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 |
|---|---|---|---|---|
| Troponin quantitative CPT 84484 | $21.32 | $38.00 | $12.47 – $36.10 | 28 |
| Tte w or without fol w/con,stres HCPCS C8928 | $868.12 | $1,567.00 | $518.51 – $1,488.65 | 28 |
| Tte w or without fol w/cont, com HCPCS C8921 | $809.95 | $1,462.00 | $495.91 – $1,388.90 | 28 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $627.68 | $1,133.00 | $384.31 – $1,076.35 | 28 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $365.97 – $3,668.82 | 6 |
| Ugt1a1 gene analy common variants CPT 81350 | $813.62 | $702.00 | $234.00 – $666.90 | 28 |
| Ultrasound breast complete CPT 76641 | $797.16 | $1,092.00 | $31.55 – $385.84 | 28 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $706.64 | $968.00 | $29.51 – $341.85 | 28 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $237.25 | $325.00 | $20.74 – $172.25 | 28 |
| Ultrasound encephalogram CPT 76506 | $470.85 | $645.00 | $28.15 – $341.85 | 28 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $411.72 | $564.00 | $33.58 – $298.92 | 28 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $394.20 | $540.00 | $33.58 – $286.20 | 28 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $411.72 | $564.00 | $19.52 – $298.92 | 28 |
| Ultrasound guidance for vascular access CPT 76937 | $203.67 | $279.00 | $8.81 – $147.87 | 28 |
| Ultrasound guide intraoperative CPT 76998 | $215.35 | $295.00 | $24.58 – $156.35 | 28 |
| Ultrasound hips infant dynamic CPT 76885 | $283.24 | $388.00 | $32.22 – $205.64 | 28 |
| Ultrasound joint complete left CPT 76881 | $449.68 | $616.00 | $10.67 – $326.48 | 28 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $516.11 | $707.00 | $40.21 – $374.71 | 28 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $283.24 | $388.00 | $20.45 – $205.64 | 28 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $604.44 | $828.00 | $82.09 – $438.84 | 28 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $529.25 | $725.00 | $36.97 – $384.25 | 28 |
| Ultrasound spinal canal and contents CPT 76800 | $291.27 | $399.00 | $50.88 – $211.47 | 28 |
| Ultrasound transabd ea addl gest CPT 76812 | $700.07 | $959.00 | $62.26 – $508.27 | 28 |
| Unlisted hematology&coagj px CPT 85999 | $31.24 | $57.00 | $13.57 – $54.15 | 28 |
| Unlisted transfusion med px CPT 86999 | $163.21 | $268.00 | $17.89 – $50.35 | 28 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $218.32 | $339.00 | $7.46 – $179.67 | 28 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $1,522.19 | $2,629.00 | $53.25 – $1,393.37 | 28 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,217.64 | $2,103.00 | $43.76 – $1,114.59 | 28 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,112.75 | $3,375.00 | $99.72 – $1,788.75 | 28 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,760.94 | $2,813.00 | $77.68 – $1,490.89 | 28 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,408.50 | $2,250.00 | $64.79 – $1,192.50 | 28 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $378.03 | $587.00 | $9.16 – $311.11 | 28 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $463.04 | $719.00 | $10.18 – $381.07 | 28 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $150.72 | $320.00 | $108.54 – $304.00 | 27 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $169.56 | $360.00 | $122.11 – $342.00 | 27 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $772.80 | $1,200.00 | $39.35 – $636.00 | 28 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $723.86 | $1,124.00 | $35.28 – $595.72 | 28 |
| Uppr gi scope w/submuc inj CPT 43236 | $169.56 | $360.00 | $122.11 – $342.00 | 27 |
| Urea nitrogen CPT 84520 | $24.12 | $43.00 | $3.95 – $40.85 | 28 |
| Urea nitrogen 24 hour urine CPT 84540 | $29.17 | $52.00 | $5.56 – $49.40 | 28 |
| Ureteroureterostomy 50760 CPT 50760 | $746.73 | $1,106.00 | $175.64 – $701.10 | 27 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $486.22 | $755.00 | $3.56 – $400.15 | 28 |
| Urethrocystography void s&i CPT 74455 | $719.99 | $1,118.00 | $14.25 – $592.54 | 28 |
| Uric acid blood CPT 84550 | $7.85 | $14.00 | $4.52 – $13.30 | 28 |
| Uric acid urine CPT 84560 | $40.39 | $72.00 | $5.08 – $15.20 | 28 |
| Urinalysis microscopic only CPT 81015 | $5.74 | $10.00 | $3.05 – $9.50 | 28 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $4.02 | $7.00 | $2.17 – $6.65 | 28 |
| Urinalysis (with microscopy) CPT 81001 | $5.74 | $10.00 | $3.17 – $9.50 | 28 |
| Urinalysis (without microscopy) CPT 81003 | $30.42 | $53.00 | $2.25 – $6.65 | 28 |
