CATHETER FOLEY COUDE 18FR 5ML 2 WAY
|
Facility
|
IP
|
$86.00
|
|
Hospital Charge Code |
23758407
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$22.36 |
Max. Negotiated Rate |
$77.40 |
Rate for Payer: Aetna of AZ Commercial |
$77.40
|
Rate for Payer: Bisbee Police All Plans |
$22.36
|
Rate for Payer: Cash Price |
$68.80
|
Rate for Payer: Self Pay Self Pay |
$68.80
|
|
CATHETER, FOLEY, IC, LATEX, 3WAY,20FR,5CC
|
Facility
|
OP
|
$74.00
|
|
Hospital Charge Code |
23288845
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$11.10 |
Max. Negotiated Rate |
$66.60 |
Rate for Payer: Aetna of AZ Commercial |
$66.60
|
Rate for Payer: Aetna of AZ Medicare |
$20.72
|
Rate for Payer: Allwell Medicare |
$11.10
|
Rate for Payer: Amerigroup Medicare |
$11.10
|
Rate for Payer: APIPA Medicare/Medicaid |
$27.64
|
Rate for Payer: AZCH Complete Medicare |
$11.10
|
Rate for Payer: Banner UC Health Medicare |
$11.10
|
Rate for Payer: Bisbee Police All Plans |
$19.24
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$50.32
|
Rate for Payer: Cash Price |
$59.20
|
Rate for Payer: Cigna of AZ Commercial |
$51.80
|
Rate for Payer: Copperpoint Commercial |
$18.32
|
Rate for Payer: Health Net of AZ Commercial |
$44.40
|
Rate for Payer: Health Net of AZ Medicare |
$20.72
|
Rate for Payer: Humana of AZ Medicare |
$11.10
|
Rate for Payer: Self Pay Self Pay |
$59.20
|
Rate for Payer: TriWest Medicare |
$11.10
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$43.14
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$13.32
|
|
CATHETER, FOLEY, IC, LATEX, 3WAY,20FR,5CC
|
Facility
|
IP
|
$74.00
|
|
Hospital Charge Code |
23288845
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$19.24 |
Max. Negotiated Rate |
$66.60 |
Rate for Payer: Aetna of AZ Commercial |
$66.60
|
Rate for Payer: Bisbee Police All Plans |
$19.24
|
Rate for Payer: Cash Price |
$59.20
|
Rate for Payer: Self Pay Self Pay |
$59.20
|
|
CATHETER FOLEY LUBRICATH 24FR 5 ML
|
Facility
|
IP
|
$20.00
|
|
Hospital Charge Code |
23758406
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$5.20 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna of AZ Commercial |
$18.00
|
Rate for Payer: Bisbee Police All Plans |
$5.20
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Self Pay Self Pay |
$16.00
|
|
CATHETER FOLEY LUBRICATH 24FR 5 ML
|
Facility
|
OP
|
$20.00
|
|
Hospital Charge Code |
23758406
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$3.00 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna of AZ Commercial |
$18.00
|
Rate for Payer: Aetna of AZ Medicare |
$5.60
|
Rate for Payer: Allwell Medicare |
$3.00
|
Rate for Payer: Amerigroup Medicare |
$3.00
|
Rate for Payer: APIPA Medicare/Medicaid |
$7.47
|
Rate for Payer: AZCH Complete Medicare |
$3.00
|
Rate for Payer: Banner UC Health Medicare |
$3.00
|
Rate for Payer: Bisbee Police All Plans |
$5.20
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$13.60
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Cigna of AZ Commercial |
$14.00
|
Rate for Payer: Copperpoint Commercial |
$4.95
|
Rate for Payer: Health Net of AZ Commercial |
$12.00
|
Rate for Payer: Health Net of AZ Medicare |
$5.60
|
Rate for Payer: Humana of AZ Medicare |
$3.00
|
Rate for Payer: Self Pay Self Pay |
$16.00
|
Rate for Payer: TriWest Medicare |
$3.00
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$11.66
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$3.60
|
|
CATHETER, FOLEY, LUBRICATH, STRL, 14FR,5ML
|
Facility
|
OP
|
$20.00
|
|
Hospital Charge Code |
23288846
