Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

B Pertussis, Nasophar Culture

Facility

OP

$212.00

Service Code	CPT 87070
Hospital Charge Code	2269430
Hospital Revenue Code	300
Min. Negotiated Rate	$33.92
Max. Negotiated Rate	$190.80
Rate for Payer: Aetna of AZ Commercial	$190.80
Rate for Payer: Aetna of AZ Medicare	$59.36
Rate for Payer: Allwell Medicare	$33.92
Rate for Payer: Amerigroup Medicare	$33.92
Rate for Payer: APIPA Medicare/Medicaid	$79.18
Rate for Payer: AZCH Complete Medicare	$33.92
Rate for Payer: Banner UC Health Medicare	$33.92
Rate for Payer: Bisbee Police All Plans	$55.12
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$144.16
Rate for Payer: Cash Price	$169.60
Rate for Payer: Cigna of AZ Commercial	$137.80
Rate for Payer: Copperpoint Commercial	$52.47
Rate for Payer: Health Net of AZ Commercial	$127.20
Rate for Payer: Health Net of AZ Medicare	$59.36
Rate for Payer: Humana of AZ Medicare	$33.92
Rate for Payer: Self Pay Self Pay	$169.60
Rate for Payer: TriWest Medicare	$33.92
Rate for Payer: UnitedHealth Group of AZ Commercial	$123.60
Rate for Payer: UnitedHealth Group of AZ Medicare	$38.16

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$6,264.90

Service Code	APR-DRG 0562
Hospital Charge Code	APRDRG0564
Min. Negotiated Rate	$6,264.90
Max. Negotiated Rate	$6,264.90
Rate for Payer: AHCCCS Medicaid	$6,264.90
Rate for Payer: Allwell Medicaid	$6,264.90
Rate for Payer: AZCH Complete Medicaid	$6,264.90
Rate for Payer: Banner UC Health Medicaid	$6,264.90
Rate for Payer: Mercy Care Medicaid	$6,264.90

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$6,264.90

Service Code	APR-DRG 0562
Hospital Charge Code	APRDRG0563
Min. Negotiated Rate	$6,264.90
Max. Negotiated Rate	$6,264.90
Rate for Payer: AHCCCS Medicaid	$6,264.90
Rate for Payer: Allwell Medicaid	$6,264.90
Rate for Payer: AZCH Complete Medicaid	$6,264.90
Rate for Payer: Banner UC Health Medicaid	$6,264.90
Rate for Payer: Mercy Care Medicaid	$6,264.90

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$4,353.59

Service Code	APR-DRG 0561
Hospital Charge Code	APRDRG0563
Min. Negotiated Rate	$4,353.59
Max. Negotiated Rate	$4,353.59
Rate for Payer: AHCCCS Medicaid	$4,353.59
Rate for Payer: Allwell Medicaid	$4,353.59
Rate for Payer: AZCH Complete Medicaid	$4,353.59
Rate for Payer: Banner UC Health Medicaid	$4,353.59
Rate for Payer: Mercy Care Medicaid	$4,353.59

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$9,988.64

Service Code	APR-DRG 0563
Hospital Charge Code	APRDRG0563
Min. Negotiated Rate	$9,988.64
Max. Negotiated Rate	$9,988.64
Rate for Payer: AHCCCS Medicaid	$9,988.64
Rate for Payer: Allwell Medicaid	$9,988.64
Rate for Payer: AZCH Complete Medicaid	$9,988.64
Rate for Payer: Banner UC Health Medicaid	$9,988.64
Rate for Payer: Mercy Care Medicaid	$9,988.64

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$18,725.28

Service Code	APR-DRG 0564
Hospital Charge Code	APRDRG0564
Min. Negotiated Rate	$18,725.28
Max. Negotiated Rate	$18,725.28
Rate for Payer: AHCCCS Medicaid	$18,725.28
Rate for Payer: Allwell Medicaid	$18,725.28
Rate for Payer: AZCH Complete Medicaid	$18,725.28
Rate for Payer: Banner UC Health Medicaid	$18,725.28
Rate for Payer: Mercy Care Medicaid	$18,725.28

