Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm at Banner Payson Medical Center

807 South Ponderosa Street, Payson, AZ · Banner Health · · NPI 1063923340

Source: hospital's published price file ↗ · Published Mar 2, 2026 · Ingested Aug 12, 2026

$213.11

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$422.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$38.22 with Aetna vs $369.59 with Blue Cross Blue Shield of Arizona — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Aetna Banner Employee Plans $38.22 ↓ -82%
Wellpoint Medicare Advantage HMO $38.50 ↓ -82%
Gila River Health Care Corporation Managed Care Program $38.50 ↓ -82%
UPMC Health Plan Medicare Advantage $38.50 ↓ -82%
Aetna Medicare Advantage $38.50 ↓ -82%
United Healthcare UHC Medicare Advantage $38.50 ↓ -82%
TriWest Healthcare Alliance Corp - VA CCN VA Community Care Network $38.50 ↓ -82%
Arizona Physicians IPA Medicare Advantage $38.50 ↓ -82%
Cigna Healthcare of Arizona, Inc. HMO Medicare Advantage Plan/PPO Medicare Advantage Plan $38.50 ↓ -82%
Banner Health Medicare Advantage $38.50 ↓ -82%
TriWest Healthcare Alliance Corp - VA CCN Tricare $38.50 ↓ -82%
Banner University Health Plan Medicare Advantage $38.50 ↓ -82%
Health Choice Arizona, Inc. Medicare Advantage $38.50 ↓ -82%
Blue Cross Blue Shield of Arizona Medicare Advantage $38.50 ↓ -82%
Health Net Medicare $38.50 ↓ -82%
Care 1st Medicare Advantage $38.50 ↓ -82%
Mercy Care Mercy Care Advantage $38.50 ↓ -82%
Kaiser Foundation Health Plan Medicare Advantage $38.50 ↓ -82%
Carelon Medicare Advantage $40.42 ↓ -81%
Humana Medicare Advantage $40.81 ↓ -81%
Plotkin Health Plotkin Health $42.26 ↓ -80%
National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Insurance Group (VUMI) NHSI VUMI $42.26 ↓ -80%
Gold Kidney Health Plan Medicare Advantage $42.35 ↓ -80%
Arizona Priority Care Medicare Advantage $42.35 ↓ -80%
Devoted Health Services Medicare Advantage $42.35 ↓ -80%
Aetna Joint Venture $49.77 ↓ -77%
Aetna Aetna Qualified Health Plan $52.40 ↓ -75%
Banner University Health Plan AZ Medicaid - AHCCCS $53.76 ↓ -75%
Health Choice Arizona, Inc. Medicaid $53.76 ↓ -75%
Health Net Medicaid $53.76 ↓ -75%
Arizona Physicians IPA Medicaid $53.76 ↓ -75%
Mercy Care Mercy Medicaid $53.76 ↓ -75%
Health Choice Arizona, Inc. ACA Health Plan $54.93 ↓ -74%
Health Net Commerical Exchange Product $56.98 ↓ -73%
Aetna Medical Rental $60.38 ↓ -72%
Aetna Broad Network $62.16 ↓ -71%
United Healthcare UHC Individual Exchange $62.91 ↓ -70%
Oscar Health Plan Commercial $63.52 ↓ -70%
Quiktrip Corporation Commercial $65.73 ↓ -69%
Cigna Healthcare of Arizona, Inc. Commerical/HMO Benefit Plan/Local Flex Plan/Network Benefit Plan/Open Access Plan $74.74 ↓ -65%
Provider Network of America Commercial $84.51 ↓ -60%
Arizona Medical Network Commercial $84.51 ↓ -60%
Blue Cross Blue Shield of Arizona BXBSAZ Neighborhood $277.19 ↑ +30%
Blue Cross Blue Shield of Arizona BCBSAZ Alliance/Blue HPN $295.67 ↑ +39%
Blue Cross Blue Shield of Arizona BXBSAZ Alliance CHS $310.45 ↑ +46%
Blue Cross Blue Shield of Arizona BCBSAZ Medicare $353.01 ↑ +66%
Blue Cross Blue Shield of Arizona BCBSAZ Workers Comp $369.59 ↑ +73%
Blue Cross Blue Shield of Arizona Commercial $369.59 ↑ +73%

Visitor-reported prices

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Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm at other Arizona hospitals

Hospital City Cash price Negotiated range
Mercy Gilbert Medical Center Gilbert $27,295.92 $53.71 – $16,012.15
Arizona General Hospital Laveen Phoenix $7,626.62 $53.71 – $14,011.55
St. Joseph’s Hospital and Medical Center Phoenix $12,232.79 $53.71 – $4,532.23
Arizona General Hospital Mesa Mesa $8,226.09 $53.71 – $14,011.55
Chandler Regional Medical Center Chandler $29,737.02 $53.71 – $17,467.80

All Arizona hospitals for this procedure →