Copper Queen Community Hospital

All Charges

Charge

Type

Setting

Price

CATH FOLEY 12FR 5CC 2-WAY ST

Facility

$106.00

Hospital Charge Code	22355144
Hospital Revenue Code	270
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$95.40
Rate for Payer: Aetna of AZ Commercial	$95.40
Rate for Payer: Bisbee Police All Plans	$27.56
Rate for Payer: Cash Price	$84.80
Rate for Payer: Self Pay Self Pay	$84.80

CATH FOLEY 12FR 5CC 2-WAY ST

Facility

$106.00

Hospital Charge Code	22355144
Hospital Revenue Code	270
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$95.40
Rate for Payer: Aetna of AZ Commercial	$95.40
Rate for Payer: Aetna of AZ Medicare	$29.68
Rate for Payer: Allwell Medicare	$15.90
Rate for Payer: Amerigroup Medicare	$15.90
Rate for Payer: APIPA Medicare/Medicaid	$39.59
Rate for Payer: AZCH Complete Medicare	$15.90
Rate for Payer: Banner UC Health Medicare	$15.90
Rate for Payer: Bisbee Police All Plans	$27.56
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$72.08
Rate for Payer: Cash Price	$84.80
Rate for Payer: Cigna of AZ Commercial	$74.20
Rate for Payer: Copperpoint Commercial	$26.24
Rate for Payer: Health Net of AZ Commercial	$63.60
Rate for Payer: Health Net of AZ Medicare	$29.68
Rate for Payer: Humana of AZ Medicare	$15.90
Rate for Payer: Self Pay Self Pay	$84.80
Rate for Payer: TriWest Medicare	$15.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$61.80
Rate for Payer: UnitedHealth Group of AZ Medicare	$19.08

CATH FOLEY 14FR 30CC 2-WAY ST

Facility

$71.00

Hospital Charge Code	22355107
Hospital Revenue Code	270
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Cash Price	$56.80
Rate for Payer: Self Pay Self Pay	$56.80

CATH FOLEY 14FR 30CC 2-WAY ST

Facility

$71.00

Hospital Charge Code	22355107
Hospital Revenue Code	270
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Aetna of AZ Medicare	$19.88
Rate for Payer: Allwell Medicare	$10.65
Rate for Payer: Amerigroup Medicare	$10.65
Rate for Payer: APIPA Medicare/Medicaid	$26.52
Rate for Payer: AZCH Complete Medicare	$10.65
Rate for Payer: Banner UC Health Medicare	$10.65
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$48.28
Rate for Payer: Cash Price	$56.80
Rate for Payer: Cigna of AZ Commercial	$49.70
Rate for Payer: Copperpoint Commercial	$17.57
Rate for Payer: Health Net of AZ Commercial	$42.60
Rate for Payer: Health Net of AZ Medicare	$19.88
Rate for Payer: Humana of AZ Medicare	$10.65
Rate for Payer: Self Pay Self Pay	$56.80
Rate for Payer: TriWest Medicare	$10.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$41.39
Rate for Payer: UnitedHealth Group of AZ Medicare	$12.78

CATH FOLEY 14FR 5CC 2-WAY ST

Facility

$32.00

Hospital Charge Code	22355143
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

CATH FOLEY 14FR 5CC 2-WAY ST

Facility

$32.00

Hospital Charge Code	22355143
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
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	$4.80
Rate for Payer: Amerigroup Medicare	$4.80
Rate for Payer: APIPA Medicare/Medicaid	$11.95
Rate for Payer: AZCH Complete Medicare	$4.80
Rate for Payer: Banner UC Health Medicare	$4.80
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	$4.80
Rate for Payer: Self Pay Self Pay	$25.60
Rate for Payer: TriWest Medicare	$4.80
Rate for Payer: UnitedHealth Group of AZ Commercial	$18.66
Rate for Payer: UnitedHealth Group of AZ Medicare	$5.76

CATH FOLEY 16FR 30CC 2-WAY ST

Facility

$26.00

Hospital Charge Code	22355160
Hospital Revenue Code	270
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$23.40
Rate for Payer: Aetna of AZ Commercial	$23.40
Rate for Payer: Bisbee Police All Plans	$6.76
Rate for Payer: Cash Price	$20.80
Rate for Payer: Self Pay Self Pay	$20.80

CATH FOLEY 16FR 30CC 2-WAY ST

Facility

$26.00

Hospital Charge Code	22355160
Hospital Revenue Code	270
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$23.40
Rate for Payer: Aetna of AZ Commercial	$23.40
Rate for Payer: Aetna of AZ Medicare	$7.28
Rate for Payer: Allwell Medicare	$3.90
Rate for Payer: Amerigroup Medicare	$3.90
Rate for Payer: APIPA Medicare/Medicaid	$9.71
Rate for Payer: AZCH Complete Medicare	$3.90
Rate for Payer: Banner UC Health Medicare	$3.90
Rate for Payer: Bisbee Police All Plans	$6.76
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$17.68
Rate for Payer: Cash Price	$20.80
Rate for Payer: Cigna of AZ Commercial	$18.20
Rate for Payer: Copperpoint Commercial	$6.44
Rate for Payer: Health Net of AZ Commercial	$15.60
Rate for Payer: Health Net of AZ Medicare	$7.28
Rate for Payer: Humana of AZ Medicare	$3.90
Rate for Payer: Self Pay Self Pay	$20.80
Rate for Payer: TriWest Medicare	$3.90
Rate for Payer: UnitedHealth Group of AZ Commercial	$15.16
Rate for Payer: UnitedHealth Group of AZ Medicare	$4.68

