healthcosts.net

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

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 paravert facet/nerve lumb ea add bil CPT 64495 not published not published $176.09 – $681.68 6
Ghs phenylketonurid CPT 84030 $7.99 $17.00 $5.50 – $15.30 27
Ghs picc line insert < 5 CPT 36568 $406.93 $846.00 $346.86 – $761.40 27
Ghs plngl fx pm cl CPT 26725 not published not published $149.49 – $2,518.60 6
Ghs polysom <6 yrs 4/> parameters CPT 95782 $3,318.81 $6,215.00 $663.00 – $5,593.50 27
Ghs ppd (tb intradermal) CPT 86580 $19.40 $53.00 $17.89 – $47.70 27
Ghs prostatic acid phosphatase (mayo) CPT 84066 $28.20 $60.00 $9.66 – $54.00 27
Ghs protoporphyrins fract CPT 84202 $52.17 $111.00 $14.35 – $99.90 27
Ghs pr without cont pulse ox CPT 94625 $114.47 $242.00 $29.48 – $217.80 27
Ghs pt - work hardening/int 2hrs CPT 97545 $42.64 $183.00 $43.55 – $164.70 27
Ghs quinidine CPT 80194 $28.20 $60.00 $14.60 – $54.00 27
Ghs respiratory syncytical virus igg/m CPT 86756 $26.35 $72.00 $15.89 – $64.80 27
Ghs reticulocyte count CPT 85044 $6.42 $13.00 $4.31 – $11.70 27
Ghs sedimentation rate CPT 85651 $6.42 $13.00 $4.27 – $11.70 27
Ghs sensitivity (per antimicro) CPT 87184 $10.88 $23.00 $7.48 – $20.70 27
Ghs sleep study unattended CPT 95800 $497.50 $625.00 $101.17 – $562.50 27
Ghs strapping shoulder - 29240 CPT 29240 $82.48 $354.00 $81.00 – $212.40 27
Ghs superficial wnd dehiscence simp12020 CPT 12020 not published not published $380.02 – $2,518.60 6
Ghs urine, porphyrins quant CPT 84120 $29.14 $62.00 $14.71 – $55.80 27
Giardia ag if CPT 87269 $28.85 $61.00 $13.61 – $54.90 27
Giardia lamblia antibody CPT 86674 $24.52 $67.00 $14.72 – $60.30 27
Gi inhouse confirmation CPT 87045 $29.80 $63.00 $9.44 – $26.10 27
Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 $1,144.25 $1,990.00 $586.96 – $1,791.00 27
Glucagon plasma - sendout CPT 82943 $31.49 $67.00 $14.29 – $60.30 27
Glucose 1 hr post dose CPT 82950 $7.05 $15.00 $4.75 – $13.50 27
Glucose body fluid CPT 82945 $61.57 $131.00 $3.93 – $10.80 27
Glucose tolerance test (gtt) 3 specimens CPT 82951 $18.33 $39.00 $12.87 – $35.10 27
Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 $5.64 $12.00 $3.92 – $10.80 27
Gonadotropin follicle stimulating hormone (fsh) CPT 83001 $27.26 $58.00 $18.58 – $50.40 27
Gonadotropin luteinizing hormone (lh) CPT 83002 $27.26 $58.00 $18.52 – $51.30 27
Graft axiofill 1000mg HCPCS J3590 $27.89 $49.30 $0.97 – $6.08 27
Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 $68.93 $136.50 $14.80 – $92.43 27
Graft nerve adv 3-4x70mm HCPCS C1762 $36,498.37 $72,274.00 $641.41 – $2,425.50 27
Graft patch felt ptfe 2x2 HCPCS C1768 $29,862.67 $59,134.00 $141.37 – $534.60 27
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 $45.10 $89.30 $12.49 – $78.03 27
Graft xenmtrx sft rect 15x20cm HCPCS C1781 $36,542.81 $72,362.00 $74.49 – $281.70 27
Graft xenmtrx sft rect 19x28cm HCPCS C2625 $2,713.37 $5,373.00 $202.30 – $765.00 27
Granisetron hcl injection HCPCS J1626 $15.15 $78.10 $0.23 – $70.29 27
Granulocyte pheresis ea unit HCPCS P9050 $2,574.03 $5,385.00 $419.77 – $4,846.50 27
G-tube reposition CPT 43761 $357.38 $743.00 $192.95 – $668.70 27
Guided cath fluid drainage 10030 CPT 10030 $203.46 $423.00 $173.43 – $380.70 27
Guide wire threaded 1.4x150mm HCPCS C1769 $5,460.74 $13,895.00 $39.51 – $149.40 27
Guide worley csg 9fx50cm std HCPCS C1892 $1,728.02 $4,397.00 $74.49 – $281.70 27
Gw stiffened micro access kit HCPCS C1894 $3,095.27 $7,876.00 $22.85 – $86.40 27
Handpiece aquabeam hp2000 HCPCS C2596 $6,886.93 $17,524.00 $336.29 – $1,271.70 27
Hands-On Manual Therapy (each 15 minutes) CPT 97140 $19.34 $83.00 $19.75 – $74.70 27
Hand X-ray CPT 73130 $121.90 $230.00 $58.65 – $207.00 27
Hand X-ray (2 views, both hands) CPT 73120 $99.64 $188.00 $76.52 – $169.20 27
