Does Wickenburg Community Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Wickenburg Community Hospital. In a medical emergency, call 911.

Where is Wickenburg Community Hospital?

520 Rose Lane, Wickenburg, AZ 85390, in Maricopa County, Arizona.

What is the phone number of Wickenburg Community Hospital?

(928) 684-5421, as listed by Medicare (CMS).

What is the Medicare star rating of Wickenburg Community Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Wickenburg Community Hospital — Wickenburg, AZ

Quick answers

Does Wickenburg Community Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Wickenburg Community Hospital. In a medical emergency, call 911.
Where is Wickenburg Community Hospital?: 520 Rose Lane, Wickenburg, AZ 85390, in Maricopa County, Arizona.
What is the phone number of Wickenburg Community Hospital?: (928) 684-5421, as listed by Medicare (CMS).
What is the Medicare star rating of Wickenburg Community Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[5][8][10]

Acute Care
Emergency Care
Laboratory
Medical Imaging
Surgical Center
Transitional Care
Urgent Care
Cardiopulmonary Testing
Diagnostic imaging
Nuclear medicine

Conditions treated^[7]

Stroke
Cardiac emergencies
Trauma
Behavioral health crisis

Treatments^{[5][6][8][10]}

Infusion therapy (Boyd Infusion Center)
CT scan
MRI
Ultrasound
Echocardiography
Bone densitometry
Fluoroscopy
General X-ray
3D mammography
Outpatient blood transfusion
Retail pharmacy

Procedures^[5][6][8]

Interventional radiology
Cardio-pulmonary testing
Chemistry lab testing
Hematology lab testing
Coagulation testing
Blood bank
Serology testing
Urinalysis

Programs and centers^[5][7]

Acute care unit (inpatient)
Telestroke
Tele-behavioral crisis
Air medical transport base (PHI)

Emergency care (hospital website)^[5][7][10]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level IV

Visiting and practical information

Patient portal	Patient Portal

Recognition^[6][8]

American College of Radiology accreditation (imaging modalities)
Arizona Department of Health Services certified clinical laboratory

Doctors and clinicians (217)

217 doctors and other clinicians list Wickenburg Community Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 193 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Banner del E. Webb Medical Center31 mi · Sun City West, AZ · Acute Care Hospital
Banner Boswell Medical Center37 mi · Sun City, AZ · Acute Care Hospital
HonorHealth Sonoran Crossing Medical Center37 mi · Phoenix, AZ · Acute Care Hospital
Abrazo Arrowhead Hospital38 mi · Glendale, AZ · Acute Care Hospital
Banner Thunderbird Medical Center41 mi · Glendale, AZ · Acute Care Hospital

Other hospitals nearby

Avenir Behavioral Health Center31 mi · Surprise, AZ · Psychiatric Hospital
Destiny Springs Healthcare33 mi · Surprise, AZ · Psychiatric Hospital
PAM Health Rehabilitation Hospital of Surprise33 mi · Surprise, AZ · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Home health agencies

Community First Home Health Care, LLC9.4 mi · Wickenburg, AZ

All home health agencies in the state →

Dialysis facilities

DaVita Wickenburg Dialysis9.4 mi · Wickenburg, AZ · 3 of 5 stars

All dialysis facilities in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Adelante Healthcare Wickenburg0.3 mi · Wickenburg, AZ · Community health center

Clinics and urgent care

Community Hospital Association, Inc.9.4 mi · Wickenburg, AZ · Urgent care center
Community Hospital Clinic-Wickenburg9.4 mi · Wickenburg, AZ · Rural health clinic
Community Hospital Clinic- Wittmann17 mi · Wittmann, AZ · Rural health clinic

Pharmacies

Arizona CVS Stores, L.L.C.9.4 mi · Wickenburg, AZ · Pharmacy
Community Hospital Association, Inc.9.4 mi · Wickenburg, AZ · Community/retail pharmacy
Raley's Arizona LLC9.4 mi · Wickenburg, AZ · Community/retail pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Wickenburg Community Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	Not reported to Medicare
Overall rating of the hospital	Not reported to Medicare
Would recommend the hospital	Not reported to Medicare
Nurses communicated well	Not reported to Medicare
Doctors communicated well	Not reported to Medicare
Staff explained medicines	Not reported to Medicare
Information about recovery at home	Not reported to Medicare
Room and bathroom kept clean	Not reported to Medicare
Quiet at night	Not reported to Medicare
Rated the hospital 9 or 10 out of 10	85%National average: 72%
Would definitely recommend the hospital	81%National average: 71%
Nurses “always” communicated well	88%National average: 80%
Doctors “always” communicated well	89%National average: 80%
Staff “always” explained medicines before giving them	63%National average: 62%
Were given information about recovery at home	85%National average: 86%
Room and bathroom “always” clean	85%National average: 74%
Area around the room “always” quiet at night	66%National average: 60%
Completed surveys	52Response rate: 33%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Too few cases to report
Deaths within 30 days: pneumonia patients	13.4%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	Too few cases to report
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Too few cases to report
Readmitted within 30 days: pneumonia	16.8%
Readmitted within 30 days: COPD	20.2%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	156 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Arizona Best hospitals in Arizona

