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	$13.76
Max. Negotiated Rate	$77.40
Rate for Payer: Aetna of AZ Commercial	$77.40
Rate for Payer: Aetna of AZ Medicare	$24.08
Rate for Payer: Allwell Medicare	$13.76
Rate for Payer: Amerigroup Medicare	$13.76
Rate for Payer: APIPA Medicare/Medicaid	$32.12
Rate for Payer: AZCH Complete Medicare	$13.76
Rate for Payer: Banner UC Health Medicare	$13.76
Rate for Payer: Bisbee Police All Plans	$22.36
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$58.48
Rate for Payer: Cash Price	$68.80
Rate for Payer: Cigna of AZ Commercial	$60.20
Rate for Payer: Copperpoint Commercial	$21.29
Rate for Payer: Health Net of AZ Commercial	$51.60
Rate for Payer: Health Net of AZ Medicare	$24.08
Rate for Payer: Humana of AZ Medicare	$13.76
Rate for Payer: Self Pay Self Pay	$68.80
Rate for Payer: TriWest Medicare	$13.76
Rate for Payer: UnitedHealth Group of AZ Commercial	$50.14
Rate for Payer: UnitedHealth Group of AZ Medicare	$15.48

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 COUDE 20FR 5CC 2 WAY

Facility

$45.07

Hospital Charge Code	27742597
Hospital Revenue Code	270
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$40.56
Rate for Payer: Aetna of AZ Commercial	$40.56
Rate for Payer: Aetna of AZ Medicare	$12.62
Rate for Payer: Allwell Medicare	$7.21
Rate for Payer: Amerigroup Medicare	$7.21
Rate for Payer: APIPA Medicare/Medicaid	$16.83
Rate for Payer: AZCH Complete Medicare	$7.21
Rate for Payer: Banner UC Health Medicare	$7.21
Rate for Payer: Bisbee Police All Plans	$11.72
Rate for Payer: Blue Cross Blue Shield of Arizona All Commercial	$30.65
Rate for Payer: Cash Price	$36.06
Rate for Payer: Cigna of AZ Commercial	$31.55
Rate for Payer: Copperpoint Commercial	$11.15
Rate for Payer: Health Net of AZ Commercial	$27.04
Rate for Payer: Health Net of AZ Medicare	$12.62
Rate for Payer: Humana of AZ Medicare	$7.21
Rate for Payer: Self Pay Self Pay	$36.06
Rate for Payer: TriWest Medicare	$7.21
Rate for Payer: UnitedHealth Group of AZ Commercial	$26.28
Rate for Payer: UnitedHealth Group of AZ Medicare	$8.11

CATHETER FOLEY COUDE 20FR 5CC 2 WAY

Facility

$45.07

Hospital Charge Code	27742597
Hospital Revenue Code	270
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$40.56
Rate for Payer: Aetna of AZ Commercial	$40.56
Rate for Payer: Bisbee Police All Plans	$11.72
Rate for Payer: Cash Price	$36.06
Rate for Payer: Self Pay Self Pay	$36.06

CATHETER, FOLEY, IC, LATEX, 3WAY,20FR,5CC

Facility

$74.00

Hospital Charge Code	23288845
Hospital Revenue Code	272
Min. Negotiated Rate	$11.84
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	$11.84
Rate for Payer: Amerigroup Medicare	$11.84
Rate for Payer: APIPA Medicare/Medicaid	$27.64
Rate for Payer: AZCH Complete Medicare	$11.84
Rate for Payer: Banner UC Health Medicare	$11.84
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	$11.84
Rate for Payer: Self Pay Self Pay	$59.20
Rate for Payer: TriWest Medicare	$11.84
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

