▸ Hospital · AZ · CCN 030068
Mt. Graham Regional Medical Center
1600 TWENTIETH AVENUE, SAFFORD, AZ, 85548-
25 beds2
Compliance grade
A
100/100
Procedures tracked
154
of 209 target codes
Payers
30
with negotiated rates
Rates published
36,695
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 4 | — | $248.5 | $248.5 | $340.8 | $29,221 |
| Psychotherapy 30 minutes | CPT | 90832 | 1 | $263 | — | $263 | $263 | $263 |
| Psychotherapy 45 minutes | CPT | 90834 | 1 | $206 | — | $206 | $206 | $206 |
| Psychotherapy 60 minutes | CPT | 90837 | 1 | $302 | — | $302 | $302 | $302 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 9 | $530 | $141.4 | $50.4 | $450.98 | $43,770 |
| ED visit level 2 | CPT | 99282 | 15 | $2,300 | $279.3 | $67.2 | $525.18 | $40,909 |
| ED visit level 3 | CPT | 99283 | 23 | $33,119 | $383.6 | $142.8 | $784.55 | $40,909 |
| ED visit level 4 | CPT | 99284 | 29 | $13,643 | $636.3 | $237.3 | $1,195.59 | $43,770 |
| ED visit level 5 | CPT | 99285 | 15 | $27,689 | $978.6 | $469 | $1,994.79 | $43,770 |
| Critical care, first hour | CPT | 99291 | 10 | $31,152 | $1,675.8 | $1,055.6 | $1,508 | $40,909 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 17 | $4,392 | $1,187.2 | $878 | $1,696 | $29,221 |
| CT head with contrast | CPT | 70460 | 5 | $2,366 | $1,306.2 | $946 | $1,791.36 | $43,770 |
| CT head with and without contrast | CPT | 70470 | 5 | $2,772 | $1,590.4 | $1,109 | $2,181.12 | $43,770 |
| CT neck with contrast | CPT | 70491 | 12 | $2,477 | $1,383.9 | $991 | $2,477 | $43,770 |
| MRI brain without contrast | CPT | 70551 | 9 | $3,181 | $307.68 | $1,272 | $3,181 | $43,770 |
| MRI brain with contrast | CPT | 70552 | 4 | $3,411 | $504.15 | $2,037.7 | $2,794.56 | $43,770 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $4,285 | $504.15 | $1,701.7 | $4,035 | $43,770 |
| Chest X-ray single view | CPT | 71045 | 18 | $7,709.27 | $105.38 | $122 | $305.5 | $29,221 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $2,619.4 | $105.38 | $137 | $343.2 | $29,221 |
| Chest X-ray 3 views | CPT | 71047 | 4 | — | $105.38 | $195.3 | $267.84 | $29,221 |
| CT chest without contrast | CPT | 71250 | 8 | $3,102 | $1,201.2 | $886 | $1,716 | $43,770 |
| CT chest with contrast | CPT | 71260 | 14 | $5,208 | $1,472.8 | $1,042 | $2,604 | $43,770 |
| CT chest with and without contrast | CPT | 71270 | 5 | $3,031 | $1,771.7 | $1,212 | $2,531 | $43,770 |
| MRI chest without contrast | CPT | 71550 | 5 | $2,783 | $307.68 | $1,113 | $2,191.68 | $43,770 |
| MRI chest with contrast | CPT | 71551 | 4 | — | $898.87 | $2,062.2 | $2,828.16 | $29,221 |
| MRI chest with and without contrast | CPT | 71552 | 4 | — | $504.15 | $2,417.8 | $3,315.84 | $43,770 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $492.7 | $147.98 | $197 | $492.7 | $43,770 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $4,433.75 | $1,378.3 | $988 | $2,469 | $43,770 |
| CT thoracic spine without contrast | CPT | 72128 | 8 | $2,407 | $1,334.9 | $963 | $1,907 | $43,770 |
| CT lumbar spine without contrast | CPT | 72131 | 10 | $2,456 | $1,369.2 | $982 | $2,206 | $43,770 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $3,211 | $307.68 | $1,284 | $3,211 | $43,770 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $3,195 | $307.68 | $1,278 | $3,195 | $43,770 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $4,508 | $307.68 | $1,288 | $2,970 | $43,770 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 4 | $3,443 | $504.15 | $2,060.1 | $2,825.28 | $43,770 |
| MRI cervical spine with and without contrast | CPT | 72156 | 5 | $4,265 | $504.15 | $1,706 | $3,614.4 | $43,770 |
| MRI lumbar spine with contrast | CPT | 72158 | 6 | $4,274 | $504.15 | $1,710 | $3,623.04 | $43,770 |
| CT pelvis without contrast | CPT | 72192 | 6 | $2,290 | $1,253 | $916 | $1,646.8 | $29,221 |
| CT pelvis with contrast | CPT | 72193 | 5 | $2,517 | $1,411.9 | $1,007 | $1,936.32 | $43,770 |
| Shoulder X-ray | CPT | 73030 | 12 | $852.8 | $105.38 | $34 | $400 | $43,770 |