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3.00 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna of AZ Commercial |
$18.00
|
Rate for Payer: Aetna of AZ Medicare |
$5.60
|
Rate for Payer: Allwell Medicare |
$3.00
|
Rate for Payer: Amerigroup Medicare |
$3.00
|
Rate for Payer: APIPA Medicare/Medicaid |
$7.47
|
Rate for Payer: AZCH Complete Medicare |
$3.00
|
Rate for Payer: Banner UC Health Medicare |
$3.00
|
Rate for Payer: Bisbee Police All Plans |
$5.20
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$13.60
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Cigna of AZ Commercial |
$14.00
|
Rate for Payer: Copperpoint Commercial |
$4.95
|
Rate for Payer: Health Net of AZ Commercial |
$12.00
|
Rate for Payer: Health Net of AZ Medicare |
$5.60
|
Rate for Payer: Humana of AZ Medicare |
$3.00
|
Rate for Payer: Self Pay Self Pay |
$16.00
|
Rate for Payer: TriWest Medicare |
$3.00
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$11.66
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$3.60
|
|
CATHETER, FOLEY, LUBRICATH, STRL, 14FR,5ML
|
Facility
|
IP
|
$20.00
|
|
Hospital Charge Code |
23288846
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.20 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna of AZ Commercial |
$18.00
|
Rate for Payer: Bisbee Police All Plans |
$5.20
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Self Pay Self Pay |
$16.00
|
|
CATHETER MELKER EMER 3.5 ID 3.8 CM
|
Facility
|
IP
|
$1,399.00
|
|
Hospital Charge Code |
23371937
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$363.74 |
Max. Negotiated Rate |
$1,259.10 |
Rate for Payer: Aetna of AZ Commercial |
$1,259.10
|
Rate for Payer: Bisbee Police All Plans |
$363.74
|
Rate for Payer: Cash Price |
$1,119.20
|
Rate for Payer: Self Pay Self Pay |
$1,119.20
|
|
CATHETER MELKER EMER 3.5 ID 3.8 CM
|
Facility
|
OP
|
$1,399.00
|
|
Hospital Charge Code |
23371937
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$209.85 |
Max. Negotiated Rate |
$1,259.10 |
Rate for Payer: Aetna of AZ Commercial |
$1,259.10
|
Rate for Payer: Aetna of AZ Medicare |
$391.72
|
Rate for Payer: Allwell Medicare |
$209.85
|
Rate for Payer: Amerigroup Medicare |
$209.85
|
Rate for Payer: APIPA Medicare/Medicaid |
$522.53
|
Rate for Payer: AZCH Complete Medicare |
$209.85
|
Rate for Payer: Banner UC Health Medicare |
$209.85
|
Rate for Payer: Bisbee Police All Plans |
$363.74
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$951.32
|
Rate for Payer: Cash Price |
$1,119.20
|
Rate for Payer: Cigna of AZ Commercial |
$979.30
|
Rate for Payer: Copperpoint Commercial |
$346.25
|
Rate for Payer: Health Net of AZ Commercial |
$839.40
|
Rate for Payer: Health Net of AZ Medicare |
$391.72
|
Rate for Payer: Humana of AZ Medicare |
$209.85
|
Rate for Payer: Self Pay Self Pay |
$1,119.20
|
Rate for Payer: TriWest Medicare |
$209.85
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$815.62
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$251.82
|
|
CATHETER NEXIVA DIFFUSICS 22G X 1.00
|
Facility
|
OP
|
$37.00
|
|
Hospital Charge Code |
23244513
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.55 |
Max. Negotiated Rate |
$33.30 |
Rate for Payer: Aetna of AZ Commercial |
$33.30
|
Rate for Payer: Aetna of AZ Medicare |
$10.36
|
Rate for Payer: Allwell Medicare |
$5.55
|
Rate for Payer: Amerigroup Medicare |
$5.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$13.82
|
Rate for Payer: AZCH Complete Medicare |
$5.55
|
Rate for Payer: Banner UC Health Medicare |
$5.55
|
Rate for Payer: Bisbee Police All Plans |
$9.62
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$25.16
|
