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Service Code CPT 12011
Hospital Charge Code 22282773
Hospital Revenue Code 450
Min. Negotiated Rate $140.40
Max. Negotiated Rate $486.00
Rate for Payer: Aetna of AZ Commercial $486.00
Rate for Payer: Bisbee Police All Plans $140.40
Rate for Payer: Cash Price $432.00
Rate for Payer: Self Pay Self Pay $432.00
Service Code CPT 12011
Hospital Charge Code 22282773
Hospital Revenue Code 450
Min. Negotiated Rate $81.00
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $486.00
Rate for Payer: Aetna of AZ Medicare $151.20
Rate for Payer: AHCCCS Medicaid $260.34
Rate for Payer: Allwell Medicaid $260.34
Rate for Payer: Allwell Medicare $81.00
Rate for Payer: Amerigroup Medicare $81.00
Rate for Payer: APIPA Medicare/Medicaid $201.69
Rate for Payer: AZCH Complete Medicaid $260.34
Rate for Payer: AZCH Complete Medicare $81.00
Rate for Payer: Banner UC Health Medicaid $260.34
Rate for Payer: Banner UC Health Medicare $81.00
Rate for Payer: Bisbee Police All Plans $140.40
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $367.20
Rate for Payer: Cash Price $432.00
Rate for Payer: Cash Price $432.00
Rate for Payer: Cigna of AZ Commercial $378.00
Rate for Payer: Copperpoint Commercial $133.65
Rate for Payer: Health Net of AZ Commercial $324.00
Rate for Payer: Health Net of AZ Medicare $151.20
Rate for Payer: Humana of AZ Medicare $81.00
Rate for Payer: Mercy Care Medicaid $260.34
Rate for Payer: Self Pay Self Pay $432.00
Rate for Payer: TriWest Medicare $81.00
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $97.20
Service Code CPT 12013
Hospital Charge Code 22282774
Hospital Revenue Code 450
Min. Negotiated Rate $93.75
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $562.50
Rate for Payer: Aetna of AZ Medicare $175.00
Rate for Payer: AHCCCS Medicaid $260.34
Rate for Payer: Allwell Medicaid $260.34
Rate for Payer: Allwell Medicare $93.75
Rate for Payer: Amerigroup Medicare $93.75
Rate for Payer: APIPA Medicare/Medicaid $233.44
Rate for Payer: AZCH Complete Medicaid $260.34
Rate for Payer: AZCH Complete Medicare $93.75
Rate for Payer: Banner UC Health Medicaid $260.34
Rate for Payer: Banner UC Health Medicare $93.75
Rate for Payer: Bisbee Police All Plans $162.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $425.00
Rate for Payer: Cash Price $500.00
Rate for Payer: Cash Price $500.00
Rate for Payer: Cigna of AZ Commercial $437.50
Rate for Payer: Copperpoint Commercial $154.69
Rate for Payer: Health Net of AZ Commercial $375.00
Rate for Payer: Health Net of AZ Medicare $175.00
Rate for Payer: Humana of AZ Medicare $93.75
Rate for Payer: Mercy Care Medicaid $260.34
Rate for Payer: Self Pay Self Pay $500.00
Rate for Payer: TriWest Medicare $93.75
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $112.50
Service Code CPT 12013
Hospital Charge Code 22282774
Hospital Revenue Code 450
Min. Negotiated Rate $162.50
Max. Negotiated Rate $562.50
Rate for Payer: Aetna of AZ Commercial $562.50
Rate for Payer: Bisbee Police All Plans $162.50
Rate for Payer: Cash Price $500.00
Rate for Payer: Self Pay Self Pay $500.00
Service Code CPT 12014
Hospital Charge Code 22282775
Hospital Revenue Code 450
Min. Negotiated Rate $197.60
Max. Negotiated Rate $684.00
Rate for Payer: Aetna of AZ Commercial $684.00
Rate for Payer: Bisbee Police All Plans $197.60
Rate for Payer: Cash Price $608.00
Rate for Payer: Self Pay Self Pay $608.00
Service Code CPT 12014
Hospital Charge Code 22282775
Hospital Revenue Code 450
Min. Negotiated Rate $114.00
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $684.00
Rate for Payer: Aetna of AZ Medicare $212.80
