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 |
|---|---|---|---|---|
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $82.32 | $147.00 | $42.84 – $122.55 | 28 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $143.36 | $256.00 | $85.10 – $243.20 | 28 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $239.68 | $428.00 | $142.63 – $406.60 | 28 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $228.77 | $453.00 | $43.08 – $171.95 | 28 |
| Injection epidural blood patch or clot CPT 62273 | $536.12 | $934.00 | $100.06 – $495.02 | 28 |
| Injection for arthrography wrist (both sides) CPT 25246 | $248.46 | $492.00 | $46.17 – $184.30 | 28 |
| Injection for bladder x-ray CPT 51600 | $268.66 | $532.00 | $27.61 – $281.96 | 28 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $257.55 | $510.00 | $31.65 – $180.20 | 28 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $58.61 | $132.00 | $29.85 – $83.60 | 27 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $174.87 | $259.00 | $87.85 – $246.05 | 27 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $55.10 | $96.00 | $9.45 – $91.20 | 28 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $148.54 | $220.00 | $74.62 – $209.00 | 27 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $37.21 | $79.00 | $26.80 – $75.05 | 27 |
| Inj proc myelogram lumbar CPT 62284 | $361.08 | $715.00 | $53.79 – $378.95 | 28 |
| Inj proc sialogram CPT 42550 | $73.70 | $166.00 | $39.51 – $157.70 | 27 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $3.31 | $4.90 | $0.17 – $0.48 | 28 |
| Inj retro urethrocysto CPT 51610 | $183.32 | $363.00 | $39.75 – $192.39 | 28 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | $20.81 | $37.10 | $10.42 – $35.24 | 28 |
| Ins cerv dilator (sep proc) CPT 59200 | $345.01 | $511.00 | $42.90 – $485.45 | 28 |
| Insert intrauterine device iud CPT 58300 | not published | not published | $49.12 – $49.12 | 1 |
| Insertion catheter bladder non indwelling CPT 51701 | $90.69 | $158.00 | $24.80 – $150.10 | 28 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $673.06 | $1,368.00 | $75.30 – $725.04 | 28 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $651.41 | $1,324.00 | $83.78 – $701.72 | 28 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $782.28 | $1,590.00 | $75.30 – $842.70 | 28 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $414.01 | $879.00 | $298.16 – $835.05 | 27 |
| Insert tunneled cv 2cath 2sits without port/pmp 36565 CPT 36565 | $413.07 | $877.00 | $297.48 – $833.15 | 27 |
| Insitu hybridization auto CPT 88367 | $453.39 | $762.00 | $77.53 – $723.90 | 28 |
| Insitu hybridization (fish) CPT 88366 | $307.62 | $517.00 | $175.37 – $491.15 | 28 |
| Insitu hybridization manual CPT 88368 | $453.39 | $762.00 | $104.42 – $723.90 | 28 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $77.35 | $130.00 | $30.94 – $123.50 | 28 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $217.17 | $365.00 | $108.14 – $346.75 | 28 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | $845.26 | $1,718.00 | $77.83 – $1,632.10 | 28 |
| Insulin total CPT 83525 | $31.98 | $57.00 | $11.43 – $54.15 | 28 |
| Intestinal stricturoplasty CPT 44615 | $1,910.70 | $2,830.00 | $673.54 – $2,688.50 | 27 |
| Int hrhc lig 1 hroid without img CPT 46945 | $409.30 | $869.00 | $294.76 – $825.55 | 27 |
| Int hrhc lig 2+hroid without img CPT 46946 | $461.58 | $980.00 | $332.42 – $931.00 | 27 |
| Intrapul surf admin endo tube CPT 94610 | $80.18 | $138.00 | $46.81 – $131.10 | 28 |
| Intrinsic factor antibody CPT 86340 | $31.27 | $59.00 | $15.08 – $56.05 | 28 |
| Intubation endotracheal emergency procedure CPT 31500 | $403.10 | $608.00 | $126.86 – $355.30 | 28 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $0.30 | $1.30 | $0.14 – $1.24 | 28 |
| Iron CPT 83540 | $116.69 | $208.00 | $6.47 – $19.00 | 28 |
| Iron binding capacity CPT 83550 | $15.15 | $27.00 | $8.74 – $25.65 | 28 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $110.96 | $304.00 | $24.33 – $288.80 | 28 |
| IV Fluids (each additional hour) CPT 96361 | $53.35 | $78.00 | $12.04 – $74.10 | 28 |
| IV Fluids (first hour) CPT 96360 | $330.37 | $483.00 | $31.58 – $458.85 | 28 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $121.75 | $178.00 | $19.25 – $169.10 | 28 |
| IV Medicine Infusion (additional drug) CPT 96367 | $140.22 | $205.00 | $27.70 – $194.75 | 28 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $64.98 | $95.00 | $19.91 – $90.25 | 28 |
| IV Medicine Infusion (first hour) CPT 96365 | $398.77 | $583.00 | $61.03 – $553.85 | 28 |
| IV Push Injection (each additional drug) CPT 96375 | $74.05 | $129.00 | $14.97 – $122.55 | 28 |