CATH FOLEY 16FR 5CC 2-WAY ST

Facility

$20.00

Hospital Charge Code	22355142
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

CATH FOLEY 16FR 5CC 2-WAY ST

Facility

$20.00

Hospital Charge Code	22355142
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

CATH FOLEY 18FR 30CC 2-WAY ST

Facility

$97.00

Hospital Charge Code	22355149
Hospital Revenue Code	270
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Aetna of AZ Medicare	$27.16
Rate for Payer: Allwell Medicare	$14.55
Rate for Payer: Amerigroup Medicare	$14.55
Rate for Payer: APIPA Medicare/Medicaid	$36.23
Rate for Payer: AZCH Complete Medicare	$14.55
Rate for Payer: Banner UC Health Medicare	$14.55
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$65.96
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cigna of AZ Commercial	$67.90
Rate for Payer: Copperpoint Commercial	$24.01
Rate for Payer: Health Net of AZ Commercial	$58.20
Rate for Payer: Health Net of AZ Medicare	$27.16
Rate for Payer: Humana of AZ Medicare	$14.55
Rate for Payer: Self Pay Self Pay	$77.60
Rate for Payer: TriWest Medicare	$14.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$56.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$17.46

CATH FOLEY 18FR 30CC 2-WAY ST

Facility

$97.00

Hospital Charge Code	22355149
Hospital Revenue Code	270
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Cash Price	$77.60
Rate for Payer: Self Pay Self Pay	$77.60

CATH FOLEY 18FR 5CC 2-WAY ST

Facility

$20.00

Hospital Charge Code	22355136
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

CATH FOLEY 18FR 5CC 2-WAY ST

Facility

$20.00

Hospital Charge Code	22355136
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

CATH FOLEY 20FR 30CC 2-WAY ST

Facility

$71.00

Hospital Charge Code	22355108
Hospital Revenue Code	270
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Aetna of AZ Medicare	$19.88
Rate for Payer: Allwell Medicare	$10.65
Rate for Payer: Amerigroup Medicare	$10.65
Rate for Payer: APIPA Medicare/Medicaid	$26.52
Rate for Payer: AZCH Complete Medicare	$10.65
Rate for Payer: Banner UC Health Medicare	$10.65
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$48.28
Rate for Payer: Cash Price	$56.80
Rate for Payer: Cigna of AZ Commercial	$49.70
Rate for Payer: Copperpoint Commercial	$17.57
Rate for Payer: Health Net of AZ Commercial	$42.60
Rate for Payer: Health Net of AZ Medicare	$19.88
Rate for Payer: Humana of AZ Medicare	$10.65
Rate for Payer: Self Pay Self Pay	$56.80
Rate for Payer: TriWest Medicare	$10.65
Rate for Payer: UnitedHealth Group of AZ Commercial	$41.39
Rate for Payer: UnitedHealth Group of AZ Medicare	$12.78

CATH FOLEY 20FR 30CC 2-WAY ST

Facility

$71.00

Hospital Charge Code	22355108
Hospital Revenue Code	270
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of AZ Commercial	$63.90
Rate for Payer: Bisbee Police All Plans	$18.46
Rate for Payer: Cash Price	$56.80
Rate for Payer: Self Pay Self Pay	$56.80

CATH FOLEY 20FR 5CC 2-WAY LATEX

Facility

$23.00

Hospital Charge Code	22355165
Hospital Revenue Code	270
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of AZ Commercial	$20.70
Rate for Payer: Aetna of AZ Medicare	$6.44
Rate for Payer: Allwell Medicare	$3.45
Rate for Payer: Amerigroup Medicare	$3.45
Rate for Payer: APIPA Medicare/Medicaid	$8.59
Rate for Payer: AZCH Complete Medicare	$3.45
Rate for Payer: Banner UC Health Medicare	$3.45
Rate for Payer: Bisbee Police All Plans	$5.98
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$15.64
Rate for Payer: Cash Price	$18.40
Rate for Payer: Cigna of AZ Commercial	$16.10
Rate for Payer: Copperpoint Commercial	$5.69
Rate for Payer: Health Net of AZ Commercial	$13.80
Rate for Payer: Health Net of AZ Medicare	$6.44
Rate for Payer: Humana of AZ Medicare	$3.45
Rate for Payer: Self Pay Self Pay	$18.40
Rate for Payer: TriWest Medicare	$3.45
Rate for Payer: UnitedHealth Group of AZ Commercial	$13.41
Rate for Payer: UnitedHealth Group of AZ Medicare	$4.14