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 61 common services exactly as Wickenburg Community Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Office/outpatient visit new	$644	$418.60	$49.09 – $54.54
New patient office visit (about 30–44 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: Qc e/m level iii new pt	$644	$418.60	$49.09 – $54.54
New patient office visit (about 30–44 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient · modifier 25 In the file: E&m initial level iii w/mod 25	$510	$331.50	$49.09 – $54.54
New patient office visit (about 30–44 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: Office/outpatient visit new	$587.75	$382.04	$49.09 – $54.54
New patient office visit (about 45–59 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Office/outpatient visit new	$1,826	$1,186.90	$49.09 – $54.54
New patient office visit (about 60–74 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: Qc e/m level v new pt	$1,826	$1,186.90	$49.09 – $54.54
New patient office visit (about 60–74 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient · modifier 25 In the file: E&m initial level v w/mod 25	$1,121	$728.65	$49.09 – $54.54
New patient office visit (about 60–74 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Office/outpatient visit est	$644	$418.60	$49.09 – $54.54
Established patient office visit (about 20–29 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: Qc e/m level iii est pt	$644	$418.60	$49.09 – $54.54
Established patient office visit (about 20–29 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · modifier 25 In the file: E&m estabilshed level iii w/mod 25	$338	$219.70	$49.09 – $54.54
Established patient office visit (about 20–29 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: Office/outpatient visit est	$275	$178.75	$49.09 – $54.54
Established patient office visit (about 30–39 minutes): 10 of 258 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $54.54 AHCCCS_QMB_-IP — X9: $54.54 AHCCCS_QMB_-OP — X9B: $54.54 AHCCCS_QMB_-PRO — X9P: $54.54 AHCCCS_QMB_-REC — X9R: $54.54 AHCCCS_QMB_-SW — X9S: $54.54 HEALTH_CHOICE_AZ_-CLIN — X3C: $49.09 HEALTH_CHOICE_AZ_-IP — X3: $49.09 HEALTH_CHOICE_AZ_-OP — X3B: $49.09 HEALTH_CHOICE_AZ_-PRO — X3P: $49.09
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: Prev visit new age 18-39	$444	$288.60	Not listed in the file
Preventive checkup, new patient, age 18–39: 10 of 234 insurance plan rates AARP_UHC_SUPPLMT_PLAN_36273_-CLIN — CAC: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-IP — CA: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-OP — CAB: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-PRO — CAP: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-REC — CAR: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-SW — CAS: 60% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-CLIN — WBC: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-IP — WB: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-OP — WBB: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-PRO — WBP: 30% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: Prev visit new age 40-64	$516	$335.40	Not listed in the file
Preventive checkup, new patient, age 40–64: 10 of 234 insurance plan rates AARP_UHC_SUPPLMT_PLAN_36273_-CLIN — CAC: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-IP — CA: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-OP — CAB: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-PRO — CAP: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-REC — CAR: 60% (a percentage in the contract, not a dollar amount) AARP_UHC_SUPPLMT_PLAN_36273_-SW — CAS: 60% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-CLIN — WBC: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-IP — WB: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-OP — WBB: 30% (a percentage in the contract, not a dollar amount) AETNA_ADV_BHN_HMO_-PRO — WBP: 30% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Emergency dept visit	$1,427	$927.55	$124.42 – $315.16
Emergency room visit (moderate): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $138.24 AHCCCS_QMB_-IP — X9: $138.24 AHCCCS_QMB_-OP — X9B: $138.24 AHCCCS_QMB_-PRO — X9P: $138.24 AHCCCS_QMB_-REC — X9R: $138.24 AHCCCS_QMB_-SW — X9S: $138.24 CARE_1ST_-CLIN — X5C_1: $315.16 CARE_1ST_-IP — X5_1: $315.16 CARE_1ST_-OP — X5B_1: $315.16 CARE_1ST_-PRO — X5P_1: $315.16
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: Er level iii	$1,427	$927.55	$124.42 – $315.16
Emergency room visit (moderate): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $138.24 AHCCCS_QMB_-IP — X9: $138.24 AHCCCS_QMB_-OP — X9B: $138.24 AHCCCS_QMB_-PRO — X9P: $138.24 AHCCCS_QMB_-REC — X9R: $138.24 AHCCCS_QMB_-SW — X9S: $138.24 CARE_1ST_-CLIN — X5C_1: $315.16 CARE_1ST_-IP — X5_1: $315.16 CARE_1ST_-OP — X5B_1: $315.16 CARE_1ST_-PRO — X5P_1: $315.16
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · modifier 25 In the file: Er level iii w/mod 25	$1,498	$973.70	$124.42 – $315.16
Emergency room visit (moderate): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $138.24 AHCCCS_QMB_-IP — X9: $138.24 AHCCCS_QMB_-OP — X9B: $138.24 AHCCCS_QMB_-PRO — X9P: $138.24 AHCCCS_QMB_-REC — X9R: $138.24 AHCCCS_QMB_-SW — X9S: $138.24 CARE_1ST_-CLIN — X5C_1: $315.16 CARE_1ST_-IP — X5_1: $315.16 CARE_1ST_-OP — X5B_1: $315.16 CARE_1ST_-PRO — X5P_1: $315.16
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Emergency dept visit	$2,571	$1,671.15	$199.06 – $481.74
Emergency room visit (moderately high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $221.18 AHCCCS_QMB_-IP — X9: $221.18 AHCCCS_QMB_-OP — X9B: $221.18 AHCCCS_QMB_-PRO — X9P: $221.18 AHCCCS_QMB_-REC — X9R: $221.18 AHCCCS_QMB_-SW — X9S: $221.18 CARE_1ST_-CLIN — X5C_1: $481.74 CARE_1ST_-IP — X5_1: $481.74 CARE_1ST_-OP — X5B_1: $481.74 CARE_1ST_-PRO — X5P_1: $481.74
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: Er level iv	$2,571	$1,671.15	$199.06 – $481.74
Emergency room visit (moderately high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $221.18 AHCCCS_QMB_-IP — X9: $221.18 AHCCCS_QMB_-OP — X9B: $221.18 AHCCCS_QMB_-PRO — X9P: $221.18 AHCCCS_QMB_-REC — X9R: $221.18 AHCCCS_QMB_-SW — X9S: $221.18 CARE_1ST_-CLIN — X5C_1: $481.74 CARE_1ST_-IP — X5_1: $481.74 CARE_1ST_-OP — X5B_1: $481.74 CARE_1ST_-PRO — X5P_1: $481.74
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · modifier 25 In the file: Er level iv w/mod 25	$2,571	$1,671.15	$199.06 – $481.74
Emergency room visit (moderately high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $221.18 AHCCCS_QMB_-IP — X9: $221.18 AHCCCS_QMB_-OP — X9B: $221.18 AHCCCS_QMB_-PRO — X9P: $221.18 AHCCCS_QMB_-REC — X9R: $221.18 AHCCCS_QMB_-SW — X9S: $221.18 CARE_1ST_-CLIN — X5C_1: $481.74 CARE_1ST_-IP — X5_1: $481.74 CARE_1ST_-OP — X5B_1: $481.74 CARE_1ST_-PRO — X5P_1: $481.74
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Emergency dept visit	$4,191	$2,724.15	$299.16 – $687.56
Emergency room visit (high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $332.40 AHCCCS_QMB_-IP — X9: $332.40 AHCCCS_QMB_-OP — X9B: $332.40 AHCCCS_QMB_-PRO — X9P: $332.40 AHCCCS_QMB_-REC — X9R: $332.40 AHCCCS_QMB_-SW — X9S: $332.40 CARE_1ST_-CLIN — X5C_1: $687.56 CARE_1ST_-IP — X5_1: $687.56 CARE_1ST_-OP — X5B_1: $687.56 CARE_1ST_-PRO — X5P_1: $687.56
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: Er level v	$4,191	$2,724.15	$299.16 – $687.56
Emergency room visit (high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $332.40 AHCCCS_QMB_-IP — X9: $332.40 AHCCCS_QMB_-OP — X9B: $332.40 AHCCCS_QMB_-PRO — X9P: $332.40 AHCCCS_QMB_-REC — X9R: $332.40 AHCCCS_QMB_-SW — X9S: $332.40 CARE_1ST_-CLIN — X5C_1: $687.56 CARE_1ST_-IP — X5_1: $687.56 CARE_1ST_-OP — X5B_1: $687.56 CARE_1ST_-PRO — X5P_1: $687.56
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · modifier 25 In the file: Er level v w/mod 25	$4,191	$2,724.15	$299.16 – $687.56
Emergency room visit (high): 10 of 288 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $332.40 AHCCCS_QMB_-IP — X9: $332.40 AHCCCS_QMB_-OP — X9B: $332.40 AHCCCS_QMB_-PRO — X9P: $332.40 AHCCCS_QMB_-REC — X9R: $332.40 AHCCCS_QMB_-SW — X9S: $332.40 CARE_1ST_-CLIN — X5C_1: $687.56 CARE_1ST_-IP — X5_1: $687.56 CARE_1ST_-OP — X5B_1: $687.56 CARE_1ST_-PRO — X5P_1: $687.56

