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 |
|---|---|---|---|---|
| Mr sfty med physics xm cstmz CPT 76017 | $239.03 | $451.00 | $175.25 – $405.90 | 27 |
| Mthfr gene analy common variants CPT 81291 | $88.26 | $197.00 | $65.34 – $177.30 | 27 |
| Multiple sleep latency test CPT 95805 | $3,470.56 | $4,360.00 | $353.64 – $3,139.20 | 27 |
| Mumps antibody igg CPT 86735 | $22.69 | $62.00 | $13.05 – $50.40 | 27 |
| Mycoplasma antibody igm CPT 86738 | $20.13 | $55.00 | $13.24 – $49.50 | 27 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $236.10 | $527.00 | $175.40 – $474.30 | 27 |
| Myelogphy 2/> spine regions CPT 72270 | $474.35 | $895.00 | $364.26 – $805.50 | 27 |
| Myelography l-s spine CPT 72265 | $518.87 | $979.00 | $288.61 – $881.10 | 27 |
| Myelography neck spine CPT 72240 | $511.45 | $965.00 | $285.88 – $868.50 | 27 |
| Myelography thoracic spine CPT 72255 | $509.86 | $962.00 | $269.28 – $865.80 | 27 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $390.57 | $812.00 | $332.92 – $730.80 | 27 |
| Myelography via inj w/s&i cervical CPT 62302 | $195.29 | $406.00 | $166.46 – $365.40 | 27 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $469.94 | $977.00 | $400.57 – $879.30 | 27 |
| Myelography via inj w/s&i thoracic CPT 62303 | $195.29 | $406.00 | $166.46 – $365.40 | 27 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $63.45 | $135.00 | $11.53 – $31.50 | 27 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $3.90 | $20.10 | $3.51 – $18.09 | 27 |
| Natriuretic peptide CPT 83880 | $55.46 | $118.00 | $39.26 – $106.20 | 27 |
| Natural killer cells total count CPT 86357 | $41.72 | $114.00 | $37.73 – $102.60 | 27 |
| Ndl round specialty proguide HCPCS C1715 | $231.08 | $588.00 | $39.51 – $149.40 | 27 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $100.17 | $189.00 | $58.65 – $170.10 | 27 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $980.12 | $1,937.00 | $129.45 – $1,743.30 | 27 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $816.68 | $1,614.00 | $266.89 – $1,452.60 | 27 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $653.25 | $1,291.00 | $79.00 – $1,161.90 | 27 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $1,218.18 | $2,456.00 | $266.89 – $2,210.40 | 27 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $1,015.31 | $2,047.00 | $266.89 – $1,842.30 | 27 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $811.95 | $1,637.00 | $166.84 – $1,473.30 | 27 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $120.84 | $228.00 | $58.65 – $205.20 | 27 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $165.89 | $313.00 | $79.00 – $281.70 | 27 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $197.16 | $372.00 | $79.00 – $334.80 | 27 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $774.16 | $1,533.00 | $266.89 – $1,379.70 | 27 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $645.39 | $1,278.00 | $241.82 – $1,150.20 | 27 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $516.11 | $1,022.00 | $166.84 – $919.80 | 27 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $720.95 | $1,422.00 | $129.45 – $1,279.80 | 27 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $600.80 | $1,185.00 | $129.45 – $1,066.50 | 27 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $480.64 | $948.00 | $79.00 – $853.20 | 27 |
| Nerve teasing preparations CPT 88362 | $857.71 | $1,712.00 | $475.71 – $1,540.80 | 27 |
| Neuromatrix nerve cuff, cm HCPCS C9355 | $217.40 | $430.50 | $62.04 – $387.45 | 27 |
| New Patient Office Visit (level 2) CPT 99202 | $1,429.27 | $1,475.00 | $34.85 – $76.50 | 27 |
| New Patient Office Visit (level 3) CPT 99203 | $2,141.49 | $2,210.00 | $54.54 – $189.00 | 27 |
| New Patient Office Visit (level 4) CPT 99204 | $2,577.54 | $2,660.00 | $54.54 – $256.50 | 27 |
| New Patient Office Visit (level 5) CPT 99205 | $3,449.64 | $3,560.00 | $54.54 – $292.50 | 27 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $784.99 | $1,632.00 | $416.71 – $979.20 | 27 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $654.72 | $1,240.00 | $273.41 – $1,116.00 | 27 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $615.12 | $1,165.00 | $273.41 – $1,048.50 | 27 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $346.90 | $657.00 | $267.40 – $591.30 | 27 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $465.17 | $881.00 | $354.82 – $792.90 | 27 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $288.82 | $547.00 | $222.63 – $492.30 | 27 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $272.10 | $481.00 | $180.97 – $432.90 | 27 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $82.15 | $155.00 | $58.65 – $139.50 | 27 |
