Ethylene glycol -sendout 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

$38.07

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.

$81.00

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.

$14.90 with Health Net vs $72.90 with Provider Network of America — 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
Health Net Medicaid $14.90 ↓ -61%
Mercy Care Mercy Medicaid $14.90 ↓ -61%
Banner University Health Plan AZ Medicaid - AHCCCS $14.90 ↓ -61%
Health Choice Arizona, Inc. Medicaid $14.90 ↓ -61%
Arizona Physicians IPA Medicaid $14.90 ↓ -61%
Aetna Banner Employee Plans $32.97 ↓ -13%
Arizona Physicians IPA Medicare Advantage $33.21 ↓ -13%
Gila River Health Care Corporation Managed Care Program $33.21 ↓ -13%
United Healthcare UHC Medicare Advantage $33.21 ↓ -13%
UPMC Health Plan Medicare Advantage $33.21 ↓ -13%
Blue Cross Blue Shield of Arizona Medicare Advantage $33.21 ↓ -13%
Banner University Health Plan Medicare Advantage $33.21 ↓ -13%
Mercy Care Mercy Care Advantage $33.21 ↓ -13%
Cigna Healthcare of Arizona, Inc. HMO Medicare Advantage Plan/PPO Medicare Advantage Plan $33.21 ↓ -13%
Aetna Medicare Advantage $33.21 ↓ -13%
Banner Health Medicare Advantage $33.21 ↓ -13%
Health Choice Arizona, Inc. Medicare Advantage $33.21 ↓ -13%
Kaiser Foundation Health Plan Medicare Advantage $33.21 ↓ -13%
TriWest Healthcare Alliance Corp - VA CCN VA Community Care Network $33.21 ↓ -13%
TriWest Healthcare Alliance Corp - VA CCN Tricare $33.21 ↓ -13%
Health Net Medicare $33.21 ↓ -13%
Wellpoint Medicare Advantage HMO $33.21 ↓ -13%
Care 1st Medicare Advantage $33.21 ↓ -13%
Carelon Medicare Advantage $34.87 ↓ -8%
Humana Medicare Advantage $35.20 ↓ -8%
National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Insurance Group (VUMI) NHSI VUMI $36.45 ↓ -4%
Plotkin Health Plotkin Health $36.45 ↓ -4%
Gold Kidney Health Plan Medicare Advantage $36.53 ↓ -4%
Arizona Priority Care Medicare Advantage $36.53 ↓ -4%
Devoted Health Services Medicare Advantage $36.53 ↓ -4%
Aetna Joint Venture $42.93 ↑ +13%
Aetna Aetna Qualified Health Plan $45.20 ↑ +19%
Health Choice Arizona, Inc. ACA Health Plan $47.38 ↑ +24%
Health Net Commerical Exchange Product $49.15 ↑ +29%
Aetna Medical Rental $52.08 ↑ +37%
Blue Cross Blue Shield of Arizona BXBSAZ Neighborhood $52.86 ↑ +39%
Aetna Broad Network $53.62 ↑ +41%
United Healthcare UHC Individual Exchange $54.27 ↑ +43%
Oscar Health Plan Commercial $54.80 ↑ +44%
Blue Cross Blue Shield of Arizona BCBSAZ Alliance/Blue HPN $56.39 ↑ +48%
Quiktrip Corporation Commercial $56.70 ↑ +49%
Blue Cross Blue Shield of Arizona BXBSAZ Alliance CHS $59.20 ↑ +56%
Cigna Healthcare of Arizona, Inc. Commerical/HMO Benefit Plan/Local Flex Plan/Network Benefit Plan/Open Access Plan $64.48 ↑ +69%
Blue Cross Blue Shield of Arizona BCBSAZ Medicare $67.32 ↑ +77%
Blue Cross Blue Shield of Arizona BCBSAZ Workers Comp $70.48 ↑ +85%
Blue Cross Blue Shield of Arizona Commercial $70.48 ↑ +85%
Arizona Medical Network Commercial $72.90 ↑ +91%
Provider Network of America Commercial $72.90 ↑ +91%

Visitor-reported prices

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Ethylene glycol -sendout at other Arizona hospitals

Hospital City Cash price Negotiated range
Mercy Gilbert Medical Center Gilbert $51.42 $14.90 – $160.93
Banner University Medical Center Phoenix Phoenix $15.04 $14.90 – $60.75
Banner University Medical Center Tucson Tucson $15.23 $14.90 – $64.80
Banner University Medical Center South Tucson $14.66 $14.90 – $64.80
Banner Baywood Medical Center Mesa $10.29 $14.90 – $60.75
Banner Boswell Medical Center Sun City $14.19 $14.90 – $64.80
Banner Casa Grande Medical Center Casa Grande $10.62 $14.90 – $60.75
Banner Del Webb Medical Center Sun City West $14.48 $14.90 – $64.80

All Arizona hospitals for this procedure →