CATH FOLEY 20FR 5CC 2-WAY LATEX

Facility

$23.00

Hospital Charge Code	22355165
Hospital Revenue Code	270
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of AZ Commercial	$20.70
Rate for Payer: Bisbee Police All Plans	$5.98
Rate for Payer: Cash Price	$18.40
Rate for Payer: Self Pay Self Pay	$18.40

CATH FOLEY 20FR 5CC 2-WAY ST SILCONE

Facility

$75.00

Hospital Charge Code	22355137
Hospital Revenue Code	270
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna of AZ Commercial	$67.50
Rate for Payer: Bisbee Police All Plans	$19.50
Rate for Payer: Cash Price	$60.00
Rate for Payer: Self Pay Self Pay	$60.00

CATH FOLEY 20FR 5CC 2-WAY ST SILCONE

Facility

$75.00

Hospital Charge Code	22355137
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna of AZ Commercial	$67.50
Rate for Payer: Aetna of AZ Medicare	$21.00
Rate for Payer: Allwell Medicare	$11.25
Rate for Payer: Amerigroup Medicare	$11.25
Rate for Payer: APIPA Medicare/Medicaid	$28.01
Rate for Payer: AZCH Complete Medicare	$11.25
Rate for Payer: Banner UC Health Medicare	$11.25
Rate for Payer: Bisbee Police All Plans	$19.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$51.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cigna of AZ Commercial	$52.50
Rate for Payer: Copperpoint Commercial	$18.56
Rate for Payer: Health Net of AZ Commercial	$45.00
Rate for Payer: Health Net of AZ Medicare	$21.00
Rate for Payer: Humana of AZ Medicare	$11.25
Rate for Payer: Self Pay Self Pay	$60.00
Rate for Payer: TriWest Medicare	$11.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$43.72
Rate for Payer: UnitedHealth Group of AZ Medicare	$13.50

CATH FOLEY 22FR 30CC 2-WAY ST

Facility

$97.00

Hospital Charge Code	22355150
Hospital Revenue Code	270
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Cash Price	$77.60
Rate for Payer: Self Pay Self Pay	$77.60

CATH FOLEY 22FR 30CC 2-WAY ST

Facility

$97.00

Hospital Charge Code	22355150
Hospital Revenue Code	270
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Aetna of AZ Medicare	$27.16
Rate for Payer: Allwell Medicare	$14.55
Rate for Payer: Amerigroup Medicare	$14.55
Rate for Payer: APIPA Medicare/Medicaid	$36.23
Rate for Payer: AZCH Complete Medicare	$14.55
Rate for Payer: Banner UC Health Medicare	$14.55
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$65.96
Rate for Payer: Cash Price	$77.60
Rate for Payer: Cigna of AZ Commercial	$67.90
Rate for Payer: Copperpoint Commercial	$24.01
Rate for Payer: Health Net of AZ Commercial	$58.20
Rate for Payer: Health Net of AZ Medicare	$27.16
Rate for Payer: Humana of AZ Medicare	$14.55
Rate for Payer: Self Pay Self Pay	$77.60
Rate for Payer: TriWest Medicare	$14.55
Rate for Payer: UnitedHealth Group of AZ Commercial	$56.55
Rate for Payer: UnitedHealth Group of AZ Medicare	$17.46

CATH FOLEY 22FR 5CC 2-WAY ST

Facility

$75.00

Hospital Charge Code	22355138
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna of AZ Commercial	$67.50
Rate for Payer: Aetna of AZ Medicare	$21.00
Rate for Payer: Allwell Medicare	$11.25
Rate for Payer: Amerigroup Medicare	$11.25
Rate for Payer: APIPA Medicare/Medicaid	$28.01
Rate for Payer: AZCH Complete Medicare	$11.25
Rate for Payer: Banner UC Health Medicare	$11.25
Rate for Payer: Bisbee Police All Plans	$19.50
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$51.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cigna of AZ Commercial	$52.50
Rate for Payer: Copperpoint Commercial	$18.56
Rate for Payer: Health Net of AZ Commercial	$45.00
Rate for Payer: Health Net of AZ Medicare	$21.00
Rate for Payer: Humana of AZ Medicare	$11.25
Rate for Payer: Self Pay Self Pay	$60.00
Rate for Payer: TriWest Medicare	$11.25
Rate for Payer: UnitedHealth Group of AZ Commercial	$43.72
Rate for Payer: UnitedHealth Group of AZ Medicare	$13.50

CATH FOLEY 22FR 5CC 2-WAY ST

Facility

$75.00

Hospital Charge Code	22355138
Hospital Revenue Code	270
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna of AZ Commercial	$67.50
Rate for Payer: Bisbee Police All Plans	$19.50
Rate for Payer: Cash Price	$60.00
Rate for Payer: Self Pay Self Pay	$60.00

CATH FOLEY 24FR 30CC 2-WAY ST

Facility

$97.00

Hospital Charge Code	22355151
Hospital Revenue Code	270
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$87.30
Rate for Payer: Aetna of AZ Commercial	$87.30
Rate for Payer: Bisbee Police All Plans	$25.22
Rate for Payer: Cash Price	$77.60
Rate for Payer: Self Pay Self Pay	$77.60

Know your out-of-pocket cost for care.

All Charges