Rate for Payer: AHCCCS Medicaid $260.34
Rate for Payer: Allwell Medicaid $260.34
Rate for Payer: Allwell Medicare $114.00
Rate for Payer: Amerigroup Medicare $114.00
Rate for Payer: APIPA Medicare/Medicaid $283.86
Rate for Payer: AZCH Complete Medicaid $260.34
Rate for Payer: AZCH Complete Medicare $114.00
Rate for Payer: Banner UC Health Medicaid $260.34
Rate for Payer: Banner UC Health Medicare $114.00
Rate for Payer: Bisbee Police All Plans $197.60
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $516.80
Rate for Payer: Cash Price $608.00
Rate for Payer: Cash Price $608.00
Rate for Payer: Cigna of AZ Commercial $532.00
Rate for Payer: Copperpoint Commercial $188.10
Rate for Payer: Health Net of AZ Commercial $456.00
Rate for Payer: Health Net of AZ Medicare $212.80
Rate for Payer: Humana of AZ Medicare $114.00
Rate for Payer: Mercy Care Medicaid $260.34
Rate for Payer: Self Pay Self Pay $608.00
Rate for Payer: TriWest Medicare $114.00
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $136.80
Service Code CPT 12015
Hospital Charge Code 22282776
Hospital Revenue Code 450
Min. Negotiated Rate $146.55
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $879.30
Rate for Payer: Aetna of AZ Medicare $273.56
Rate for Payer: AHCCCS Medicaid $260.34
Rate for Payer: Allwell Medicaid $260.34
Rate for Payer: Allwell Medicare $146.55
Rate for Payer: Amerigroup Medicare $146.55
Rate for Payer: APIPA Medicare/Medicaid $364.91
Rate for Payer: AZCH Complete Medicaid $260.34
Rate for Payer: AZCH Complete Medicare $146.55
Rate for Payer: Banner UC Health Medicaid $260.34
Rate for Payer: Banner UC Health Medicare $146.55
Rate for Payer: Bisbee Police All Plans $254.02
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $664.36
Rate for Payer: Cash Price $781.60
Rate for Payer: Cash Price $781.60
Rate for Payer: Cigna of AZ Commercial $683.90
Rate for Payer: Copperpoint Commercial $241.81
Rate for Payer: Health Net of AZ Commercial $586.20
Rate for Payer: Health Net of AZ Medicare $273.56
Rate for Payer: Humana of AZ Medicare $146.55
Rate for Payer: Mercy Care Medicaid $260.34
Rate for Payer: Self Pay Self Pay $781.60
Rate for Payer: TriWest Medicare $146.55
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $175.86
Service Code CPT 12015
Hospital Charge Code 22282776
Hospital Revenue Code 450
Min. Negotiated Rate $254.02
Max. Negotiated Rate $879.30
Rate for Payer: Aetna of AZ Commercial $879.30
Rate for Payer: Bisbee Police All Plans $254.02
Rate for Payer: Cash Price $781.60
Rate for Payer: Self Pay Self Pay $781.60
Service Code CPT 12016
Hospital Charge Code 22282777
Hospital Revenue Code 450
Min. Negotiated Rate $185.40
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,112.40
Rate for Payer: Aetna of AZ Medicare $346.08
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $185.40
Rate for Payer: Amerigroup Medicare $185.40
Rate for Payer: APIPA Medicare/Medicaid $461.65
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $185.40
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $185.40
Rate for Payer: Bisbee Police All Plans $321.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $840.48
Rate for Payer: Cash Price $988.80
Rate for Payer: Cash Price $988.80
Rate for Payer: Cigna of AZ Commercial $865.20
Rate for Payer: Copperpoint Commercial $305.91
Rate for Payer: Health Net of AZ Commercial $741.60
Rate for Payer: Health Net of AZ Medicare $346.08
Rate for Payer: Humana of AZ Medicare $185.40
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $988.80
Rate for Payer: TriWest Medicare $185.40
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $222.48
