate for Payer: APIPA Medicare/Medicaid	$340.63
Rate for Payer: AZCH Complete Medicaid	$575.74
Rate for Payer: AZCH Complete Medicare	$136.80
Rate for Payer: Banner UC Health Medicaid	$575.74
Rate for Payer: Banner UC Health Medicare	$136.80
Rate for Payer: Bisbee Police All Plans	$237.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$620.16
Rate for Payer: Cash Price	$729.60
Rate for Payer: Cash Price	$729.60
Rate for Payer: Cigna of AZ Commercial	$638.40
Rate for Payer: Copperpoint Commercial	$225.72
Rate for Payer: Health Net of AZ Commercial	$547.20
Rate for Payer: Health Net of AZ Medicare	$255.36
Rate for Payer: Humana of AZ Medicare	$136.80
Rate for Payer: Mercy Care Medicaid	$575.74
Rate for Payer: Self Pay Self Pay	$729.60
Rate for Payer: TriWest Medicare	$136.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare	$164.16

Blood Culture

Facility

$166.00

Service Code	CPT 87040
Hospital Charge Code	850752
Hospital Revenue Code	306
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$149.40
Rate for Payer: Aetna of AZ Commercial	$149.40
Rate for Payer: Bisbee Police All Plans	$43.16
Rate for Payer: Cash Price	$132.80
Rate for Payer: Self Pay Self Pay	$132.80

Blood Culture

Facility

$166.00

Service Code	CPT 87040
Hospital Charge Code	850752
Hospital Revenue Code	306
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$149.40
Rate for Payer: Aetna of AZ Commercial	$149.40
Rate for Payer: Aetna of AZ Medicare	$46.48
Rate for Payer: AHCCCS Medicaid	$10.32
Rate for Payer: Allwell Medicaid	$10.32
Rate for Payer: Allwell Medicare	$24.90
Rate for Payer: Amerigroup Medicare	$24.90
Rate for Payer: APIPA Medicare/Medicaid	$62.00
Rate for Payer: AZCH Complete Medicaid	$10.32
Rate for Payer: AZCH Complete Medicare	$24.90
Rate for Payer: Banner UC Health Medicaid	$10.32
Rate for Payer: Banner UC Health Medicare	$24.90
Rate for Payer: Bisbee Police All Plans	$43.16
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$112.88
Rate for Payer: Cash Price	$132.80
Rate for Payer: Cash Price	$132.80
Rate for Payer: Cigna of AZ Commercial	$107.90
Rate for Payer: Copperpoint Commercial	$41.08
Rate for Payer: Health Net of AZ Commercial	$99.60
Rate for Payer: Health Net of AZ Medicare	$46.48
Rate for Payer: Humana of AZ Medicare	$24.90
Rate for Payer: Mercy Care Medicaid	$10.32
Rate for Payer: Self Pay Self Pay	$132.80
Rate for Payer: TriWest Medicare	$24.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$96.78
Rate for Payer: UnitedHealth Group of AZ Medicare	$29.88

Blood Drugs of Abuse, 7,WB LC

Facility

$80.00

Service Code	CPT 80101
Hospital Charge Code	22311178
Hospital Revenue Code	301
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Cash Price	$64.00
Rate for Payer: Self Pay Self Pay	$64.00

Blood Drugs of Abuse, 7,WB LC

Facility

$80.00

Service Code	CPT 80101
Hospital Charge Code	22311178
Hospital Revenue Code	301
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of AZ Commercial	$72.00
Rate for Payer: Aetna of AZ Medicare	$22.40
Rate for Payer: Allwell Medicare	$12.00
Rate for Payer: Amerigroup Medicare	$12.00
Rate for Payer: APIPA Medicare/Medicaid	$29.88
Rate for Payer: AZCH Complete Medicare	$12.00
Rate for Payer: Banner UC Health Medicare	$12.00
Rate for Payer: Bisbee Police All Plans	$20.80
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$54.40
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cigna of AZ Commercial	$52.00
Rate for Payer: Copperpoint Commercial	$19.80
Rate for Payer: Health Net of AZ Commercial	$48.00
Rate for Payer: Health Net of AZ Medicare	$22.40
Rate for Payer: Humana of AZ Medicare	$12.00
Rate for Payer: Self Pay Self Pay	$64.00
Rate for Payer: TriWest Medicare	$12.00
Rate for Payer: UnitedHealth Group of AZ Commercial	$46.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$14.40

