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 |
|---|---|---|---|---|
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,256.87 | $4,885.00 | $141.37 – $564.30 | 28 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $2,256.87 | $4,885.00 | $139.52 – $564.30 | 28 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $996.53 | $2,157.00 | $139.52 – $564.30 | 28 |
| Levetiracetam therapeutic drug level CPT 80177 | $35.34 | $63.00 | $13.25 – $38.00 | 28 |
| Liberta rc ipg HCPCS C1820 | $48,182.20 | $87,604.00 | $1,162.63 – $4,640.75 | 28 |
| Lidocaine therapeutic drug level CPT 80176 | $25.25 | $45.00 | $14.69 – $42.75 | 28 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $2,538,266.72 | $3,759,504.00 | $541,744.53 – $3,571,528.80 | 28 |
| Ligate/strip long leg vein CPT 37722 | $872.76 | $1,853.00 | $419.25 – $1,174.20 | 27 |
| Ligate/strip short leg vein CPT 37718 | $778.09 | $1,652.00 | $373.46 – $1,045.95 | 27 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $378.68 | $804.00 | $181.81 – $509.20 | 27 |
| Lipase CPT 83690 | $32.54 | $58.00 | $6.89 – $19.95 | 28 |
| Lipoprotein blood high res frac & quant CPT 83701 | $57.22 | $102.00 | $33.86 – $96.90 | 28 |
| Lipoprotein blood quant CPT 83704 | $57.78 | $103.00 | $34.19 – $97.85 | 28 |
| Lipoprotein direct measurement hdl CPT 83718 | $35.90 | $64.00 | $8.19 – $23.75 | 28 |
| Lipoprotein direct measurement ldl CPT 83721 | $52.73 | $94.00 | $10.50 – $30.40 | 28 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $57.78 | $103.00 | $34.19 – $97.85 | 28 |
| Lithium therapeutic drug level CPT 80178 | $29.17 | $52.00 | $6.61 – $49.40 | 28 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $613.11 | $529.00 | $176.19 – $502.55 | 28 |
| Liver Function Test CPT 80076 | $60.59 | $108.00 | $8.17 – $102.60 | 28 |
| Liver imag w/vasclr flow CPT 78202 | $41.86 | $62.00 | $21.03 – $58.90 | 27 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $47.26 | $70.00 | $23.74 – $66.50 | 27 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.51 | $2.24 | $0.76 – $2.13 | 28 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $367.66 | $635.00 | $46.47 – $336.55 | 28 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,021.87 | $3,492.00 | $54.95 – $1,850.76 | 28 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,684.89 | $2,910.00 | $53.25 – $1,542.30 | 28 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,347.91 | $2,328.00 | $43.76 – $1,233.84 | 28 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,047.09 | $6,465.00 | $99.72 – $3,426.45 | 28 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,372.89 | $5,388.00 | $77.68 – $2,855.64 | 28 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,698.06 | $4,310.00 | $64.79 – $2,284.30 | 28 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $457.24 | $710.00 | $9.84 – $376.30 | 28 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $658.17 | $1,022.00 | $11.53 – $541.66 | 28 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $732.87 | $1,138.00 | $13.23 – $603.14 | 28 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $170.66 | $265.00 | $7.12 – $140.45 | 28 |
| Low frequency non-thermal Ultrasound CPT 97610 | $152.42 | $266.00 | $38.33 – $252.70 | 28 |
| Lsh uterus 250 g or less CPT 58541 | $224.20 | $476.00 | $161.46 – $452.20 | 27 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $465.38 | $801.00 | $28.20 – $760.95 | 28 |
| Lung Function Test (Spirometry) CPT 94010 | $305.02 | $525.00 | $18.78 – $498.75 | 28 |
| Lung perfusion imaging CPT 78580 | $62.79 | $93.00 | $31.55 – $88.35 | 27 |
| Lymphocyte transformation mitogen CPT 86353 | $78.44 | $148.00 | $49.03 – $140.60 | 28 |
| Macroscopic exam arthropod CPT 87168 | $7.28 | $13.00 | $4.27 – $12.35 | 28 |
| Magnesium CPT 83735 | $49.37 | $88.00 | $6.70 – $19.95 | 28 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $0.20 | $0.88 | $0.30 – $0.84 | 28 |
| Mammosite ced HCPCS C1728 | $7,642.25 | $13,895.00 | $336.29 – $1,342.35 | 28 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,845.25 | $3,355.00 | $74.49 – $297.35 | 28 |
| Mastectomy partial CPT 19301 | $1,215.18 | $2,580.00 | $583.42 – $1,634.00 | 27 |
| Mast mod rad CPT 19307 | $3,196.88 | $4,735.00 | $267.97 – $750.50 | 27 |
| Mastoids complete CPT 70130 | $349.69 | $543.00 | $15.26 – $287.79 | 28 |
| M.avium-intra dna amp prob CPT 87561 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $35.34 | $63.00 | $14.46 – $59.85 | 28 |
| Mayo aathr protein s free CPT 85306 | $36.17 | $66.00 | $15.32 – $57.00 | 28 |