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$18,725.28

Service Code	APR-DRG 0564
Hospital Charge Code	APRDRG0563
Min. Negotiated Rate	$18,725.28
Max. Negotiated Rate	$18,725.28
Rate for Payer: AHCCCS Medicaid	$18,725.28
Rate for Payer: Allwell Medicaid	$18,725.28
Rate for Payer: AZCH Complete Medicaid	$18,725.28
Rate for Payer: Banner UC Health Medicaid	$18,725.28
Rate for Payer: Mercy Care Medicaid	$18,725.28

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$4,353.59

Service Code	APR-DRG 0561
Hospital Charge Code	APRDRG0564
Min. Negotiated Rate	$4,353.59
Max. Negotiated Rate	$4,353.59
Rate for Payer: AHCCCS Medicaid	$4,353.59
Rate for Payer: Allwell Medicaid	$4,353.59
Rate for Payer: AZCH Complete Medicaid	$4,353.59
Rate for Payer: Banner UC Health Medicaid	$4,353.59
Rate for Payer: Mercy Care Medicaid	$4,353.59

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$18,725.28

Service Code	APR-DRG 0564
Hospital Charge Code	APRDRG0561
Min. Negotiated Rate	$18,725.28
Max. Negotiated Rate	$18,725.28
Rate for Payer: AHCCCS Medicaid	$18,725.28
Rate for Payer: Allwell Medicaid	$18,725.28
Rate for Payer: AZCH Complete Medicaid	$18,725.28
Rate for Payer: Banner UC Health Medicaid	$18,725.28
Rate for Payer: Mercy Care Medicaid	$18,725.28

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$6,264.90

Service Code	APR-DRG 0562
Hospital Charge Code	APRDRG0561
Min. Negotiated Rate	$6,264.90
Max. Negotiated Rate	$6,264.90
Rate for Payer: AHCCCS Medicaid	$6,264.90
Rate for Payer: Allwell Medicaid	$6,264.90
Rate for Payer: AZCH Complete Medicaid	$6,264.90
Rate for Payer: Banner UC Health Medicaid	$6,264.90
Rate for Payer: Mercy Care Medicaid	$6,264.90

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$9,988.64

Service Code	APR-DRG 0563
Hospital Charge Code	APRDRG0564
Min. Negotiated Rate	$9,988.64
Max. Negotiated Rate	$9,988.64
Rate for Payer: AHCCCS Medicaid	$9,988.64
Rate for Payer: Allwell Medicaid	$9,988.64
Rate for Payer: AZCH Complete Medicaid	$9,988.64
Rate for Payer: Banner UC Health Medicaid	$9,988.64
Rate for Payer: Mercy Care Medicaid	$9,988.64

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$4,353.59

Service Code	APR-DRG 0561
Hospital Charge Code	APRDRG0561
Min. Negotiated Rate	$4,353.59
Max. Negotiated Rate	$4,353.59
Rate for Payer: AHCCCS Medicaid	$4,353.59
Rate for Payer: Allwell Medicaid	$4,353.59
Rate for Payer: AZCH Complete Medicaid	$4,353.59
Rate for Payer: Banner UC Health Medicaid	$4,353.59
Rate for Payer: Mercy Care Medicaid	$4,353.59

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$6,264.90

Service Code	APR-DRG 0562
Hospital Charge Code	APRDRG0562
Min. Negotiated Rate	$6,264.90
Max. Negotiated Rate	$6,264.90
Rate for Payer: AHCCCS Medicaid	$6,264.90
Rate for Payer: Allwell Medicaid	$6,264.90
Rate for Payer: AZCH Complete Medicaid	$6,264.90
Rate for Payer: Banner UC Health Medicaid	$6,264.90
Rate for Payer: Mercy Care Medicaid	$6,264.90

