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 |
|---|---|---|---|---|
| Snrpn/ube3a gene CPT 81331 | $338.43 | $292.00 | $51.07 – $277.40 | 28 |
| Sodium 24 hour urine CPT 84300 | $40.39 | $72.00 | $5.06 – $15.20 | 28 |
| Sodium serum/plasma/whole blood CPT 84295 | $17.39 | $31.00 | $4.81 – $29.45 | 28 |
| Specific gravity body fluid CPT 84315 | $5.61 | $10.00 | $3.28 – $9.50 | 28 |
| Specimen fat stain CPT 89125 | $10.96 | $18.00 | $5.88 – $17.10 | 28 |
| Spine X-ray (single view, one level) CPT 72020 | $247.94 | $385.00 | $7.12 – $204.05 | 28 |
| Splenectomy total open 38100 CPT 38100 | $2,046.41 | $3,031.00 | $721.38 – $2,879.45 | 27 |
| Split blood or products CPT 86985 | $222.28 | $365.00 | $24.02 – $346.75 | 28 |
| Sputum specimen collection CPT 89220 | $222.28 | $365.00 | $18.78 – $346.75 | 28 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $28,910.20 | $52,564.00 | $141.37 – $564.30 | 28 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $5,095.75 | $9,265.00 | $39.51 – $157.70 | 28 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $19,274.20 | $35,044.00 | $141.37 – $564.30 | 28 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $5,095.75 | $9,265.00 | $336.29 – $1,342.35 | 28 |
| Stimulants synthetic CPT 80371 | $89.76 | $160.00 | $23.37 – $152.00 | 28 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $67.52 | $100.00 | $33.92 – $95.00 | 27 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $178.20 | $311.00 | $16.76 – $196.65 | 28 |
| Strapping of elbow or wrist 29260 CPT 29260 | $260.71 | $455.00 | $18.38 – $287.85 | 28 |
| Strapping of hand or finger CPT 29280 | $151.27 | $264.00 | $19.60 – $250.80 | 28 |
| Strapping of knee CPT 29530 | $269.88 | $471.00 | $17.45 – $298.30 | 28 |
| Strep b dna amp probe CPT 87653 | $59.36 | $106.00 | $35.09 – $100.70 | 28 |
| Stress test pulmonary CPT 94618 | $306.19 | $527.00 | $11.97 – $500.65 | 28 |
| Str markers specimen anal CPT 81265 | $1,653.89 | $1,427.00 | $233.07 – $665.00 | 28 |
| Sugars single quant CPT 84378 | $34.22 | $61.00 | $11.53 – $57.95 | 28 |
| Sulfonylurea screen qn-sendout CPT 80377 | $99.86 | $178.00 | $23.37 – $169.10 | 28 |
| Surg dx exam anorectal CPT 45990 | $130.47 | $277.00 | $93.96 – $263.15 | 27 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | $249.63 | $530.00 | $126.14 – $503.50 | 27 |
| Surgical pathology level 1 gross examination only CPT 88300 | $31.54 | $53.00 | $11.64 – $50.35 | 28 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $49.98 | $84.00 | $17.89 – $79.80 | 28 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $67.83 | $114.00 | $31.12 – $108.30 | 28 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $67.83 | $114.00 | $34.68 – $108.30 | 28 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $453.39 | $762.00 | $203.34 – $723.90 | 28 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,018.64 | $1,712.00 | $285.45 – $1,626.40 | 28 |
| Susceptibility agar dilution per agent CPT 87181 | $36.96 | $66.00 | $4.75 – $14.25 | 28 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $31.36 | $56.00 | $4.75 – $53.20 | 28 |
| Susceptibility mic per plate CPT 87186 | $121.80 | $200.00 | $8.65 – $24.70 | 28 |
| Suscept studies macrobroth dilution ea CPT 87188 | $64.40 | $115.00 | $6.64 – $55.10 | 28 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $1,308.44 | $2,778.00 | $661.16 – $2,639.10 | 27 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $27.56 | $52.00 | $4.40 – $49.40 | 28 |
| System pacing micra av HCPCS C1786 | $23,660.31 | $35,044.00 | $2,754.85 – $10,996.25 | 28 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $73,932.72 | $109,504.00 | $4,169.76 – $16,644.00 | 28 |
| T3 (triiodothyronine) free CPT 84481 | $39.83 | $71.00 | $16.94 – $51.30 | 28 |
| T3 (triiodothyronine) total CPT 84480 | $24.12 | $43.00 | $14.18 – $40.85 | 28 |
| T4 (thyroxine) free CPT 84439 | $37.03 | $66.00 | $9.02 – $26.60 | 28 |
| T4 (thyroxine) total CPT 84436 | $31.42 | $56.00 | $6.87 – $53.20 | 28 |
| Tacrolimus therapeutic drug level CPT 80197 | $31.98 | $57.00 | $13.73 – $54.15 | 28 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $208.01 | $323.00 | $7.80 – $171.19 | 28 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,775.81 | $2,395.00 | $759.53 – $2,165.05 | 28 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $10,151.68 | $8,759.00 | $1,262.17 – $8,321.05 | 28 |
