Banner Ocotillo Medical Center
1405 S Alma School Rd, Chandler, AZ · Banner Health · · NPI 1972139004
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $2,052.04 – $3,741.03 | 6 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $3,741.03 – $8,928.20 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | $778.04 | $3,569.00 | $266.89 – $2,676.75 | 15 |
| Knee MRI (with contrast) CPT 73722 | $648.33 | $2,974.00 | $487.00 – $3,070.63 | 15 |
| Knee MRI (without contrast) CPT 73721 | $518.62 | $2,379.00 | $166.84 – $1,784.25 | 15 |
| Knee X-ray CPT 73564 | $138.88 | $448.00 | $79.00 – $467.28 | 15 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $105.40 | $340.00 | $58.65 – $347.17 | 15 |
| Knee X-ray (3 views, both knees) CPT 73562 | $124.00 | $400.00 | $58.65 – $347.17 | 15 |
| Knee X-ray (standing, both knees) CPT 73565 | $122.76 | $396.00 | $58.65 – $297.00 | 25 |
| Kras gene addl variants CPT 81276 | $176.90 | $580.00 | $193.25 – $435.00 | 25 |
| Kras gene variants exon 2 CPT 81275 | $284.26 | $932.00 | $193.25 – $699.00 | 25 |
| Lactate dehydrogenase (ldh) CPT 83615 | $32.73 | $167.00 | $6.04 – $14.25 | 25 |
| Lactic acid CPT 83605 | $29.99 | $153.00 | $11.57 – $26.25 | 25 |
| Lactoferrin fecal qualitative CPT 83630 | $19.21 | $98.00 | $19.70 – $54.75 | 25 |
| Lactoferrin fecal quant CPT 83631 | $39.98 | $204.00 | $19.63 – $153.00 | 25 |
| Laparo-asst vag hysterectomy CPT 58550 | not published | not published | $3,668.82 – $9,813.71 | 6 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $3,668.82 – $15,138.00 | 7 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | not published | not published | $3,668.82 – $3,741.03 | 6 |
| Laparoscopy aspiration CPT 49322 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Laparoscopy biopsy CPT 49321 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparoscopy lymphadenectomy CPT 38571 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparoscopy lymphadenectomy CPT 38572 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparoscopy lymph node biop CPT 38570 | not published | not published | $3,668.82 – $9,813.71 | 6 |
| Laparoscopy lysis CPT 58660 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparoscopy remove adnexa CPT 58661 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparo urethral suspension CPT 51990 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparo-vag hyst incl t/o CPT 58552 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparo-vag hyst w/t/o compl CPT 58554 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Lap ing hernia repair recur CPT 49651 | not published | not published | $3,668.82 – $7,292.89 | 6 |
| Lap insert tunnel ip cath CPT 49324 | not published | not published | $2,440.42 – $3,668.82 | 6 |
| Lap revision perm ip cath CPT 49325 | not published | not published | $2,440.42 – $3,668.82 | 6 |
| Laps abltj uterine fibroids CPT 58674 | not published | not published | $4,281.62 – $6,458.05 | 6 |
| Lap w/omentopexy add-on 49326 CPT 49326 | not published | not published | $1,220.21 – $2,632.61 | 6 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $420.78 | $933.00 | $124.40 – $4,018.00 | 15 |
| Laser surgery of prostate CPT 52648 | not published | not published | $3,200.08 – $9,813.71 | 6 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $3,741.03 – $3,741.03 | 1 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $8,677.91 | $30,664.00 | $539.00 – $6,221.80 | 15 |
| Lead capillary CPT 83655 | $15.48 | $79.00 | $12.11 – $27.75 | 25 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $8,677.91 | $30,664.00 | $539.00 – $2,021.25 | 15 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,579.06 | $19,714.00 | $539.00 – $7,475.97 | 15 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $543.13 | $2,073.00 | $166.84 – $1,554.75 | 25 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $540.60 | $2,040.00 | $129.45 – $1,530.00 | 15 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $432.48 | $1,632.00 | $79.00 – $1,224.00 | 15 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $544.96 | $2,080.00 | $166.84 – $1,560.00 | 25 |
| Leishmania antibody CPT 86717 | $12.84 | $37.00 | $12.25 – $27.75 | 25 |
| Lens, intraocular (new tech) HCPCS C1780 | $427.43 | $1,413.00 | $282.60 – $1,806.05 | 15 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $652.49 | $2,157.00 | $118.80 – $445.50 | 14 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $652.49 | $2,157.00 | $118.80 – $445.50 | 14 |
