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 |
|---|---|---|---|---|
| Pregnancy Ultrasound (limited) CPT 76815 | $509.54 | $698.00 | $28.49 – $369.94 | 28 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $193.45 | $365.00 | $32.78 – $346.75 | 28 |
| Pretreat rbc absorption reference CPT 86978 | $146.81 | $277.00 | $24.53 – $263.15 | 28 |
| Pretreat rbc density gradient separation reference CPT 86972 | $277.09 | $455.00 | $38.30 – $432.25 | 28 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $91.35 | $150.00 | $24.53 – $142.50 | 28 |
| Pretreat rbc w enzyme reference CPT 86971 | $222.28 | $365.00 | $21.75 – $346.75 | 28 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $198.29 | $421.00 | $142.80 – $399.95 | 27 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $123.87 | $263.00 | $89.21 – $249.85 | 27 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $258.52 | $516.00 | $122.81 – $490.20 | 27 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $175.85 | $351.00 | $83.54 – $333.45 | 27 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $130.26 | $260.00 | $61.88 – $247.00 | 27 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $133.27 | $266.00 | $63.31 – $252.70 | 27 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $92.68 | $185.00 | $44.03 – $175.75 | 27 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $50.60 | $101.00 | $24.04 – $95.95 | 27 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $221.84 | $471.00 | $159.76 – $447.45 | 27 |
| Pr incision & drainage abscess simple/single CPT 10060 | $121.99 | $259.00 | $87.85 – $246.05 | 27 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $146.01 | $310.00 | $105.15 – $294.50 | 27 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $125.29 | $266.00 | $90.23 – $252.70 | 27 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $307.72 | $490.00 | $7.62 – $259.70 | 28 |
| Procalcitonin CPT 84145 | $46.00 | $82.00 | $27.22 – $77.90 | 28 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $6.69 | $29.20 | $2.52 – $27.74 | 28 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $58.88 | $125.00 | $42.40 – $118.75 | 27 |
| Progesterone CPT 84144 | $35.34 | $63.00 | $20.86 – $59.85 | 28 |
| Prolactin CPT 84146 | $33.10 | $59.00 | $19.38 – $56.05 | 28 |
| Prolng ip/obs e/m ea 15 min CPT 99418 | $52.60 | $105.00 | $24.99 – $99.75 | 27 |
| Prolong service without contact CPT 99358 | $134.23 | $285.00 | $67.83 – $270.75 | 27 |
| Prolong serv without contact add CPT 99359 | $65.47 | $139.00 | $33.08 – $132.05 | 27 |
| _propoxygc/msur CPT 80367 | $31.42 | $56.00 | $13.33 – $53.20 | 28 |
| Prostate biopsy, any mthd HCPCS G0416 | $271.91 | $457.00 | $65.85 – $434.15 | 28 |
| Protein c activity CPT 85303 | $23.02 | $42.00 | $13.84 – $39.90 | 28 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $31.98 | $57.00 | $10.74 – $54.15 | 28 |
| Protein s total CPT 85305 | $35.07 | $64.00 | $11.61 – $55.10 | 28 |
| Protein total 24 hour urine CPT 84156 | $33.10 | $59.00 | $3.67 – $11.40 | 28 |
| Protein total body fluid CPT 84157 | $31.42 | $56.00 | $4.00 – $11.40 | 28 |
| Protein total serum plasma whole blood CPT 84155 | $31.42 | $56.00 | $3.67 – $53.20 | 28 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $31.78 | $58.00 | $3.94 – $55.10 | 28 |
| Prp i/hern init block >5 yr CPT 49507 | $1,088.48 | $2,311.00 | $522.71 – $1,463.95 | 27 |
| Pr removal intrauterine device CPT 58301 | $319.14 | $556.00 | $64.47 – $528.20 | 28 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $232.20 | $493.00 | $167.23 – $468.35 | 27 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $69.71 | $148.00 | $50.20 – $140.60 | 27 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $73.48 | $156.00 | $52.92 – $148.20 | 27 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $55.58 | $118.00 | $40.03 – $112.10 | 27 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $73.95 | $157.00 | $53.25 – $149.15 | 27 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $875.12 | $1,858.00 | $630.23 – $1,765.10 | 27 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | $54.11 | $108.00 | $25.70 – $102.60 | 27 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $291.08 | $618.00 | $139.75 – $391.40 | 27 |
| PSA (Prostate) Test CPT 84153 | $31.42 | $56.00 | $18.39 – $53.20 | 28 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $57.30 | $100.00 | $19.00 – $95.00 | 28 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $64.18 | $112.00 | $13.77 – $106.40 | 28 |