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Bmp	$422	$274.30	$7.61 – $28.18
Basic metabolic panel (blood test): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8.46 AHCCCS_QMB_-IP — X9: $8.46 AHCCCS_QMB_-OP — X9B: $8.46 AHCCCS_QMB_-PRO — X9P: $8.46 AHCCCS_QMB_-REC — X9R: $8.46 AHCCCS_QMB_-SW — X9S: $8.46 BCBS_-CLIN — BAC_1: $28.18 BCBS_-IP — BA_1: $28.18 BCBS_-OP — BAB_1: $28.18 BCBS_-REC — BAR_1: $28.18
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: Metabolic panel total ca	$422	$274.30	$7.61 – $28.18
Basic metabolic panel (blood test): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8.46 AHCCCS_QMB_-IP — X9: $8.46 AHCCCS_QMB_-OP — X9B: $8.46 AHCCCS_QMB_-PRO — X9P: $8.46 AHCCCS_QMB_-REC — X9R: $8.46 AHCCCS_QMB_-SW — X9S: $8.46 BCBS_-CLIN — BAC_1: $28.18 BCBS_-IP — BA_1: $28.18 BCBS_-OP — BAB_1: $28.18 BCBS_-REC — BAR_1: $28.18
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Cmp	$636	$413.40	$9.50 – $35.16
Comprehensive metabolic panel (blood test): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $10.56 AHCCCS_QMB_-IP — X9: $10.56 AHCCCS_QMB_-OP — X9B: $10.56 AHCCCS_QMB_-PRO — X9P: $10.56 AHCCCS_QMB_-REC — X9R: $10.56 AHCCCS_QMB_-SW — X9S: $10.56 BCBS_-CLIN — BAC_1: $35.16 BCBS_-IP — BA_1: $35.16 BCBS_-OP — BAB_1: $35.16 BCBS_-REC — BAR_1: $35.16
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: Comprehen metabolic panel	$636	$413.40	$9.50 – $35.16
Comprehensive metabolic panel (blood test): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $10.56 AHCCCS_QMB_-IP — X9: $10.56 AHCCCS_QMB_-OP — X9B: $10.56 AHCCCS_QMB_-PRO — X9P: $10.56 AHCCCS_QMB_-REC — X9R: $10.56 AHCCCS_QMB_-SW — X9S: $10.56 BCBS_-CLIN — BAC_1: $35.16 BCBS_-IP — BA_1: $35.16 BCBS_-OP — BAB_1: $35.16 BCBS_-REC — BAR_1: $35.16
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: Lipid panel	$295	$191.75	$12.05 – $49.04
Cholesterol panel (lipid panel): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $13.39 AHCCCS_QMB_-IP — X9: $13.39 AHCCCS_QMB_-OP — X9B: $13.39 AHCCCS_QMB_-PRO — X9P: $13.39 AHCCCS_QMB_-REC — X9R: $13.39 AHCCCS_QMB_-SW — X9S: $13.39 BCBS_-CLIN — BAC_1: $49.04 BCBS_-IP — BA_1: $49.04 BCBS_-OP — BAB_1: $49.04 BCBS_-REC — BAR_1: $49.04
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: Renal function panel	$460	$299	$7.81 – $28.89
Kidney function panel: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8.68 AHCCCS_QMB_-IP — X9: $8.68 AHCCCS_QMB_-OP — X9B: $8.68 AHCCCS_QMB_-PRO — X9P: $8.68 AHCCCS_QMB_-REC — X9R: $8.68 AHCCCS_QMB_-SW — X9S: $8.68 BCBS_-CLIN — BAC_1: $28.89 BCBS_-IP — BA_1: $28.89 BCBS_-OP — BAB_1: $28.89 BCBS_-REC — BAR_1: $28.89
Liver function panel CPT 80076 · Inpatient or outpatient In the file: Hepatic function panel	$355	$230.75	$7.35 – $27.19
Liver function panel: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8.17 AHCCCS_QMB_-IP — X9: $8.17 AHCCCS_QMB_-OP — X9B: $8.17 AHCCCS_QMB_-PRO — X9P: $8.17 AHCCCS_QMB_-REC — X9R: $8.17 AHCCCS_QMB_-SW — X9S: $8.17 BCBS_-CLIN — BAC_1: $27.19 BCBS_-IP — BA_1: $27.19 BCBS_-OP — BAB_1: $27.19 BCBS_-REC — BAR_1: $27.19
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: .ua w/ micro charge only	$157	$102.05	$2.85 – $10.57
Urine test (automated, with microscope): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $3.17 AHCCCS_QMB_-IP — X9: $3.17 AHCCCS_QMB_-OP — X9B: $3.17 AHCCCS_QMB_-PRO — X9P: $3.17 AHCCCS_QMB_-REC — X9R: $3.17 AHCCCS_QMB_-SW — X9S: $3.17 BCBS_-CLIN — BAC_1: $10.57 BCBS_-IP — BA_1: $10.57 BCBS_-OP — BAB_1: $10.57 BCBS_-REC — BAR_1: $10.57
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: Urinalysis auto w/scope	$157	$102.05	$2.85 – $10.57
Urine test (automated, with microscope): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $3.17 AHCCCS_QMB_-IP — X9: $3.17 AHCCCS_QMB_-OP — X9B: $3.17 AHCCCS_QMB_-PRO — X9P: $3.17 AHCCCS_QMB_-REC — X9R: $3.17 AHCCCS_QMB_-SW — X9S: $3.17 BCBS_-CLIN — BAC_1: $10.57 BCBS_-IP — BA_1: $10.57 BCBS_-OP — BAB_1: $10.57 BCBS_-REC — BAR_1: $10.57
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: .ua w/o micro charge only	$95	$61.75	$2.03 – $7.50
Urine test (automated, without microscope): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2.25 AHCCCS_QMB_-IP — X9: $2.25 AHCCCS_QMB_-OP — X9B: $2.25 AHCCCS_QMB_-PRO — X9P: $2.25 AHCCCS_QMB_-REC — X9R: $2.25 AHCCCS_QMB_-SW — X9S: $2.25 BCBS_-CLIN — BAC_1: $7.50 BCBS_-IP — BA_1: $7.50 BCBS_-OP — BAB_1: $7.50 BCBS_-REC — BAR_1: $7.50
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: Urinalysis auto w/o scope	$95	$61.75	$2.03 – $7.50
Urine test (automated, without microscope): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2.25 AHCCCS_QMB_-IP — X9: $2.25 AHCCCS_QMB_-OP — X9B: $2.25 AHCCCS_QMB_-PRO — X9P: $2.25 AHCCCS_QMB_-REC — X9R: $2.25 AHCCCS_QMB_-SW — X9S: $2.25 BCBS_-CLIN — BAC_1: $7.50 BCBS_-IP — BA_1: $7.50 BCBS_-OP — BAB_1: $7.50 BCBS_-REC — BAR_1: $7.50
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · modifier QW In the file: Urinalysis (clinic)	$104	$67.60	$2.03 – $7.50
Urine test (automated, without microscope): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2.25 AHCCCS_QMB_-IP — X9: $2.25 AHCCCS_QMB_-OP — X9B: $2.25 AHCCCS_QMB_-PRO — X9P: $2.25 AHCCCS_QMB_-REC — X9R: $2.25 AHCCCS_QMB_-SW — X9S: $2.25 BCBS_-CLIN — BAC_1: $7.50 BCBS_-IP — BA_1: $7.50 BCBS_-OP — BAB_1: $7.50 BCBS_-REC — BAR_1: $7.50
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Assay of psa total	$190	$123.50	$16.55 – $61.27
