Banner Payson Medical Center
807 South Ponderosa Street, Payson, AZ · Banner Health · · NPI 1063923340
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 |
|---|---|---|---|---|
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $25.85 | $55.00 | $18.05 – $49.50 | 27 |
| Mayo myoglobin CPT 83874 | $27.73 | $59.00 | $12.92 – $53.10 | 27 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $48.88 | $104.00 | $13.33 – $50.40 | 27 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $26.32 | $56.00 | $13.33 – $50.40 | 27 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $48.88 | $104.00 | $13.33 – $50.40 | 27 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $91.65 | $195.00 | $21.21 – $57.60 | 27 |
| Mayo organic acids qualitative each specimen CPT 83919 | $23.50 | $50.00 | $16.45 – $45.00 | 27 |
| Mayo oxalate 24 hour urine CPT 83945 | $51.23 | $109.00 | $14.45 – $60.30 | 27 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $48.88 | $104.00 | $11.53 – $93.60 | 27 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $22.69 | $62.00 | $15.03 – $55.80 | 27 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $192.15 | $525.00 | $12.05 – $33.30 | 27 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $35.07 | $71.00 | $17.98 – $63.90 | 27 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $29.61 | $63.00 | $13.76 – $56.70 | 27 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $29.14 | $62.00 | $8.44 – $55.80 | 27 |
| Mayo pregnenolone CPT 84140 | $29.61 | $63.00 | $20.67 – $56.70 | 27 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $27.73 | $59.00 | $16.59 – $53.10 | 27 |
| Mayo proinsulin CPT 84206 | $38.07 | $81.00 | $26.69 – $72.90 | 27 |
| Mayo psaft prostate specific antigen free CPT 84154 | $26.32 | $56.00 | $18.39 – $50.40 | 27 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $169.20 | $360.00 | $18.40 – $50.40 | 27 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $28.16 | $57.00 | $13.36 – $51.30 | 27 |
| Mayo receptor assay transferrin soluble CPT 84238 | $235.00 | $500.00 | $36.57 – $99.00 | 27 |
| Mayo renin CPT 84244 | $65.80 | $140.00 | $21.99 – $59.40 | 27 |
| Mayo repu protein electrophoresis urine CPT 84166 | $25.38 | $54.00 | $17.83 – $48.60 | 27 |
| Mayo selenium CPT 84255 | $36.19 | $77.00 | $25.53 – $69.30 | 27 |
| Mayo serotonin CPT 84260 | $43.71 | $93.00 | $30.98 – $83.70 | 27 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $25.99 | $71.00 | $19.35 – $63.90 | 27 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $26.79 | $57.00 | $13.73 – $51.30 | 27 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $136.15 | $372.00 | $21.62 – $221.40 | 27 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $22.69 | $62.00 | $4.27 – $46.80 | 27 |
| Mayo tau phosphorylated 217 each CPT 84393 | $211.97 | $451.00 | $22.21 – $315.00 | 27 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $280.90 | $627.00 | $208.92 – $564.30 | 27 |
| Mayo tgrp testosterone free CPT 84402 | $36.19 | $77.00 | $25.47 – $69.30 | 27 |
| Mayo tgrp testosterone total CPT 84403 | $36.66 | $78.00 | $25.81 – $70.20 | 27 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $52.64 | $112.00 | $22.17 – $100.80 | 27 |
| Mayo thyroglobulin CPT 84432 | $38.54 | $82.00 | $16.06 – $51.30 | 27 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $29.28 | $80.00 | $10.18 – $72.00 | 27 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $26.35 | $72.00 | $12.39 – $34.20 | 27 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $31.49 | $67.00 | $13.33 – $50.40 | 27 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $36.60 | $100.00 | $14.16 – $90.00 | 27 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $31.02 | $66.00 | $13.54 – $59.40 | 27 |
| Mayo vasoactive intestinal peptide CPT 84586 | $75.20 | $160.00 | $35.33 – $144.00 | 27 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $34.78 | $74.00 | $20.24 – $66.60 | 27 |
| Mayo vitamin b3 (niacin) CPT 84591 | $44.18 | $94.00 | $17.06 – $46.80 | 27 |
| Mayo vitamin k CPT 84597 | $39.95 | $85.00 | $13.72 – $76.50 | 27 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $37.13 | $79.00 | $13.25 – $71.10 | 27 |
| #mec-opiates CPT 80356 | $26.32 | $56.00 | $13.33 – $50.40 | 27 |
| Metabolic Blood Panel (Basic) CPT 80048 | $21.62 | $46.00 | $8.46 – $41.40 | 27 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $22.56 | $48.00 | $10.56 – $43.20 | 27 |
| Methotrexate therapeutic drug level CPT 80204 | $54.52 | $116.00 | $38.57 – $104.40 | 27 |
| Methylphenidate CPT 80360 | $31.49 | $67.00 | $15.95 – $60.30 | 27 |