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$18,725.28

Service Code	APR-DRG 0564
Hospital Charge Code	APRDRG0562
Min. Negotiated Rate	$18,725.28
Max. Negotiated Rate	$18,725.28
Rate for Payer: AHCCCS Medicaid	$18,725.28
Rate for Payer: Allwell Medicaid	$18,725.28
Rate for Payer: AZCH Complete Medicaid	$18,725.28
Rate for Payer: Banner UC Health Medicaid	$18,725.28
Rate for Payer: Mercy Care Medicaid	$18,725.28

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$9,988.64

Service Code	APR-DRG 0563
Hospital Charge Code	APRDRG0561
Min. Negotiated Rate	$9,988.64
Max. Negotiated Rate	$9,988.64
Rate for Payer: AHCCCS Medicaid	$9,988.64
Rate for Payer: Allwell Medicaid	$9,988.64
Rate for Payer: AZCH Complete Medicaid	$9,988.64
Rate for Payer: Banner UC Health Medicaid	$9,988.64
Rate for Payer: Mercy Care Medicaid	$9,988.64

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$9,988.64

Service Code	APR-DRG 0563
Hospital Charge Code	APRDRG0562
Min. Negotiated Rate	$9,988.64
Max. Negotiated Rate	$9,988.64
Rate for Payer: AHCCCS Medicaid	$9,988.64
Rate for Payer: Allwell Medicaid	$9,988.64
Rate for Payer: AZCH Complete Medicaid	$9,988.64
Rate for Payer: Banner UC Health Medicaid	$9,988.64
Rate for Payer: Mercy Care Medicaid	$9,988.64

Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma

Facility

IP

$4,353.59

Service Code	APR-DRG 0561
Hospital Charge Code	APRDRG0562
Min. Negotiated Rate	$4,353.59
Max. Negotiated Rate	$4,353.59
Rate for Payer: AHCCCS Medicaid	$4,353.59
Rate for Payer: Allwell Medicaid	$4,353.59
Rate for Payer: AZCH Complete Medicaid	$4,353.59
Rate for Payer: Banner UC Health Medicaid	$4,353.59
Rate for Payer: Mercy Care Medicaid	$4,353.59

Brain Natriuretic Peptide (BNP)

Facility

OP

$485.00

Service Code	CPT 83880
Hospital Charge Code	785967
Hospital Revenue Code	301
Min. Negotiated Rate	$77.60
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna of AZ Commercial	$436.50
Rate for Payer: Aetna of AZ Medicare	$135.80
Rate for Payer: Allwell Medicare	$77.60
Rate for Payer: Amerigroup Medicare	$77.60
Rate for Payer: APIPA Medicare/Medicaid	$181.15
Rate for Payer: AZCH Complete Medicare	$77.60
Rate for Payer: Banner UC Health Medicare	$77.60
Rate for Payer: Bisbee Police All Plans	$126.10
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$329.80
Rate for Payer: Cash Price	$388.00
Rate for Payer: Cigna of AZ Commercial	$315.25
Rate for Payer: Copperpoint Commercial	$120.04
Rate for Payer: Health Net of AZ Commercial	$291.00
Rate for Payer: Health Net of AZ Medicare	$135.80
Rate for Payer: Humana of AZ Medicare	$77.60
Rate for Payer: Self Pay Self Pay	$388.00
Rate for Payer: TriWest Medicare	$77.60
Rate for Payer: UnitedHealth Group of AZ Commercial	$282.75
Rate for Payer: UnitedHealth Group of AZ Medicare	$87.30

Brain Natriuretic Peptide (BNP)

Facility

IP

$485.00

Service Code	CPT 83880
Hospital Charge Code	785967
Hospital Revenue Code	301
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna of AZ Commercial	$436.50
Rate for Payer: Bisbee Police All Plans	$126.10
Rate for Payer: Cash Price	$388.00
Rate for Payer: Self Pay Self Pay	$388.00

