The standard charge for MRI of pelvis before and after dye is $4,874.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
LOCATION
101 Cole Avenue, Bisbee, AZ, 85603CONTACT
(520) 432-6401 Visit WebsiteCopper Queen Community Hospital (CQCH) is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.
In compliance with federal law, CQCH provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.
Choose a plan to view the insurance rate estimate.
Standard Charge
$4,874.00Insurance Discount
-$3,509.28Rate Negotiated by your Insurance Plan
$1,364.72Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$100.8099284 - ED Level 4
$618.2499285 - ED Level 5
$919.52Associated service: Revenue Code 250 charges
$8.40Associated service: Revenue Code 258 charges
$7.84Associated service: Revenue Code 270 charges
$63.56Associated service: Revenue Code 272 charges
$36.40Bill Observed Chain of Custody
$13.16Blood Culture
$46.48Collection of Venous Blood by venipuncture
$10.92Complete Blood Count/Hemogram Standard
$49.56Comprehensive Metabolic Panel Standard
$115.08Lactate
$71.68UA Micro Standard
$10.92Urine Culture
$48.44To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$487.40Rate Negotiated by your Insurance Plan
$4,386.60Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$324.0099284 - ED Level 4
$1,987.2099285 - ED Level 5
$2,955.60Associated service: Revenue Code 250 charges
$27.00Associated service: Revenue Code 258 charges
$25.20Associated service: Revenue Code 270 charges
$204.30Associated service: Revenue Code 272 charges
$117.00Bill Observed Chain of Custody
$42.30Blood Culture
$149.40Collection of Venous Blood by venipuncture
$35.10Complete Blood Count/Hemogram Standard
$159.30Comprehensive Metabolic Panel Standard
$369.90Lactate
$230.40UA Micro Standard
$35.10Urine Culture
$155.70To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,340.22Rate Negotiated by your Insurance Plan
$533.78Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$295.0899284 - ED Level 4
$442.3699285 - ED Level 5
$664.80Bill Observed Chain of Custody
$3.17Blood Culture
$10.32Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77Comprehensive Metabolic Panel Standard
$10.56Lactate
$11.57UA Micro Standard
$3.05Urine Culture
$8.07To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,340.22Rate Negotiated by your Insurance Plan
$533.78Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$295.0899284 - ED Level 4
$442.3699285 - ED Level 5
$664.80Bill Observed Chain of Custody
$3.17Blood Culture
$10.32Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77Comprehensive Metabolic Panel Standard
$10.56Lactate
$11.57UA Micro Standard
$3.05Urine Culture
$8.07To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,340.22Rate Negotiated by your Insurance Plan
$533.78Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$295.0899284 - ED Level 4
$442.3699285 - ED Level 5
$664.80Bill Observed Chain of Custody
$3.17Blood Culture
$10.32Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77Comprehensive Metabolic Panel Standard
$10.56Lactate
$11.57UA Micro Standard
$3.05Urine Culture
$8.07To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$3,053.56Rate Negotiated by your Insurance Plan
$1,820.44Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$134.4699284 - ED Level 4
$824.6999285 - ED Level 5
$1,226.57Associated service: Revenue Code 250 charges
$11.21Associated service: Revenue Code 258 charges
$10.46Associated service: Revenue Code 270 charges
$84.78Associated service: Revenue Code 272 charges
$48.55Bill Observed Chain of Custody
$17.55Blood Culture
$62.00Collection of Venous Blood by venipuncture
$14.57Complete Blood Count/Hemogram Standard
$66.11Comprehensive Metabolic Panel Standard
$153.51Lactate
$95.62UA Micro Standard
$14.57Urine Culture
$64.62To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,340.22Rate Negotiated by your Insurance Plan
$533.78Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$295.0899284 - ED Level 4
$442.3699285 - ED Level 5
$664.80Bill Observed Chain of Custody
$3.17Blood Culture
$10.32Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77Comprehensive Metabolic Panel Standard
$10.56Lactate
$11.57UA Micro Standard
$3.05Urine Culture
$8.07To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$1,462.20Rate Negotiated by your Insurance Plan
$3,411.80Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$252.0099284 - ED Level 4
$1,545.6099285 - ED Level 5
$2,298.80Associated service: Revenue Code 250 charges
$21.00Associated service: Revenue Code 258 charges
$18.20Associated service: Revenue Code 270 charges
$158.90Associated service: Revenue Code 272 charges
$91.00Bill Observed Chain of Custody
$30.55Blood Culture
$107.90Collection of Venous Blood by venipuncture
$25.35Complete Blood Count/Hemogram Standard
$115.05Comprehensive Metabolic Panel Standard
$267.15Lactate
$166.40UA Micro Standard
$25.35Urine Culture
$112.45To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$3,606.76Rate Negotiated by your Insurance Plan
$1,267.24Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$93.6099284 - ED Level 4
$574.0899285 - ED Level 5
$853.84Associated service: Revenue Code 250 charges
$7.80Associated service: Revenue Code 258 charges
$7.28Associated service: Revenue Code 270 charges
$59.02Associated service: Revenue Code 272 charges
$33.80Bill Observed Chain of Custody
$12.22Blood Culture
$43.16Collection of Venous Blood by venipuncture
