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 |
|---|---|---|---|---|
| New Patient Office Visit (level 4) CPT 99204 | $2,340.80 | $2,660.00 | $54.54 – $390.45 | 28 |
| New Patient Office Visit (level 5) CPT 99205 | $3,132.80 | $3,560.00 | $54.54 – $514.90 | 28 |
| Nipple exploration CPT 19110 | $638.20 | $1,355.00 | $306.64 – $858.80 | 27 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $83.72 | $124.00 | $42.06 – $117.80 | 27 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $85.07 | $126.00 | $42.74 – $119.70 | 27 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $101.95 | $151.00 | $51.22 – $143.45 | 27 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $91.15 | $135.00 | $45.79 – $128.25 | 27 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $42.54 | $63.00 | $21.37 – $59.85 | 27 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $209.30 | $325.00 | $7.80 – $172.25 | 28 |
| Npm1 gene CPT 81310 | $857.66 | $740.00 | $246.52 – $703.00 | 28 |
| Nras gene variants exon 2&3 CPT 81311 | $1,029.19 | $888.00 | $295.79 – $843.60 | 28 |
| Nuclear Stress Test (Heart) CPT 78452 | $137.06 | $203.00 | $68.86 – $192.85 | 27 |
| Nudt15 gene common variants CPT 81306 | $1,014.12 | $875.00 | $291.36 – $831.25 | 28 |
| Observation direct referral from physician office for admission HCPCS G0379 | $441.55 | $654.00 | $30.00 – $621.30 | 28 |
| Observation/inpatient hospital care hi severity 99236 CPT 99236 | $277.55 | $554.00 | $131.85 – $526.30 | 27 |
| Observation/inpatient hospital care low severity 99234 CPT 99234 | $170.84 | $341.00 | $81.16 – $323.95 | 27 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $215.93 | $431.00 | $102.58 – $409.45 | 27 |
| Observation per hour HCPCS G0378 | $58.64 | $108.00 | $30.00 – $102.60 | 28 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $478.88 | $656.00 | $51.22 – $347.68 | 28 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | $279.59 | $383.00 | $27.22 – $202.99 | 28 |
| Off/op cnsltj new/est low 30 CPT 99243 | $124.25 | $248.00 | $59.02 – $235.60 | 27 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $199.40 | $398.00 | $94.72 – $378.10 | 27 |
| Off/op consltj new/est hi 55 CPT 99245 | $246.49 | $492.00 | $117.10 – $467.40 | 27 |
| Off/op consltj new/est sf 20 CPT 99242 | $88.68 | $177.00 | $42.13 – $168.15 | 27 |
| Onco (ovar) five proteins CPT 81503 | $3,118.87 | $2,691.00 | $387.77 – $2,556.45 | 28 |
| Oncoprotein dcp CPT 83951 | $108.83 | $194.00 | $64.41 – $184.30 | 28 |
| Open bx/exc inguinofem nodes CPT 38531 | $798.34 | $1,695.00 | $383.30 – $1,073.50 | 27 |
| Oph Ultrasound dx quan a-scan only CPT 76511 | $270.10 | $370.00 | $21.38 – $351.50 | 28 |
| Organic acids total quant ea spec CPT 83918 | $56.66 | $101.00 | $23.60 – $67.45 | 28 |
| Oscillation chest wall mechanical per session CPT 94669 | $230.72 | $348.00 | $20.04 – $330.60 | 28 |
| Osmolality blood CPT 83930 | $31.42 | $56.00 | $6.61 – $53.20 | 28 |
| Osmolality urine CPT 83935 | $31.42 | $56.00 | $6.82 – $53.20 | 28 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $85.95 | $150.00 | $35.70 – $142.50 | 28 |
| Parathormone (pth) intact CPT 83970 | $69.56 | $124.00 | $41.28 – $117.80 | 28 |
| Parathyroid planar imaging CPT 78070 | $67.52 | $100.00 | $33.92 – $95.00 | 27 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $19.78 | $42.00 | $14.25 – $39.90 | 27 |
| Partial hysterectomy CPT 58180 | $424.00 | $628.00 | $149.46 – $596.60 | 27 |
| Pdgfra gene CPT 81314 | $1,146.25 | $989.00 | $329.51 – $939.55 | 28 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,355.37 | $4,068.00 | $53.25 – $2,156.04 | 28 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,962.81 | $3,390.00 | $50.20 – $1,796.70 | 28 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,570.25 | $2,712.00 | $47.15 – $1,437.36 | 28 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,189.88 | $3,555.00 | $94.98 – $1,884.15 | 28 |
| Pelvic MRI (with contrast) CPT 72196 | $1,825.21 | $2,963.00 | $75.30 – $1,570.39 | 28 |
| Pelvic MRI (without contrast) CPT 72195 | $1,459.92 | $2,370.00 | $63.77 – $1,256.10 | 28 |
| Pelvic Ultrasound (complete) CPT 76856 | $768.69 | $1,053.00 | $29.85 – $558.09 | 28 |
| Pelvic Ultrasound (limited) CPT 76857 | $609.55 | $835.00 | $21.71 – $442.55 | 28 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $249.87 | $388.00 | $7.80 – $205.64 | 28 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $299.46 | $465.00 | $11.19 – $246.45 | 28 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $12,047.20 | $21,904.00 | $1,162.63 – $4,640.75 | 28 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,086.58 | $1,893.00 | $209.96 – $1,003.29 | 28 |
