Banner Page Hospital
501 North Navajo Drive, Page, AZ · Banner Health · · NPI 1578515789
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $49.37 | $88.00 | $29.28 – $83.60 | 28 |
| 17-hydroxypregnenolone CPT 84143 | $38.71 | $69.00 | $22.81 – $65.55 | 28 |
| 17-ketosteroids CPT 83586 | $44.88 | $80.00 | $12.80 – $76.00 | 28 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $122.24 | $244.00 | $82.76 – $231.80 | 27 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $736.82 | $1,330.00 | $451.14 – $1,263.50 | 28 |
| 3d recon without postprocess indpndt CPT 76376 | $89.94 | $146.00 | $6.19 – $77.38 | 28 |
| 5' nucleotidase - sendout CPT 83915 | $55.54 | $99.00 | $11.15 – $94.05 | 28 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $37.63 | $71.00 | $12.01 – $67.45 | 28 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $985.47 | $1,637.00 | $50.20 – $867.61 | 28 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $279.33 | $464.00 | $34.60 – $245.92 | 28 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,306.74 | $3,984.00 | $61.06 – $2,111.52 | 28 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,922.28 | $3,320.00 | $55.63 – $1,759.60 | 28 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,537.82 | $2,656.00 | $51.90 – $1,407.68 | 28 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,015.94 | $4,896.00 | $94.98 – $2,594.88 | 28 |
| Abdominal MRI (with contrast) CPT 74182 | $2,513.28 | $4,080.00 | $75.30 – $2,162.40 | 28 |
| Abdominal MRI (without contrast) CPT 74181 | $2,010.62 | $3,264.00 | $63.77 – $1,729.92 | 28 |
| Abdominal paracentesis w/image guidance CPT 49083 | $608.02 | $1,204.00 | $95.32 – $638.12 | 28 |
| Abdominal Ultrasound (complete) CPT 76700 | $773.80 | $1,060.00 | $35.62 – $561.80 | 28 |
| Abdominal Ultrasound (limited) CPT 76705 | $757.74 | $1,038.00 | $25.44 – $550.14 | 28 |
| Abdominal X-ray (2 views) CPT 74019 | $195.13 | $303.00 | $10.18 – $160.59 | 28 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $270.48 | $420.00 | $13.91 – $222.60 | 28 |
| Abdominal X-ray (single view) CPT 74018 | $132.66 | $206.00 | $8.14 – $109.18 | 28 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $232.80 | $461.00 | $65.80 – $244.33 | 28 |
| Abl1 gene CPT 81170 | $1,043.10 | $900.00 | $300.00 – $855.00 | 28 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,532.67 | $3,035.00 | $174.69 – $1,608.55 | 28 |
| Acetylcholine receptor modulating antibody CPT 86043 | $41.34 | $78.00 | $12.05 – $74.10 | 28 |
| Acne surgery 10040 CPT 10040 | $65.47 | $139.00 | $20.03 – $132.05 | 27 |
| Acute hepatitis panel CPT 80074 | $140.81 | $251.00 | $47.63 – $238.45 | 28 |
| Acyclovir 400 mg tablet HCPCS J8499 | $2.56 | $28.73 | $0.09 – $0.57 | 28 |
| #acylcarnitineprfl CPT 82017 | $64.52 | $115.00 | $16.87 – $109.25 | 28 |
| Adapter b 8 channel 10cm HCPCS C1883 | $2,418.35 | $4,397.00 | $1,046.49 – $4,177.15 | 28 |
| Adenovirus antibody,serum - quest CPT 86603 | $32.33 | $61.00 | $12.87 – $57.95 | 28 |
| Adh-sendout CPT 84588 | $57.22 | $102.00 | $33.94 – $96.90 | 28 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $67.52 | $100.00 | $27.02 – $95.00 | 28 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $154.61 | $229.00 | $44.93 – $217.55 | 28 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $326.10 | $483.00 | $125.88 – $458.85 | 28 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $313.27 | $464.00 | $97.32 – $440.80 | 28 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $391.59 | $580.00 | $44.93 – $551.00 | 28 |
| Administration immunization each additional vaccine CPT 90472 | $23.68 | $37.00 | $12.55 – $35.15 | 28 |
| Administration vaccine hepatitis b HCPCS G0010 | $67.20 | $105.00 | $29.00 – $99.75 | 28 |
| Administration vaccine influenza virus HCPCS G0008 | $67.20 | $105.00 | $29.00 – $99.75 | 28 |
| Administration vaccine pneumococcal HCPCS G0009 | $67.20 | $105.00 | $29.00 – $99.75 | 28 |
| _afb id by dna probe rflx ast CPT 87149 | $40.88 | $73.00 | $20.05 – $69.35 | 28 |
| #afb mycobacteria suscep. #1 CPT 87190 | $35.28 | $63.00 | $7.31 – $59.85 | 28 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $211.32 | $347.00 | $50.00 – $329.65 | 28 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $163.84 | $282.00 | $31.44 – $267.90 | 28 |
| Albumin body fluid quantitative each specimen CPT 82042 | $32.54 | $58.00 | $7.78 – $22.80 | 28 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $31.42 | $56.00 | $5.78 – $53.20 | 28 |
