In-111 autol wbc diag per dose 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

$3,031.60

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.

Full explanation →

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

$5,956.00

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.

$2,441.96 with Mercy Care vs $30,689.78 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
Mercy Care Mercy Care Advantage $2,441.96 ↓ -19%
Gila River Health Care Corporation Managed Care Program $2,441.96 ↓ -19%
Arizona Physicians IPA Medicare Advantage $2,441.96 ↓ -19%
Wellpoint Medicare Advantage HMO $2,441.96 ↓ -19%
Health Net Medicare $2,441.96 ↓ -19%
United Healthcare UHC Medicare Advantage $2,441.96 ↓ -19%
UPMC Health Plan Medicare Advantage $2,441.96 ↓ -19%
TriWest Healthcare Alliance Corp - VA CCN Tricare $2,441.96 ↓ -19%
TriWest Healthcare Alliance Corp - VA CCN VA Community Care Network $2,441.96 ↓ -19%
Care 1st Medicare Advantage $2,441.96 ↓ -19%
Kaiser Foundation Health Plan Medicare Advantage $2,441.96 ↓ -19%
Health Choice Arizona, Inc. Medicare Advantage $2,441.96 ↓ -19%
Blue Cross Blue Shield of Arizona Medicare Advantage $2,441.96 ↓ -19%
Banner Health Medicare Advantage $2,441.96 ↓ -19%
Aetna Medicare Advantage $2,441.96 ↓ -19%
Cigna Healthcare of Arizona, Inc. HMO Medicare Advantage Plan/PPO Medicare Advantage Plan $2,441.96 ↓ -19%
Banner University Health Plan Medicare Advantage $2,441.96 ↓ -19%
Carelon Medicare Advantage $2,564.06 ↓ -15%
Humana Medicare Advantage $2,588.48 ↓ -15%
National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Insurance Group (VUMI) NHSI VUMI $2,680.20 ↓ -12%
Plotkin Health Plotkin Health $2,680.20 ↓ -12%
Gold Kidney Health Plan Medicare Advantage $2,686.16 ↓ -11%
Devoted Health Services Medicare Advantage $2,686.16 ↓ -11%
Arizona Priority Care Medicare Advantage $2,686.16 ↓ -11%
Aetna Joint Venture $3,156.68 ↑ +4%
Aetna Aetna Qualified Health Plan $3,323.45 ↑ +10%
Health Choice Arizona, Inc. ACA Health Plan $3,484.26 ↑ +15%
Health Net Commerical Exchange Product $3,614.10 ↑ +19%
Aetna Medical Rental $3,829.71 ↑ +26%
Aetna Broad Network $3,942.87 ↑ +30%
United Healthcare UHC Individual Exchange $3,990.52 ↑ +32%
Oscar Health Plan Commercial $4,029.23 ↑ +33%
Quiktrip Corporation Commercial $4,169.20 ↑ +38%
Health Choice Arizona, Inc. Medicaid $4,209.96 ↑ +39%
Banner University Health Plan AZ Medicaid - AHCCCS $4,209.96 ↑ +39%
Mercy Care Mercy Medicaid $4,209.96 ↑ +39%
Health Net Medicaid $4,209.96 ↑ +39%
Arizona Physicians IPA Medicaid $4,209.96 ↑ +39%
Cigna Healthcare of Arizona, Inc. Commerical/HMO Benefit Plan/Local Flex Plan/Network Benefit Plan/Open Access Plan $4,740.98 ↑ +56%
Provider Network of America Commercial $5,360.40 ↑ +77%
Arizona Medical Network Commercial $5,360.40 ↑ +77%
Blue Cross Blue Shield of Arizona BXBSAZ Neighborhood $23,017.33 ↑ +659%
Blue Cross Blue Shield of Arizona BCBSAZ Alliance/Blue HPN $24,551.82 ↑ +710%
Blue Cross Blue Shield of Arizona BXBSAZ Alliance CHS $25,779.32 ↑ +750%
Blue Cross Blue Shield of Arizona BCBSAZ Medicare $29,312.79 ↑ +867%
Blue Cross Blue Shield of Arizona BCBSAZ Workers Comp $30,689.78 ↑ +912%
Blue Cross Blue Shield of Arizona Commercial $30,689.78 ↑ +912%

Visitor-reported prices

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In-111 autol wbc diag per dose at other Arizona hospitals

Hospital City Cash price Negotiated range
Mercy Gilbert Medical Center Gilbert $3,368.24 $100.00 – $10,542.84
Banner University Medical Center Phoenix Phoenix $1,232.24 $1,031.39 – $2,581.50
Banner University Medical Center Tucson Tucson $1,313.08 $1,031.39 – $4,201.84
Banner University Medical Center South Tucson $1,360.35 $1,031.39 – $4,201.84
Banner Baywood Medical Center Mesa $1,086.96 $1,031.39 – $6,376.83
Banner Boswell Medical Center Sun City $600.21 $1,031.39 – $2,527.20
Banner Casa Grande Medical Center Casa Grande $481.10 $930.30 – $1,993.50
Banner Del Webb Medical Center Sun City West $562.30 $1,031.39 – $2,527.20

All Arizona hospitals for this procedure →