Blood Urea Nitrogen

Facility

$64.00

Service Code	CPT 84520
Hospital Charge Code	633605
Hospital Revenue Code	301
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$57.60
Rate for Payer: Aetna of AZ Commercial	$57.60
Rate for Payer: Bisbee Police All Plans	$16.64
Rate for Payer: Cash Price	$51.20
Rate for Payer: Self Pay Self Pay	$51.20

Blood Urea Nitrogen

Facility

$64.00

Service Code	CPT 84520
Hospital Charge Code	633605
Hospital Revenue Code	301
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$57.60
Rate for Payer: Aetna of AZ Commercial	$57.60
Rate for Payer: Aetna of AZ Medicare	$17.92
Rate for Payer: AHCCCS Medicaid	$3.95
Rate for Payer: Allwell Medicaid	$3.95
Rate for Payer: Allwell Medicare	$9.60
Rate for Payer: Amerigroup Medicare	$9.60
Rate for Payer: APIPA Medicare/Medicaid	$23.90
Rate for Payer: AZCH Complete Medicaid	$3.95
Rate for Payer: AZCH Complete Medicare	$9.60
Rate for Payer: Banner UC Health Medicaid	$3.95
Rate for Payer: Banner UC Health Medicare	$9.60
Rate for Payer: Bisbee Police All Plans	$16.64
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$43.52
Rate for Payer: Cash Price	$51.20
Rate for Payer: Cash Price	$51.20
Rate for Payer: Cigna of AZ Commercial	$41.60
Rate for Payer: Copperpoint Commercial	$15.84
Rate for Payer: Health Net of AZ Commercial	$38.40
Rate for Payer: Health Net of AZ Medicare	$17.92
Rate for Payer: Humana of AZ Medicare	$9.60
Rate for Payer: Mercy Care Medicaid	$3.95
Rate for Payer: Self Pay Self Pay	$51.20
Rate for Payer: TriWest Medicare	$9.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$37.31
Rate for Payer: UnitedHealth Group of AZ Medicare	$11.52

BLUE INTRAOSSEOUS MODULE PEDS

Facility

$362.00

Hospital Charge Code	23175128
Hospital Revenue Code	272
Min. Negotiated Rate	$94.12
Max. Negotiated Rate	$325.80
Rate for Payer: Aetna of AZ Commercial	$325.80
Rate for Payer: Bisbee Police All Plans	$94.12
Rate for Payer: Cash Price	$289.60
Rate for Payer: Self Pay Self Pay	$289.60

BLUE INTRAOSSEOUS MODULE PEDS

Facility

$362.00

Hospital Charge Code	23175128
Hospital Revenue Code	272
Min. Negotiated Rate	$54.30
Max. Negotiated Rate	$325.80
Rate for Payer: Aetna of AZ Commercial	$325.80
Rate for Payer: Aetna of AZ Medicare	$101.36
Rate for Payer: Allwell Medicare	$54.30
Rate for Payer: Amerigroup Medicare	$54.30
Rate for Payer: APIPA Medicare/Medicaid	$135.21
Rate for Payer: AZCH Complete Medicare	$54.30
Rate for Payer: Banner UC Health Medicare	$54.30
Rate for Payer: Bisbee Police All Plans	$94.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$246.16
Rate for Payer: Cash Price	$289.60
Rate for Payer: Cigna of AZ Commercial	$253.40
Rate for Payer: Copperpoint Commercial	$89.60
Rate for Payer: Health Net of AZ Commercial	$217.20
Rate for Payer: Health Net of AZ Medicare	$101.36
Rate for Payer: Humana of AZ Medicare	$54.30
Rate for Payer: Self Pay Self Pay	$289.60
Rate for Payer: TriWest Medicare	$54.30
Rate for Payer: UnitedHealth Group of AZ Commercial	$211.05
Rate for Payer: UnitedHealth Group of AZ Medicare	$65.16

