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 |
|---|---|---|---|---|
| Enterorrhaphy 1perforation 44602 CPT 44602 | $1,746.47 | $3,708.00 | $1,257.75 – $3,522.60 | 27 |
| Enzyme histochemistry CPT 88319 | $1,018.64 | $1,712.00 | $107.67 – $1,626.40 | 28 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $17.96 | $26.60 | $0.28 – $0.80 | 28 |
| Epstein barr early antigen antibody CPT 86663 | $29.15 | $55.00 | $13.12 – $52.25 | 28 |
| Epstein barr nuclear antigen antibody CPT 86664 | $28.62 | $54.00 | $15.29 – $43.70 | 28 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $32.86 | $62.00 | $18.14 – $52.25 | 28 |
| ER Visit (level 1, minor) CPT 99281 | $249.00 | $205.00 | $11.12 – $108.65 | 28 |
| ER Visit (level 2) CPT 99282 | $317.60 | $380.00 | $37.65 – $201.40 | 28 |
| ER Visit (level 3) CPT 99283 | $921.59 | $660.00 | $56.65 – $349.80 | 28 |
| ER Visit (level 4) CPT 99284 | $2,573.71 | $1,085.00 | $103.46 – $575.05 | 28 |
| ER Visit (level 5, high severity) CPT 99285 | $3,139.06 | $1,575.00 | $150.27 – $834.75 | 28 |
| Esophagoscopy balloon <30mm CPT 43220 | $144.60 | $307.00 | $104.13 – $291.65 | 27 |
| Esophagoscopy flex biopsy CPT 43202 | $126.23 | $268.00 | $90.91 – $254.60 | 27 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $107.39 | $228.00 | $77.34 – $216.60 | 27 |
| Esophagoscopy snare les remv CPT 43217 | $196.41 | $417.00 | $141.45 – $396.15 | 27 |
| Esoph egd dilation <30 mm CPT 43249 | $187.93 | $399.00 | $135.34 – $379.05 | 27 |
| Established Patient Office Visit (level 1) CPT 99211 | $255.20 | $290.00 | $8.55 – $137.75 | 28 |
| Established Patient Office Visit (level 2) CPT 99212 | $646.80 | $735.00 | $34.42 – $171.00 | 28 |
| Established Patient Office Visit (level 3) CPT 99213 | $1,298.00 | $1,475.00 | $54.54 – $212.80 | 28 |
| Established Patient Office Visit (level 4) CPT 99214 | $2,002.00 | $2,275.00 | $54.54 – $300.20 | 28 |
| Established Patient Office Visit (level 5) CPT 99215 | $2,820.40 | $3,205.00 | $54.54 – $421.80 | 28 |
| Estradiol total CPT 82670 | $47.12 | $84.00 | $27.94 – $79.80 | 28 |
| Estrogens total-sendout CPT 82672 | $37.03 | $66.00 | $21.70 – $62.70 | 28 |
| Ethylene glycol -sendout CPT 82693 | $45.44 | $81.00 | $14.90 – $76.95 | 28 |
| Euglobulin lysis CPT 85360 | $14.25 | $26.00 | $8.41 – $24.70 | 28 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $165.50 | $295.00 | $98.11 – $280.25 | 28 |
| Event monitor CPT 93270 | $206.25 | $375.00 | $8.07 – $356.25 | 28 |
| Evoked oa emissions ltd CPT 92587 | $113.43 | $168.00 | $3.53 – $159.60 | 28 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $103.82 – $1,901.83 | 6 |
| Exc abd les sc 3 cm/> CPT 22903 | $540.71 | $1,148.00 | $389.40 – $1,090.60 | 27 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | $603.82 | $1,282.00 | $290.02 – $812.25 | 27 |
| Exc back les sbq <3 cm 21930 CPT 21930 | $445.57 | $946.00 | $320.88 – $898.70 | 27 |
| Exc back tum deep 5 cm/> CPT 21933 | $908.56 | $1,929.00 | $654.32 – $1,832.55 | 27 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $217.60 | $462.00 | $156.71 – $438.90 | 27 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $99.38 | $211.00 | $71.57 – $200.45 | 27 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $125.29 | $266.00 | $90.23 – $252.70 | 27 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $176.15 | $374.00 | $126.86 – $355.30 | 27 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $216.19 | $459.00 | $155.69 – $436.05 | 27 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $133.29 | $283.00 | $95.99 – $268.85 | 27 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $189.34 | $402.00 | $136.36 – $381.90 | 27 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $335.35 | $712.00 | $241.51 – $676.40 | 27 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $126.23 | $268.00 | $90.91 – $254.60 | 27 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $179.92 | $382.00 | $129.57 – $362.90 | 27 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | $637.73 | $1,354.00 | $459.28 – $1,286.30 | 27 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $189.34 | $402.00 | $136.36 – $381.90 | 27 |
| Excise anal ext tag/papilla CPT 46220 | $146.01 | $310.00 | $105.15 – $294.50 | 27 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $158.73 | $337.00 | $114.31 – $320.15 | 27 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $165.32 | $351.00 | $119.06 – $333.45 | 27 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $139.42 | $296.00 | $100.40 – $281.20 | 27 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $301.44 | $640.00 | $217.09 – $608.00 | 27 |