PSA (prostate specific antigen) blood test: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $18.39 AHCCCS_QMB_-IP — X9: $18.39 AHCCCS_QMB_-OP — X9B: $18.39 AHCCCS_QMB_-PRO — X9P: $18.39 AHCCCS_QMB_-REC — X9R: $18.39 AHCCCS_QMB_-SW — X9S: $18.39 BCBS_-CLIN — BAC_1: $61.27 BCBS_-IP — BA_1: $61.27 BCBS_-OP — BAB_1: $61.27 BCBS_-REC — BAR_1: $61.27
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: Psa (diagnostic)	$190	$123.50	$16.55 – $61.27
PSA (prostate specific antigen) blood test: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $18.39 AHCCCS_QMB_-IP — X9: $18.39 AHCCCS_QMB_-OP — X9B: $18.39 AHCCCS_QMB_-PRO — X9P: $18.39 AHCCCS_QMB_-REC — X9R: $18.39 AHCCCS_QMB_-SW — X9S: $18.39 BCBS_-CLIN — BAC_1: $61.27 BCBS_-IP — BA_1: $61.27 BCBS_-OP — BAB_1: $61.27 BCBS_-REC — BAR_1: $61.27
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Assay thyroid stim hormone	$394	$256.10	$15.12 – $55.93
Thyroid stimulating hormone (TSH) test: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $16.80 AHCCCS_QMB_-IP — X9: $16.80 AHCCCS_QMB_-OP — X9B: $16.80 AHCCCS_QMB_-PRO — X9P: $16.80 AHCCCS_QMB_-REC — X9R: $16.80 AHCCCS_QMB_-SW — X9S: $16.80 BCBS_-CLIN — BAC_1: $55.93 BCBS_-IP — BA_1: $55.93 BCBS_-OP — BAB_1: $55.93 BCBS_-REC — BAR_1: $55.93
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Thyroid function cascade (inc s-tsh)	$394	$256.10	$15.12 – $55.93
Thyroid stimulating hormone (TSH) test: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $16.80 AHCCCS_QMB_-IP — X9: $16.80 AHCCCS_QMB_-OP — X9B: $16.80 AHCCCS_QMB_-PRO — X9P: $16.80 AHCCCS_QMB_-REC — X9R: $16.80 AHCCCS_QMB_-SW — X9S: $16.80 BCBS_-CLIN — BAC_1: $55.93 BCBS_-IP — BA_1: $55.93 BCBS_-OP — BAB_1: $55.93 BCBS_-REC — BAR_1: $55.93
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Cbc w/diff	$218	$141.70	$6.99 – $25.87
Complete blood count (CBC) with differential: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $7.77 AHCCCS_QMB_-IP — X9: $7.77 AHCCCS_QMB_-OP — X9B: $7.77 AHCCCS_QMB_-PRO — X9P: $7.77 AHCCCS_QMB_-REC — X9R: $7.77 AHCCCS_QMB_-SW — X9S: $7.77 BCBS_-CLIN — BAC_1: $25.87 BCBS_-IP — BA_1: $25.87 BCBS_-OP — BAB_1: $25.87 BCBS_-REC — BAR_1: $25.87
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: Complete cbc w/auto diff wbc	$218	$141.70	$6.99 – $25.87
Complete blood count (CBC) with differential: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $7.77 AHCCCS_QMB_-IP — X9: $7.77 AHCCCS_QMB_-OP — X9B: $7.77 AHCCCS_QMB_-PRO — X9P: $7.77 AHCCCS_QMB_-REC — X9R: $7.77 AHCCCS_QMB_-SW — X9S: $7.77 BCBS_-CLIN — BAC_1: $25.87 BCBS_-IP — BA_1: $25.87 BCBS_-OP — BAB_1: $25.87 BCBS_-REC — BAR_1: $25.87
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Complete cbc automated	$166	$107.90	$5.82 – $21.52
Complete blood count (CBC), automated: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $6.47 AHCCCS_QMB_-IP — X9: $6.47 AHCCCS_QMB_-OP — X9B: $6.47 AHCCCS_QMB_-PRO — X9P: $6.47 AHCCCS_QMB_-REC — X9R: $6.47 AHCCCS_QMB_-SW — X9S: $6.47 BCBS_-CLIN — BAC_1: $21.52 BCBS_-IP — BA_1: $21.52 BCBS_-OP — BAB_1: $21.52 BCBS_-REC — BAR_1: $21.52
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: Hemogram	$166	$107.90	$5.82 – $21.52
Complete blood count (CBC), automated: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $6.47 AHCCCS_QMB_-IP — X9: $6.47 AHCCCS_QMB_-OP — X9B: $6.47 AHCCCS_QMB_-PRO — X9P: $6.47 AHCCCS_QMB_-REC — X9R: $6.47 AHCCCS_QMB_-SW — X9S: $6.47 BCBS_-CLIN — BAC_1: $21.52 BCBS_-IP — BA_1: $21.52 BCBS_-OP — BAB_1: $21.52 BCBS_-REC — BAR_1: $21.52
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin time	$127	$82.55	$3.86 – $14.30
Blood clotting time test (prothrombin time, PT): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $4.29 AHCCCS_QMB_-IP — X9: $4.29 AHCCCS_QMB_-OP — X9B: $4.29 AHCCCS_QMB_-PRO — X9P: $4.29 AHCCCS_QMB_-REC — X9R: $4.29 AHCCCS_QMB_-SW — X9S: $4.29 BCBS_-CLIN — BAC_1: $14.30 BCBS_-IP — BA_1: $14.30 BCBS_-OP — BAB_1: $14.30 BCBS_-REC — BAR_1: $14.30
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Pt/inr	$127	$82.55	$3.86 – $14.30
Blood clotting time test (prothrombin time, PT): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $4.29 AHCCCS_QMB_-IP — X9: $4.29 AHCCCS_QMB_-OP — X9B: $4.29 AHCCCS_QMB_-PRO — X9P: $4.29 AHCCCS_QMB_-REC — X9R: $4.29 AHCCCS_QMB_-SW — X9S: $4.29 BCBS_-CLIN — BAC_1: $14.30 BCBS_-IP — BA_1: $14.30 BCBS_-OP — BAB_1: $14.30 BCBS_-REC — BAR_1: $14.30
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · modifier QW In the file: Inr (clinic)	$127	$82.55	$3.86 – $14.30
Blood clotting time test (prothrombin time, PT): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $4.29 AHCCCS_QMB_-IP — X9: $4.29 AHCCCS_QMB_-OP — X9B: $4.29 AHCCCS_QMB_-PRO — X9P: $4.29 AHCCCS_QMB_-REC — X9R: $4.29 AHCCCS_QMB_-SW — X9S: $4.29 BCBS_-CLIN — BAC_1: $14.30 BCBS_-IP — BA_1: $14.30 BCBS_-OP — BAB_1: $14.30 BCBS_-REC — BAR_1: $14.30
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Ptt	$220	$143	$5.41 – $20.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $6.01 AHCCCS_QMB_-IP — X9: $6.01 AHCCCS_QMB_-OP — X9B: $6.01 AHCCCS_QMB_-PRO — X9P: $6.01 AHCCCS_QMB_-REC — X9R: $6.01 AHCCCS_QMB_-SW — X9S: $6.01 BCBS_-CLIN — BAC_1: $20.01 BCBS_-IP — BA_1: $20.01 BCBS_-OP — BAB_1: $20.01 BCBS_-REC — BAR_1: $20.01
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Thromboplastin time partial	$220	$143	$5.41 – $20.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $6.01 AHCCCS_QMB_-IP — X9: $6.01 AHCCCS_QMB_-OP — X9B: $6.01 AHCCCS_QMB_-PRO — X9P: $6.01 AHCCCS_QMB_-REC — X9R: $6.01 AHCCCS_QMB_-SW — X9S: $6.01 BCBS_-CLIN — BAC_1: $20.01 BCBS_-IP — BA_1: $20.01 BCBS_-OP — BAB_1: $20.01 BCBS_-REC — BAR_1: $20.01