Haptoglobin quantitative CPT 83010 $27.73 $59.00 $12.58 – $47.70 27
Hba1/hba2 full gene sequence CPT 81259 $806.40 $1,800.00 $600.00 – $1,620.00 27
Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 $1,559.79 $2,943.00 $129.45 – $2,648.70 27
Hcg qualitative CPT 84703 $10.81 $23.00 $7.52 – $20.70 27
Hcg quantitative CPT 84702 $31.49 $67.00 $15.05 – $41.40 27
Head CT scan (with and without contrast) CPT 70470 $733.12 $1,446.00 $129.45 – $1,301.40 27
Head CT scan (with contrast) CPT 70460 $610.94 $1,205.00 $129.45 – $1,084.50 27
Head CT scan (without contrast) CPT 70450 $488.75 $964.00 $79.00 – $867.60 27
Heel (Calcaneus) X-ray (both feet) CPT 73650 $75.26 $142.00 $57.79 – $127.80 27
Helicobacter pylori antibody igm CPT 86677 $28.55 $78.00 $16.85 – $70.20 27
Hematocrit CPT 85014 $3.95 $8.00 $2.37 – $7.20 27
Hemoglobin CPT 85018 $3.95 $8.00 $2.37 – $7.20 27
Hemoglobin methemoglobin quantitative CPT 83050 $27.73 $59.00 $8.20 – $22.50 27
Hemoglobin plasma CPT 83051 $10.34 $22.00 $7.31 – $19.80 27
Hemoglobin urine CPT 83069 $5.64 $12.00 $3.95 – $10.80 27
Hemolysins/agglutinins auto CPT 86940 $179.34 $490.00 $8.77 – $441.00 27
Hemolysins and agglutinins incubated CPT 86941 $13.54 $37.00 $12.11 – $33.30 27
Hemophilus influenza antibdy CPT 86684 $22.69 $62.00 $15.84 – $55.80 27
Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 not published not published $575.40 – $2,518.60 6
Heparin assay CPT 85520 $32.11 $65.00 $13.09 – $58.50 27
Heparin neutralization CPT 85525 $17.78 $36.00 $11.84 – $32.40 27
Heparin-protamine tolerance CPT 85530 $19.76 $40.00 $13.09 – $36.00 27
Hepatitis a antibody igm CPT 86709 $20.13 $55.00 $11.26 – $49.50 27
Hepatitis b core antibody igm CPT 86705 $20.13 $55.00 $11.77 – $49.50 27
Hepatitis b core antibody total CPT 86704 $20.13 $55.00 $12.05 – $49.50 27
Hepatitis b surface antibody CPT 86706 $20.13 $55.00 $10.74 – $49.50 27
Hepatitis c antibody CPT 86803 $18.67 $51.00 $14.27 – $45.90 27
Hernia Repair (Inguinal) CPT 49505 not published not published $2,307.97 – $4,768.74 6
Herpes simplex 1 ag if CPT 87274 $28.38 $60.00 $11.98 – $54.00 27
Herpes simplex 2 ag if CPT 87273 $28.38 $60.00 $11.98 – $54.00 27
Herpes simplex type 1 antibody igg CPT 86695 $19.40 $53.00 $13.19 – $36.00 27
Herpes simplex type 2 antibody igg CPT 86696 $21.59 $59.00 $19.35 – $53.10 27
Herpes simplex virus isolation CPT 87255 $48.25 $102.00 $33.86 – $91.80 27
Heterophile antibodies screening CPT 86308 $5.86 $16.00 $5.18 – $14.40 27
Hhv-6 dna quant CPT 87533 $59.60 $126.00 $41.76 – $113.40 27
Hip and Pelvis X-ray (2 views, both hips) CPT 73521 $119.25 $225.00 $79.00 – $202.50 27
Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 $155.82 $294.00 $79.00 – $264.60 27
Hip and Pelvis X-ray (single view, left side) CPT 73501 $95.40 $180.00 $58.65 – $162.00 27
Hip X-ray CPT 73502 $133.03 $251.00 $58.65 – $225.90 27
Histamine CPT 83088 $41.83 $89.00 $29.53 – $80.10 27
Histochemical stains add-on CPT 88314 $46.09 $92.00 $22.59 – $82.80 27
Hla class i high defin qual CPT 86832 $355.75 $972.00 $323.75 – $874.80 27
Hla class ii high defin qual CPT 86833 $357.95 $978.00 $325.80 – $880.20 27
Hla class i&ii antibody qual CPT 86828 $70.64 $193.00 $64.19 – $173.70 27
Hla class ii phenotype qual CPT 86831 $90.04 $246.00 $81.88 – $221.40 27
Hla class i phenotype qual CPT 86830 $105.04 $287.00 $95.52 – $258.30 27
Hla i & ii type verify lr CPT 81371 $543.87 $1,214.00 $404.52 – $1,092.60 27
Hla i & ii typing hr CPT 81378 $464.58 $1,037.00 $345.57 – $933.30 27
Hla i & ii typing lr CPT 81370 $540.74 $1,207.00 $402.12 – $1,086.30 27
Hla ii typing 1 loc hr CPT 81382 $166.66 $372.00 $123.68 – $334.80 27
Hla i low res one antigen equiv ea CPT 81374 $99.90 $223.00 $74.33 – $200.70 27
Hla i typing 1 locus hr CPT 81380 $238.34 $532.00 $177.25 – $478.80 27

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.