$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

$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	$3.20
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	$3.20
Rate for Payer: Amerigroup Medicare	$3.20
Rate for Payer: APIPA Medicare/Medicaid	$7.47
Rate for Payer: AZCH Complete Medicare	$3.20
Rate for Payer: Banner UC Health Medicare	$3.20
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	$3.20
Rate for Payer: Self Pay Self Pay	$16.00
Rate for Payer: TriWest Medicare	$3.20
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	$3.20
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	$3.20
Rate for Payer: Amerigroup Medicare	$3.20
Rate for Payer: APIPA Medicare/Medicaid	$7.47
Rate for Payer: AZCH Complete Medicare	$3.20
Rate for Payer: Banner UC Health Medicare	$3.20
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	$3.20
Rate for Payer: Self Pay Self Pay	$16.00
Rate for Payer: TriWest Medicare	$3.20
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 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	$223.84
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	$223.84
Rate for Payer: Amerigroup Medicare	$223.84
Rate for Payer: APIPA Medicare/Medicaid	$522.53
Rate for Payer: AZCH Complete Medicare	$223.84
Rate for Payer: Banner UC Health Medicare	$223.84
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	$223.84
Rate for Payer: Self Pay Self Pay	$1,119.20
Rate for Payer: TriWest Medicare	$223.84
Rate for Payer: UnitedHealth Group of AZ Commercial	$815.62
Rate for Payer: UnitedHealth Group of AZ Medicare	$251.82

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	$8.48
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	$8.48
Rate for Payer: Amerigroup Medicare	$8.48
Rate for Payer: APIPA Medicare/Medicaid	$19.80
Rate for Payer: AZCH Complete Medicare	$8.48
Rate for Payer: Banner UC Health Medicare	$8.48
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	$8.48
Rate for Payer: Self Pay Self Pay	$42.40
Rate for Payer: TriWest Medicare	$8.48
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	$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

$11.00

Hospital Charge Code	22355404
Hospital Revenue Code	270
Min. Negotiated Rate	$1.76
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	$1.76
Rate for Payer: Amerigroup Medicare	$1.76
Rate for Payer: APIPA Medicare/Medicaid	$4.11
Rate for Payer: AZCH Complete Medicare	$1.76
Rate for Payer: Banner UC Health Medicare	$1.76
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	$1.76
Rate for Payer: Self Pay Self Pay	$8.80
Rate for Payer: TriWest Medicare	$1.76
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

$67.00

Hospital Charge Code	22355172
Hospital Revenue Code	270
Min. Negotiated Rate	$10.72
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	$10.72
Rate for Payer: Amerigroup Medicare	$10.72
Rate for Payer: APIPA Medicare/Medicaid	$25.02
Rate for Payer: AZCH Complete Medicare	$10.72
Rate for Payer: Banner UC Health Medicare	$10.72
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	$10.72
Rate for Payer: Self Pay Self Pay	$53.60
Rate for Payer: TriWest Medicare	$10.72
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

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	$16.96
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	$16.96
Rate for Payer: Amerigroup Medicare	$16.96
Rate for Payer: APIPA Medicare/Medicaid	$39.59
Rate for Payer: AZCH Complete Medicare	$16.96
Rate for Payer: Banner UC Health Medicare	$16.96
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	$26.23
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	$16.96
Rate for Payer: Self Pay Self Pay	$84.80
Rate for Payer: TriWest Medicare	$16.96
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	$11.36
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	$11.36
Rate for Payer: Amerigroup Medicare	$11.36
Rate for Payer: APIPA Medicare/Medicaid	$26.52
Rate for Payer: AZCH Complete Medicare	$11.36
Rate for Payer: Banner UC Health Medicare	$11.36
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	$11.36
Rate for Payer: Self Pay Self Pay	$56.80
Rate for Payer: TriWest Medicare	$11.36
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	$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

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 16FR 30CC 2-WAY ST

Facility

$26.00

Hospital Charge Code	22355160
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
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	$4.16
Rate for Payer: Amerigroup Medicare	$4.16
Rate for Payer: APIPA Medicare/Medicaid	$9.71
Rate for Payer: AZCH Complete Medicare	$4.16
Rate for Payer: Banner UC Health Medicare	$4.16
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	$6.43
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	$4.16
Rate for Payer: Self Pay Self Pay	$20.80
Rate for Payer: TriWest Medicare	$4.16
Rate for Payer: UnitedHealth Group of AZ Commercial	$15.16
Rate for Payer: UnitedHealth Group of AZ Medicare	$4.68

Know your out-of-pocket cost for care.

All Charges