BLUE INTUBATION MODULE PEDS

Facility

$302.00

Hospital Charge Code	23175716
Hospital Revenue Code	272
Min. Negotiated Rate	$45.30
Max. Negotiated Rate	$271.80
Rate for Payer: Aetna of AZ Commercial	$271.80
Rate for Payer: Aetna of AZ Medicare	$84.56
Rate for Payer: Allwell Medicare	$45.30
Rate for Payer: Amerigroup Medicare	$45.30
Rate for Payer: APIPA Medicare/Medicaid	$112.80
Rate for Payer: AZCH Complete Medicare	$45.30
Rate for Payer: Banner UC Health Medicare	$45.30
Rate for Payer: Bisbee Police All Plans	$78.52
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$205.36
Rate for Payer: Cash Price	$241.60
Rate for Payer: Cigna of AZ Commercial	$211.40
Rate for Payer: Copperpoint Commercial	$74.74
Rate for Payer: Health Net of AZ Commercial	$181.20
Rate for Payer: Health Net of AZ Medicare	$84.56
Rate for Payer: Humana of AZ Medicare	$45.30
Rate for Payer: Self Pay Self Pay	$241.60
Rate for Payer: TriWest Medicare	$45.30
Rate for Payer: UnitedHealth Group of AZ Commercial	$176.07
Rate for Payer: UnitedHealth Group of AZ Medicare	$54.36

BLUE INTUBATION MODULE PEDS

Facility

$302.00

Hospital Charge Code	23175716
Hospital Revenue Code	272
Min. Negotiated Rate	$78.52
Max. Negotiated Rate	$271.80
Rate for Payer: Aetna of AZ Commercial	$271.80
Rate for Payer: Bisbee Police All Plans	$78.52
Rate for Payer: Cash Price	$241.60
Rate for Payer: Self Pay Self Pay	$241.60

BLUE IV DELIVERY MODULE PEDS

Facility

$290.00

Hospital Charge Code	23175709
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$261.00
Rate for Payer: Aetna of AZ Commercial	$261.00
Rate for Payer: Aetna of AZ Medicare	$81.20
Rate for Payer: Allwell Medicare	$43.50
Rate for Payer: Amerigroup Medicare	$43.50
Rate for Payer: APIPA Medicare/Medicaid	$108.32
Rate for Payer: AZCH Complete Medicare	$43.50
Rate for Payer: Banner UC Health Medicare	$43.50
Rate for Payer: Bisbee Police All Plans	$75.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$197.20
Rate for Payer: Cash Price	$232.00
Rate for Payer: Cigna of AZ Commercial	$203.00
Rate for Payer: Copperpoint Commercial	$71.78
Rate for Payer: Health Net of AZ Commercial	$174.00
Rate for Payer: Health Net of AZ Medicare	$81.20
Rate for Payer: Humana of AZ Medicare	$43.50
Rate for Payer: Self Pay Self Pay	$232.00
Rate for Payer: TriWest Medicare	$43.50
Rate for Payer: UnitedHealth Group of AZ Commercial	$169.07
Rate for Payer: UnitedHealth Group of AZ Medicare	$52.20

BLUE IV DELIVERY MODULE PEDS

Facility

$290.00

Hospital Charge Code	23175709
Hospital Revenue Code	272
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$261.00
Rate for Payer: Aetna of AZ Commercial	$261.00
Rate for Payer: Bisbee Police All Plans	$75.40
Rate for Payer: Cash Price	$232.00
Rate for Payer: Self Pay Self Pay	$232.00