Rate for Payer: Cash Price |
$29.60
|
Rate for Payer: Cigna of AZ Commercial |
$25.90
|
Rate for Payer: Copperpoint Commercial |
$9.16
|
Rate for Payer: Health Net of AZ Commercial |
$22.20
|
Rate for Payer: Health Net of AZ Medicare |
$10.36
|
Rate for Payer: Humana of AZ Medicare |
$5.55
|
Rate for Payer: Self Pay Self Pay |
$29.60
|
Rate for Payer: TriWest Medicare |
$5.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$21.57
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$6.66
|
|
CATHETER NEXIVA DIFFUSICS 22G X 1.00
|
Facility
|
IP
|
$37.00
|
|
Hospital Charge Code |
23244513
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$9.62 |
Max. Negotiated Rate |
$33.30 |
Rate for Payer: Aetna of AZ Commercial |
$33.30
|
Rate for Payer: Bisbee Police All Plans |
$9.62
|
Rate for Payer: Cash Price |
$29.60
|
Rate for Payer: Self Pay Self Pay |
$29.60
|
|
CATHETER NEXIVA DIFFUSICS 24G X 0.75
|
Facility
|
OP
|
$37.00
|
|
Hospital Charge Code |
23244512
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$5.55 |
Max. Negotiated Rate |
$33.30 |
Rate for Payer: Aetna of AZ Commercial |
$33.30
|
Rate for Payer: Aetna of AZ Medicare |
$10.36
|
Rate for Payer: Allwell Medicare |
$5.55
|
Rate for Payer: Amerigroup Medicare |
$5.55
|
Rate for Payer: APIPA Medicare/Medicaid |
$13.82
|
Rate for Payer: AZCH Complete Medicare |
$5.55
|
Rate for Payer: Banner UC Health Medicare |
$5.55
|
Rate for Payer: Bisbee Police All Plans |
$9.62
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$25.16
|
Rate for Payer: Cash Price |
$29.60
|
Rate for Payer: Cigna of AZ Commercial |
$25.90
|
Rate for Payer: Copperpoint Commercial |
$9.16
|
Rate for Payer: Health Net of AZ Commercial |
$22.20
|
Rate for Payer: Health Net of AZ Medicare |
$10.36
|
Rate for Payer: Humana of AZ Medicare |
$5.55
|
Rate for Payer: Self Pay Self Pay |
$29.60
|
Rate for Payer: TriWest Medicare |
$5.55
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$21.57
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$6.66
|
|
CATHETER NEXIVA DIFFUSICS 24G X 0.75
|
Facility
|
IP
|
$37.00
|
|
Hospital Charge Code |
23244512
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$9.62 |
Max. Negotiated Rate |
$33.30 |
Rate for Payer: Aetna of AZ Commercial |
$33.30
|
Rate for Payer: Bisbee Police All Plans |
$9.62
|
Rate for Payer: Cash Price |
$29.60
|
Rate for Payer: Self Pay Self Pay |
$29.60
|
|
CATHETER, SYS CLSD NEX, 18GA, 1.25,HF, DPRT
|
Facility
|
IP
|
$33.00
|
|
Hospital Charge Code |
23244515
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$8.58 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
|
CATHETER, SYS CLSD NEX, 18GA, 1.25,HF, DPRT
|
Facility
|
OP
|
$33.00
|
|
Hospital Charge Code |
23244515
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.95 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Aetna of AZ Medicare |
$9.24
|
Rate for Payer: Allwell Medicare |
$4.95
|
Rate for Payer: Amerigroup Medicare |
$4.95
|
Rate for Payer: APIPA Medicare/Medicaid |
$12.33
|
Rate for Payer: AZCH Complete Medicare |
$4.95
|
Rate for Payer: Banner UC Health Medicare |
$4.95
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$22.44
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Cigna of AZ Commercial |
$23.10
|
Rate for Payer: Copperpoint Commercial |
$8.17
|
Rate for Payer: Health Net of AZ Commercial |
$19.80
|
Rate for Payer: Health Net of AZ Medicare |
$9.24
|
Rate for Payer: Humana of AZ Medicare |
$4.95
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
Rate for Payer: TriWest Medicare |
$4.95
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$19.24