| Humerus X-ray | CPT | 73060 | 9 | $782.6 | $105.38 | $157 | $301 | $43,770 |
| Hand X-ray 3 views | CPT | 73130 | 14 | $1,152 | $105.38 | $170 | $423.8 | $43,770 |
| MRI upper extremity joint without contrast | CPT | 73221 | 7 | $3,082 | $307.68 | $1,233 | $2,832 | $43,770 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 5 | $3,951 | $504.15 | $1,580 | $3,312.96 | $43,770 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $543.4 | $105.38 | $148 | $288.8 | $43,770 |
| Ankle X-ray 3 views | CPT | 73610 | 13 | $832 | $105.38 | $166 | $320 | $43,770 |
| MRI lower extremity joint without contrast | CPT | 73721 | 9 | $6,154 | $307.68 | $1,231 | $3,077 | $43,770 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 6 | $3,894 | $504.15 | $1,558 | $3,122.48 | $43,770 |
| CT abdomen without contrast | CPT | 74150 | 5 | $2,259 | $1,231.3 | $904 | $1,688.64 | $43,770 |
| CT abdomen with contrast | CPT | 74160 | 5 | $2,652 | $1,506.4 | $1,061 | $1,979.84 | $43,770 |
| CT abdomen with and without contrast | CPT | 74170 | 5 | $2,990 | $1,743 | $1,196 | $2,390.4 | $29,221 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $3,622 | $307.68 | $1,449 | $2,872.24 | $43,770 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 19 | $8,326 | $504.15 | $1,665 | $4,163 | $43,770 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 8 | $4,596 | $2,867.2 | $1,838 | $3,932.16 | $43,770 |
| MRI abdomen without contrast | CPT | 74181 | 6 | $3,147 | $307.68 | $1,259 | $2,435.24 | $43,770 |
| MRI abdomen with and without contrast | CPT | 74183 | 8 | $4,258 | $504.15 | $1,703 | $4,008 | $43,770 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,105 | $147.98 | $309.4 | $1,105 | $43,770 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $1,762.8 | $474.6 | $105 | $692 | $43,770 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 4 | — | $147.98 | $515.9 | $707.52 | $43,770 |
| Obstetric ultrasound first trimester | CPT | 76801 | 10 | $1,734.2 | $147.98 | $347 | $767.05 | $43,770 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 9 | $1,003.6 | $147.98 | $280 | $280 | $43,770 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 5 | $1,112.8 | $307.68 | $445 | $821.76 | $43,770 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $791.7 | $147.98 | $242 | $317 | $43,770 |
| Pelvic ultrasound complete | CPT | 76856 | 10 | $910 | $147.98 | $364 | $910 | $43,770 |
| Scrotal ultrasound | CPT | 76870 | 10 | $1,739.4 | $147.98 | $348 | $869.7 | $43,770 |
| Diagnostic mammography unilateral | CPT | 77065 | 7 | $419.9 | $118.08 | $168 | $371.45 | $42,736 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $474.5 | $150.54 | $190 | $474.5 | $43,770 |
| Screening mammography bilateral | CPT | 77067 | 11 | $876.2 | $124.84 | $175 | $438.1 | $42,736 |
| EKG complete | CPT | 93000 | 2 | $141.2 | — | $32 | $70.6 | $109.2 |
| EKG tracing only | CPT | 93005 | 20 | $3,850 | $154 | $46.8 | $440 | $43,770 |
| EKG interpretation only | CPT | 93010 | 19 | $597.79 | $31.5 | $22.4 | $32 | $29,221 |
| Transthoracic echocardiogram complete | CPT | 93306 | 10 | $3,647 | $635.82 | $98 | $1,094 | $43,770 |
| Transthoracic echocardiogram | CPT | 93307 | 4 | — | $307.68 | $137.9 | $1,372.95 | $43,770 |
| Stress echocardiogram | CPT | 93350 | 4 | — | $635.82 | $210 | $683.9 | $43,770 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 1 | $19,724 | — | $5,614.57 | $5,614.57 | $5,614.57 |
| COPD w MCC | MS-DRG | 190 | 1 | $97,641 | — | $32,672 | $32,672 | $32,672 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 0 | $24,719 | — | — | — | — |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 0 | $56,694 | — | — | — | — |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 0 | $68,104 | — | — | — | — |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 1 | $9,641.18 | — | $9,641.18 | $9,641.18 | $9,641.18 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 1 | $65,844 | — | $65,844 | $65,844 | $65,844 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 1 | $41,718 | — | $5,218.68 | $25,459 | $41,718 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 1 | $12,050 | — | $4,177.58 | $8,113.66 | $12,050 |