| Excision breast lesion CPT 19125 | $850.16 | $1,805.00 | $408.06 – $1,142.85 | 27 |
| Excision of anal lesion(s) CPT 46922 | $167.20 | $355.00 | $120.42 – $337.25 | 27 |
| Excision of meckels diverticulum 44800 CPT 44800 | $950.95 | $2,019.00 | $480.52 – $1,918.05 | 27 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $578.86 | $1,229.00 | $416.88 – $1,167.55 | 27 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $221.84 | $471.00 | $159.76 – $447.45 | 27 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $180.39 | $383.00 | $129.91 – $363.85 | 27 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $196.88 | $418.00 | $141.79 – $397.10 | 27 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $235.50 | $500.00 | $169.60 – $475.00 | 27 |
| Exc neck tum deep < 5 cm CPT 21556 | $647.15 | $1,374.00 | $466.06 – $1,305.30 | 27 |
| Exc neck tum deep 5 cm/> CPT 21554 | $898.20 | $1,907.00 | $646.85 – $1,811.65 | 27 |
| Exc rect tum transanal full CPT 45172 | $999.46 | $2,122.00 | $719.78 – $2,015.90 | 27 |
| Exc rect tum transanal part CPT 45171 | $743.71 | $1,579.00 | $535.60 – $1,500.05 | 27 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $206.30 | $438.00 | $148.57 – $416.10 | 27 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $547.77 | $1,163.00 | $394.49 – $1,104.85 | 27 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $373.97 | $794.00 | $269.32 – $754.30 | 27 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | $579.80 | $1,231.00 | $278.48 – $779.95 | 27 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | $761.14 | $1,616.00 | $365.66 – $1,024.10 | 27 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | $412.84 – $1,718.26 | 6 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | $574.62 | $1,220.00 | $275.77 – $772.35 | 27 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $137.06 | $291.00 | $98.71 – $276.45 | 27 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | $601.94 | $1,278.00 | $289.00 – $809.40 | 27 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $5,095.75 | $9,265.00 | $641.41 – $2,560.25 | 28 |
| Expl lap celiotomy w/wo bx 49000 CPT 49000 | $1,363.82 | $2,020.00 | $120.19 – $479.75 | 27 |
| Exploration/repair of rectum 45563 CPT 45563 | $2,052.62 | $4,358.00 | $1,037.20 – $4,140.10 | 27 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $425.78 | $904.00 | $306.64 – $858.80 | 27 |
| Explore scrotum CPT 55110 | $475.71 | $1,010.00 | $342.59 – $959.50 | 27 |
| Explore wound abdomen 20102 CPT 20102 | $316.04 | $671.00 | $227.60 – $637.45 | 27 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $413.07 | $877.00 | $297.48 – $833.15 | 27 |
| External chromosome analysis 20-25 cells CPT 88264 | $293.02 | $434.00 | $144.61 – $412.30 | 28 |
| External newborn metabolic screening panel HCPCS S3620 | $148.60 | $244.00 | $58.07 – $231.80 | 28 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $28.09 | $53.00 | $17.89 – $50.35 | 28 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $291.67 | $432.00 | $143.75 – $410.40 | 28 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $68.90 | $130.00 | $17.93 – $51.30 | 28 |
| Eye Socket (Orbit) X-ray CPT 70200 | $270.48 | $420.00 | $12.55 – $222.60 | 28 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $1,362.09 | $2,222.00 | $54.95 – $1,177.66 | 28 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,135.28 | $1,852.00 | $49.18 – $981.56 | 28 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $907.85 | $1,481.00 | $55.63 – $784.93 | 28 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $3,577.37 | $5,798.00 | $92.94 – $3,072.94 | 28 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $2,384.70 | $3,865.00 | $58.34 – $2,048.45 | 28 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $171.30 | $266.00 | $9.16 – $140.98 | 28 |
| Facial Bones X-ray (complete) CPT 70150 | $314.92 | $489.00 | $11.87 – $259.17 | 28 |
| Factor ix CPT 85250 | $43.29 | $79.00 | $19.04 – $71.25 | 28 |
| Factor viii CPT 85240 | $36.17 | $66.00 | $17.90 – $62.70 | 28 |
| Fat/lipids feces qualitative CPT 82705 | $38.15 | $68.00 | $5.10 – $64.60 | 28 |
| Fatty acids nonesterified CPT 82725 | $38.71 | $69.00 | $18.77 – $65.55 | 28 |
| #fecal-sodium CPT 84302 | $32.54 | $58.00 | $4.86 – $14.25 | 28 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $41.51 | $74.00 | $18.64 – $70.30 | 28 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $0.10 | $0.45 | $0.15 – $0.43 | 28 |
| Fern test HCPCS Q0114 | $37.03 | $66.00 | $9.74 – $62.70 | 28 |
| Ferritin CPT 82728 | $33.66 | $60.00 | $13.63 – $57.00 | 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.