Service Code CPT 12016
Hospital Charge Code 22282777
Hospital Revenue Code 450
Min. Negotiated Rate $321.36
Max. Negotiated Rate $1,112.40
Rate for Payer: Aetna of AZ Commercial $1,112.40
Rate for Payer: Bisbee Police All Plans $321.36
Rate for Payer: Cash Price $988.80
Rate for Payer: Self Pay Self Pay $988.80
Service Code CPT 12017
Hospital Charge Code 22282778
Hospital Revenue Code 450
Min. Negotiated Rate $413.14
Max. Negotiated Rate $1,430.10
Rate for Payer: Aetna of AZ Commercial $1,430.10
Rate for Payer: Bisbee Police All Plans $413.14
Rate for Payer: Cash Price $1,271.20
Rate for Payer: Self Pay Self Pay $1,271.20
Service Code CPT 12017
Hospital Charge Code 22282778
Hospital Revenue Code 450
Min. Negotiated Rate $238.35
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,430.10
Rate for Payer: Aetna of AZ Medicare $444.92
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $238.35
Rate for Payer: Amerigroup Medicare $238.35
Rate for Payer: APIPA Medicare/Medicaid $593.49
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $238.35
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $238.35
Rate for Payer: Bisbee Police All Plans $413.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,080.52
Rate for Payer: Cash Price $1,271.20
Rate for Payer: Cash Price $1,271.20
Rate for Payer: Cigna of AZ Commercial $1,112.30
Rate for Payer: Copperpoint Commercial $393.28
Rate for Payer: Health Net of AZ Commercial $953.40
Rate for Payer: Health Net of AZ Medicare $444.92
Rate for Payer: Humana of AZ Medicare $238.35
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,271.20
Rate for Payer: TriWest Medicare $238.35
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $286.02
Service Code CPT 12018
Hospital Charge Code 22282779
Hospital Revenue Code 450
Min. Negotiated Rate $260.34
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,772.10
Rate for Payer: Aetna of AZ Medicare $551.32
Rate for Payer: AHCCCS Medicaid $260.34
Rate for Payer: Allwell Medicaid $260.34
Rate for Payer: Allwell Medicare $295.35
Rate for Payer: Amerigroup Medicare $295.35
Rate for Payer: APIPA Medicare/Medicaid $735.42
Rate for Payer: AZCH Complete Medicaid $260.34
Rate for Payer: AZCH Complete Medicare $295.35
Rate for Payer: Banner UC Health Medicaid $260.34
Rate for Payer: Banner UC Health Medicare $295.35
Rate for Payer: Bisbee Police All Plans $511.94
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $1,338.92
Rate for Payer: Cash Price $1,575.20
Rate for Payer: Cash Price $1,575.20
Rate for Payer: Cigna of AZ Commercial $1,378.30
Rate for Payer: Copperpoint Commercial $487.33
Rate for Payer: Health Net of AZ Commercial $1,181.40
Rate for Payer: Health Net of AZ Medicare $551.32
Rate for Payer: Humana of AZ Medicare $295.35
Rate for Payer: Mercy Care Medicaid $260.34
Rate for Payer: Self Pay Self Pay $1,575.20
Rate for Payer: TriWest Medicare $295.35
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $354.42
Service Code CPT 12018
Hospital Charge Code 22282779
Hospital Revenue Code 450
Min. Negotiated Rate $511.94
Max. Negotiated Rate $1,772.10
Rate for Payer: Aetna of AZ Commercial $1,772.10
Rate for Payer: Bisbee Police All Plans $511.94
Rate for Payer: Cash Price $1,575.20
Rate for Payer: Self Pay Self Pay $1,575.20
Service Code CPT 12020
Hospital Charge Code 22282780
Hospital Revenue Code 450
Min. Negotiated Rate $218.14
Max. Negotiated Rate $755.10
Rate for Payer: Aetna of AZ Commercial $755.10
Rate for Payer: Bisbee Police All Plans $218.14
Rate for Payer: Cash Price $671.20
Rate for Payer: Self Pay Self Pay $671.20
Service Code CPT 12020
Hospital Charge Code 22282780