| Initial hospital care, low complexity | CPT | 99221 | 6 | $479.09 | $129.5 | $129.5 | $479.09 | $40,909 |
| Initial hospital care, moderate complexity | CPT | 99222 | 10 | $487.64 | $182 | $133 | $487.64 | $43,617 |
| Initial hospital care, high complexity | CPT | 99223 | 12 | $496.33 | $266 | $147 | $496.33 | $43,617 |
| Hospital discharge, <30 min | CPT | 99238 | 6 | $146 | $98 | $98 | $146 | $40,909 |
| Hospital discharge, >30 min | CPT | 99239 | 11 | $200 | $140 | $140 | $200 | $40,909 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $828 | $96.6 | $96.6 | $138 | $43,770 |
| General health panel | CPT | 80050 | 4 | $466 | $208.6 | $208.6 | $286.08 | $43,770 |
| Electrolyte panel | CPT | 80051 | 6 | $85 | $59.5 | $59.5 | $85 | $43,770 |
| Comprehensive metabolic panel | CPT | 80053 | 23 | $1,116 | $130.2 | $130.2 | $186 | $43,770 |
| Lipid panel | CPT | 80061 | 12 | $828 | $95.9 | $85.56 | $137 | $43,770 |
| Renal function panel | CPT | 80069 | 8 | $158 | $110.6 | $110.6 | $158 | $43,770 |
| Hepatic function panel | CPT | 80076 | 8 | $145 | $101.5 | $101.5 | $145 | $43,770 |
| Urinalysis non-automated | CPT | 81002 | 6 | $261 | — | $10 | $10 | $20 |
| Urinalysis automated | CPT | 81003 | 18 | $1,368 | $32.2 | $32.2 | $46 | $43,770 |
| Glucose quantitative | CPT | 82947 | 5 | $96 | $33.6 | $33.6 | $48 | $43,770 |
| Hemoglobin A1c | CPT | 83036 | 11 | $197 | $66.5 | $66.5 | $95 | $43,770 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $626.96 | $102.2 | $101.89 | $146 | $43,770 |
| Complete blood count with automated differential | CPT | 85025 | 23 | $5,222.64 | $67.9 | $67.9 | $97 | $43,770 |
| Complete blood count without differential | CPT | 85027 | 11 | $569 | $60.2 | $60.2 | $86 | $43,770 |
| Urine culture identification | CPT | 87088 | 15 | $156 | $54.6 | $54.6 | $78 | $43,770 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $4,224 | $184.8 | $184.8 | $528 | $43,770 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 8 | $1,796 | $314.3 | $314.3 | $898 | $43,770 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 3 | $4,220 | — | $2,532 | $4,220 | $4,220 |
| Vaginal delivery only | CPT | 59409 | 5 | $1,632 | $2,559.2 | $1,431.5 | $2,302.1 | $43,770 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | $2,090 | — | $2,090 | $2,090 | $2,090 |
| Routine obstetric care with C-section | CPT | 59510 | 2 | $4,674 | — | $4,674 | $4,674 | $4,674 |
| C-section delivery only | CPT | 59514 | 5 | $1,838 | $1,305.63 | $1,305.63 | $1,838 | $43,941 |
| C-section with postpartum | CPT | 59515 | 0 | $1,838 | — | — | — | — |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 0 | $62,801 | — | — | — | — |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $152 | — | $45.6 | $152 | $152 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $302.4 | — | $64.8 | $198.92 | $216 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | $489 | — | $98.4 | $302.52 | $373.33 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 5 | $556 | — | $123.6 | $380.44 | $556 |
| Office visit, established patient, 5 min | CPT | 99211 | 9 | $314 | $109.9 | $46 | $157 | $43,770 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 9 | $207 | $128.8 | $28.8 | $96 | $29,221 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 23 | $771 | $70 | $47.1 | $136.54 | $43,770 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 16 | $1,228 | — | $66.9 | $223 | $1,228 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $412 | — | $9.6 | $323 | $357 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 7 | $3,400 | $1,316 | $315 | $1,804.8 | $43,617 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $4,210.02 | $1,603.7 | $245 | $1,744.85 | $43,770 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 6 | $2,035 | $315 | $315 | $450 | $43,617 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | $2,160 | $731.5 | $315 | $731.5 | $43,617 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | $4,833.08 | $1,512 | $350 | $2,020 | $44,013 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $4,210 | $1,512 | $287 | $2,105 | $43,617 |