| Npm1 gene CPT 81310 | $331.52 | $740.00 | $246.52 – $666.00 | 27 |
| Nras gene variants exon 2&3 CPT 81311 | $397.82 | $888.00 | $295.79 – $799.20 | 27 |
| Nuclear rx IV admin CPT 79101 | $381.28 | $674.00 | $180.97 – $606.60 | 27 |
| Nuclear Stress Test (Heart) CPT 78452 | $1,698.58 | $3,217.00 | $946.81 – $2,895.30 | 27 |
| Nudt15 gene common variants CPT 81306 | $392.00 | $875.00 | $291.36 – $787.50 | 27 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $82.62 | $242.30 | $56.27 – $218.07 | 27 |
| Observation direct referral from physician office for admission HCPCS G0379 | $620.65 | $654.00 | $30.00 – $588.60 | 27 |
| Observation per hour HCPCS G0378 | $51.84 | $108.00 | $30.00 – $97.20 | 27 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $211.29 | $343.00 | $79.00 – $308.70 | 27 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | $140.45 | $228.00 | $62.26 – $205.20 | 27 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $29.59 | $216.00 | $51.41 – $194.40 | 27 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $17.67 | $129.00 | $30.70 – $116.10 | 27 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $23.56 | $172.00 | $40.94 – $154.80 | 27 |
| Onco (ovar) five proteins CPT 81503 | $1,205.57 | $2,691.00 | $387.77 – $2,421.90 | 27 |
| Oncoprotein dcp CPT 83951 | $91.18 | $194.00 | $64.41 – $174.60 | 27 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Optx medial ankle fx CPT 27766 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $2,307.97 – $4,768.74 | 6 |
| Organic acids total quant ea spec CPT 83918 | $47.47 | $101.00 | $23.60 – $63.90 | 27 |
| Orthopantogram CPT 70355 | $191.86 | $362.00 | $35.78 – $325.80 | 27 |
| Oscillation chest wall mechanical per session CPT 94669 | $171.56 | $348.00 | $136.21 – $313.20 | 27 |
| Osmolality blood CPT 83930 | $26.32 | $56.00 | $6.61 – $50.40 | 27 |
| Osmolality urine CPT 83935 | $26.32 | $56.00 | $6.82 – $50.40 | 27 |
| Other immunoelectrophoresis CPT 86325 | $25.62 | $70.00 | $23.13 – $63.00 | 27 |
| Oth resp proc, group HCPCS G0239 | $61.62 | $125.00 | $18.01 – $112.50 | 27 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $15.38 | $66.00 | $15.71 – $59.40 | 27 |
| Ot re-evaluation patient/family CPT 97168 | $17.67 | $129.00 | $30.70 – $116.10 | 27 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $3.57 | $83.00 | $19.75 – $74.70 | 27 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $3.74 | $87.00 | $20.71 – $78.30 | 27 |
| Parathormone (pth) intact CPT 83970 | $58.28 | $124.00 | $41.28 – $111.60 | 27 |
| Parathyrd planar w/spect&ct CPT 78072 | $365.90 | $693.00 | $282.05 – $623.70 | 27 |
| Parathyroid planar imaging CPT 78070 | $255.02 | $483.00 | $196.58 – $434.70 | 27 |
| Parathyroid planar img w/tomo spect CPT 78071 | $335.28 | $635.00 | $258.44 – $571.50 | 27 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Partial removal foot fascia CPT 28060 | not published | not published | $2,052.04 – $3,372.77 | 6 |
| Partial removal of toe CPT 28160 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Part removal of metatarsal CPT 28110 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Pdgfra gene CPT 81314 | $443.07 | $989.00 | $329.51 – $890.10 | 27 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $980.12 | $1,937.00 | $129.45 – $1,743.30 | 27 |
| Pelvic CT scan (with contrast) CPT 72193 | $816.68 | $1,614.00 | $129.45 – $1,452.60 | 27 |
| Pelvic CT scan (without contrast) CPT 72192 | $653.25 | $1,291.00 | $79.00 – $1,161.90 | 27 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,167.29 | $2,066.00 | $266.89 – $1,859.40 | 27 |
| Pelvic MRI (with contrast) CPT 72196 | $972.93 | $1,722.00 | $266.89 – $1,549.80 | 27 |
| Pelvic MRI (without contrast) CPT 72195 | $778.00 | $1,377.00 | $166.84 – $1,239.30 | 27 |
| Pelvic Ultrasound (complete) CPT 76856 | $314.78 | $511.00 | $79.00 – $459.90 | 27 |
| Pelvic Ultrasound (limited) CPT 76857 | $286.44 | $465.00 | $79.00 – $418.50 | 27 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $107.06 | $202.00 | $79.00 – $181.80 | 27 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $117.13 | $221.00 | $79.00 – $198.90 | 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.