| Target gsa panel organ neop CPT 81445 | $2,079.25 | $1,794.00 | $597.91 – $1,704.30 | 28 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $159.00 | $300.00 | $100.00 – $285.00 | 28 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $98.58 | $186.00 | $61.98 – $176.70 | 28 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $74.73 | $141.00 | $46.98 – $133.95 | 28 |
| T cells absolute cd 4 count CPT 86361 | $42.93 | $81.00 | $26.78 – $76.95 | 28 |
| T cells total count CPT 86359 | $60.42 | $114.00 | $37.73 – $108.30 | 28 |
| Telehealth original site facility fee HCPCS Q3014 | $28.36 | $42.00 | $6.05 – $39.90 | 28 |
| Test stress cardiovascular tracing only CPT 93017 | $1,161.28 | $1,720.00 | $36.59 – $1,634.00 | 28 |
| Theophylline therapeutic drug level CPT 80198 | $24.12 | $43.00 | $14.14 – $40.85 | 28 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $65.32 | $114.00 | $27.13 – $108.30 | 28 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $87.67 | $153.00 | $28.89 – $145.35 | 28 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $505.54 | $785.00 | $90.23 – $416.05 | 28 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $247.30 | $384.00 | $8.14 – $203.52 | 28 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,055.45 | $2,090.00 | $98.71 – $738.29 | 28 |
| Three-Phase Bone Scan (Nuclear Medicine) CPT 78315 | $87.77 | $130.00 | $44.10 – $123.50 | 27 |
| Thrombin time CPT 85670 | $30.69 | $56.00 | $5.77 – $53.20 | 28 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $56.44 | $103.00 | $6.47 – $97.85 | 28 |
| Thyroglobulin antibody CPT 86800 | $50.88 | $96.00 | $15.91 – $54.15 | 28 |
| Thyroid imaging CPT 78013 | $31.73 | $47.00 | $15.94 – $44.65 | 27 |
| Thyroid (TSH) Test CPT 84443 | $30.29 | $54.00 | $16.80 – $48.45 | 28 |
| Thyroid Ultrasound CPT 76536 | $768.69 | $1,053.00 | $24.76 – $558.09 | 28 |
| Thyroid uptake measurement CPT 78012 | $16.88 | $25.00 | $8.48 – $23.75 | 27 |
| Thyroxine binding globulin (tbg) CPT 84442 | $25.25 | $45.00 | $14.78 – $42.75 | 28 |
| Tissue culture placenta CPT 88235 | $304.50 | $451.00 | $150.30 – $428.45 | 28 |
| Tissue culture skin/biopsy CPT 88233 | $285.59 | $423.00 | $140.73 – $401.85 | 28 |
| Tissue culture tumor CPT 88239 | $299.10 | $443.00 | $147.52 – $420.85 | 28 |
| Tissue exam koh skin/hair/nails CPT 87220 | $120.40 | $215.00 | $4.27 – $60.80 | 28 |
| Tissue transglutaminase iga CPT 86364 | $31.27 | $59.00 | $11.53 – $33.25 | 28 |
| Tobramycin peak therapeutic drug level CPT 80200 | $27.49 | $49.00 | $16.13 – $46.55 | 28 |
| Toe X-ray (both feet) CPT 73660 | $179.68 | $279.00 | $6.11 – $147.87 | 28 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $44.35 | $77.00 | $13.33 – $53.20 | 28 |
| Tomosynthesis breast screen bilateral CPT 77063 | $39.25 | $77.00 | $14.99 – $59.85 | 27 |
| Total hysterectomy CPT 58150 | $1,782.42 | $2,640.00 | $157.08 – $627.00 | 27 |
| Total tau CPT 84394 | $253.01 | $451.00 | $107.34 – $428.45 | 28 |
| Toxoplasma antibody igg CPT 86777 | $33.39 | $63.00 | $14.39 – $57.00 | 28 |
| Toxoplasma antibody igm CPT 86778 | $31.80 | $60.00 | $14.41 – $41.80 | 28 |
| Tpmt gene com vrnts CPT 81335 | $608.48 | $525.00 | $174.81 – $498.75 | 28 |
| Transferrin CPT 84466 | $21.88 | $39.00 | $12.76 – $37.05 | 28 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $694.96 | $952.00 | $30.19 – $504.56 | 28 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $585.46 | $802.00 | $32.56 – $425.06 | 28 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $2,394.86 | $3,965.00 | $380.42 – $2,508.00 | 28 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $388.48 | $594.00 | $85.60 – $564.30 | 28 |
| Treat ectopic pregnancy CPT 59150 | $242.56 | $515.00 | $174.69 – $489.25 | 27 |
| Treat ectopic pregnancy CPT 59151 | $236.44 | $502.00 | $170.28 – $476.90 | 27 |
| Treat foot bone lesion CPT 28005 | $707.44 | $1,502.00 | $509.48 – $1,426.90 | 27 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | not published | not published | $380.11 – $1,901.83 | 6 |
| Treponema pallidum antibody CPT 86780 | $39.22 | $74.00 | $13.24 – $38.00 | 28 |
| Trg gene rearrangement anal CPT 81342 | $701.20 | $605.00 | $201.50 – $574.75 | 28 |
| Trichinella antibody CPT 86784 | $36.57 | $69.00 | $12.56 – $65.55 | 28 |
| #tricyclicantidprssnt CPT 80337 | $48.81 | $87.00 | $10.35 – $82.65 | 28 |
| Triglycerides CPT 84478 | $30.29 | $54.00 | $5.74 – $40.85 | 28 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | $1,063.05 | $2,257.00 | $765.57 – $2,144.15 | 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.