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$5.94
|
|
CATHETER, SYS CLSD NEX 18GA1.75IHF DPRT
|
Facility
|
OP
|
$33.00
|
|
Hospital Charge Code |
23244516
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.95 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Aetna of AZ Medicare |
$9.24
|
Rate for Payer: Allwell Medicare |
$4.95
|
Rate for Payer: Amerigroup Medicare |
$4.95
|
Rate for Payer: APIPA Medicare/Medicaid |
$12.33
|
Rate for Payer: AZCH Complete Medicare |
$4.95
|
Rate for Payer: Banner UC Health Medicare |
$4.95
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$22.44
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Cigna of AZ Commercial |
$23.10
|
Rate for Payer: Copperpoint Commercial |
$8.17
|
Rate for Payer: Health Net of AZ Commercial |
$19.80
|
Rate for Payer: Health Net of AZ Medicare |
$9.24
|
Rate for Payer: Humana of AZ Medicare |
$4.95
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
Rate for Payer: TriWest Medicare |
$4.95
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$19.24
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$5.94
|
|
CATHETER, SYS CLSD NEX 18GA1.75IHF DPRT
|
Facility
|
IP
|
$33.00
|
|
Hospital Charge Code |
23244516
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$8.58 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
|
CATHETER SYS CLSED NEX 20GA 1 DPRT
|
Facility
|
IP
|
$33.00
|
|
Hospital Charge Code |
23244514
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$8.58 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
|
CATHETER SYS CLSED NEX 20GA 1 DPRT
|
Facility
|
OP
|
$33.00
|
|
Hospital Charge Code |
23244514
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$4.95 |
Max. Negotiated Rate |
$29.70 |
Rate for Payer: Aetna of AZ Commercial |
$29.70
|
Rate for Payer: Aetna of AZ Medicare |
$9.24
|
Rate for Payer: Allwell Medicare |
$4.95
|
Rate for Payer: Amerigroup Medicare |
$4.95
|
Rate for Payer: APIPA Medicare/Medicaid |
$12.33
|
Rate for Payer: AZCH Complete Medicare |
$4.95
|
Rate for Payer: Banner UC Health Medicare |
$4.95
|
Rate for Payer: Bisbee Police All Plans |
$8.58
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$22.44
|
Rate for Payer: Cash Price |
$26.40
|
Rate for Payer: Cigna of AZ Commercial |
$23.10
|
Rate for Payer: Copperpoint Commercial |
$8.17
|
Rate for Payer: Health Net of AZ Commercial |
$19.80
|
Rate for Payer: Health Net of AZ Medicare |
$9.24
|
Rate for Payer: Humana of AZ Medicare |
$4.95
|
Rate for Payer: Self Pay Self Pay |
$26.40
|
Rate for Payer: TriWest Medicare |
$4.95
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$19.24
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$5.94
|
|
CATHETER THORACIC 40FR
|
Facility
|
IP
|
$53.00
|
|
Hospital Charge Code |
23371936
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$13.78 |
Max. Negotiated Rate |
$47.70 |
Rate for Payer: Aetna of AZ Commercial |
$47.70
|
Rate for Payer: Bisbee Police All Plans |
$13.78
|
Rate for Payer: Cash Price |
$42.40
|
Rate for Payer: Self Pay Self Pay |
$42.40
|
|
CATHETER THORACIC 40FR
|
Facility
|
OP
|
$53.00
|
|
Hospital Charge Code |
23371936
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$7.95 |
Max. Negotiated Rate |
$47.70 |
Rate for Payer: Aetna of AZ Commercial |
$47.70
|
Rate for Payer: Aetna of AZ Medicare |
$14.84
|
Rate for Payer: Allwell Medicare |
$7.95
|
Rate for Payer: Amerigroup Medicare |
$7.95
|
Rate for Payer: APIPA Medicare/Medicaid |
$19.80
|
Rate for Payer: AZCH Complete Medicare |
$7.95
|
Rate for Payer: Banner UC Health Medicare |
$7.95
|
