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 |
|---|---|---|---|---|
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $330.17 | $701.00 | $237.78 – $665.95 | 27 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $368.32 | $782.00 | $250.73 – $742.90 | 27 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $386.22 | $820.00 | $278.14 – $779.00 | 27 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $471.94 | $1,002.00 | $250.73 – $951.90 | 27 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $430.49 | $914.00 | $310.03 – $868.30 | 27 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $521.87 | $1,108.00 | $250.73 – $1,052.60 | 27 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $14.25 | $26.00 | $8.60 – $24.70 | 28 |
| Ghs mbp CPT 83873 | $35.34 | $63.00 | $17.20 – $59.85 | 28 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $216.66 | $345.00 | $14.52 – $182.85 | 28 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $216.66 | $345.00 | $52.36 – $209.00 | 28 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $307.72 | $490.00 | $47.84 – $259.70 | 28 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $109.90 | $175.00 | $6.66 – $92.75 | 28 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $110.73 | $175.00 | $39.03 – $155.80 | 28 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,362.10 | $2,373.00 | $24.23 – $1,502.90 | 28 |
| Ghs nerve blk intercostal, single level CPT 64420 | $504.55 | $879.00 | $56.64 – $556.70 | 28 |
| Ghs ng placement w fluoro guidance CPT 43752 | $178.77 | $354.00 | $36.29 – $187.62 | 28 |
| Ghs ot group caregiver training CPT 97552 | $49.28 | $86.00 | $20.47 – $81.70 | 28 |
| Ghs ot prosthetic training/15 min CPT 97761 | $57.30 | $100.00 | $23.80 – $95.00 | 28 |
| Ghs pacing - transcutaneous CPT 92953 | $713.48 | $1,243.00 | $0.94 – $1,180.85 | 28 |
| Ghs phenylketonurid CPT 84030 | $9.54 | $17.00 | $5.50 – $16.15 | 28 |
| Ghs picc line insert < 5 CPT 36568 | $1,058.29 | $2,151.00 | $88.38 – $2,043.45 | 28 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $4,319.42 | $6,215.00 | $666.87 – $5,904.25 | 28 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $33.66 | $60.00 | $9.66 – $57.00 | 28 |
| Ghs protoporphyrins fract CPT 84202 | $62.27 | $111.00 | $14.35 – $105.45 | 28 |
| Ghs quinidine CPT 80194 | $33.66 | $60.00 | $14.60 – $57.00 | 28 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $38.16 | $72.00 | $15.89 – $68.40 | 28 |
| Ghs reticulocyte count CPT 85044 | $7.12 | $13.00 | $4.31 – $12.35 | 28 |
| Ghs sensitivity (per antimicro) CPT 87184 | $12.88 | $23.00 | $7.48 – $21.85 | 28 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $118.22 | $251.00 | $85.14 – $238.45 | 27 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $179.92 | $382.00 | $129.57 – $362.90 | 27 |
| Ghs sleep study unattended CPT 95800 | $499.38 | $625.00 | $94.69 – $593.75 | 28 |
| Ghs strapping shoulder - 29240 CPT 29240 | $226.91 | $396.00 | $17.45 – $250.80 | 28 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $395.64 | $840.00 | $284.93 – $798.00 | 27 |
| Ghs urine, porphyrins quant CPT 84120 | $34.78 | $62.00 | $14.71 – $58.90 | 28 |
| Ghs vaginal delivery only CPT 59409 | $999.93 | $2,123.00 | $720.12 – $2,016.85 | 27 |
| Giardia ag if CPT 87269 | $34.16 | $61.00 | $13.61 – $57.95 | 28 |
| Giardia lamblia antibody CPT 86674 | $35.51 | $67.00 | $14.72 – $63.65 | 28 |
| Gi inhouse confirmation CPT 87045 | $35.28 | $63.00 | $9.44 – $27.55 | 28 |
| Glucagon plasma - sendout CPT 82943 | $37.59 | $67.00 | $14.29 – $63.65 | 28 |
| Glucose 1 hr post dose CPT 82950 | $8.42 | $15.00 | $4.75 – $14.25 | 28 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $5.61 | $10.00 | $3.28 – $9.50 | 28 |
| Glucose body fluid CPT 82945 | $73.49 | $131.00 | $3.93 – $11.40 | 28 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $21.88 | $39.00 | $12.87 – $37.05 | 28 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $6.73 | $12.00 | $3.92 – $11.40 | 28 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $32.54 | $58.00 | $18.58 – $53.20 | 28 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $32.54 | $58.00 | $18.52 – $54.15 | 28 |