| Mgmt promoter methylation analysis CPT 81287 | $300.61 | $671.00 | $124.64 – $603.90 | 27 |
| Microdissection laser CPT 88380 | $330.16 | $659.00 | $48.08 – $181.80 | 27 |
| Microsatellite instability CPT 81301 | $468.61 | $1,046.00 | $348.56 – $941.40 | 27 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | $102.29 | $193.00 | $58.65 – $173.70 | 27 |
| Middle cerebral artery echo CPT 76821 | $308.62 | $501.00 | $79.00 – $450.90 | 27 |
| Mlh1 gene CPT 81288 | $258.50 | $577.00 | $192.32 – $519.30 | 27 |
| Mnl appl strs jt radiography CPT 77071 | $171.72 | $324.00 | $58.65 – $291.60 | 27 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $12,609.85 | $24,970.00 | $1,452.99 – $5,494.50 | 27 |
| Mopath procedure level 1 CPT 81400 | $86.02 | $192.00 | $63.96 – $172.80 | 27 |
| Mopath procedure level 3 CPT 81402 | $202.05 | $451.00 | $150.33 – $405.90 | 27 |
| Mopath procedure level 5 CPT 81404 | $369.60 | $825.00 | $274.83 – $742.50 | 27 |
| Mopath procedure level 6 CPT 81405 | $405.44 | $905.00 | $301.35 – $814.50 | 27 |
| Mopath procedure level 7 CPT 81406 | $865.09 | $1,931.00 | $282.88 – $1,737.90 | 27 |
| Mopath procedure level 8 CPT 81407 | $1,137.47 | $2,539.00 | $846.27 – $2,285.10 | 27 |
| Mopath procedure level 9 CPT 81408 | $2,688.00 | $6,000.00 | $2,000.00 – $5,400.00 | 27 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $277.05 | $553.00 | $108.14 – $328.50 | 27 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $381.76 | $762.00 | $211.16 – $685.80 | 27 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $234.47 | $468.00 | $108.14 – $328.50 | 27 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $55.11 | $110.00 | $26.18 – $99.00 | 27 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $182.86 | $365.00 | $108.14 – $328.50 | 27 |
| M/phmtrc alysishquant/semiq CPT 88369 | $55.11 | $110.00 | $26.18 – $99.00 | 27 |
| M/phmtrc alys skeletal musc CPT 88355 | $182.86 | $365.00 | $108.14 – $328.50 | 27 |
| MRA abdomen post contrast CPT 74185 | $1,033.53 | $1,827.00 | $289.88 – $1,096.20 | 27 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $700.34 | $1,238.00 | $196.59 – $743.40 | 27 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $954.90 | $1,688.00 | $267.75 – $1,012.50 | 27 |
| MRA pelvis CPT 72198 | $1,227.57 | $2,170.00 | $344.15 – $1,301.40 | 27 |
| MRA spinal canal CPT 72159 | $1,458.94 | $2,579.00 | $409.12 – $1,547.10 | 27 |
| MRA upper extremity post contrast-bil CPT 73225 | $943.02 | $1,667.00 | $264.42 – $999.90 | 27 |
| MRI breast c- unilateral CPT 77046 | $554.26 | $981.00 | $166.84 – $882.90 | 27 |
| MRI breast c-+ w/cad uni CPT 77048 | $831.68 | $1,472.00 | $350.34 – $1,324.80 | 27 |
| MRI breast without cont bi CPT 77047 | $831.11 | $1,471.00 | $166.84 – $1,323.90 | 27 |
| MRI breast w IV cont bi CPT 77049 | $1,246.95 | $2,207.00 | $525.27 – $1,986.30 | 27 |
| MRI chest without contrast CPT 71550 | $444.09 | $786.00 | $166.84 – $707.40 | 27 |
| MRI chest without & w/contrast CPT 71552 | $666.14 | $1,179.00 | $266.89 – $1,061.10 | 27 |
| MRI chest w IV cont CPT 71551 | $555.40 | $983.00 | $400.08 – $884.70 | 27 |
| MRI guid ndl plc s&i CPT 77021 | $462.73 | $819.00 | $194.92 – $737.10 | 27 |
| MRI guid parenchymal tiss ablation CPT 77022 | $659.92 | $1,168.00 | $277.98 – $1,051.20 | 27 |
| MRI loex nonjt w IV cont CPT 73719 | $496.63 | $879.00 | $241.82 – $791.10 | 27 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $397.19 | $703.00 | $166.84 – $632.70 | 27 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $596.07 | $1,055.00 | $266.89 – $949.50 | 27 |
| MRI orbit fac&nck w IV cont CPT 70542 | $605.37 | $1,187.00 | $266.89 – $1,068.30 | 27 |
| MRI tmj CPT 70336 | $694.95 | $1,230.00 | $166.84 – $738.00 | 27 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $502.28 | $889.00 | $166.84 – $800.10 | 27 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $753.71 | $1,334.00 | $266.89 – $1,200.60 | 27 |
| MRI upper extremity w/dye CPT 73219 | $628.28 | $1,112.00 | $266.89 – $1,000.80 | 27 |
| Mr safety determination physician/other qhp CPT 76016 | $57.24 | $108.00 | $43.96 – $97.20 | 27 |
| Mr safety implant elec prepj CPT 76018 | $100.70 | $190.00 | $66.55 – $171.00 | 27 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $96.99 | $183.00 | $43.55 – $164.70 | 27 |
| Mr safety implt pos&/immoblj CPT 76019 | $153.70 | $290.00 | $43.07 – $261.00 | 27 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $20.14 | $38.00 | $15.47 – $34.20 | 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.