Rate for Payer: Bisbee Police All Plans |
$13.78
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$36.04
|
Rate for Payer: Cash Price |
$42.40
|
Rate for Payer: Cigna of AZ Commercial |
$37.10
|
Rate for Payer: Copperpoint Commercial |
$13.12
|
Rate for Payer: Health Net of AZ Commercial |
$31.80
|
Rate for Payer: Health Net of AZ Medicare |
$14.84
|
Rate for Payer: Humana of AZ Medicare |
$7.95
|
Rate for Payer: Self Pay Self Pay |
$42.40
|
Rate for Payer: TriWest Medicare |
$7.95
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$30.90
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$9.54
|
|
CATH FEMALE
|
Facility
|
IP
|
$11.00
|
|
Hospital Charge Code |
22355404
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$2.86 |
Max. Negotiated Rate |
$9.90 |
Rate for Payer: Aetna of AZ Commercial |
$9.90
|
Rate for Payer: Bisbee Police All Plans |
$2.86
|
Rate for Payer: Cash Price |
$8.80
|
Rate for Payer: Self Pay Self Pay |
$8.80
|
|
CATH FEMALE
|
Facility
|
OP
|
$11.00
|
|
Hospital Charge Code |
22355404
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$1.65 |
Max. Negotiated Rate |
$9.90 |
Rate for Payer: Aetna of AZ Commercial |
$9.90
|
Rate for Payer: Aetna of AZ Medicare |
$3.08
|
Rate for Payer: Allwell Medicare |
$1.65
|
Rate for Payer: Amerigroup Medicare |
$1.65
|
Rate for Payer: APIPA Medicare/Medicaid |
$4.11
|
Rate for Payer: AZCH Complete Medicare |
$1.65
|
Rate for Payer: Banner UC Health Medicare |
$1.65
|
Rate for Payer: Bisbee Police All Plans |
$2.86
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$7.48
|
Rate for Payer: Cash Price |
$8.80
|
Rate for Payer: Cigna of AZ Commercial |
$7.70
|
Rate for Payer: Copperpoint Commercial |
$2.72
|
Rate for Payer: Health Net of AZ Commercial |
$6.60
|
Rate for Payer: Health Net of AZ Medicare |
$3.08
|
Rate for Payer: Humana of AZ Medicare |
$1.65
|
Rate for Payer: Self Pay Self Pay |
$8.80
|
Rate for Payer: TriWest Medicare |
$1.65
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$6.41
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$1.98
|
|
CATH FOLEY 10FR 3CC 2-WAY ST
|
Facility
|
OP
|
$67.00
|
|
Hospital Charge Code |
22355172
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$10.05 |
Max. Negotiated Rate |
$60.30 |
Rate for Payer: Aetna of AZ Commercial |
$60.30
|
Rate for Payer: Aetna of AZ Medicare |
$18.76
|
Rate for Payer: Allwell Medicare |
$10.05
|
Rate for Payer: Amerigroup Medicare |
$10.05
|
Rate for Payer: APIPA Medicare/Medicaid |
$25.02
|
Rate for Payer: AZCH Complete Medicare |
$10.05
|
Rate for Payer: Banner UC Health Medicare |
$10.05
|
Rate for Payer: Bisbee Police All Plans |
$17.42
|
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial |
$45.56
|
Rate for Payer: Cash Price |
$53.60
|
Rate for Payer: Cigna of AZ Commercial |
$46.90
|
Rate for Payer: Copperpoint Commercial |
$16.58
|
Rate for Payer: Health Net of AZ Commercial |
$40.20
|
Rate for Payer: Health Net of AZ Medicare |
$18.76
|
Rate for Payer: Humana of AZ Medicare |
$10.05
|
Rate for Payer: Self Pay Self Pay |
$53.60
|
Rate for Payer: TriWest Medicare |
$10.05
|
Rate for Payer: UnitedHealth Group of AZ Commercial |
$39.06
|
Rate for Payer: UnitedHealth Group of AZ Medicare |
$12.06
|
|
CATH FOLEY 10FR 3CC 2-WAY ST
|
Facility
|
IP
|
$67.00
|
|
Hospital Charge Code |
22355172
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$17.42 |
Max. Negotiated Rate |
$60.30 |
Rate for Payer: Aetna of AZ Commercial |
$60.30
|
Rate for Payer: Bisbee Police All Plans |
$17.42
|
Rate for Payer: Cash Price |
$53.60
|
Rate for Payer: Self Pay Self Pay |
$53.60
|
|