| Levetiracetam therapeutic drug level CPT 80177 | $12.35 | $63.00 | $13.25 – $30.00 | 25 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $1,529.80 | $7,649.00 | $2,101.79 – $5,736.75 | 25 |
| Liberta rc ipg HCPCS C1820 | $24,791.93 | $87,604.00 | $977.00 – $79,219.12 | 15 |
| Lidocaine therapeutic drug level CPT 80176 | $8.82 | $45.00 | $14.69 – $33.75 | 25 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $1,137,249.96 | $3,759,504.00 | $4.73 – $2,819,628.00 | 11 |
| Lipase CPT 83690 | $48.80 | $249.00 | $6.89 – $39.00 | 25 |
| Lipoprotein blood high res frac & quant CPT 83701 | $19.99 | $102.00 | $33.86 – $76.50 | 25 |
| Lipoprotein blood quant CPT 83704 | $20.19 | $103.00 | $34.19 – $77.25 | 25 |
| Lipoprotein direct measurement hdl CPT 83718 | $24.11 | $123.00 | $8.19 – $18.75 | 25 |
| Lipoprotein direct measurement ldl CPT 83721 | $18.42 | $94.00 | $10.50 – $24.00 | 25 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $20.19 | $103.00 | $34.19 – $77.25 | 25 |
| Lithium therapeutic drug level CPT 80178 | $10.19 | $52.00 | $6.61 – $39.00 | 25 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $3,471.20 | $17,356.00 | $1,063.14 – $13,017.00 | 13 |
| Liver Function Test CPT 80076 | $56.25 | $287.00 | $8.17 – $215.25 | 25 |
| Liver imaging CPT 78201 | $511.36 | $1,598.00 | $354.82 – $1,198.50 | 25 |
| Liver/spleen imag static only CPT 78215 | $468.48 | $1,464.00 | $273.41 – $1,098.00 | 25 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $2,052.04 – $3,741.03 | 6 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.68 | $2.24 | $0.45 – $6.95 | 15 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $123.76 | $467.00 | $79.00 – $350.25 | 25 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,030.85 | $3,890.00 | $129.45 – $2,917.50 | 25 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $859.13 | $3,242.00 | $266.89 – $2,431.50 | 25 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $687.14 | $2,593.00 | $79.00 – $1,944.75 | 25 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $518.52 | $3,626.00 | $266.89 – $2,719.50 | 25 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $432.15 | $3,022.00 | $266.89 – $2,266.50 | 25 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $345.63 | $2,417.00 | $166.84 – $1,812.75 | 25 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $136.71 | $441.00 | $79.00 – $330.75 | 25 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $155.93 | $503.00 | $79.00 – $377.25 | 25 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $184.76 | $596.00 | $79.00 – $447.00 | 25 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $97.96 | $316.00 | $58.65 – $347.17 | 15 |
| Low frequency non-thermal Ultrasound CPT 97610 | $58.41 | $298.00 | $42.94 – $241.00 | 13 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $33.38 | $642.00 | $191.73 – $547.63 | 25 |
| Lung function test (mbc/mvv) CPT 94200 | $11.75 | $226.00 | $40.35 – $169.50 | 25 |
| Lung Function Test (Spirometry) CPT 94010 | $26.42 | $508.00 | $101.17 – $381.00 | 25 |
| Lung perfusion imaging CPT 78580 | $499.52 | $1,561.00 | $273.41 – $1,170.75 | 25 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $689.28 | $2,154.00 | $354.82 – $1,615.50 | 25 |
| Lymphocyte transformation mitogen CPT 86353 | $51.36 | $148.00 | $49.03 – $111.00 | 25 |
| Macroscopic exam arthropod CPT 87168 | $4.37 | $13.00 | $4.27 – $9.75 | 25 |
| Macroscopic exam parasite CPT 87169 | $19.49 | $58.00 | $4.31 – $43.50 | 25 |
| Magnesium CPT 83735 | $25.87 | $132.00 | $6.70 – $15.75 | 25 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $0.01 | $0.42 | $0.08 – $2.51 | 15 |
| Mammosite ced HCPCS C1728 | $3,932.28 | $13,895.00 | $282.60 – $1,059.75 | 15 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $228.08 | $754.00 | $150.80 – $796.00 | 15 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,727.71 | $6,105.00 | $62.60 – $612.42 | 15 |
| M.avium-intra dna amp prob CPT 87561 | $35.62 | $106.00 | $35.09 – $79.50 | 25 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $12.35 | $63.00 | $14.46 – $47.25 | 25 |
| Mayo aathr protein s free CPT 85306 | $18.28 | $66.00 | $15.32 – $45.00 | 25 |
| Mayo activated protein c resistance assay CPT 85307 | $18.28 | $66.00 | $15.32 – $49.50 | 25 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $58.80 | $300.00 | $38.57 – $225.00 | 25 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.