| Albumin serum plasma or whole blood CPT 82040 | $35.34 | $63.00 | $4.95 – $37.05 | 28 |
| Alkaline phosphatase CPT 84075 | $31.98 | $57.00 | $5.18 – $46.55 | 28 |
| Allergen alpha lactalbumin ige CPT 86008 | $42.40 | $80.00 | $17.93 – $60.80 | 28 |
| Allergen egg white ige CPT 86003 | $29.68 | $56.00 | $5.22 – $52.25 | 28 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $31.27 | $59.00 | $7.97 – $53.20 | 28 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $2,119.15 | $3,853.00 | $641.41 – $2,560.25 | 28 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $108.83 | $194.00 | $64.41 – $184.30 | 28 |
| Alpha-fetoprotein amniotic CPT 82106 | $28.61 | $51.00 | $17.00 – $48.45 | 28 |
| Alpha-fetoprotein tumor marker CPT 82105 | $28.61 | $51.00 | $16.77 – $48.45 | 28 |
| Alt/sgpt CPT 84460 | $33.10 | $59.00 | $5.30 – $47.50 | 28 |
| Aluminum - quest CPT 82108 | $43.20 | $77.00 | $25.48 – $73.15 | 28 |
| Amantadine (symmetrel)-sendout CPT 80375 | $181.76 | $324.00 | $23.37 – $139.65 | 28 |
| Aminolevulinic acid delta CPT 82135 | $42.08 | $75.00 | $16.45 – $71.25 | 28 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $10.26 | $44.80 | $2.42 – $42.56 | 28 |
| Amitriptyline (elavil) -sendout CPT 80335 | $38.15 | $68.00 | $7.38 – $29.45 | 28 |
| Ammonia CPT 82140 | $64.52 | $115.00 | $14.57 – $41.80 | 28 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $419.15 | $830.00 | $71.57 – $439.90 | 28 |
| Amphetamine confirm urine -sendout CPT 80324 | $87.52 | $156.00 | $13.33 – $53.20 | 28 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $0.30 | $1.29 | $0.44 – $1.23 | 28 |
| Amputation toe interphalangeal joint CPT 28825 | $450.75 | $957.00 | $169.02 – $909.15 | 27 |
| Amylase CPT 82150 | $191.30 | $341.00 | $6.48 – $19.00 | 28 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $86.39 | $154.00 | $23.37 – $128.25 | 28 |
| Analysis gene f2 20210g>a variant CPT 81240 | $229.48 | $198.00 | $65.69 – $188.10 | 28 |
| Analysis gene f5 leiden variant CPT 81241 | $256.14 | $221.00 | $73.37 – $209.95 | 28 |
| Anca screen with reflex to titer -quest CPT 86021 | $29.15 | $55.00 | $15.05 – $43.70 | 28 |
| An cholangiogram percutaneous compl CPT 47531 | $330.27 | $654.00 | $62.75 – $346.62 | 28 |
| An fluoro guide for cvp CPT 77001 | $315.56 | $490.00 | $11.42 – $259.70 | 28 |
| Angiotensin ii CPT 82163 | $49.93 | $89.00 | $20.52 – $84.55 | 28 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $3,550.33 | $5,258.50 | $0.02 – $0.14 | 28 |
| Ankle X-ray CPT 73610 | $179.03 | $278.00 | $7.80 – $147.34 | 28 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | $155.20 | $241.00 | $7.46 – $127.73 | 28 |
| Anorectal myomectomy CPT 45108 | $457.81 | $972.00 | $329.70 – $923.40 | 27 |
| Anoscopy and biopsy CPT 46606 | $92.32 | $196.00 | $66.48 – $186.20 | 27 |
| Anoscopy control bleeding 46614 CPT 46614 | $78.66 | $167.00 | $56.65 – $158.65 | 27 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $81.09 | $153.00 | $12.88 – $145.35 | 28 |
| Antibody elution rbc reference CPT 86860 | $193.45 | $365.00 | $29.53 – $346.75 | 28 |
| Antibody htlv/hiv confirm test CPT 86689 | $266.59 | $503.00 | $19.35 – $448.40 | 28 |
| Antibody htlv-i CPT 86687 | $14.84 | $28.00 | $9.09 – $26.60 | 28 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $126.67 | $239.00 | $18.37 – $53.20 | 28 |
| Antibody id rbc panel CPT 86870 | $464.06 | $762.00 | $40.57 – $723.90 | 28 |
| Antibody influenza virus CPT 86710 | $36.04 | $68.00 | $13.55 – $64.60 | 28 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $32.86 | $62.00 | $12.87 – $58.90 | 28 |
| Antibody screen rbc CPT 86850 | $69.43 | $114.00 | $9.77 – $108.30 | 28 |
| Antibody tetanus CPT 86774 | $33.39 | $63.00 | $14.80 – $59.85 | 28 |
| Antidepressant not specified CPT 80338 | $39.27 | $70.00 | $12.75 – $66.50 | 28 |
| Anti mog serum - sendout CPT 86362 | $443.61 | $837.00 | $12.05 – $81.70 | 28 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $30.21 | $57.00 | $12.05 – $51.30 | 28 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $32.86 | $62.00 | $12.05 – $58.90 | 28 |
| Antinuclear antibodies CPT 86038 | $28.09 | $53.00 | $12.09 – $50.35 | 28 |
| Antinuclear antibodies titer CPT 86039 | $60.95 | $115.00 | $11.16 – $56.05 | 28 |
| Antiphosphatidylserine antibody CPT 86148 | $30.21 | $57.00 | $16.07 – $54.15 | 28 |
| Antistreptolysin o titer CPT 86060 | $30.21 | $57.00 | $7.30 – $54.15 | 28 |
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.