BRAVA SKIN OSTOMY BARRIER

Facility

OP

$32.00

Hospital Charge Code	27575453
Hospital Revenue Code	270
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna of AZ Commercial	$28.80
Rate for Payer: Aetna of AZ Medicare	$8.96
Rate for Payer: Allwell Medicare	$5.12
Rate for Payer: Amerigroup Medicare	$5.12
Rate for Payer: APIPA Medicare/Medicaid	$11.95
Rate for Payer: AZCH Complete Medicare	$5.12
Rate for Payer: Banner UC Health Medicare	$5.12
Rate for Payer: Bisbee Police All Plans	$8.32
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$21.76
Rate for Payer: Cash Price	$25.60
Rate for Payer: Cigna of AZ Commercial	$22.40
Rate for Payer: Copperpoint Commercial	$7.92
Rate for Payer: Health Net of AZ Commercial	$19.20
Rate for Payer: Health Net of AZ Medicare	$8.96
Rate for Payer: Humana of AZ Medicare	$5.12
Rate for Payer: Self Pay Self Pay	$25.60
Rate for Payer: TriWest Medicare	$5.12
Rate for Payer: UnitedHealth Group of AZ Commercial	$18.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$5.76

BRAVA SKIN OSTOMY BARRIER

Facility

IP

$32.00

Hospital Charge Code	27575453
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna of AZ Commercial	$28.80
Rate for Payer: Bisbee Police All Plans	$8.32
Rate for Payer: Cash Price	$25.60
Rate for Payer: Self Pay Self Pay	$25.60

Breast Procedures Except Mastectomy

Facility

IP

$17,151.33

Service Code	APR-DRG 3633
Hospital Charge Code	APRDRG3634
Min. Negotiated Rate	$17,151.33
Max. Negotiated Rate	$17,151.33
Rate for Payer: AHCCCS Medicaid	$17,151.33
Rate for Payer: Allwell Medicaid	$17,151.33
Rate for Payer: AZCH Complete Medicaid	$17,151.33
Rate for Payer: Banner UC Health Medicaid	$17,151.33
Rate for Payer: Mercy Care Medicaid	$17,151.33

Breast Procedures Except Mastectomy

Facility

IP

$8,104.68

Service Code	APR-DRG 3631
Hospital Charge Code	APRDRG3631
Min. Negotiated Rate	$8,104.68
Max. Negotiated Rate	$8,104.68
Rate for Payer: AHCCCS Medicaid	$8,104.68
Rate for Payer: Allwell Medicaid	$8,104.68
Rate for Payer: AZCH Complete Medicaid	$8,104.68
Rate for Payer: Banner UC Health Medicaid	$8,104.68
Rate for Payer: Mercy Care Medicaid	$8,104.68

Breast Procedures Except Mastectomy

Facility

IP

$17,151.33

Service Code	APR-DRG 3633
Hospital Charge Code	APRDRG3631
Min. Negotiated Rate	$17,151.33
Max. Negotiated Rate	$17,151.33
Rate for Payer: AHCCCS Medicaid	$17,151.33
Rate for Payer: Allwell Medicaid	$17,151.33
Rate for Payer: AZCH Complete Medicaid	$17,151.33
Rate for Payer: Banner UC Health Medicaid	$17,151.33
Rate for Payer: Mercy Care Medicaid	$17,151.33

Breast Procedures Except Mastectomy

Facility

IP

$17,151.33

Service Code	APR-DRG 3633
Hospital Charge Code	APRDRG3633
Min. Negotiated Rate	$17,151.33
Max. Negotiated Rate	$17,151.33
Rate for Payer: AHCCCS Medicaid	$17,151.33
Rate for Payer: Allwell Medicaid	$17,151.33
Rate for Payer: AZCH Complete Medicaid	$17,151.33
Rate for Payer: Banner UC Health Medicaid	$17,151.33
Rate for Payer: Mercy Care Medicaid	$17,151.33

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