$10.14Complete Blood Count/Hemogram Standard
$46.02Comprehensive Metabolic Panel Standard
$106.86Lactate
$66.56UA Micro Standard
$10.14Urine Culture
$44.98To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$3,506.84Rate Negotiated by your Insurance Plan
$1,367.16Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$100.9899284 - ED Level 4
$619.3499285 - ED Level 5
$921.16Associated service: Revenue Code 250 charges
$8.42Associated service: Revenue Code 258 charges
$7.85Associated service: Revenue Code 270 charges
$63.67Associated service: Revenue Code 272 charges
$36.47Bill Observed Chain of Custody
$13.18Blood Culture
$46.56Collection of Venous Blood by venipuncture
$10.94Complete Blood Count/Hemogram Standard
$49.65Comprehensive Metabolic Panel Standard
$115.29Lactate
$71.81UA Micro Standard
$10.94Urine Culture
$48.53To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$1,949.60Rate Negotiated by your Insurance Plan
$2,924.40Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$216.0099284 - ED Level 4
$1,324.8099285 - ED Level 5
$1,970.40Associated service: Revenue Code 250 charges
$18.00Associated service: Revenue Code 258 charges
$16.80Associated service: Revenue Code 270 charges
$136.20Associated service: Revenue Code 272 charges
$78.00Bill Observed Chain of Custody
$28.20Blood Culture
$99.60Collection of Venous Blood by venipuncture
$23.40Complete Blood Count/Hemogram Standard
$106.20Comprehensive Metabolic Panel Standard
$246.60Lactate
$153.60UA Micro Standard
$23.40Urine Culture
$103.80To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$3,509.28Rate Negotiated by your Insurance Plan
$1,364.72Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$100.8099284 - ED Level 4
$618.2499285 - ED Level 5
$919.52Associated service: Revenue Code 250 charges
$8.40Associated service: Revenue Code 258 charges
$7.84Associated service: Revenue Code 270 charges
$63.56Associated service: Revenue Code 272 charges
$36.40Bill Observed Chain of Custody
$13.16Blood Culture
$46.48Collection of Venous Blood by venipuncture
$10.92Complete Blood Count/Hemogram Standard
$49.56Comprehensive Metabolic Panel Standard
$115.08Lactate
$71.68UA Micro Standard
$10.92Urine Culture
$48.44To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,340.22Rate Negotiated by your Insurance Plan
$533.78Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$295.0899284 - ED Level 4
$442.3699285 - ED Level 5
$664.80Bill Observed Chain of Custody
$3.17Blood Culture
$10.32Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77Comprehensive Metabolic Panel Standard
$10.56Lactate
$11.57UA Micro Standard
$3.05Urine Culture
$8.07To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$974.80Rate Negotiated by your Insurance Plan
$3,899.20Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$288.0099284 - ED Level 4
$1,766.4099285 - ED Level 5
$2,627.20Associated service: Revenue Code 250 charges
$24.00Associated service: Revenue Code 258 charges
$22.40Associated service: Revenue Code 270 charges
$181.60Associated service: Revenue Code 272 charges
$104.00Bill Observed Chain of Custody
$37.60Blood Culture
$132.80Collection of Venous Blood by venipuncture
$31.20Complete Blood Count/Hemogram Standard
$141.60Comprehensive Metabolic Panel Standard
$328.80Lactate
$204.80UA Micro Standard
$31.20Urine Culture
$138.40To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$3,996.68Rate Negotiated by your Insurance Plan
$877.32Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$64.8099284 - ED Level 4
$397.4499285 - ED Level 5
$591.12Associated service: Revenue Code 250 charges
$5.40Associated service: Revenue Code 258 charges
$5.04Associated service: Revenue Code 270 charges
$40.86Associated service: Revenue Code 272 charges
$23.40Bill Observed Chain of Custody
$8.46Blood Culture
$29.88Collection of Venous Blood by venipuncture
$7.02Complete Blood Count/Hemogram Standard
$31.86Comprehensive Metabolic Panel Standard
$73.98Lactate
$46.08UA Micro Standard
$7.02Urine Culture
$31.14To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$2,032.46Rate Negotiated by your Insurance Plan
$2,841.54Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$209.8899284 - ED Level 4
$1,287.2699285 - ED Level 5
$1,914.57Associated service: Revenue Code 250 charges
$17.49Associated service: Revenue Code 258 charges
$16.32Associated service: Revenue Code 270 charges
$132.34Associated service: Revenue Code 272 charges
$75.79Bill Observed Chain of Custody
$27.40Blood Culture
$96.78Collection of Venous Blood by venipuncture
$22.74Complete Blood Count/Hemogram Standard
$103.19Comprehensive Metabolic Panel Standard
$239.61Lactate
$149.25UA Micro Standard
$22.74Urine Culture
$100.86To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$4,874.00Insurance Discount
-$4,045.42Rate Negotiated by your Insurance Plan
$828.58Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
96365 INFUSION INTO A VEIN FOR THERAPY, PREVENTION, OR DIAGN
$61.2099284 - ED Level 4
$375.3699285 - ED Level 5
$558.28Associated service: Revenue Code 250 charges
$5.10Associated service: Revenue Code 258 charges
$4.76Associated service: Revenue Code 270 charges
$38.59Associated service: Revenue Code 272 charges
$22.10Bill Observed Chain of Custody
$7.99Blood Culture
$28.22Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09Comprehensive Metabolic Panel Standard
$69.87Lactate
$43.52UA Micro Standard
$6.63Urine Culture
$29.41To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.