| Urine Culture Test CPT 87086 | $14.00 | $25.00 | $8.07 – $23.75 | 28 |
| Urine pregnancy test CPT 81025 | $33.29 | $58.00 | $8.61 – $55.10 | 28 |
| Vaccine Administration (one shot) CPT 90471 | $67.20 | $105.00 | $20.22 – $99.75 | 28 |
| Vag hyst including t/o CPT 58262 | $1,142.17 | $2,425.00 | $205.89 – $576.65 | 27 |
| Vaginal hysterectomy CPT 58260 | $1,028.66 | $2,184.00 | $185.20 – $518.70 | 27 |
| Valproic acid total therapeutic drug level CPT 80164 | $29.73 | $53.00 | $13.54 – $50.35 | 28 |
| Vancomycin peak therapeutic drug level CPT 80202 | $23.00 | $41.00 | $13.54 – $38.95 | 28 |
| Varicella zoster antibody igg CPT 86787 | $28.09 | $53.00 | $12.88 – $37.05 | 28 |
| Vasectomy CPT 55250 | $357.68 | $727.00 | $200.47 – $561.45 | 28 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $16.88 | $25.00 | $5.95 – $23.75 | 27 |
| Venipuncture <3 yrs other vein CPT 36406 | $15.53 | $23.00 | $5.47 – $21.85 | 27 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $505.54 | $785.00 | $30.19 – $416.05 | 28 |
| Ventilator each subsequent day CPT 94003 | $944.78 | $1,425.00 | $62.36 – $1,353.75 | 28 |
| Ventilator Management (first day) CPT 94002 | $1,322.02 | $1,994.00 | $88.64 – $1,894.30 | 28 |
| Version cephalic external CPT 59412 | $502.99 | $745.00 | $99.62 – $707.75 | 28 |
| Very long chain fatty acids CPT 82726 | $115.01 | $205.00 | $19.75 – $194.75 | 28 |
| Virus isolation addl studies ea CPT 87253 | $36.40 | $65.00 | $20.20 – $57.95 | 28 |
| Vital capacity test CPT 94150 | $57.52 | $99.00 | $21.05 – $94.05 | 28 |
| Vitamin b-12 CPT 82607 | $30.29 | $54.00 | $15.08 – $51.30 | 28 |
| Vitamin D Test CPT 82306 | $49.93 | $89.00 | $29.60 – $84.55 | 28 |
| Vkorc1 gene CPT 81355 | $307.14 | $265.00 | $88.20 – $251.75 | 28 |
| Volume measurement urine timed CPT 81050 | $6.31 | $11.00 | $3.64 – $10.45 | 28 |
| Walking (Gait) Training (each 15 minutes) CPT 97116 | $47.56 | $83.00 | $19.75 – $78.85 | 28 |
| Warde 1003990 aldosterone CPT 82088 | $151.47 | $270.00 | $40.75 – $116.85 | 28 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $97.61 | $174.00 | $27.80 – $79.80 | 28 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $34.22 | $61.00 | $12.90 – $57.95 | 28 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $42.64 | $76.00 | $25.25 – $72.20 | 28 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $46.00 | $82.00 | $15.50 – $77.90 | 28 |
| Warde 1015200 kappa light chain free CPT 83521 | $38.71 | $69.00 | $17.27 – $57.95 | 28 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $33.10 | $59.00 | $8.02 – $56.05 | 28 |
| Warde 3008005 oligoclonal bands CPT 83916 | $46.56 | $83.00 | $27.39 – $78.85 | 28 |
| Warde 3016000 west nile virus antibody CPT 86788 | $38.16 | $72.00 | $16.85 – $68.40 | 28 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $38.16 | $72.00 | $14.39 – $68.40 | 28 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $29.15 | $55.00 | $12.25 – $52.25 | 28 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $15.12 | $27.00 | $8.90 – $25.65 | 28 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $39.76 | $71.00 | $17.98 – $67.45 | 28 |
| Warde 3400852 arsenic CPT 82175 | $53.30 | $95.00 | $18.97 – $59.85 | 28 |
| Warde 3708165 mercury urine CPT 83825 | $49.37 | $88.00 | $16.26 – $46.55 | 28 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $52.47 | $99.00 | $18.40 – $94.05 | 28 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $31.80 | $60.00 | $11.53 – $53.20 | 28 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $88.08 | $157.00 | $8.10 – $23.75 | 28 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $65.08 | $116.00 | $38.62 – $110.20 | 28 |
| Warde aldolase CPT 82085 | $29.73 | $53.00 | $9.71 – $50.35 | 28 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $79.10 | $141.00 | $16.87 – $48.45 | 28 |
| Warde amiodarone therapeutic drug level CPT 80151 | $50.49 | $90.00 | $18.64 – $85.50 | 28 |
| Warde analysis gene hfe common variants CPT 81256 | $228.32 | $197.00 | $65.36 – $187.15 | 28 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $570.23 | $492.00 | $163.96 – $467.40 | 28 |
| Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites CPT 80339 | $98.74 | $176.00 | $23.37 – $167.20 | 28 |
| Warde anti-mullerian hormone CPT 82166 | $65.08 | $116.00 | $38.62 – $110.20 | 28 |
| Warde apolipoprotein b CPT 82172 | $98.18 | $175.00 | $21.09 – $60.80 | 28 |
| Warde bile acids CPT 82239 | $35.34 | $63.00 | $17.12 – $59.85 | 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.