Hospital Revenue Code 450
Min. Negotiated Rate $125.85
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $755.10
Rate for Payer: Aetna of AZ Medicare $234.92
Rate for Payer: AHCCCS Medicaid $760.04
Rate for Payer: Allwell Medicaid $760.04
Rate for Payer: Allwell Medicare $125.85
Rate for Payer: Amerigroup Medicare $125.85
Rate for Payer: APIPA Medicare/Medicaid $313.37
Rate for Payer: AZCH Complete Medicaid $760.04
Rate for Payer: AZCH Complete Medicare $125.85
Rate for Payer: Banner UC Health Medicaid $760.04
Rate for Payer: Banner UC Health Medicare $125.85
Rate for Payer: Bisbee Police All Plans $218.14
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $570.52
Rate for Payer: Cash Price $671.20
Rate for Payer: Cash Price $671.20
Rate for Payer: Cigna of AZ Commercial $587.30
Rate for Payer: Copperpoint Commercial $207.65
Rate for Payer: Health Net of AZ Commercial $503.40
Rate for Payer: Health Net of AZ Medicare $234.92
Rate for Payer: Humana of AZ Medicare $125.85
Rate for Payer: Mercy Care Medicaid $760.04
Rate for Payer: Self Pay Self Pay $671.20
Rate for Payer: TriWest Medicare $125.85
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $151.02
Service Code CPT 12021
Hospital Charge Code 22282781
Hospital Revenue Code 450
Min. Negotiated Rate $80.55
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $483.30
Rate for Payer: Aetna of AZ Medicare $150.36
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $80.55
Rate for Payer: Amerigroup Medicare $80.55
Rate for Payer: APIPA Medicare/Medicaid $200.57
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $80.55
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $80.55
Rate for Payer: Bisbee Police All Plans $139.62
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $365.16
Rate for Payer: Cash Price $429.60
Rate for Payer: Cash Price $429.60
Rate for Payer: Cigna of AZ Commercial $375.90
Rate for Payer: Copperpoint Commercial $132.91
Rate for Payer: Health Net of AZ Commercial $322.20
Rate for Payer: Health Net of AZ Medicare $150.36
Rate for Payer: Humana of AZ Medicare $80.55
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $429.60
Rate for Payer: TriWest Medicare $80.55
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $96.66
Service Code CPT 12021
Hospital Charge Code 22282781
Hospital Revenue Code 450
Min. Negotiated Rate $139.62
Max. Negotiated Rate $483.30
Rate for Payer: Aetna of AZ Commercial $483.30
Rate for Payer: Bisbee Police All Plans $139.62
Rate for Payer: Cash Price $429.60
Rate for Payer: Self Pay Self Pay $429.60
Service Code CPT 12031
Hospital Charge Code 22282782
Hospital Revenue Code 450
Min. Negotiated Rate $165.90
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $995.40
Rate for Payer: Aetna of AZ Medicare $309.68
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $165.90
Rate for Payer: Amerigroup Medicare $165.90
Rate for Payer: APIPA Medicare/Medicaid $413.09
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $165.90
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $165.90
Rate for Payer: Bisbee Police All Plans $287.56
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $752.08
Rate for Payer: Cash Price $884.80
Rate for Payer: Cash Price $884.80
Rate for Payer: Cigna of AZ Commercial $774.20
Rate for Payer: Copperpoint Commercial $273.74
Rate for Payer: Health Net of AZ Commercial $663.60
Rate for Payer: Health Net of AZ Medicare $309.68
Rate for Payer: Humana of AZ Medicare $165.90
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $884.80
Rate for Payer: TriWest Medicare $165.90
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $199.08
Service Code CPT 12031
