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 |
|---|---|---|---|---|
| Contrast x-ray of hip CPT 73525 | $216.06 | $844.00 | $25.78 – $447.32 | 28 |
| Contrast x-ray of knee joint CPT 73580 | $180.74 | $706.00 | $25.10 – $374.18 | 28 |
| Contrast x-ray of wrist CPT 73115 | $99.58 | $389.00 | $24.76 – $206.17 | 28 |
| Controller infinity pt dbs HCPCS C1787 | $7,642.25 | $13,895.00 | $1,162.63 – $4,640.75 | 28 |
| Coombs direct CPT 86880 | $67.31 | $127.00 | $5.39 – $120.65 | 28 |
| Coombs indirect titer reference CPT 86886 | $193.45 | $365.00 | $5.18 – $346.75 | 28 |
| Correct inverted nipple(s) CPT 19355 | $1,140.76 | $2,422.00 | $547.81 – $1,534.25 | 27 |
| Cortisol total am CPT 82533 | $181.20 | $323.00 | $16.30 – $55.10 | 28 |
| Counseling smoke cess interm >10mins CPT 99407 | $31.56 | $67.00 | $9.65 – $63.65 | 27 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $1,482.25 | $2,695.00 | $39.51 – $157.70 | 28 |
| #covid19rsv-rsv CPT 87634 | $118.16 | $211.00 | $70.20 – $200.45 | 28 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $28.09 | $53.00 | $13.03 – $50.35 | 28 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $668.30 | $1,008.00 | $63.35 – $957.60 | 28 |
| C-peptide CPT 84681 | $35.34 | $63.00 | $20.81 – $59.85 | 28 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $452.83 | $683.00 | $177.30 – $648.85 | 28 |
| C-reactive protein CPT 86140 | $8.48 | $16.00 | $5.18 – $15.20 | 28 |
| C-reactive protein high sensitivity CPT 86141 | $69.43 | $131.00 | $12.95 – $54.15 | 28 |
| C-reactive protein, quantitative CPT 86406 | $42.93 | $81.00 | $10.64 – $56.05 | 28 |
| Creatine kinase CPT 82550 | $30.86 | $55.00 | $6.51 – $19.00 | 28 |
| Creatine kinase isoenzymes CPT 82552 | $33.10 | $59.00 | $13.39 – $56.05 | 28 |
| Creatine kinase mb CPT 82553 | $37.03 | $66.00 | $11.55 – $62.70 | 28 |
| Creatine - sendout CPT 82540 | $33.66 | $60.00 | $4.64 – $57.00 | 28 |
| Creatinine CPT 82565 | $25.25 | $45.00 | $5.12 – $42.75 | 28 |
| Creatinine 24 hour urine CPT 82570 | $40.95 | $73.00 | $5.18 – $15.20 | 28 |
| Creatinine clearance urine CPT 82575 | $16.27 | $29.00 | $9.46 – $27.55 | 28 |
| #creutz-prot.,western blot CPT 84182 | $86.96 | $155.00 | $29.21 – $83.60 | 28 |
| Critical care each additional 30 minutes CPT 99292 | $594.09 | $1,035.00 | $68.07 – $548.55 | 28 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $1,188.18 | $2,070.00 | $192.33 – $1,097.10 | 28 |
| Cryoprecipitate each unit HCPCS P9012 | $43.34 | $89.00 | $30.19 – $84.55 | 28 |
| Cryptococcus abs qn - sendout CPT 86641 | $23.32 | $44.00 | $14.41 – $41.80 | 28 |
| Cryptosporidium antigen CPT 87272 | $62.16 | $111.00 | $11.98 – $57.95 | 28 |
| Crystal identification light microscopy CPT 89060 | $13.40 | $22.00 | $7.33 – $20.90 | 28 |
| CT 3d report other modality w/workstation CPT 76377 | $45.29 | $102.00 | $24.28 – $96.90 | 27 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,304.49 | $2,253.00 | $81.41 – $1,194.09 | 28 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,597.91 | $6,214.00 | $94.98 – $3,293.42 | 28 |
| CT Angiogram of the Abdomen CPT 74175 | $2,422.54 | $4,184.00 | $78.69 – $2,217.52 | 28 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $2,816.77 | $4,172.00 | $102.78 – $2,211.16 | 28 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,306.74 | $3,984.00 | $79.03 – $2,111.52 | 28 |
| CT Angiogram of the Head CPT 70496 | $1,364.54 | $2,226.00 | $75.98 – $1,179.78 | 28 |
| CT Angiogram of the Neck CPT 70498 | $1,266.46 | $2,066.00 | $75.98 – $1,094.98 | 28 |
| CT angio pelvis CPT 72191 | $1,177.69 | $2,034.00 | $78.02 – $1,078.02 | 28 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,190.42 | $2,056.00 | $78.02 – $1,089.68 | 28 |
| CT bone density axial CPT 77078 | $198.60 | $343.00 | $10.85 – $181.79 | 28 |
| CT guidance for needle placement CPT 77012 | $1,003.29 | $1,486.00 | $45.22 – $787.58 | 28 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $855.56 | $1,172.00 | $35.70 – $621.16 | 28 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $176.89 | $262.00 | $25.10 – $138.86 | 28 |
| CT limited or localized follow-up study CPT 76380 | $717.70 | $1,063.00 | $42.06 – $563.39 | 28 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,241.95 | $2,145.00 | $52.92 – $1,136.85 | 28 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,426.52 | $5,918.00 | $87.17 – $3,136.54 | 28 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $2,855.63 | $4,932.00 | $79.37 – $2,613.96 | 28 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,284.15 | $3,945.00 | $75.64 – $2,090.85 | 28 |