| Colonoscopy with polyp removal | CPT | 45385 | 8 | $2,310 | $287 | $287 | $1,080 | $43,617 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 3 | $13,204 | — | $660.83 | $1,400 | $10,884 |
| Total hip replacement | CPT | 27130 | 3 | $11,620 | — | $1,872.5 | $3,160 | $11,620 |
| Total knee replacement | CPT | 27447 | 6 | $11,486 | — | $4,023.49 | $4,423.49 | $10,149 |
| Knee revision arthroplasty all components | CPT | 27487 | 0 | $10,297 | — | — | — | — |
| Shoulder arthroscopy with decompression | CPT | 29826 | 2 | $4,190 | — | $703.69 | $758.26 | $2,280.25 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 2 | $5,493 | — | $1,954.5 | $3,865.75 | $4,332.31 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 2 | $4,954.5 | — | $1,841.38 | $2,595 | $4,303 |
| ACL reconstruction | CPT | 29888 | 1 | $8,677.5 | — | $2,200 | $2,745.68 | $3,909 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 1 | $176,948 | — | $63,929 | $120,439 | $176,948 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 1 | $37,027 | — | $37,027 | $37,027 | $37,027 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 1 | $71,312 | — | $71,312 | $71,312 | $71,312 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 1 | $31,900 | — | $31,900 | $31,900 | $31,900 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 0 | $28,042 | — | — | — | — |
| Open appendectomy | CPT | 44950 | 0 | $1,203.46 | — | — | — | — |
| Laparoscopic appendectomy | CPT | 44970 | 6 | $7,942 | — | $1,218 | $1,303 | $7,942 |
| Laparoscopic cholecystectomy | CPT | 47562 | 1 | $1,232.34 | — | $1,232.34 | $1,232.34 | $1,232.34 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 8 | $17,005 | $1,021.27 | $670.28 | $1,400.6 | $43,941 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 0 | $39,328 | — | — | — | — |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 0 | $20,366 | — | — | — | — |
| Lap inguinal hernia repair | CPT | 49650 | 2 | $5,212 | — | $802.1 | $1,679.46 | $4,560.5 |
| Vaginal hysterectomy | CPT | 58260 | 2 | $7,942 | — | $1,736.67 | $3,909 | $7,942 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 1 | $5,148.5 | — | $1,762 | $2,346.88 | $2,931.75 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 2 | $8,677.5 | — | $1,976 | $3,583.25 | $8,677.5 |
| Lap salpingo-oophorectomy | CPT | 58661 | 8 | $7,206.5 | $914.13 | $914.13 | $1,306 | $43,941 |
| PCI single major coronary artery | CPT | 92920 | 0 | $21,113 | — | — | — | — |
| PCI with drug-eluting stent | CPT | 92928 | 1 | $46,808 | — | $7,021 | $7,021 | $7,021 |
| Coronary angiography with bypass cath | CPT | 93458 | 1 | $49,114 | — | $7,367 | $7,367 | $24,557 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 126 | $487.64 |
| de-identified max | 104 | $506 |
| eff date | 104 | $43,770 |
| de-identified min | 104 | $385 |
| amount | 104 | $550 |
| Meritain Health | 88 | $522.59 |
| Humana | 83 | $487.64 |
| Aetna | 77 | $375.47 |
| arizona physicians ipa inc | 62 | $468.73 |
| summit administration services | 44 | $450 |
| Cigna | 24 | $510.76 |
| physicians mutual insurance co | 24 | $223 |
| Molina | 20 | $784.55 |
| Anthem BCBS | 18 | $186 |
| wmi mutual insurance company | 16 | $281.69 |
| dmba deseret alliance | 15 | $336.5 |
| assured benefits administrator | 12 | $412.75 |
| Blue Cross Blue Shield | 11 | $347 |
| wellpoint insurance company | 10 | $886.28 |
| allied benefit - aso | 9 | $348 |
| network health plans | 8 | $203 |
| ods health plan inc | 8 | $571.62 |
| apwu health plan | 7 | $136.54 |
| crum and forster | 7 | $186 |
| healthnow administrative servi | 7 | $301.5 |
| state of new mexico aso | 6 | $186 |
| ca medi-cal | 6 | $262.75 |
| albuquerque public schools aso | 6 | $220 |
| apricus | 6 | $2,332.5 |
| allied benefit - bpo | 3 | $166 |