Hospital Charge Code 22282782
Hospital Revenue Code 450
Min. Negotiated Rate $287.56
Max. Negotiated Rate $995.40
Rate for Payer: Aetna of AZ Commercial $995.40
Rate for Payer: Bisbee Police All Plans $287.56
Rate for Payer: Cash Price $884.80
Rate for Payer: Self Pay Self Pay $884.80
Service Code CPT 12032
Hospital Charge Code 22282783
Hospital Revenue Code 450
Min. Negotiated Rate $371.54
Max. Negotiated Rate $1,286.10
Rate for Payer: Aetna of AZ Commercial $1,286.10
Rate for Payer: Bisbee Police All Plans $371.54
Rate for Payer: Cash Price $1,143.20
Rate for Payer: Self Pay Self Pay $1,143.20
Service Code CPT 12032
Hospital Charge Code 22282783
Hospital Revenue Code 450
Min. Negotiated Rate $214.35
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,286.10
Rate for Payer: Aetna of AZ Medicare $400.12
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $214.35
Rate for Payer: Amerigroup Medicare $214.35
Rate for Payer: APIPA Medicare/Medicaid $533.73
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $214.35
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $214.35
Rate for Payer: Bisbee Police All Plans $371.54
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $971.72
Rate for Payer: Cash Price $1,143.20
Rate for Payer: Cash Price $1,143.20
Rate for Payer: Cigna of AZ Commercial $1,000.30
Rate for Payer: Copperpoint Commercial $353.68
Rate for Payer: Health Net of AZ Commercial $857.40
Rate for Payer: Health Net of AZ Medicare $400.12
Rate for Payer: Humana of AZ Medicare $214.35
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,143.20
Rate for Payer: TriWest Medicare $214.35
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $257.22
Service Code CPT 12034
Hospital Charge Code 22282784
Hospital Revenue Code 450
Min. Negotiated Rate $377.78
Max. Negotiated Rate $1,307.70
Rate for Payer: Aetna of AZ Commercial $1,307.70
Rate for Payer: Bisbee Police All Plans $377.78
Rate for Payer: Cash Price $1,162.40
Rate for Payer: Self Pay Self Pay $1,162.40
Service Code CPT 12034
Hospital Charge Code 22282784
Hospital Revenue Code 450
Min. Negotiated Rate $217.95
Max. Negotiated Rate $2,161.00
Rate for Payer: Aetna of AZ Commercial $1,307.70
Rate for Payer: Aetna of AZ Medicare $406.84
Rate for Payer: AHCCCS Medicaid $501.46
Rate for Payer: Allwell Medicaid $501.46
Rate for Payer: Allwell Medicare $217.95
Rate for Payer: Amerigroup Medicare $217.95
Rate for Payer: APIPA Medicare/Medicaid $542.70
Rate for Payer: AZCH Complete Medicaid $501.46
Rate for Payer: AZCH Complete Medicare $217.95
Rate for Payer: Banner UC Health Medicaid $501.46
Rate for Payer: Banner UC Health Medicare $217.95
Rate for Payer: Bisbee Police All Plans $377.78
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial $988.04
Rate for Payer: Cash Price $1,162.40
Rate for Payer: Cash Price $1,162.40
Rate for Payer: Cigna of AZ Commercial $1,017.10
Rate for Payer: Copperpoint Commercial $359.62
Rate for Payer: Health Net of AZ Commercial $871.80
Rate for Payer: Health Net of AZ Medicare $406.84
Rate for Payer: Humana of AZ Medicare $217.95
Rate for Payer: Mercy Care Medicaid $501.46
Rate for Payer: Self Pay Self Pay $1,162.40
Rate for Payer: TriWest Medicare $217.95
Rate for Payer: UnitedHealth Group of AZ Commercial $2,161.00
Rate for Payer: UnitedHealth Group of AZ Medicare $261.54
Service Code CPT 12035
Hospital Charge Code 22282785
Hospital Revenue Code 450
Min. Negotiated Rate $286.00
Max. Negotiated Rate $990.00
Rate for Payer: Aetna of AZ Commercial $990.00
Rate for Payer: Bisbee Police All Plans $286.00
Rate for Payer: Cash Price $880.00
Rate for Payer: Self Pay Self Pay $880.00