| Pertussis ag if CPT 87265 | $20.16 | $36.00 | $11.98 – $34.20 | 28 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $74,681.20 | $135,784.00 | $141.37 – $564.30 | 28 |
| Ph body fluid CPT 83986 | $58.34 | $104.00 | $3.58 – $48.45 | 28 |
| Phencyclidine (pcp) CPT 83992 | $37.59 | $67.00 | $12.91 – $53.20 | 28 |
| Phenobarbital therapeutic drug level CPT 80184 | $33.10 | $59.00 | $15.30 – $50.35 | 28 |
| Phenytoin total therapeutic drug level CPT 80185 | $29.73 | $53.00 | $13.25 – $50.35 | 28 |
| Phlebotomy therapeutic CPT 99195 | $83.58 | $229.00 | $77.68 – $217.55 | 28 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $502.56 | $1,067.00 | $241.17 – $675.45 | 27 |
| Phosphorus CPT 84100 | $26.37 | $47.00 | $4.74 – $44.65 | 28 |
| Phosphorus 24 hour urine CPT 84105 | $41.51 | $74.00 | $5.78 – $17.10 | 28 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $281.88 | $486.00 | $81.00 – $461.70 | 28 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $172.84 | $298.00 | $70.92 – $283.10 | 28 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $227.94 | $393.00 | $81.00 – $373.35 | 28 |
| Physical Therapy Re-Evaluation CPT 97164 | $172.84 | $298.00 | $68.51 – $283.10 | 28 |
| Physician standby services CPT 99360 | $74.42 | $158.00 | $37.60 – $150.10 | 27 |
| Pik3ca gene trgt seq alys CPT 81309 | $956.18 | $825.00 | $274.83 – $783.75 | 28 |
| Pinworm exam CPT 87172 | $7.28 | $13.00 | $4.27 – $12.35 | 28 |
| Place gastrostomy tube open 43832 CPT 43832 | $1,847.91 | $2,737.00 | $651.41 – $2,600.15 | 27 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $493.38 | $977.00 | $88.87 – $517.81 | 28 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $293.91 | $582.00 | $31.42 – $308.46 | 28 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $598.93 | $1,186.00 | $76.32 – $628.58 | 28 |
| Placement of seton CPT 46020 | $290.14 | $616.00 | $113.73 – $585.20 | 27 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $215.25 | $442.00 | $47.63 – $419.90 | 28 |
| Platelet aggregation each agent teg CPT 85576 | $41.10 | $75.00 | $24.91 – $71.25 | 28 |
| Platelet automated CPT 85049 | $7.67 | $14.00 | $4.48 – $13.30 | 28 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $356.00 | $731.00 | $247.96 – $694.45 | 28 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $454.86 | $934.00 | $266.95 – $747.65 | 28 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $913.12 | $1,875.00 | $423.31 – $1,664.40 | 28 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $179.78 | $356.00 | $27.13 – $188.68 | 28 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $269.58 | $464.00 | $43.08 – $440.80 | 28 |
| Pm device progr eval dual CPT 93280 | $47.10 | $100.00 | $26.93 – $95.00 | 27 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $44.32 | $79.00 | $26.07 – $75.05 | 28 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $5,243.84 | $6,563.00 | $666.87 – $6,234.85 | 28 |
| Polysom any age 1-3> param CPT 95808 | $2,118.36 | $3,048.00 | $419.12 – $2,316.10 | 28 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $4,450.78 | $6,404.00 | $517.35 – $4,866.85 | 28 |
| Potassium 24 hour urine CPT 84133 | $39.27 | $70.00 | $4.73 – $52.25 | 28 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $3.30 | $14.40 | $0.11 – $13.68 | 28 |
| Potassium serum/plasma/whole blood CPT 84132 | $46.00 | $82.00 | $4.76 – $37.05 | 28 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $813.89 | $1,728.00 | $586.14 – $1,641.60 | 27 |
| Pr application of long arm splint CPT 29105 | $108.30 | $189.00 | $40.59 – $119.70 | 28 |
| Pr application splint static short arm CPT 29125 | $110.02 | $192.00 | $39.65 – $121.60 | 28 |
| Pr biopsy skin punch single lesion CPT 11104 | $59.82 | $127.00 | $43.08 – $120.65 | 27 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $15.07 | $32.00 | $4.61 – $30.40 | 27 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $93.19 | $186.00 | $44.27 – $176.70 | 27 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $136.77 | $273.00 | $64.97 – $259.35 | 27 |
| Prealbumin CPT 84134 | $30.29 | $54.00 | $14.59 – $51.30 | 28 |
| Pr ecg 12 lead report only CPT 93010 | $14.85 | $22.00 | $5.24 – $20.90 | 27 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $246.80 | $524.00 | $177.74 – $497.80 | 27 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $894.25 | $1,225.00 | $43.42 – $649.25 | 28 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $750.44 | $1,028.00 | $43.42 – $544.84 | 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.