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 |
|---|---|---|---|---|
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $360.57 | $1,654.00 | $166.84 – $1,346.00 | 15 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $540.86 | $2,481.00 | $266.89 – $1,860.75 | 15 |
| MRI upper extremity w/dye CPT 73219 | $450.82 | $2,068.00 | $266.89 – $1,580.51 | 15 |
| Mr safety determination physician/other qhp CPT 76016 | $41.85 | $135.00 | $45.36 – $154.85 | 25 |
| Mr safety implant elec prepj CPT 76018 | $64.17 | $207.00 | $66.55 – $161.42 | 25 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $59.83 | $193.00 | $38.60 – $144.75 | 14 |
| Mr safety implt pos&/immoblj CPT 76019 | $89.90 | $290.00 | $43.07 – $217.50 | 25 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $12.40 | $40.00 | $13.44 – $43.06 | 25 |
| Mr sfty med physics xm cstmz CPT 76017 | $168.64 | $544.00 | $175.25 – $425.09 | 25 |
| Mthfr gene analy common variants CPT 81291 | $96.08 | $315.00 | $65.34 – $147.75 | 25 |
| Mumps antibody igg CPT 86735 | $21.51 | $62.00 | $13.05 – $42.00 | 25 |
| Mycophenolic acid HCPCS J7518 | $0.09 | $2.59 | $0.37 – $2.46 | 15 |
| Mycoplasma antibody igm CPT 86738 | $19.08 | $55.00 | $13.24 – $41.25 | 25 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $258.03 | $846.00 | $175.40 – $634.50 | 25 |
| Myelogphy 2/> spine regions CPT 72270 | $837.93 | $2,703.00 | $354.62 – $2,027.25 | 25 |
| Myelography l-s spine CPT 72265 | $663.09 | $2,139.00 | $279.66 – $1,604.25 | 25 |
| Myelography neck spine CPT 72240 | $663.09 | $2,139.00 | $277.01 – $1,604.25 | 25 |
| Myelography thoracic spine CPT 72255 | $663.71 | $2,141.00 | $260.93 – $1,605.75 | 25 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $1,440.94 | $3,195.00 | $518.51 – $2,396.25 | 25 |
| Myelography via inj w/s&i cervical CPT 62302 | $1,027.83 | $2,279.00 | $518.51 – $1,709.25 | 25 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $959.28 | $2,127.00 | $518.51 – $1,595.25 | 25 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,142.83 | $2,534.00 | $518.51 – $1,900.50 | 25 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $38.42 | $135.00 | $11.53 – $26.25 | 25 |
| Natriuretic peptide CPT 83880 | $74.68 | $381.00 | $39.26 – $88.50 | 25 |
| Natural killer cells total count CPT 86357 | $39.56 | $114.00 | $37.73 – $85.50 | 25 |
| Ndl round specialty proguide HCPCS C1715 | $125.83 | $588.00 | $33.20 – $530.08 | 15 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $95.79 | $309.00 | $58.65 – $231.75 | 25 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $1,050.20 | $3,963.00 | $129.45 – $2,972.25 | 25 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $875.30 | $3,303.00 | $266.89 – $2,477.25 | 25 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $700.13 | $2,642.00 | $79.00 – $1,981.50 | 25 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $516.94 | $3,615.00 | $266.89 – $2,711.25 | 25 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $430.86 | $3,013.00 | $266.89 – $2,259.75 | 25 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $344.63 | $2,410.00 | $166.84 – $1,807.50 | 25 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $114.70 | $370.00 | $58.65 – $277.50 | 25 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $124.62 | $402.00 | $79.00 – $301.50 | 25 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $166.16 | $536.00 | $79.00 – $402.00 | 25 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $572.33 | $2,687.00 | $266.89 – $2,015.25 | 25 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $476.91 | $2,239.00 | $241.82 – $1,679.25 | 25 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $381.48 | $1,791.00 | $166.84 – $1,343.25 | 25 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $430.00 | $2,228.00 | $129.45 – $1,671.00 | 25 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $358.40 | $1,857.00 | $129.45 – $1,392.75 | 25 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $286.60 | $1,485.00 | $79.00 – $1,113.75 | 25 |
| Nerve teasing preparations CPT 88362 | $457.10 | $1,712.00 | $209.47 – $1,436.61 | 25 |
| Neuromatrix nerve cuff, cm HCPCS C9355 | $121.83 | $430.50 | $62.04 – $978.11 | 13 |
| Neuroplasty nerve of hand or foot 64704 CPT 64704 | not published | not published | $1,271.93 – $2,440.42 | 6 |
| New Patient Office Visit (level 2) CPT 99202 | $1,147.55 | $1,475.00 | $54.54 – $1,124.00 | 14 |
| New Patient Office Visit (level 3) CPT 99203 | $1,719.38 | $2,210.00 | $54.54 – $1,657.50 | 14 |