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head w/o	$3,624	$2,355.60	$71.10 – $376.66
CT scan of the head or brain, without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $376.66 BCBS_-IP — BA_1: $376.66 BCBS_-OP — BAB_1: $376.66 BCBS_-REC — BAR_1: $376.66
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: Ct head/brain w/o dye	$3,624	$2,355.60	$71.10 – $376.66
CT scan of the head or brain, without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $376.66 BCBS_-IP — BA_1: $376.66 BCBS_-OP — BAB_1: $376.66 BCBS_-REC — BAR_1: $376.66
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain stem w/o & w/dye	$6,367	$4,138.55	$240.20 – $1,187.98
MRI of the brain, before and after contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $266.89 AHCCCS_QMB_-IP — X9: $266.89 AHCCCS_QMB_-OP — X9B: $266.89 AHCCCS_QMB_-PRO — X9P: $266.89 AHCCCS_QMB_-REC — X9R: $266.89 AHCCCS_QMB_-SW — X9S: $266.89 BCBS_-CLIN — BAC_1: $1,187.98 BCBS_-IP — BA_1: $1,187.98 BCBS_-OP — BAB_1: $1,187.98 BCBS_-REC — BAR_1: $1,187.98
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: Mri brain wo + w/iv	$6,367	$4,138.55	$240.20 – $1,187.98
MRI of the brain, before and after contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $266.89 AHCCCS_QMB_-IP — X9: $266.89 AHCCCS_QMB_-OP — X9B: $266.89 AHCCCS_QMB_-PRO — X9P: $266.89 AHCCCS_QMB_-REC — X9R: $266.89 AHCCCS_QMB_-SW — X9S: $266.89 BCBS_-CLIN — BAC_1: $1,187.98 BCBS_-IP — BA_1: $1,187.98 BCBS_-OP — BAB_1: $1,187.98 BCBS_-REC — BAR_1: $1,187.98
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: Chest 2 views	$610	$396.50	$52.79 – $953.68
Chest X-ray, 2 views: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $58.65 AHCCCS_QMB_-IP — X9: $58.65 AHCCCS_QMB_-OP — X9B: $58.65 AHCCCS_QMB_-PRO — X9P: $58.65 AHCCCS_QMB_-REC — X9R: $58.65 AHCCCS_QMB_-SW — X9S: $58.65 BCBS_-CLIN — BAC_1: $93.22 BCBS_-IP — BA_1: $93.22 BCBS_-OP — BAB_1: $93.22 BCBS_-REC — BAR_1: $93.22
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: X-ray exam chest 2 views	$610	$396.50	$52.79 – $953.68
Chest X-ray, 2 views: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $58.65 AHCCCS_QMB_-IP — X9: $58.65 AHCCCS_QMB_-OP — X9B: $58.65 AHCCCS_QMB_-PRO — X9P: $58.65 AHCCCS_QMB_-REC — X9R: $58.65 AHCCCS_QMB_-SW — X9S: $58.65 BCBS_-CLIN — BAC_1: $93.22 BCBS_-IP — BA_1: $93.22 BCBS_-OP — BAB_1: $93.22 BCBS_-REC — BAR_1: $93.22
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: Lumbar spine complete	$1,011	$657.15	$71.10 – $164.92
X-ray of the lower spine, at least 4 views: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $164.92 BCBS_-IP — BA_1: $164.92 BCBS_-OP — BAB_1: $164.92 BCBS_-REC — BAR_1: $164.92
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: X-ray exam l-2 spine 4/>vws	$1,011	$657.15	$71.10 – $164.92
X-ray of the lower spine, at least 4 views: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $164.92 BCBS_-IP — BA_1: $164.92 BCBS_-OP — BAB_1: $164.92 BCBS_-REC — BAR_1: $164.92
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar spine w/o dye	$4,735	$3,077.75	$150.16 – $691.39
MRI of the lower back (lumbar spine), without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $166.84 AHCCCS_QMB_-IP — X9: $166.84 AHCCCS_QMB_-OP — X9B: $166.84 AHCCCS_QMB_-PRO — X9P: $166.84 AHCCCS_QMB_-REC — X9R: $166.84 AHCCCS_QMB_-SW — X9S: $166.84 BCBS_-CLIN — BAC_1: $691.39 BCBS_-IP — BA_1: $691.39 BCBS_-OP — BAB_1: $691.39 BCBS_-REC — BAR_1: $691.39
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: Mri lumbar w/o	$4,735	$3,077.75	$150.16 – $691.39
MRI of the lower back (lumbar spine), without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $166.84 AHCCCS_QMB_-IP — X9: $166.84 AHCCCS_QMB_-OP — X9B: $166.84 AHCCCS_QMB_-PRO — X9P: $166.84 AHCCCS_QMB_-REC — X9R: $166.84 AHCCCS_QMB_-SW — X9S: $166.84 BCBS_-CLIN — BAC_1: $691.39 BCBS_-IP — BA_1: $691.39 BCBS_-OP — BAB_1: $691.39 BCBS_-REC — BAR_1: $691.39
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/dye	$1,967	$1,278.55	$116.51 – $966.99
CT scan of the pelvis, with contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $129.45 AHCCCS_QMB_-IP — X9: $129.45 AHCCCS_QMB_-OP — X9B: $129.45 AHCCCS_QMB_-PRO — X9P: $129.45 AHCCCS_QMB_-REC — X9R: $129.45 AHCCCS_QMB_-SW — X9S: $129.45 BCBS_-CLIN — BAC_1: $966.99 BCBS_-IP — BA_1: $966.99 BCBS_-OP — BAB_1: $966.99 BCBS_-REC — BAR_1: $966.99
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: Ct pelvis w/iv + no oral	$1,967	$1,278.55	$116.51 – $966.99
CT scan of the pelvis, with contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $129.45 AHCCCS_QMB_-IP — X9: $129.45 AHCCCS_QMB_-OP — X9B: $129.45 AHCCCS_QMB_-PRO — X9P: $129.45 AHCCCS_QMB_-REC — X9R: $129.45 AHCCCS_QMB_-SW — X9S: $129.45 BCBS_-CLIN — BAC_1: $966.99 BCBS_-IP — BA_1: $966.99 BCBS_-OP — BAB_1: $966.99 BCBS_-REC — BAR_1: $966.99
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: Mri jnt of lwr extre w/o dye	$3,173	$2,062.45	$150.16 – $794.52
MRI of a leg joint (such as the knee), without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $166.84 AHCCCS_QMB_-IP — X9: $166.84 AHCCCS_QMB_-OP — X9B: $166.84 AHCCCS_QMB_-PRO — X9P: $166.84 AHCCCS_QMB_-REC — X9R: $166.84 AHCCCS_QMB_-SW — X9S: $166.84 BCBS_-CLIN — BAC_1: $794.52 BCBS_-IP — BA_1: $794.52 BCBS_-OP — BAB_1: $794.52 BCBS_-REC — BAR_1: $794.52
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: Mri hip left w/o	$3,173	$2,062.45	$150.16 – $794.52
MRI of a leg joint (such as the knee), without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $166.84 AHCCCS_QMB_-IP — X9: $166.84 AHCCCS_QMB_-OP — X9B: $166.84 AHCCCS_QMB_-PRO — X9P: $166.84 AHCCCS_QMB_-REC — X9R: $166.84 AHCCCS_QMB_-SW — X9S: $166.84 BCBS_-CLIN — BAC_1: $794.52 BCBS_-IP — BA_1: $794.52 BCBS_-OP — BAB_1: $794.52 BCBS_-REC — BAR_1: $794.52
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: Mri hip right w/o	$3,173	$2,062.45	$150.16 – $794.52
MRI of a leg joint (such as the knee), without contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $166.84 AHCCCS_QMB_-IP — X9: $166.84 AHCCCS_QMB_-OP — X9B: $166.84 AHCCCS_QMB_-PRO — X9P: $166.84 AHCCCS_QMB_-REC — X9R: $166.84 AHCCCS_QMB_-SW — X9S: $166.84 BCBS_-CLIN — BAC_1: $794.52 BCBS_-IP — BA_1: $794.52 BCBS_-OP — BAB_1: $794.52 BCBS_-REC — BAR_1: $794.52
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd & pelv w/contrast	$4,545	$2,954.25	$217.64 – $1,216.34
CT scan of the abdomen and pelvis, with contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $241.82 AHCCCS_QMB_-IP — X9: $241.82 AHCCCS_QMB_-OP — X9B: $241.82 AHCCCS_QMB_-PRO — X9P: $241.82 AHCCCS_QMB_-REC — X9R: $241.82 AHCCCS_QMB_-SW — X9S: $241.82 BCBS_-CLIN — BAC_1: $1,216.34 BCBS_-IP — BA_1: $1,216.34 BCBS_-OP — BAB_1: $1,216.34 BCBS_-REC — BAR_1: $1,216.34
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: Ct abd pelvis w/ iv + no oral	$4,545	$2,954.25	$217.64 – $1,216.34
CT scan of the abdomen and pelvis, with contrast: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $241.82 AHCCCS_QMB_-IP — X9: $241.82 AHCCCS_QMB_-OP — X9B: $241.82 AHCCCS_QMB_-PRO — X9P: $241.82 AHCCCS_QMB_-REC — X9R: $241.82 AHCCCS_QMB_-SW — X9S: $241.82 BCBS_-CLIN — BAC_1: $1,216.34 BCBS_-IP — BA_1: $1,216.34 BCBS_-OP — BAB_1: $1,216.34 BCBS_-REC — BAR_1: $1,216.34
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us abdomen complete	$1,357	$882.05	$71.10 – $339.66
Ultrasound of the abdomen, complete: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $310.95 BCBS_-IP — BA_1: $310.95 BCBS_-OP — BAB_1: $310.95 BCBS_-REC — BAR_1: $310.95
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: Us exam abdom complete	$1,357	$882.05	$71.10 – $339.66
Ultrasound of the abdomen, complete: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $310.95 BCBS_-IP — BA_1: $310.95 BCBS_-OP — BAB_1: $310.95 BCBS_-REC — BAR_1: $310.95
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Transvaginal us non-ob	$1,162	$755.30	$71.10 – $203.57
Transvaginal ultrasound: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $203.57 BCBS_-IP — BA_1: $203.57 BCBS_-OP — BAB_1: $203.57 BCBS_-REC — BAR_1: $203.57
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: Us transvaginal	$1,162	$755.30	$71.10 – $203.57
Transvaginal ultrasound: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $79 AHCCCS_QMB_-IP — X9: $79 AHCCCS_QMB_-OP — X9B: $79 AHCCCS_QMB_-PRO — X9P: $79 AHCCCS_QMB_-REC — X9R: $79 AHCCCS_QMB_-SW — X9S: $79 BCBS_-CLIN — BAC_1: $203.57 BCBS_-IP — BA_1: $203.57 BCBS_-OP — BAB_1: $203.57 BCBS_-REC — BAR_1: $203.57
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Dx mammo incl cad uni	$542	$352.30	$113.43 – $344.18
Diagnostic mammogram, one breast: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $344.18 BCBS_-IP — BA_1: $344.18 BCBS_-OP — BAB_1: $344.18 BCBS_-REC — BAR_1: $344.18 BCBS_-SW — BAS_1: $344.18 BCBS__-PRO — BAP_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $344.18
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: Mammo uni diagnostic w/us if necessary	$542	$352.30	$113.43 – $344.18
Diagnostic mammogram, one breast: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $344.18 BCBS_-IP — BA_1: $344.18 BCBS_-OP — BAB_1: $344.18 BCBS_-REC — BAR_1: $344.18 BCBS_-SW — BAS_1: $344.18 BCBS__-PRO — BAP_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $344.18 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $344.18
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Dx mammo incl cad bi	$755	$490.75	$143.66 – $440.33
Diagnostic mammogram, both breasts: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $440.33 BCBS_-IP — BA_1: $440.33 BCBS_-OP — BAB_1: $440.33 BCBS_-REC — BAR_1: $440.33 BCBS_-SW — BAS_1: $440.33 BCBS__-PRO — BAP_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $440.33
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: Mammo bil diagnostic w/us if necessary	$755	$490.75	$143.66 – $440.33
Diagnostic mammogram, both breasts: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $440.33 BCBS_-IP — BA_1: $440.33 BCBS_-OP — BAB_1: $440.33 BCBS_-REC — BAR_1: $440.33 BCBS_-SW — BAS_1: $440.33 BCBS__-PRO — BAP_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $440.33 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $440.33
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Mammogram screening	$513	$333.45	$115.54 – $363.68
Screening mammogram, both breasts: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $363.68 BCBS_-IP — BA_1: $363.68 BCBS_-OP — BAB_1: $363.68 BCBS_-REC — BAR_1: $363.68 BCBS_-SW — BAS_1: $363.68 BCBS__-PRO — BAP_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $363.68
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: Scr mammo bi incl cad	$513	$333.45	$115.54 – $363.68
Screening mammogram, both breasts: 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $363.68 BCBS_-IP — BA_1: $363.68 BCBS_-OP — BAB_1: $363.68 BCBS_-REC — BAR_1: $363.68 BCBS_-SW — BAS_1: $363.68 BCBS__-PRO — BAP_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $363.68 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $363.68