| Pt application of modality traction mechanical CPT 97012 | $70.48 | $123.00 | $13.80 – $116.85 | 28 |
| Pten gene full sequence CPT 81321 | $2,086.20 | $1,800.00 | $600.00 – $1,710.00 | 28 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $101.42 | $177.00 | $34.91 – $168.15 | 28 |
| Pt wheelchair management each 15 minutes CPT 97542 | $47.56 | $83.00 | $19.75 – $78.85 | 28 |
| Pulmonary vent imaging CPT 78579 | $41.86 | $62.00 | $21.03 – $58.90 | 27 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $42.63 | $70.00 | $14.47 – $66.50 | 28 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $164.63 | $326.00 | $83.10 – $232.75 | 28 |
| Puncture spinal lumbar diagnostic CPT 62270 | $109.38 | $162.00 | $54.95 – $153.90 | 27 |
| Pyruvate CPT 84210 | $24.68 | $44.00 | $14.48 – $41.80 | 28 |
| Pyruvate kinase CPT 84220 | $104.91 | $187.00 | $9.44 – $177.65 | 28 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $70.89 | $105.00 | $35.62 – $99.75 | 27 |
| Quant diff pulm perf w/imaging CPT 78597 | $61.44 | $91.00 | $30.87 – $86.45 | 27 |
| Quest t3 uptake CPT 84479 | $31.42 | $56.00 | $6.47 – $53.20 | 28 |
| Rapid Strep Test CPT 87880 | $28.00 | $50.00 | $16.53 – $47.50 | 28 |
| Rbc count only automated CPT 85041 | $5.48 | $10.00 | $3.02 – $9.50 | 28 |
| Rbc serum pretx incubj drugs CPT 86975 | $449.44 | $848.00 | $29.53 – $805.60 | 28 |
| Recon, cta for surg plan HCPCS G0288 | $117.48 | $174.00 | $12.97 – $92.22 | 28 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $340.90 | $700.00 | $188.93 – $665.00 | 28 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $347.72 | $714.00 | $99.72 – $279.30 | 28 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $170.45 | $350.00 | $118.72 – $332.50 | 28 |
| Red blood cells washed each unit HCPCS P9022 | $242.04 | $497.00 | $149.59 – $418.95 | 28 |
| Reduce bowel obstruction 44050 CPT 44050 | $1,158.19 | $2,459.00 | $585.24 – $2,336.05 | 27 |
| Removal anal seton other marker 46030 CPT 46030 | $110.21 | $234.00 | $79.37 – $222.30 | 27 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $175.15 | $359.00 | $120.76 – $338.20 | 28 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $234.56 | $498.00 | $156.03 – $437.00 | 28 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $128.92 | $225.00 | $76.32 – $213.75 | 28 |
| Removal foreign body foot subcutaneous right CPT 28190 | $147.11 | $299.00 | $67.50 – $189.05 | 28 |
| Removal of anal tags CPT 46230 | $212.89 | $452.00 | $153.32 – $429.40 | 27 |
| Removal of breast lesion CPT 19120 | $765.38 | $1,625.00 | $367.35 – $1,028.85 | 27 |
| Removal of gallbladder 47600 CPT 47600 | $1,899.23 | $2,813.00 | $167.55 – $668.80 | 27 |
| Removal of gallbladder 47610 CPT 47610 | $2,231.40 | $3,305.00 | $786.59 – $3,139.75 | 27 |
| Removal of hydrocele CPT 55040 | $413.07 | $877.00 | $297.48 – $833.15 | 27 |
| Removal of hydroceles CPT 55041 | $626.90 | $1,331.00 | $451.48 – $1,264.45 | 27 |
| Removal of ovary(s) 58940 CPT 58940 | $239.01 | $354.00 | $84.25 – $336.30 | 27 |
| Removal of ovary/tube(s) CPT 58720 | $1,314.54 | $1,947.00 | $115.91 – $462.65 | 27 |
| Removal of sperm cord lesion CPT 55520 | $841.68 | $1,787.00 | $403.99 – $1,131.45 | 27 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $89.49 | $190.00 | $64.45 – $180.50 | 27 |
| Removal sutr and stapl no anes CPT 15854 | $74.05 | $129.00 | $15.50 – $122.55 | 28 |
| Removal sutr or stapl no anes CPT 15853 | $74.05 | $129.00 | $7.38 – $68.37 | 28 |
| Remove anal fist complex CPT 46280 | $582.63 | $1,237.00 | $419.59 – $1,175.15 | 27 |
| Remove anal fist inter CPT 46275 | $511.51 | $1,086.00 | $368.37 – $1,031.70 | 27 |
| Remove anal fist subq CPT 46270 | $486.07 | $1,032.00 | $350.05 – $980.40 | 27 |
| Remove esophagus obstruction CPT 74235 | $224.76 | $349.00 | $36.41 – $184.97 | 28 |
| Remove ext hem groups 2+ CPT 46250 | $390.93 | $830.00 | $281.54 – $788.50 | 27 |
| Remove int/ext hem 1 group CPT 46255 | $438.03 | $930.00 | $315.46 – $883.50 | 27 |
| Remove pilonidal cyst compl CPT 11772 | $708.85 | $1,505.00 | $510.50 – $1,429.75 | 27 |
| Remove pilonidal cyst exten CPT 11771 | $541.65 | $1,150.00 | $390.08 – $1,092.50 | 27 |
| Remove shoulder foreign body subq 23330 CPT 23330 | $304.74 | $647.00 | $146.53 – $410.40 | 27 |
| Remove wrist tendon lesion CPT 25111 | $844.63 | $1,251.00 | $282.89 – $792.30 | 27 |
| Renal function panel CPT 80069 | $87.52 | $156.00 | $8.68 – $148.20 | 28 |
| Repair bladder defect CPT 57288 | $225.14 | $478.00 | $162.14 – $454.10 | 27 |
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.