| New Patient Office Visit (level 4) CPT 99204 | $2,069.48 | $2,660.00 | $54.54 – $1,995.00 | 14 |
| New Patient Office Visit (level 5) CPT 99205 | $2,769.68 | $3,560.00 | $54.54 – $2,670.00 | 14 |
| Njx cath slct p-art angrp bi CPT 93573 | $539.80 | $2,699.00 | $210.56 – $12,389.00 | 14 |
| Njx cth slct p-art angrp uni CPT 93569 | $269.80 | $1,349.00 | $126.32 – $12,389.00 | 14 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,573.09 | $3,488.00 | $416.71 – $4,018.00 | 15 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $840.32 | $2,626.00 | $273.41 – $1,969.50 | 25 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $621.76 | $1,943.00 | $273.41 – $1,457.25 | 25 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $558.40 | $1,745.00 | $354.82 – $1,308.75 | 25 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $593.60 | $1,855.00 | $354.82 – $1,391.25 | 25 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $530.56 | $1,658.00 | $273.41 – $1,243.50 | 25 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $542.68 | $1,794.00 | $180.97 – $1,345.50 | 25 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $93.31 | $301.00 | $58.65 – $225.75 | 25 |
| Npm1 gene CPT 81310 | $362.34 | $1,188.00 | $246.52 – $891.00 | 25 |
| Nras gene variants exon 2&3 CPT 81311 | $270.84 | $888.00 | $295.79 – $666.00 | 25 |
| Nuclear Stress Test (Heart) CPT 78452 | $1,373.12 | $4,291.00 | $946.81 – $3,218.25 | 25 |
| Nudt15 gene common variants CPT 81306 | $428.22 | $1,404.00 | $291.36 – $656.25 | 25 |
| Observation direct referral from physician office for admission HCPCS G0379 | $275.33 | $654.00 | $30.00 – $1,078.19 | 25 |
| Observation per hour HCPCS G0378 | $36.40 | $130.00 | $26.00 – $10,759.00 | 15 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $174.44 | $445.00 | $79.00 – $333.75 | 25 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | $124.26 | $317.00 | $62.26 – $237.75 | 14 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $108.05 | $522.00 | $81.00 – $391.50 | 14 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $65.00 | $314.00 | $62.80 – $385.17 | 14 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $86.32 | $417.00 | $81.00 – $385.17 | 14 |
| Onco (ovar) five proteins CPT 81503 | $820.76 | $2,691.00 | $387.77 – $2,018.25 | 25 |
| Oncoprotein dcp CPT 83951 | $38.02 | $194.00 | $64.41 – $145.50 | 25 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $2,289.36 – $4,620.72 | 6 |
| Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 | not published | not published | $1,009.45 – $3,741.03 | 6 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $4,542.09 – $4,620.72 | 6 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $4,542.09 – $5,254.47 | 6 |
| Optx medial ankle fx CPT 27766 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $5,254.47 – $8,928.20 | 6 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $4,620.72 – $8,928.20 | 6 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $2,307.97 – $4,620.72 | 6 |
| Organic acids total quant ea spec CPT 83918 | $19.80 | $101.00 | $23.60 – $53.25 | 25 |
| Orthopantogram CPT 70355 | $90.52 | $292.00 | $34.67 – $219.00 | 25 |
| Oscillation chest wall mechanical per session CPT 94669 | $135.20 | $522.00 | $136.21 – $391.50 | 25 |
| Osmolality blood CPT 83930 | $10.98 | $56.00 | $6.61 – $42.00 | 25 |
| Osmolality urine CPT 83935 | $10.98 | $56.00 | $6.82 – $42.00 | 25 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $2,052.04 – $3,741.03 | 6 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $4,620.72 – $8,928.20 | 6 |
| Other immunoelectrophoresis CPT 86325 | $24.29 | $70.00 | $23.13 – $52.50 | 25 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $27.64 | $141.00 | $28.20 – $241.00 | 14 |
| Ot re-evaluation patient/family CPT 97168 | $56.30 | $272.00 | $54.40 – $254.59 | 14 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $29.86 | $126.00 | $25.20 – $241.00 | 14 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $33.65 | $142.00 | $28.40 – $241.00 | 14 |
| Palingen or palingen xplus HCPCS Q4173 | $64.07 | $226.40 | $24.19 – $2,078.33 | 13 |
| Palingen or promatrx HCPCS Q4174 | $354.63 | $1,253.10 | $155.87 – $1,579.51 | 13 |
| Parathormone (pth) intact CPT 83970 | $24.30 | $124.00 | $41.28 – $93.00 | 25 |
| Parathyrd planar w/spect&ct CPT 78072 | $870.72 | $2,721.00 | $354.82 – $2,040.75 | 25 |
| Parathyroid planar imaging CPT 78070 | $621.76 | $1,943.00 | $273.41 – $1,457.25 | 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.