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: Electrocardiogram complete	$620	$403	$135.70
Electrocardiogram (ECG/EKG) with reading: 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $135.70 BCBS_-IP — BA_1: $135.70 BCBS_-OP — BAB_1: $135.70 BCBS_-REC — BAR_1: $135.70 BCBS_-SW — BAS_1: $135.70 BCBS__-PRO — BAP_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $135.70
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Inpatient or outpatient In the file: Qc fac ekg intrp and report - global	$620	$403	$135.70
Electrocardiogram (ECG/EKG) with reading: 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $135.70 BCBS_-IP — BA_1: $135.70 BCBS_-OP — BAB_1: $135.70 BCBS_-REC — BAR_1: $135.70 BCBS_-SW — BAS_1: $135.70 BCBS__-PRO — BAP_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $135.70 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $135.70

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: Therapeutic exercises	$130	$84.50	$26.87 – $118.61
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $118.61 BCBS_-IP — BA_1: $118.61 BCBS_-OP — BAB_1: $118.61 BCBS_-REC — BAR_1: $118.61 BCBS_-SW — BAS_1: $118.61 BCBS__-PRO — BAP_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $118.61
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier 59 In the file: Ot therap ex per 15 (l1)59	$130	$84.50	$118.61
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $118.61 BCBS_-IP — BA_1: $118.61 BCBS_-OP — BAB_1: $118.61 BCBS_-REC — BAR_1: $118.61 BCBS_-SW — BAS_1: $118.61 BCBS__-PRO — BAP_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $118.61
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: Ot therap ex per 15 (l1)	$130	$84.50	$118.61
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $118.61 BCBS_-IP — BA_1: $118.61 BCBS_-OP — BAB_1: $118.61 BCBS_-REC — BAR_1: $118.61 BCBS_-SW — BAS_1: $118.61 BCBS__-PRO — BAP_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $118.61 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $118.61
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: Pt eval low complex 20 min	$288	$187.20	$90.61 – $376.80
Physical therapy evaluation (low complexity): 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $376.80 BCBS_-IP — BA_1: $376.80 BCBS_-OP — BAB_1: $376.80 BCBS_-REC — BAR_1: $376.80 BCBS_-SW — BAS_1: $376.80 BCBS__-PRO — BAP_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $376.80
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: Pt initial eval low complexity	$288	$187.20	$376.80
Physical therapy evaluation (low complexity): 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $376.80 BCBS_-IP — BA_1: $376.80 BCBS_-OP — BAB_1: $376.80 BCBS_-REC — BAR_1: $376.80 BCBS_-SW — BAS_1: $376.80 BCBS__-PRO — BAP_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $376.80 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $376.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: Pt eval mod complex 30 min	$288	$187.20	$90.61 – $396.62
Physical therapy evaluation (moderate complexity): 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $396.62 BCBS_-IP — BA_1: $396.62 BCBS_-OP — BAB_1: $396.62 BCBS_-REC — BAR_1: $396.62 BCBS_-SW — BAS_1: $396.62 BCBS__-PRO — BAP_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $396.62
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: Pt initial eval mod complexity	$288	$187.20	$396.62
Physical therapy evaluation (moderate complexity): 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $396.62 BCBS_-IP — BA_1: $396.62 BCBS_-OP — BAB_1: $396.62 BCBS_-REC — BAR_1: $396.62 BCBS_-SW — BAS_1: $396.62 BCBS__-PRO — BAP_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $396.62
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: Pt eval high complex 45 min	$288	$187.20	$90.61 – $396.62
Physical therapy evaluation (high complexity): 10 of 321 insurance plan rates BCBS_-CLIN — BAC_1: $396.62 BCBS_-IP — BA_1: $396.62 BCBS_-OP — BAB_1: $396.62 BCBS_-REC — BAR_1: $396.62 BCBS_-SW — BAS_1: $396.62 BCBS__-PRO — BAP_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $396.62
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: Pt initial eval high complexity	$288	$187.20	$396.62
Physical therapy evaluation (high complexity): 10 of 291 insurance plan rates BCBS_-CLIN — BAC_1: $396.62 BCBS_-IP — BA_1: $396.62 BCBS_-OP — BAB_1: $396.62 BCBS_-REC — BAR_1: $396.62 BCBS_-SW — BAS_1: $396.62 BCBS__-PRO — BAP_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-CLIN — BMC_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-IP — BM_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-OP — BMB_1: $396.62 BCBS_AZ_METROPOLITAN_TRUST_AMT001_-PRO — BMP_1: $396.62
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Psychotherapy 30min w/pt	$249	$161.85	$87.19 – $472.87
Psychotherapy, 30 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $278.62 BCBS_-IP — BA_1: $278.62 BCBS_-OP — BAB_1: $278.62 BCBS_-REC — BAR_1: $278.62
Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: Psytx w pt 30 minutes	$249	$161.85	$87.19 – $472.87
Psychotherapy, 30 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $278.62 BCBS_-IP — BA_1: $278.62 BCBS_-OP — BAB_1: $278.62 BCBS_-REC — BAR_1: $278.62
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psycotherapy 45 min w/pt	$329	$213.85	$87.19 – $472.87
Psychotherapy, 45 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $417.91 BCBS_-IP — BA_1: $417.91 BCBS_-OP — BAB_1: $417.91 BCBS_-REC — BAR_1: $417.91
Psychotherapy, 45 minutes CPT 90834 · Inpatient or outpatient In the file: Psytx w pt 45 minutes	$329	$213.85	$87.19 – $472.87
Psychotherapy, 45 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $417.91 BCBS_-IP — BA_1: $417.91 BCBS_-OP — BAB_1: $417.91 BCBS_-REC — BAR_1: $417.91
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Psychotherapy 60min w/pt	$481	$312.65	$87.19 – $630.78
Psychotherapy, 60 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $630.78 BCBS_-IP — BA_1: $630.78 BCBS_-OP — BAB_1: $630.78 BCBS_-REC — BAR_1: $630.78
Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: Psytx w pt 60 minutes	$481	$312.65	$87.19 – $630.78
Psychotherapy, 60 minutes: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $630.78 BCBS_-IP — BA_1: $630.78 BCBS_-OP — BAB_1: $630.78 BCBS_-REC — BAR_1: $630.78
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Family psytx w/pt 50 min	$285	$185.25	$87.19 – $636.63
Family psychotherapy, with the patient: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $636.63 BCBS_-IP — BA_1: $636.63 BCBS_-OP — BAB_1: $636.63 BCBS_-REC — BAR_1: $636.63
Family psychotherapy, with the patient CPT 90847 · Inpatient or outpatient In the file: Psychotherapy w/pt & fam 50 minutes	$285	$185.25	$87.19 – $636.63
Family psychotherapy, with the patient: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $96.88 AHCCCS_QMB_-IP — X9: $96.88 AHCCCS_QMB_-OP — X9B: $96.88 AHCCCS_QMB_-PRO — X9P: $96.88 AHCCCS_QMB_-REC — X9R: $96.88 AHCCCS_QMB_-SW — X9S: $96.88 BCBS_-CLIN — BAC_1: $636.63 BCBS_-IP — BA_1: $636.63 BCBS_-OP — BAB_1: $636.63 BCBS_-REC — BAR_1: $636.63

