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 |
|---|---|---|---|---|
| Histamine CPT 83088 | $49.93 | $89.00 | $29.53 – $84.55 | 28 |
| Histochemical stains add-on CPT 88314 | $90.44 | $152.00 | $22.59 – $144.40 | 28 |
| Hla class i high defin qual CPT 86832 | $515.16 | $972.00 | $323.75 – $923.40 | 28 |
| Hla class ii high defin qual CPT 86833 | $518.34 | $978.00 | $325.80 – $929.10 | 28 |
| Hla class i&ii antibody qual CPT 86828 | $102.29 | $193.00 | $64.19 – $183.35 | 28 |
| Hla class ii phenotype qual CPT 86831 | $130.38 | $246.00 | $81.88 – $233.70 | 28 |
| Hla class i phenotype qual CPT 86830 | $152.11 | $287.00 | $95.52 – $272.65 | 28 |
| Hla i & ii type verify lr CPT 81371 | $1,407.03 | $1,214.00 | $404.52 – $1,153.30 | 28 |
| Hla i & ii typing hr CPT 81378 | $1,201.88 | $1,037.00 | $345.57 – $985.15 | 28 |
| Hla i & ii typing lr CPT 81370 | $1,398.91 | $1,207.00 | $402.12 – $1,146.65 | 28 |
| Hla ii typing 1 loc hr CPT 81382 | $431.15 | $372.00 | $123.68 – $353.40 | 28 |
| Hla i low res one antigen equiv ea CPT 81374 | $258.46 | $223.00 | $74.33 – $211.85 | 28 |
| Hla i typing 1 locus hr CPT 81380 | $616.59 | $532.00 | $177.25 – $505.40 | 28 |
| Hla i typing complete hr CPT 81379 | $1,167.11 | $1,007.00 | $335.38 – $956.65 | 28 |
| Hla i typing complete lr CPT 81372 | $1,403.55 | $1,211.00 | $403.59 – $1,150.45 | 28 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $591.09 | $510.00 | $169.90 – $484.50 | 28 |
| Hla i typing low res one locus ea CPT 81373 | $443.90 | $383.00 | $127.43 – $363.85 | 28 |
| Hla x-math non-cytotoxic CPT 86825 | $174.37 | $329.00 | $109.49 – $312.55 | 28 |
| Homocysteine CPT 83090 | $32.54 | $58.00 | $17.92 – $55.10 | 28 |
| Homogenization tissue CPT 87176 | $10.08 | $18.00 | $5.88 – $17.10 | 28 |
| Homovanillic acid (hva) CPT 83150 | $38.15 | $68.00 | $22.41 – $64.60 | 28 |
| Hpv types 16 & 18 only CPT 87625 | $68.32 | $122.00 | $40.55 – $115.90 | 28 |
| Human epididymis protein 4 (he4) CPT 86305 | $51.41 | $97.00 | $13.98 – $92.15 | 28 |
| Hysterosalpingography s&i CPT 74740 | $669.12 | $1,039.00 | $16.62 – $550.67 | 28 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $225.20 – $1,901.83 | 6 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $147.46 – $1,901.83 | 6 |
| Iaadi respiratory synctial virus CPT 87280 | $33.60 | $60.00 | $13.42 – $57.00 | 28 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $72.08 | $136.00 | $45.23 – $129.20 | 28 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $88,718.72 | $131,404.00 | $10,424.40 – $41,610.00 | 28 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $67,454.20 | $122,644.00 | $14,594.16 – $58,254.00 | 28 |
| Icd crtp serena MRI HCPCS C2621 | $29,574.71 | $43,804.00 | $1,452.99 – $5,799.75 | 28 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $18,069.70 | $32,854.00 | $641.41 – $2,560.25 | 28 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | $538.35 | $1,143.00 | $387.71 – $1,085.85 | 27 |
| Ifnl3 gene CPT 81283 | $256.14 | $221.00 | $73.37 – $209.95 | 28 |
| Igh gene rearrange amp meth CPT 81261 | $688.45 | $594.00 | $197.99 – $564.30 | 28 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,024.56 | $884.00 | $294.52 – $839.80 | 28 |
| Igk rearrangeabn clonal pop CPT 81264 | $601.52 | $519.00 | $172.73 – $493.05 | 28 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $93.41 | $157.00 | $19.75 – $78.85 | 28 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $453.39 | $762.00 | $132.37 – $723.90 | 28 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $217.17 | $365.00 | $70.39 – $346.75 | 28 |
| Immune complex assay CPT 86332 | $39.22 | $74.00 | $24.37 – $70.30 | 28 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $144.51 | $257.60 | $35.32 – $244.72 | 28 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $33.39 | $63.00 | $20.81 – $59.85 | 28 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $33.39 | $63.00 | $20.81 – $59.85 | 28 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $19.08 | $36.00 | $11.98 – $34.20 | 28 |
| Immunodiffusion nes CPT 86329 | $29.15 | $55.00 | $14.05 – $40.85 | 28 |
| Immunofixation electrophoresis serum CPT 86334 | $75.26 | $142.00 | $22.34 – $64.60 | 28 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $112.46 | $189.00 | $20.71 – $82.65 | 28 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $217.17 | $365.00 | $112.21 – $346.75 | 28 |