BLUE OXYGEN DELIVERY SYSTEM PEDS

Facility

$121.00

Hospital Charge Code	23175702
Hospital Revenue Code	272
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$108.90
Rate for Payer: Aetna of AZ Commercial	$108.90
Rate for Payer: Aetna of AZ Medicare	$33.88
Rate for Payer: Allwell Medicare	$18.15
Rate for Payer: Amerigroup Medicare	$18.15
Rate for Payer: APIPA Medicare/Medicaid	$45.19
Rate for Payer: AZCH Complete Medicare	$18.15
Rate for Payer: Banner UC Health Medicare	$18.15
Rate for Payer: Bisbee Police All Plans	$31.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$82.28
Rate for Payer: Cash Price	$96.80
Rate for Payer: Cigna of AZ Commercial	$84.70
Rate for Payer: Copperpoint Commercial	$29.95
Rate for Payer: Health Net of AZ Commercial	$72.60
Rate for Payer: Health Net of AZ Medicare	$33.88
Rate for Payer: Humana of AZ Medicare	$18.15
Rate for Payer: Self Pay Self Pay	$96.80
Rate for Payer: TriWest Medicare	$18.15
Rate for Payer: UnitedHealth Group of AZ Commercial	$70.54
Rate for Payer: UnitedHealth Group of AZ Medicare	$21.78

BLUE OXYGEN DELIVERY SYSTEM PEDS

Facility

$121.00

Hospital Charge Code	23175702
Hospital Revenue Code	272
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$108.90
Rate for Payer: Aetna of AZ Commercial	$108.90
Rate for Payer: Bisbee Police All Plans	$31.46
Rate for Payer: Cash Price	$96.80
Rate for Payer: Self Pay Self Pay	$96.80

Body Fluid Culture

Facility

$327.00

Service Code	CPT 87070
Hospital Charge Code	858005
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$294.30
Rate for Payer: Aetna of AZ Commercial	$294.30
Rate for Payer: Aetna of AZ Medicare	$91.56
Rate for Payer: AHCCCS Medicaid	$8.62
Rate for Payer: Allwell Medicaid	$8.62
Rate for Payer: Allwell Medicare	$49.05
Rate for Payer: Amerigroup Medicare	$49.05
Rate for Payer: APIPA Medicare/Medicaid	$122.13
Rate for Payer: AZCH Complete Medicaid	$8.62
Rate for Payer: AZCH Complete Medicare	$49.05
Rate for Payer: Banner UC Health Medicaid	$8.62
Rate for Payer: Banner UC Health Medicare	$49.05
Rate for Payer: Bisbee Police All Plans	$85.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$222.36
Rate for Payer: Cash Price	$261.60
Rate for Payer: Cash Price	$261.60
Rate for Payer: Cigna of AZ Commercial	$212.55
Rate for Payer: Copperpoint Commercial	$80.93
Rate for Payer: Health Net of AZ Commercial	$196.20
Rate for Payer: Health Net of AZ Medicare	$91.56
Rate for Payer: Humana of AZ Medicare	$49.05
Rate for Payer: Mercy Care Medicaid	$8.62
Rate for Payer: Self Pay Self Pay	$261.60
Rate for Payer: TriWest Medicare	$49.05
Rate for Payer: UnitedHealth Group of AZ Commercial	$190.64
Rate for Payer: UnitedHealth Group of AZ Medicare	$58.86

Body Fluid Culture

Facility

$327.00

Service Code	CPT 87070
Hospital Charge Code	858005
Hospital Revenue Code	306
Min. Negotiated Rate	$85.02
Max. Negotiated Rate	$294.30
Rate for Payer: Aetna of AZ Commercial	$294.30
Rate for Payer: Bisbee Police All Plans	$85.02
Rate for Payer: Cash Price	$261.60
Rate for Payer: Self Pay Self Pay	$261.60

Know your out-of-pocket cost for care.

All Charges