| CT t-spine w /wo contrast CPT 72130 | $1,826.74 | $3,155.00 | $55.29 – $1,672.15 | 28 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,133.68 | $1,958.00 | $53.25 – $1,037.74 | 28 |
| Culture aerobic additional method definitive id each CPT 87077 | $57.68 | $103.00 | $8.08 – $23.75 | 28 |
| Culture afb any source CPT 87116 | $35.28 | $63.00 | $10.80 – $31.35 | 28 |
| Culture anaerobic additional method definitive id each CPT 87076 | $66.08 | $118.00 | $8.08 – $23.75 | 28 |
| Culture anaerobic except blood CPT 87075 | $16.24 | $29.00 | $9.47 – $27.55 | 28 |
| Culture bacteria anaerobic CPT 87073 | $16.24 | $29.00 | $9.66 – $27.55 | 28 |
| Culture bact stool aero addl path ea CPT 87046 | $35.28 | $63.00 | $9.44 – $27.55 | 28 |
| Culture body fluid CPT 87070 | $42.00 | $75.00 | $8.62 – $24.70 | 28 |
| Culture fungi definitive id mold CPT 87107 | $77.28 | $138.00 | $10.32 – $58.90 | 28 |
| Culture fungi definitive id yeast CPT 87106 | $76.16 | $136.00 | $10.32 – $58.90 | 28 |
| Culture fungi other (except blood) CPT 87102 | $43.68 | $78.00 | $8.41 – $57.00 | 28 |
| Culture fungi skin/hair/nail CPT 87101 | $33.04 | $59.00 | $7.71 – $56.05 | 28 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $35.84 | $64.00 | $14.61 – $60.80 | 28 |
| Culture mycoplasma any source CPT 87109 | $35.28 | $63.00 | $15.39 – $59.85 | 28 |
| Culture quantitative aerobic other source CPT 87071 | $34.16 | $61.00 | $9.89 – $57.95 | 28 |
| Culture screening strep group a CPT 87081 | $73.36 | $131.00 | $6.63 – $19.00 | 28 |
| Culture typing glc/hplc CPT 87143 | $21.28 | $38.00 | $12.52 – $36.10 | 28 |
| Culture typing immunologic CPT 87147 | $47.60 | $85.00 | $5.18 – $15.20 | 28 |
| Culture urine each isolate CPT 87088 | $14.00 | $25.00 | $8.09 – $23.75 | 28 |
| Cutter lead HCPCS C1773 | $2,351.78 | $3,596.00 | $269.42 – $1,075.40 | 28 |
| Cv stress test i&r only 93018 CPT 93018 | $17.90 | $38.00 | $9.04 – $36.10 | 27 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $37.03 | $66.00 | $14.32 – $62.70 | 28 |
| Cyclic citrullinated peptide antibody CPT 86200 | $31.27 | $59.00 | $12.95 – $56.05 | 28 |
| Cyclosporine 2 hour CPT 80158 | $32.54 | $58.00 | $18.05 – $55.10 | 28 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $16,865.20 | $30,664.00 | $200.87 – $801.80 | 28 |
| Cyp2c19 gene com variants CPT 81225 | $1,014.12 | $875.00 | $291.36 – $831.25 | 28 |
| Cyp2c9 gene com variants CPT 81227 | $608.48 | $525.00 | $174.81 – $498.75 | 28 |
| Cyp2d6 gene com variants CPT 81226 | $1,568.13 | $1,353.00 | $450.91 – $1,285.35 | 28 |
| Cyp3a4 gene common variants CPT 81230 | $608.48 | $525.00 | $174.81 – $498.75 | 28 |
| Cyp3a5 gene common variants CPT 81231 | $608.48 | $525.00 | $174.81 – $498.75 | 28 |
| Cystatin c CPT 82610 | $31.42 | $56.00 | $18.52 – $53.20 | 28 |
| Cystic fibrosis cftr CPT 81223 | $1,735.02 | $1,497.00 | $499.00 – $1,422.15 | 28 |
| Cystine urine quantitative CPT 82131 | $51.05 | $91.00 | $22.98 – $86.45 | 28 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $267.26 | $415.00 | $13.91 – $219.95 | 28 |
| Cystoscopy (Bladder Scope) CPT 52000 | $729.64 | $1,483.00 | $77.75 – $1,408.85 | 28 |
| Cytogenetics 25-99 CPT 88274 | $86.42 | $128.00 | $42.38 – $121.60 | 28 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $31.80 | $60.00 | $14.39 – $53.20 | 28 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $32.33 | $61.00 | $16.85 – $48.45 | 28 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $76.97 | $114.00 | $36.08 – $108.30 | 28 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $54.01 | $80.00 | $26.61 – $76.00 | 28 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $41.18 | $61.00 | $20.26 – $57.95 | 28 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $56.71 | $84.00 | $24.53 – $79.80 | 28 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $34.43 | $51.00 | $8.11 – $48.45 | 28 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $246.43 | $365.00 | $21.05 – $346.75 | 28 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $129.63 | $192.00 | $36.08 – $108.30 | 28 |
| Cytopath smear oth prep screen & interp CPT 88161 | $35.78 | $53.00 | $17.89 – $50.35 | 28 |
| Cytotoxic antibody screening CPT 86808 | $47.70 | $90.00 | $29.68 – $85.50 | 28 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $153.88 | $274.29 | $93.04 – $260.58 | 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.