| Mayo activated protein c resistance assay CPT 85307 | $36.17 | $66.00 | $15.32 – $62.70 | 28 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $168.30 | $300.00 | $38.57 – $285.00 | 28 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $88.64 | $158.00 | $13.47 – $104.50 | 28 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $70.69 | $126.00 | $14.52 – $57.95 | 28 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $31.98 | $57.00 | $14.78 – $54.15 | 28 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $67.88 | $121.00 | $23.37 – $114.95 | 28 |
| Mayo alpha 1 antitrypsin CPT 82103 | $33.10 | $59.00 | $13.44 – $38.95 | 28 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $34.78 | $62.00 | $15.08 – $43.70 | 28 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $87.52 | $156.00 | $13.33 – $53.20 | 28 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $423.04 | $365.00 | $121.63 – $346.75 | 28 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $318.72 | $275.00 | $91.66 – $261.25 | 28 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $4,033.32 | $3,480.00 | $1,160.00 – $3,306.00 | 28 |
| Mayo androstenedione CPT 82157 | $49.37 | $88.00 | $29.28 – $83.60 | 28 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $34.22 | $61.00 | $14.60 – $57.95 | 28 |
| Mayo antithrombin iii antigen CPT 85301 | $37.81 | $69.00 | $10.81 – $65.55 | 28 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $29.15 | $55.00 | $15.05 – $52.25 | 28 |
| Mayo avwpr vw factor activity CPT 85397 | $89.87 | $164.00 | $30.86 – $155.80 | 28 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $88.64 | $158.00 | $12.85 – $51.30 | 28 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $32.86 | $62.00 | $10.18 – $58.90 | 28 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $504.16 | $435.00 | $144.84 – $413.25 | 28 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $746.40 | $644.00 | $214.62 – $611.80 | 28 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $41.34 | $78.00 | $12.90 – $74.10 | 28 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $31.42 | $56.00 | $13.33 – $53.20 | 28 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $37.10 | $70.00 | $13.19 – $66.50 | 28 |
| Mayo brcmg brucella antibody igm CPT 86622 | $35.51 | $67.00 | $8.93 – $63.65 | 28 |
| Mayo c1 esterase inhibitor CPT 83883 | $40.39 | $72.00 | $13.60 – $38.95 | 28 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $47.12 | $84.00 | $13.33 – $53.20 | 28 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $64.52 | $115.00 | $16.87 – $48.45 | 28 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $42.93 | $81.00 | $26.78 – $76.95 | 28 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $425.35 | $367.00 | $122.22 – $348.65 | 28 |
| Mayo ceruloplasmin CPT 82390 | $29.73 | $53.00 | $10.74 – $50.35 | 28 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $39.27 | $70.00 | $14.12 – $40.85 | 28 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $127.20 | $240.00 | $12.88 – $62.70 | 28 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $32.33 | $61.00 | $11.82 – $57.95 | 28 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $32.33 | $61.00 | $12.68 – $57.95 | 28 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $236.31 | $350.00 | $116.49 – $332.50 | 28 |
| Mayo chromium CPT 82495 | $34.22 | $61.00 | $20.28 – $57.95 | 28 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $83.59 | $149.00 | $13.33 – $53.20 | 28 |
| Mayo coccidioides antibody CPT 86635 | $34.98 | $66.00 | $11.47 – $52.25 | 28 |
| Mayo cocou cortisone urine CPT 82542 | $509.95 | $909.00 | $24.09 – $69.35 | 28 |
| Mayo cortisol free CPT 82530 | $30.86 | $55.00 | $16.71 – $52.25 | 28 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $67.31 | $127.00 | $42.13 – $120.65 | 28 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $30.21 | $57.00 | $12.12 – $54.15 | 28 |
| Mayo cyanide CPT 82600 | $43.76 | $78.00 | $19.40 – $74.10 | 28 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $407.12 | $603.00 | $108.14 – $572.85 | 28 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $42.64 | $76.00 | $25.27 – $72.20 | 28 |
| Mayo dihydrotestosterone CPT 82642 | $49.37 | $88.00 | $12.68 – $83.60 | 28 |
| Mayo efpo chloride stool CPT 82438 | $32.54 | $58.00 | $5.00 – $14.25 | 28 |
| Mayo estriol CPT 82677 | $40.95 | $73.00 | $24.18 – $69.35 | 28 |
| Mayo estrone CPT 82679 | $42.08 | $75.00 | $24.95 – $71.25 | 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.