Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

CATHETER FOLEY COUDE 18FR 5ML 2 WAY

Facility

$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

$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, IC, LATEX, 3WAY,20FR,5CC

Facility

$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 LUBRICATH 24FR 5 ML

Facility

$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

$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

$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, FOLEY, LUBRICATH, STRL, 14FR,5ML

Facility

$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 MELKER EMER 3.5 ID 3.8 CM

Facility

$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

$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

$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

$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

$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 NEXIVA DIFFUSICS 24G X 0.75

Facility

$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, SYS CLSD NEX, 18GA, 1.25,HF, DPRT

Facility

$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

$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

$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

$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

$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

$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

$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

$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

$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 FEMALE

Facility

$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 FOLEY 10FR 3CC 2-WAY ST

Facility

$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

$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

Know your out-of-pocket cost for care.

All Charges