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: Fac exc breast lesion 1 or more	$2,351	$1,528.15	$2,060.42 – $4,520.49
Removal of breast growth (open surgery): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,289.36 AHCCCS_QMB_-IP — X9: $2,289.36 AHCCCS_QMB_-OP — X9B: $2,289.36 AHCCCS_QMB_-PRO — X9P: $2,289.36 AHCCCS_QMB_-REC — X9R: $2,289.36 AHCCCS_QMB_-SW — X9S: $2,289.36 BCBS_-CLIN — BAC_1: $3,733.52 BCBS_-IP — BA_1: $3,733.52 BCBS_-OP — BAB_1: $3,733.52 BCBS_-REC — BAR_1: $3,733.52
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: Removal of breast lesion	$2,351	$1,528.15	$2,060.42 – $4,520.49
Removal of breast growth (open surgery): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,289.36 AHCCCS_QMB_-IP — X9: $2,289.36 AHCCCS_QMB_-OP — X9B: $2,289.36 AHCCCS_QMB_-PRO — X9P: $2,289.36 AHCCCS_QMB_-REC — X9R: $2,289.36 AHCCCS_QMB_-SW — X9S: $2,289.36 BCBS_-CLIN — BAC_1: $3,733.52 BCBS_-IP — BA_1: $3,733.52 BCBS_-OP — BAB_1: $3,733.52 BCBS_-REC — BAR_1: $3,733.52
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient · modifier 26 In the file: Ex tumor breast open 1 or more	$1,888	$1,227.20	$2,060.42 – $4,520.49
Removal of breast growth (open surgery): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,289.36 AHCCCS_QMB_-IP — X9: $2,289.36 AHCCCS_QMB_-OP — X9B: $2,289.36 AHCCCS_QMB_-PRO — X9P: $2,289.36 AHCCCS_QMB_-REC — X9R: $2,289.36 AHCCCS_QMB_-SW — X9S: $2,289.36 BCBS_-CLIN — BAC_1: $3,733.52 BCBS_-IP — BA_1: $3,733.52 BCBS_-OP — BAB_1: $3,733.52 BCBS_-REC — BAR_1: $3,733.52
Total hip replacement CPT 27130 · Inpatient or outpatient In the file: Total hip arthroplasty	$113,165.69	$73,557.70	$8,035.38 – $50,433.20
Total hip replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $50,433.20 BCBS_-IP — BA_1: $50,433.20 BCBS_-OP — BAB_1: $50,433.20 BCBS_-REC — BAR_1: $50,433.20
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier LT In the file: Total hip arthroplasty	$104,471.83	$67,906.69	$8,035.38 – $50,433.20
Total hip replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $50,433.20 BCBS_-IP — BA_1: $50,433.20 BCBS_-OP — BAB_1: $50,433.20 BCBS_-REC — BAR_1: $50,433.20
Total hip replacement CPT 27130 · Inpatient or outpatient · modifier RT In the file: Total hip arthroplasty	$113,165.69	$73,557.70	$8,035.38 – $50,433.20
Total hip replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $50,433.20 BCBS_-IP — BA_1: $50,433.20 BCBS_-OP — BAB_1: $50,433.20 BCBS_-REC — BAR_1: $50,433.20
Total knee replacement CPT 27447 · Inpatient or outpatient In the file: Total knee arthroplasty	$118,930.57	$77,304.87	$8,035.38 – $52,519.44
Total knee replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $52,519.44 BCBS_-IP — BA_1: $52,519.44 BCBS_-OP — BAB_1: $52,519.44 BCBS_-REC — BAR_1: $52,519.44
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier LT In the file: Total knee arthroplasty	$113,899.45	$74,034.64	$8,035.38 – $52,519.44
Total knee replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $52,519.44 BCBS_-IP — BA_1: $52,519.44 BCBS_-OP — BAB_1: $52,519.44 BCBS_-REC — BAR_1: $52,519.44
Total knee replacement CPT 27447 · Inpatient or outpatient · modifier RT In the file: Total knee arthroplasty	$115,429.35	$75,029.08	$8,035.38 – $52,519.44
Total knee replacement: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $8,928.20 AHCCCS_QMB_-IP — X9: $8,928.20 AHCCCS_QMB_-OP — X9B: $8,928.20 AHCCCS_QMB_-PRO — X9P: $8,928.20 AHCCCS_QMB_-REC — X9R: $8,928.20 AHCCCS_QMB_-SW — X9S: $8,928.20 BCBS_-CLIN — BAC_1: $52,519.44 BCBS_-IP — BA_1: $52,519.44 BCBS_-OP — BAB_1: $52,519.44 BCBS_-REC — BAR_1: $52,519.44
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: Shoulder arthroscopy/surgery	$76,430.18	$49,679.62	$1,832.62 – $6,381.44
Shoulder arthroscopy: shaving of shoulder bone: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,036.24 AHCCCS_QMB_-IP — X9: $2,036.24 AHCCCS_QMB_-OP — X9B: $2,036.24 AHCCCS_QMB_-PRO — X9P: $2,036.24 AHCCCS_QMB_-REC — X9R: $2,036.24 AHCCCS_QMB_-SW — X9S: $2,036.24 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier LT In the file: Shoulder arthroscopy/surgery	$53,124.16	$34,530.70	$1,832.62 – $6,381.44
Shoulder arthroscopy: shaving of shoulder bone: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,036.24 AHCCCS_QMB_-IP — X9: $2,036.24 AHCCCS_QMB_-OP — X9B: $2,036.24 AHCCCS_QMB_-PRO — X9P: $2,036.24 AHCCCS_QMB_-REC — X9R: $2,036.24 AHCCCS_QMB_-SW — X9S: $2,036.24 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient · modifier RT In the file: Shoulder arthroscopy/surgery	$67,759.89	$44,043.93	$1,832.62 – $6,381.44
Shoulder arthroscopy: shaving of shoulder bone: 10 of 315 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,036.24 AHCCCS_QMB_-IP — X9: $2,036.24 AHCCCS_QMB_-OP — X9B: $2,036.24 AHCCCS_QMB_-PRO — X9P: $2,036.24 AHCCCS_QMB_-REC — X9R: $2,036.24 AHCCCS_QMB_-SW — X9S: $2,036.24 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: Knee arthroscopy/surgery	$29,126.51	$18,932.23	$1,846.84 – $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,052.04 AHCCCS_QMB_-IP — X9: $2,052.04 AHCCCS_QMB_-OP — X9B: $2,052.04 AHCCCS_QMB_-PRO — X9P: $2,052.04 AHCCCS_QMB_-REC — X9R: $2,052.04 AHCCCS_QMB_-SW — X9S: $2,052.04 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier LT In the file: Knee arthroscopy/surgery	$25,128.90	$16,333.79	$1,846.84 – $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,052.04 AHCCCS_QMB_-IP — X9: $2,052.04 AHCCCS_QMB_-OP — X9B: $2,052.04 AHCCCS_QMB_-PRO — X9P: $2,052.04 AHCCCS_QMB_-REC — X9R: $2,052.04 AHCCCS_QMB_-SW — X9S: $2,052.04 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient · modifier RT In the file: Knee arthroscopy/surgery	$29,126.51	$18,932.23	$1,846.84 – $6,381.44
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,052.04 AHCCCS_QMB_-IP — X9: $2,052.04 AHCCCS_QMB_-OP — X9B: $2,052.04 AHCCCS_QMB_-PRO — X9P: $2,052.04 AHCCCS_QMB_-REC — X9R: $2,052.04 AHCCCS_QMB_-SW — X9S: $2,052.04 BCBS_-CLIN — BAC_1: $6,381.44 BCBS_-IP — BA_1: $6,381.44 BCBS_-OP — BAB_1: $6,381.44 BCBS_-REC — BAR_1: $6,381.44
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: Egd diagnostic brush wash	$11,391.37	$7,404.39	$528.26 – $2,435.52
Upper GI endoscopy (diagnostic): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $586.96 AHCCCS_QMB_-IP — X9: $586.96 AHCCCS_QMB_-OP — X9B: $586.96 AHCCCS_QMB_-PRO — X9P: $586.96 AHCCCS_QMB_-REC — X9R: $586.96 AHCCCS_QMB_-SW — X9S: $586.96 BCBS_-CLIN — BAC_1: $2,435.52 BCBS_-IP — BA_1: $2,435.52 BCBS_-OP — BAB_1: $2,435.52 BCBS_-REC — BAR_1: $2,435.52
Upper GI endoscopy with biopsy CPT 43239 · Inpatient (hospital stay) In the file: Egd biopsy single/multiple	$32,335.67	$21,018.19	$528.26 – $3,261.52
Upper GI endoscopy with biopsy: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $586.96 AHCCCS_QMB_-IP — X9: $586.96 AHCCCS_QMB_-OP — X9B: $586.96 AHCCCS_QMB_-PRO — X9P: $586.96 AHCCCS_QMB_-REC — X9R: $586.96 AHCCCS_QMB_-SW — X9S: $586.96 BCBS_-CLIN — BAC_1: $3,261.52 BCBS_-IP — BA_1: $3,261.52 BCBS_-OP — BAB_1: $3,261.52 BCBS_-REC — BAR_1: $3,261.52
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Egd biopsy single/multiple	$14,590.32	$9,483.71	$528.26 – $3,261.52
Upper GI endoscopy with biopsy: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $586.96 AHCCCS_QMB_-IP — X9: $586.96 AHCCCS_QMB_-OP — X9B: $586.96 AHCCCS_QMB_-PRO — X9P: $586.96 AHCCCS_QMB_-REC — X9R: $586.96 AHCCCS_QMB_-SW — X9S: $586.96 BCBS_-CLIN — BAC_1: $3,261.52 BCBS_-IP — BA_1: $3,261.52 BCBS_-OP — BAB_1: $3,261.52 BCBS_-REC — BAR_1: $3,261.52
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: Diagnostic colonoscopy	$11,865.29	$7,712.44	$517.86 – $3,261.52
Colonoscopy (diagnostic): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $575.40 AHCCCS_QMB_-IP — X9: $575.40 AHCCCS_QMB_-OP — X9B: $575.40 AHCCCS_QMB_-PRO — X9P: $575.40 AHCCCS_QMB_-REC — X9R: $575.40 AHCCCS_QMB_-SW — X9S: $575.40 BCBS_-CLIN — BAC_1: $3,261.52 BCBS_-IP — BA_1: $3,261.52 BCBS_-OP — BAB_1: $3,261.52 BCBS_-REC — BAR_1: $3,261.52
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: Colonoscopy and biopsy	$15,289.63	$9,938.26	$676.62 – $3,561.57