| Immunoglobulin assay CPT 86023 | $125.08 | $236.00 | $12.46 – $224.20 | 28 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $53,000.20 | $96,364.00 | $39.51 – $157.70 | 28 |
| Implant ureth bulk agent HCPCS L8606 | $1,692.90 | $3,078.00 | $56.31 – $157.70 | 28 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $145.07 | $308.00 | $104.47 – $292.60 | 27 |
| Incision of anal sphincter CPT 46080 | $195.94 | $416.00 | $141.11 – $395.20 | 27 |
| Incision of breast lesion CPT 19020 | $816.27 | $1,209.00 | $273.40 – $765.70 | 27 |
| Incision of rectal abscess CPT 46060 | $591.58 | $1,256.00 | $426.04 – $1,193.20 | 27 |
| Incision tendon sheath CPT 26055 | $353.25 | $750.00 | $254.40 – $712.50 | 27 |
| Infect ag drug suscept pheno predict CPT 87900 | $219.52 | $392.00 | $130.35 – $372.40 | 28 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $432.88 | $773.00 | $257.45 – $734.35 | 28 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $432.88 | $773.00 | $257.45 – $734.35 | 28 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $216.72 | $387.00 | $128.73 – $367.65 | 28 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $432.88 | $773.00 | $257.45 – $734.35 | 28 |
| Infect ag ia optc obs influenza CPT 87804 | $28.00 | $50.00 | $16.55 – $47.50 | 28 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $33.60 | $60.00 | $11.98 – $57.00 | 28 |
| Infect ag if influenza a CPT 87276 | $33.60 | $60.00 | $16.07 – $57.00 | 28 |
| Infect ag if influenza b CPT 87275 | $33.60 | $60.00 | $12.25 – $57.00 | 28 |
| Infect ag if legionella pneumophila CPT 87278 | $26.32 | $47.00 | $15.60 – $44.65 | 28 |
| Infect ag if pneumocystis carinii CPT 87281 | $42.56 | $76.00 | $11.98 – $34.20 | 28 |
| Infect ag if varicella zoster CPT 87290 | $33.60 | $60.00 | $13.42 – $57.00 | 28 |
| Infect ag na hep b amp CPT 87516 | $75.60 | $135.00 | $35.09 – $128.25 | 28 |
| Infect ag na herpes simplex quant CPT 87530 | $72.24 | $129.00 | $42.84 – $122.55 | 28 |
| Infect ag na hpv high-risk types CPT 87624 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $161.28 | $288.00 | $95.80 – $273.60 | 28 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $86.24 | $154.00 | $35.09 – $146.30 | 28 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $700.56 | $1,251.00 | $416.78 – $1,188.45 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $33.60 | $60.00 | $11.98 – $57.00 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $36.96 | $66.00 | $11.98 – $34.20 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $41.44 | $74.00 | $14.38 – $41.80 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $129.36 | $231.00 | $10.33 – $42.75 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $47.60 | $85.00 | $10.33 – $56.05 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $48.72 | $87.00 | $24.08 – $82.65 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $87.92 | $157.00 | $11.98 – $34.20 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $20.16 | $36.00 | $11.98 – $34.20 | 28 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $35.84 | $64.00 | $11.98 – $60.80 | 28 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $235.76 | $421.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $64.40 | $115.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $62.72 | $112.00 | $37.27 – $106.40 | 28 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $700.56 | $1,251.00 | $416.78 – $1,188.45 | 28 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $70.56 | $126.00 | $41.68 – $119.70 | 28 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $86.24 | $154.00 | $51.31 – $146.30 | 28 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $53.76 | $96.00 | $32.56 – $91.20 | 28 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $62.16 | $111.00 | $35.09 – $100.70 | 28 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $700.56 | $1,251.00 | $416.78 – $1,188.45 | 28 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $154.00 | $275.00 | $42.84 – $122.55 | 28 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $72.24 | $129.00 | $42.84 – $122.55 | 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.