| Graft axiofill 1000mg HCPCS J3590 | $33.29 | $49.30 | $0.97 – $6.42 | 28 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $75.08 | $136.50 | $14.80 – $97.56 | 28 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $24,092.20 | $43,804.00 | $641.41 – $2,560.25 | 28 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $30,114.70 | $54,754.00 | $141.37 – $564.30 | 28 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $18,069.70 | $32,854.00 | $74.49 – $297.35 | 28 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $467.50 | $850.00 | $202.30 – $807.50 | 28 |
| Granulocyte pheresis ea unit HCPCS P9050 | $2,622.50 | $5,385.00 | $1,265.65 – $5,115.75 | 28 |
| G-tube reposition CPT 43761 | $500.46 | $991.00 | $92.26 – $525.23 | 28 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $6,059.31 | $9,265.00 | $39.51 – $157.70 | 28 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $2,875.64 | $4,397.00 | $74.49 – $297.35 | 28 |
| Gw stiffened micro access kit HCPCS C1894 | $5,150.90 | $7,876.00 | $22.85 – $91.20 | 28 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $91.68 | $160.00 | $26.61 – $152.00 | 28 |
| Hand X-ray CPT 73130 | $254.38 | $395.00 | $7.80 – $209.35 | 28 |
| Hand X-ray (2 views, both hands) CPT 73120 | $244.08 | $379.00 | $7.46 – $200.87 | 28 |
| Haptoglobin quantitative CPT 83010 | $33.10 | $59.00 | $12.58 – $50.35 | 28 |
| Hba1/hba2 full gene sequence CPT 81259 | $2,086.20 | $1,800.00 | $600.00 – $1,710.00 | 28 |
| Hcg qualitative CPT 84703 | $12.90 | $23.00 | $7.52 – $21.85 | 28 |
| Hcg quantitative CPT 84702 | $37.59 | $67.00 | $15.05 – $43.70 | 28 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $83.72 | $124.00 | $42.06 – $117.80 | 27 |
| Head CT scan (with and without contrast) CPT 70470 | $1,299.56 | $2,120.00 | $55.29 – $1,123.60 | 28 |
| Head CT scan (with contrast) CPT 70460 | $1,083.17 | $1,767.00 | $49.18 – $936.51 | 28 |
| Head CT scan (without contrast) CPT 70450 | $866.17 | $1,413.00 | $37.31 – $748.89 | 28 |
| Heart first pass add-on CPT 78496 | $42.54 | $63.00 | $14.99 – $59.85 | 27 |
| Heart infarct image CPT 78466 | $61.44 | $91.00 | $30.87 – $86.45 | 27 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $164.22 | $255.00 | $7.12 – $135.15 | 28 |
| Helicobacter pylori antibody igm CPT 86677 | $41.34 | $78.00 | $16.85 – $74.10 | 28 |
| Hematocrit CPT 85014 | $4.38 | $8.00 | $2.37 – $7.60 | 28 |
| Hemoglobin CPT 85018 | $4.38 | $8.00 | $2.37 – $7.60 | 28 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $33.10 | $59.00 | $8.20 – $56.05 | 28 |
| Hemoglobin plasma CPT 83051 | $12.34 | $22.00 | $7.31 – $20.90 | 28 |
| Hemoglobin urine CPT 83069 | $6.73 | $12.00 | $3.95 – $11.40 | 28 |
| Hemolysins/agglutinins auto CPT 86940 | $259.70 | $490.00 | $8.77 – $465.50 | 28 |
| Hemolysins and agglutinins incubated CPT 86941 | $19.61 | $37.00 | $12.11 – $35.15 | 28 |
| Hemophilus influenza antibdy CPT 86684 | $32.86 | $62.00 | $15.84 – $58.90 | 28 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $235.03 | $499.00 | $169.26 – $474.05 | 27 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | $473.83 | $1,006.00 | $341.24 – $955.70 | 27 |
| Heparin assay CPT 85520 | $35.62 | $65.00 | $13.09 – $61.75 | 28 |
| Hepatitis a antibody igm CPT 86709 | $45.58 | $86.00 | $11.26 – $81.70 | 28 |
| Hepatitis b core antibody igm CPT 86705 | $50.88 | $96.00 | $11.77 – $91.20 | 28 |
| Hepatitis b core antibody total CPT 86704 | $29.15 | $55.00 | $12.05 – $52.25 | 28 |
| Hepatitis b surface antibody CPT 86706 | $29.15 | $55.00 | $10.74 – $52.25 | 28 |
| Hepatitis c antibody CPT 86803 | $50.35 | $95.00 | $14.27 – $90.25 | 28 |
| Hernia Repair (Inguinal) CPT 49505 | $967.43 | $2,054.00 | $116.35 – $325.85 | 27 |
| Herpes simplex 1 ag if CPT 87274 | $33.60 | $60.00 | $11.98 – $57.00 | 28 |
| Herpes simplex 2 ag if CPT 87273 | $33.60 | $60.00 | $11.98 – $57.00 | 28 |
| Herpes simplex type 1 antibody igg CPT 86695 | $28.09 | $53.00 | $13.19 – $38.00 | 28 |
| Herpes simplex type 2 antibody igg CPT 86696 | $31.27 | $59.00 | $19.35 – $56.05 | 28 |
| Herpes simplex virus isolation CPT 87255 | $57.12 | $102.00 | $33.86 – $96.90 | 28 |
| Heterophile antibodies screening CPT 86308 | $8.48 | $16.00 | $5.18 – $15.20 | 28 |
| Hhv-6 dna quant CPT 87533 | $70.56 | $126.00 | $41.76 – $119.70 | 28 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $346.47 | $538.00 | $9.84 – $285.14 | 28 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $450.80 | $700.00 | $12.89 – $371.00 | 28 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $134.60 | $209.00 | $8.48 – $110.77 | 28 |
| Hip X-ray CPT 73502 | $388.98 | $604.00 | $9.84 – $320.12 | 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.