| IV Push Injection (first drug) CPT 96374 | $265.76 | $463.00 | $35.77 – $439.85 | 28 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $606.00 | $941.00 | $21.37 – $498.73 | 28 |
| Jak2 targeted sequence analysis CPT 81279 | $644.40 | $556.00 | $185.20 – $528.20 | 28 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $369.01 | $573.00 | $10.85 – $303.69 | 28 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $278.85 | $433.00 | $11.19 – $229.49 | 28 |
| John cunningham antibody CPT 86711 | $767.44 | $1,448.00 | $16.89 – $1,375.60 | 28 |
| Ketamine and metabolite screen - quest CPT 80357 | $81.35 | $145.00 | $23.37 – $137.75 | 28 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $34.22 | $61.00 | $8.17 – $57.00 | 28 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $81.02 | $120.00 | $40.70 – $114.00 | 27 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $768.69 | $1,053.00 | $31.88 – $558.09 | 28 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $483.99 | $663.00 | $25.10 – $351.39 | 28 |
| Kit gene analys d816 variant CPT 81273 | $434.62 | $375.00 | $124.87 – $356.25 | 28 |
| Kit lead specify 5-6-5 HCPCS C1778 | $14,456.20 | $26,284.00 | $1,654.10 – $6,602.50 | 28 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,482.25 | $2,695.00 | $139.94 – $558.60 | 28 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $3,357.75 | $6,105.00 | $641.41 – $2,560.25 | 28 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $535.72 – $2,052.04 | 6 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $491.83 – $2,052.04 | 6 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $555.82 – $2,052.04 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | $3,118.81 | $5,063.00 | $93.28 – $2,683.39 | 28 |
| Knee MRI (with contrast) CPT 73722 | $2,598.90 | $4,219.00 | $71.23 – $2,236.07 | 28 |
| Knee MRI (without contrast) CPT 73721 | $2,079.00 | $3,375.00 | $59.02 – $1,788.75 | 28 |
| Knee X-ray CPT 73564 | $437.28 | $679.00 | $9.84 – $359.87 | 28 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $313.63 | $487.00 | $7.46 – $258.11 | 28 |
| Knee X-ray (3 views, both knees) CPT 73562 | $382.54 | $594.00 | $8.48 – $314.82 | 28 |
| Knee X-ray (standing, both knees) CPT 73565 | $298.17 | $463.00 | $7.80 – $245.39 | 28 |
| Kras gene addl variants CPT 81276 | $672.22 | $580.00 | $193.25 – $551.00 | 28 |
| Kras gene variants exon 2 CPT 81275 | $672.22 | $580.00 | $193.25 – $551.00 | 28 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $33.08 | $49.00 | $11.66 – $46.55 | 27 |
| Lactate dehydrogenase (ldh) CPT 83615 | $31.42 | $56.00 | $6.04 – $18.05 | 28 |
| Lactic acid CPT 83605 | $49.37 | $88.00 | $11.57 – $33.25 | 28 |
| Lactoferrin fecal qualitative CPT 83630 | $54.98 | $98.00 | $19.70 – $69.35 | 28 |
| Lactoferrin fecal quant CPT 83631 | $114.44 | $204.00 | $19.63 – $193.80 | 28 |
| Laparo cholecystectomy/explr CPT 47564 | $1,380.50 | $2,931.00 | $994.20 – $2,784.45 | 27 |
| Laparo cholecystectomy/graph CPT 47563 | $887.83 | $1,885.00 | $160.10 – $448.40 | 27 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $699.81 – $3,668.82 | 6 |
| Laparoscopy remove adnexa CPT 58661 | $300.97 | $639.00 | $144.50 – $404.70 | 27 |
| Laparo-vag hyst incl t/o CPT 58552 | not published | not published | $961.40 – $6,458.05 | 6 |
| Lap ing hernia repair init CPT 49650 | $796.93 | $1,692.00 | $382.62 – $1,071.60 | 27 |
| Lap ing hernia repair recur CPT 49651 | $1,038.08 | $2,204.00 | $498.28 – $1,395.55 | 27 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $704.48 | $1,395.00 | $40.70 – $492.90 | 28 |
| Lb with mastopexy 15839 CPT 15839 | $902.91 | $1,917.00 | $276.24 – $1,821.15 | 27 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $16,865.20 | $30,664.00 | $641.41 – $2,560.25 | 28 |
| Lead capillary CPT 83655 | $44.32 | $79.00 | $12.11 – $35.15 | 28 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $16,865.20 | $30,664.00 | $641.41 – $2,560.25 | 28 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $10,842.70 | $19,714.00 | $641.41 – $2,560.25 | 28 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $718.79 | $1,194.00 | $34.26 – $632.82 | 28 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,035.25 | $1,788.00 | $50.20 – $947.64 | 28 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $827.97 | $1,430.00 | $43.76 – $757.90 | 28 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $752.50 | $1,250.00 | $30.19 – $662.50 | 28 |
| Lens, intraocular (new tech) HCPCS C1780 | $1,245.09 | $2,695.00 | $336.29 – $1,342.35 | 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.