The standard charge for CT scan, pelvis, with contrast is $2,895.00. 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
$2,895.00Insurance Discount
-$2,084.40Rate Negotiated by your Insurance Plan
$810.60Some 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.
96374 - IV Injection, single/initial
$71.4099284 - ED Level 4
$618.24Associated service: Revenue Code 250 charges
$7.84Associated service: Revenue Code 270 charges
$35.28Associated service: Revenue Code 272 charges
$11.76Basic Metabolic Panel Standard
$38.08Collection of Venous Blood by venipuncture
$10.92Complete Blood Count/Hemogram Standard
$49.56To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$289.50Rate Negotiated by your Insurance Plan
$2,605.50Some 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.
96374 - IV Injection, single/initial
$229.5099284 - ED Level 4
$1,987.20Associated service: Revenue Code 250 charges
$25.20Associated service: Revenue Code 270 charges
$113.40Associated service: Revenue Code 272 charges
$37.80Basic Metabolic Panel Standard
$122.40Collection of Venous Blood by venipuncture
$35.10Complete Blood Count/Hemogram Standard
$159.30To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,636.10Rate Negotiated by your Insurance Plan
$258.90Some 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.
96374 - IV Injection, single/initial
$155.5899284 - ED Level 4
$442.36Basic Metabolic Panel Standard
$8.46Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,636.10Rate Negotiated by your Insurance Plan
$258.90Some 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.
96374 - IV Injection, single/initial
$155.5899284 - ED Level 4
$442.36Basic Metabolic Panel Standard
$8.46Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,636.10Rate Negotiated by your Insurance Plan
$258.90Some 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.
96374 - IV Injection, single/initial
$155.5899284 - ED Level 4
$442.36Basic Metabolic Panel Standard
$8.46Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$1,813.72Rate Negotiated by your Insurance Plan
$1,081.28Some 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.
96374 - IV Injection, single/initial
$95.2499284 - ED Level 4
$824.69Associated service: Revenue Code 250 charges
$10.46Associated service: Revenue Code 270 charges
$47.06Associated service: Revenue Code 272 charges
$15.69Basic Metabolic Panel Standard
$50.80Collection of Venous Blood by venipuncture
$14.57Complete Blood Count/Hemogram Standard
$66.11To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,636.10Rate Negotiated by your Insurance Plan
$258.90Some 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.
96374 - IV Injection, single/initial
$155.5899284 - ED Level 4
$442.36Basic Metabolic Panel Standard
$8.46Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$1,928.72Rate Negotiated by your Insurance Plan
$966.28Some 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.
96374 - IV Injection, single/initial
$166.6099284 - ED Level 4
$1,703.72Basic Metabolic Panel Standard
$88.40Collection of Venous Blood by venipuncture
$4.28Complete Blood Count/Hemogram Standard
$113.62To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$1,013.25Rate Negotiated by your Insurance Plan
$1,881.75Some 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.
96374 - IV Injection, single/initial
$178.5099284 - ED Level 4
$1,545.60Associated service: Revenue Code 250 charges
$19.60Associated service: Revenue Code 270 charges
$88.20Associated service: Revenue Code 272 charges
$29.40Basic Metabolic Panel Standard
$88.40Collection of Venous Blood by venipuncture
$25.35Complete Blood Count/Hemogram Standard
$115.05To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,142.30Rate Negotiated by your Insurance Plan
$752.70Some 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.
96374 - IV Injection, single/initial
$66.3099284 - ED Level 4
$574.08Associated service: Revenue Code 250 charges
$7.28Associated service: Revenue Code 270 charges
$32.76Associated service: Revenue Code 272 charges
$10.92Basic Metabolic Panel Standard
$35.36Collection of Venous Blood by venipuncture
$10.14Complete Blood Count/Hemogram Standard
$46.02To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,082.95Rate Negotiated by your Insurance Plan
$812.05Some 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.
96374 - IV Injection, single/initial
$71.5399284 - ED Level 4
$619.34Associated service: Revenue Code 250 charges
$7.85Associated service: Revenue Code 270 charges
$35.34Associated service: Revenue Code 272 charges
$11.78Basic Metabolic Panel Standard
$38.15Collection of Venous Blood by venipuncture
$10.94Complete Blood Count/Hemogram Standard
$49.65To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$1,158.00Rate Negotiated by your Insurance Plan
$1,737.00Some 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.
96374 - IV Injection, single/initial
$153.0099284 - ED Level 4
$1,324.80Associated service: Revenue Code 250 charges
$16.80Associated service: Revenue Code 270 charges
$75.60Associated service: Revenue Code 272 charges
$25.20Basic Metabolic Panel Standard
$81.60Collection of Venous Blood by venipuncture
$23.40Complete Blood Count/Hemogram Standard
$106.20To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,084.40Rate Negotiated by your Insurance Plan
$810.60Some 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.
96374 - IV Injection, single/initial
$71.4099284 - ED Level 4
$618.24Associated service: Revenue Code 250 charges
$7.84Associated service: Revenue Code 270 charges
$35.28Associated service: Revenue Code 272 charges
$11.76Basic Metabolic Panel Standard
$38.08Collection of Venous Blood by venipuncture
$10.92Complete Blood Count/Hemogram Standard
$49.56To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,636.10Rate Negotiated by your Insurance Plan
$258.90Some 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.
96374 - IV Injection, single/initial
$155.5899284 - ED Level 4
$442.36Basic Metabolic Panel Standard
$8.46Collection of Venous Blood by venipuncture
$6.00Complete Blood Count/Hemogram Standard
$7.77To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$579.00Rate Negotiated by your Insurance Plan
$2,316.00Some 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.
96374 - IV Injection, single/initial
$204.0099284 - ED Level 4
$1,766.40Associated service: Revenue Code 250 charges
$22.40Associated service: Revenue Code 270 charges
$100.80Associated service: Revenue Code 272 charges
$33.60Basic Metabolic Panel Standard
$108.80Collection of Venous Blood by venipuncture
$31.20Complete Blood Count/Hemogram Standard
$141.60To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,373.90Rate Negotiated by your Insurance Plan
$521.10Some 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.
96374 - IV Injection, single/initial
$45.9099284 - ED Level 4
$397.44Associated service: Revenue Code 250 charges
$5.04Associated service: Revenue Code 270 charges
$22.68Associated service: Revenue Code 272 charges
$7.56Basic Metabolic Panel Standard
$24.48Collection of Venous Blood by venipuncture
$7.02Complete Blood Count/Hemogram Standard
$31.86To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$1,207.22Rate Negotiated by your Insurance Plan
$1,687.78Some 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.
96374 - IV Injection, single/initial
$148.6699284 - ED Level 4
$1,287.26Associated service: Revenue Code 250 charges
$16.32Associated service: Revenue Code 270 charges
$73.46Associated service: Revenue Code 272 charges
$24.49Basic Metabolic Panel Standard
$79.29Collection of Venous Blood by venipuncture
$22.74Complete Blood Count/Hemogram Standard
$103.19To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.
Standard Charge
$2,895.00Insurance Discount
-$2,402.85Rate Negotiated by your Insurance Plan
$492.15Some 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.
96374 - IV Injection, single/initial
$43.3599284 - ED Level 4
$375.36Associated service: Revenue Code 250 charges
$4.76Associated service: Revenue Code 270 charges
$21.42Associated service: Revenue Code 272 charges
$7.14Basic Metabolic Panel Standard
$23.12Collection of Venous Blood by venipuncture
$6.63Complete Blood Count/Hemogram Standard
$30.09To verify this rate and discuss any other associated charges to expect, please contact Copper Queen Community Hospital directly.