Colonoscopy with biopsy: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $751.80 AHCCCS_QMB_-IP — X9: $751.80 AHCCCS_QMB_-OP — X9B: $751.80 AHCCCS_QMB_-PRO — X9P: $751.80 AHCCCS_QMB_-REC — X9R: $751.80 AHCCCS_QMB_-SW — X9S: $751.80 BCBS_-CLIN — BAC_1: $3,561.57 BCBS_-IP — BA_1: $3,561.57 BCBS_-OP — BAB_1: $3,561.57 BCBS_-REC — BAR_1: $3,561.57
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: Colonoscopy w/lesion removal	$15,954.33	$10,370.31	$676.62 – $3,561.57
Colonoscopy with removal of polyps (snare): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $751.80 AHCCCS_QMB_-IP — X9: $751.80 AHCCCS_QMB_-OP — X9B: $751.80 AHCCCS_QMB_-PRO — X9P: $751.80 AHCCCS_QMB_-REC — X9R: $751.80 AHCCCS_QMB_-SW — X9S: $751.80 BCBS_-CLIN — BAC_1: $3,561.57 BCBS_-IP — BA_1: $3,561.57 BCBS_-OP — BAB_1: $3,561.57 BCBS_-REC — BAR_1: $3,561.57
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient In the file: Colon ca scrn not hi rsk ind	$12,727.01	$8,272.56	$517.86 – $3,261.52
Screening colonoscopy (not high risk): 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $575.40 AHCCCS_QMB_-IP — X9: $575.40 AHCCCS_QMB_-OP — X9B: $575.40 AHCCCS_QMB_-PRO — X9P: $575.40 AHCCCS_QMB_-REC — X9R: $575.40 AHCCCS_QMB_-SW — X9S: $575.40 BCBS_-CLIN — BAC_1: $3,261.52 BCBS_-IP — BA_1: $3,261.52 BCBS_-OP — BAB_1: $3,261.52 BCBS_-REC — BAR_1: $3,261.52
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: Laparoscopic cholecystectomy	$42,284.84	$27,485.15	$3,301.94 – $9,794
Gallbladder removal by laparoscope: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $3,668.82 AHCCCS_QMB_-IP — X9: $3,668.82 AHCCCS_QMB_-OP — X9B: $3,668.82 AHCCCS_QMB_-PRO — X9P: $3,668.82 AHCCCS_QMB_-REC — X9R: $3,668.82 AHCCCS_QMB_-SW — X9S: $3,668.82 BCBS_-CLIN — BAC_1: $9,794 BCBS_-IP — BA_1: $9,794 BCBS_-OP — BAB_1: $9,794 BCBS_-REC — BAR_1: $9,794
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: Prp i/hern init reduc >5 yr	$47,629.83	$30,959.39	$2,077.17 – $4,611.44
Groin (inguinal) hernia repair, age 5 or older: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,307.97 AHCCCS_QMB_-IP — X9: $2,307.97 AHCCCS_QMB_-OP — X9B: $2,307.97 AHCCCS_QMB_-PRO — X9P: $2,307.97 AHCCCS_QMB_-REC — X9R: $2,307.97 AHCCCS_QMB_-SW — X9S: $2,307.97 BCBS_-CLIN — BAC_1: $4,611.44 BCBS_-IP — BA_1: $4,611.44 BCBS_-OP — BAB_1: $4,611.44 BCBS_-REC — BAR_1: $4,611.44
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier 50 In the file: Prp i/hern init reduc >5 yr	$47,629.83	$30,959.39	$2,077.17 – $4,611.44
Groin (inguinal) hernia repair, age 5 or older: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,307.97 AHCCCS_QMB_-IP — X9: $2,307.97 AHCCCS_QMB_-OP — X9B: $2,307.97 AHCCCS_QMB_-PRO — X9P: $2,307.97 AHCCCS_QMB_-REC — X9R: $2,307.97 AHCCCS_QMB_-SW — X9S: $2,307.97 BCBS_-CLIN — BAC_1: $4,611.44 BCBS_-IP — BA_1: $4,611.44 BCBS_-OP — BAB_1: $4,611.44 BCBS_-REC — BAR_1: $4,611.44
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier LT In the file: Prp i/hern init reduc >5 yr	$35,485.66	$23,065.68	$2,077.17 – $4,611.44
Groin (inguinal) hernia repair, age 5 or older: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $2,307.97 AHCCCS_QMB_-IP — X9: $2,307.97 AHCCCS_QMB_-OP — X9B: $2,307.97 AHCCCS_QMB_-PRO — X9P: $2,307.97 AHCCCS_QMB_-REC — X9R: $2,307.97 AHCCCS_QMB_-SW — X9S: $2,307.97 BCBS_-CLIN — BAC_1: $4,611.44 BCBS_-IP — BA_1: $4,611.44 BCBS_-OP — BAB_1: $4,611.44 BCBS_-REC — BAR_1: $4,611.44
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: Njx interlaminar lmbr/sac	$8,842.52	$5,747.64	$414.07 – $2,236.24
Spinal injection, lower back (epidural), with imaging guidance: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $460.08 AHCCCS_QMB_-IP — X9: $460.08 AHCCCS_QMB_-OP — X9B: $460.08 AHCCCS_QMB_-PRO — X9P: $460.08 AHCCCS_QMB_-REC — X9R: $460.08 AHCCCS_QMB_-SW — X9S: $460.08 BCBS_-CLIN — BAC_1: $2,236.24 BCBS_-IP — BA_1: $2,236.24 BCBS_-OP — BAB_1: $2,236.24 BCBS_-REC — BAR_1: $2,236.24
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · modifier LT In the file: Njx interlaminar lmbr/sac	$5,048.25	$3,281.36	$414.07 – $2,236.24
Spinal injection, lower back (epidural), with imaging guidance: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $460.08 AHCCCS_QMB_-IP — X9: $460.08 AHCCCS_QMB_-OP — X9B: $460.08 AHCCCS_QMB_-PRO — X9P: $460.08 AHCCCS_QMB_-REC — X9R: $460.08 AHCCCS_QMB_-SW — X9S: $460.08 BCBS_-CLIN — BAC_1: $2,236.24 BCBS_-IP — BA_1: $2,236.24 BCBS_-OP — BAB_1: $2,236.24 BCBS_-REC — BAR_1: $2,236.24
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: Inj foramen epidural l/s	$9,644.34	$6,268.82	$536.65 – $1,704.86
Nerve root injection, lower back, with imaging guidance: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $596.28 AHCCCS_QMB_-IP — X9: $596.28 AHCCCS_QMB_-OP — X9B: $596.28 AHCCCS_QMB_-PRO — X9P: $596.28 AHCCCS_QMB_-REC — X9R: $596.28 AHCCCS_QMB_-SW — X9S: $596.28 BCBS_-CLIN — BAC_1: $1,704.86 BCBS_-IP — BA_1: $1,704.86 BCBS_-OP — BAB_1: $1,704.86 BCBS_-REC — BAR_1: $1,704.86
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier LT In the file: Inj foramen epidural l/s	$9,606.80	$6,244.42	$536.65 – $1,704.86
Nerve root injection, lower back, with imaging guidance: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $596.28 AHCCCS_QMB_-IP — X9: $596.28 AHCCCS_QMB_-OP — X9B: $596.28 AHCCCS_QMB_-PRO — X9P: $596.28 AHCCCS_QMB_-REC — X9R: $596.28 AHCCCS_QMB_-SW — X9S: $596.28 BCBS_-CLIN — BAC_1: $1,704.86 BCBS_-IP — BA_1: $1,704.86 BCBS_-OP — BAB_1: $1,704.86 BCBS_-REC — BAR_1: $1,704.86
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient · modifier RT In the file: Inj foramen epidural l/s	$9,644.34	$6,268.82	$536.65 – $1,704.86
Nerve root injection, lower back, with imaging guidance: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $596.28 AHCCCS_QMB_-IP — X9: $596.28 AHCCCS_QMB_-OP — X9B: $596.28 AHCCCS_QMB_-PRO — X9P: $596.28 AHCCCS_QMB_-REC — X9R: $596.28 AHCCCS_QMB_-SW — X9S: $596.28 BCBS_-CLIN — BAC_1: $1,704.86 BCBS_-IP — BA_1: $1,704.86 BCBS_-OP — BAB_1: $1,704.86 BCBS_-REC — BAR_1: $1,704.86
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: Carpal tunnel surgery	$16,178.43	$10,515.98	$1,144.74 – $4,502.88
Carpal tunnel release: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $1,271.93 AHCCCS_QMB_-IP — X9: $1,271.93 AHCCCS_QMB_-OP — X9B: $1,271.93 AHCCCS_QMB_-PRO — X9P: $1,271.93 AHCCCS_QMB_-REC — X9R: $1,271.93 AHCCCS_QMB_-SW — X9S: $1,271.93 BCBS_-CLIN — BAC_1: $4,502.88 BCBS_-IP — BA_1: $4,502.88 BCBS_-OP — BAB_1: $4,502.88 BCBS_-REC — BAR_1: $4,502.88
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier LT In the file: Carpal tunnel surgery	$16,000.18	$10,400.12	$1,144.74 – $4,502.88
Carpal tunnel release: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $1,271.93 AHCCCS_QMB_-IP — X9: $1,271.93 AHCCCS_QMB_-OP — X9B: $1,271.93 AHCCCS_QMB_-PRO — X9P: $1,271.93 AHCCCS_QMB_-REC — X9R: $1,271.93 AHCCCS_QMB_-SW — X9S: $1,271.93 BCBS_-CLIN — BAC_1: $4,502.88 BCBS_-IP — BA_1: $4,502.88 BCBS_-OP — BAB_1: $4,502.88 BCBS_-REC — BAR_1: $4,502.88
Carpal tunnel release CPT 64721 · Inpatient or outpatient · modifier RT In the file: Carpal tunnel surgery	$16,178.43	$10,515.98	$1,144.74 – $4,502.88
Carpal tunnel release: 10 of 345 insurance plan rates AHCCCS_QMB_-CLIN — X9C: $1,271.93 AHCCCS_QMB_-IP — X9: $1,271.93 AHCCCS_QMB_-OP — X9B: $1,271.93 AHCCCS_QMB_-PRO — X9P: $1,271.93 AHCCCS_QMB_-REC — X9R: $1,271.93 AHCCCS_QMB_-SW — X9S: $1,271.93 BCBS_-CLIN — BAC_1: $4,502.88 BCBS_-IP — BA_1: $4,502.88 BCBS_-OP — BAB_1: $4,502.88 BCBS_-REC — BAR_1: $4,502.88

Source: Wickenburg Community Hospital’s standard charges file (cdn.accureg.net, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on October 29, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	520 Rose Lane, Wickenburg, AZ 85390
County	Maricopa County
State	Arizona
Phone	(928) 684‑5421
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	Not rated by CMS
CMS Certification Number	031300
Name in Medicare records	WICKENBURG COMMUNITY HOSPITAL
Profile level	Medicare data + hospital website
Official website	wickhosp.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Hospital Services — wickhosp.com
Wickenburg Community Hospital & Clinics — wickhosp.com
Wickenburg Community Hospital & Clinics — wickhosp.com
Wickenburg Community Hospital & Clinics — wickhosp.com
Wickenburg Community Hospital & Clinics — wickhosp.com

Wickenburg Community Hospital

Summary

Profile from official sources

At a glance