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 |
|---|---|---|---|---|
| Toxoplasma antibody igm CPT 86778 | $21.96 | $60.00 | $14.41 – $39.60 | 27 |
| Tpmt gene com vrnts CPT 81335 | $235.20 | $525.00 | $174.81 – $472.50 | 27 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $58.83 | $104.00 | $32.20 – $93.60 | 27 |
| Transferrin CPT 84466 | $18.33 | $39.00 | $12.76 – $35.10 | 27 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $243.32 | $395.00 | $79.00 – $355.50 | 27 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $205.74 | $334.00 | $79.00 – $300.60 | 27 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $50.43 | $147.90 | $13.09 – $133.11 | 27 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $1,855.62 | $3,965.00 | $380.42 – $2,376.00 | 27 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $233.44 | $594.00 | $85.60 – $534.60 | 27 |
| Treat big toe fracture CPT 28505 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Treat elbow fracture CPT 24620 | not published | not published | $1,009.45 – $3,372.77 | 6 |
| Treat finger fracture each CPT 26727 | not published | not published | $2,052.04 – $7,526.50 | 6 |
| Treat foot bone lesion CPT 28005 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Treat humerus fracture CPT 24515 | not published | not published | $4,768.74 – $8,928.20 | 6 |
| Treat humerus fracture CPT 24545 | not published | not published | $4,768.74 – $8,928.20 | 6 |
| Treat kneecap fracture CPT 27524 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treat lower leg fracture CPT 27826 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treat lower leg joint CPT 27829 | not published | not published | $3,372.77 – $4,542.09 | 6 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | not published | not published | $4,542.09 – $5,422.79 | 6 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | not published | not published | $4,542.09 – $5,422.79 | 6 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | not published | not published | $4,542.09 – $5,422.79 | 6 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | not published | not published | $1,901.83 – $5,422.79 | 6 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | not published | not published | $1,901.83 – $5,422.79 | 6 |
| Treatment of ankle fracture CPT 27792 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treatment of ankle fracture CPT 27814 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treatment of ankle fracture CPT 27822 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treatment of ankle fracture CPT 27823 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treatment of fibula fracture CPT 27784 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treatment of foot infection CPT 28002 | not published | not published | $1,009.45 – $3,860.87 | 6 |
| Treatment of thigh fracture CPT 27514 | not published | not published | $4,542.09 – $10,128.08 | 6 |
| Treat metacarpal fracture CPT 26615 | not published | not published | $2,052.04 – $4,768.74 | 6 |
| Treat metatarsal fracture CPT 28485 | not published | not published | $4,542.09 – $4,768.74 | 6 |
| Treat radius fracture CPT 24665 | not published | not published | $4,542.09 – $4,768.74 | 6 |
| Treat radius fracture CPT 24666 | not published | not published | $4,768.74 – $8,928.20 | 6 |
| Treat spinal cord lesion CPT 62280 | $388.17 | $807.00 | $330.87 – $726.30 | 27 |
| Treat spinal cord lesion CPT 62281 | $388.17 | $807.00 | $330.87 – $726.30 | 27 |
| Treat thigh fracture CPT 27245 | not published | not published | $4,542.09 – $10,128.08 | 6 |
| Treat toe fracture CPT 28525 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Treat ulnar fracture CPT 24685 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Treponema pallidum antibody CPT 86780 | $27.08 | $74.00 | $13.24 – $36.00 | 27 |
| Trg gene rearrangement anal CPT 81342 | $271.04 | $605.00 | $201.50 – $544.50 | 27 |
| Trichinella antibody CPT 86784 | $25.25 | $69.00 | $12.56 – $62.10 | 27 |
| #tricyclicantidprssnt CPT 80337 | $40.89 | $87.00 | $20.71 – $78.30 | 27 |
| Triglycerides CPT 84478 | $20.21 | $43.00 | $5.74 – $16.20 | 27 |
| Trim nondyst nails CPT 11719 | $18.84 | $33.00 | $13.43 – $29.70 | 27 |
| Trml dstrj ios bvn 1st 2 l/s CPT 64628 | not published | not published | $2,140.81 – $8,928.20 | 6 |
| Troponin quantitative CPT 84484 | $22.56 | $48.00 | $12.47 – $34.20 | 27 |
| Tx closed hip disl traumatic without anes CPT 27250 | not published | not published | $149.49 – $2,518.60 | 6 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | not published | not published | $2,052.04 – $2,518.60 | 6 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $2,052.04 – $5,422.79 | 6 |
| Ugt1a1 gene analy common variants CPT 81350 | $314.50 | $702.00 | $234.00 – $631.80 | 27 |
| Ultrasound breast complete CPT 76641 | $317.24 | $515.00 | $79.00 – $308.70 | 27 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $259.95 | $422.00 | $58.65 – $252.90 | 27 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $150.92 | $245.00 | $79.00 – $220.50 | 27 |
| Ultrasound dx ophth b-scan CPT 76512 | $164.47 | $267.00 | $74.44 – $240.30 | 27 |
| Ultrasound encephalogram CPT 76506 | $244.55 | $397.00 | $79.00 – $357.30 | 27 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $176.79 | $287.00 | $79.00 – $258.30 | 27 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $232.85 | $378.00 | $79.00 – $340.20 | 27 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $195.27 | $317.00 | $75.45 – $285.30 | 27 |
| Ultrasound guidance for vascular access CPT 76937 | $104.72 | $170.00 | $40.46 – $153.00 | 27 |
| Ultrasound guide intraoperative CPT 76998 | $76.38 | $124.00 | $29.51 – $111.60 | 27 |
| Ultrasound guide tissue ablation CPT 76940 | $1,029.34 | $1,671.00 | $276.80 – $1,503.90 | 27 |
| Ultrasound hips infant dynamic CPT 76885 | $147.84 | $240.00 | $58.65 – $216.00 | 27 |
| Ultrasound infant hips ltd without stress CPT 76886 | $107.80 | $175.00 | $58.65 – $157.50 | 27 |
| Ultrasound joint complete left CPT 76881 | $184.18 | $299.00 | $45.44 – $269.10 | 27 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $207.59 | $337.00 | $95.77 – $303.30 | 27 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $141.68 | $230.00 | $62.26 – $207.00 | 27 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $313.54 | $509.00 | $166.84 – $458.10 | 27 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $242.70 | $394.00 | $79.00 – $354.60 | 27 |
| Ultrasound prostate/transrectal CPT 76872 | $205.74 | $334.00 | $79.00 – $300.60 | 27 |
| Ultrasound spinal canal and contents CPT 76800 | $150.92 | $245.00 | $79.00 – $220.50 | 27 |
| Ultrasound transabd ea addl gest CPT 76812 | $319.70 | $519.00 | $62.26 – $467.10 | 27 |
| Unlisted hematology&coagj px CPT 85999 | $28.16 | $57.00 | $13.57 – $51.30 | 27 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $149.49 – $3,860.87 | 6 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $149.49 – $2,266.74 | 6 |
| Unlisted px hands/fingers CPT 26989 | not published | not published | $149.49 – $2,518.60 | 6 |
| Unlisted px small intestine CPT 44799 | not published | not published | $586.96 – $5,422.79 | 6 |
| Unlisted transfusion med px CPT 86999 | $122.74 | $268.00 | $17.89 – $47.70 | 27 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $125.61 | $237.00 | $58.65 – $213.30 | 27 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $599.10 | $1,184.00 | $129.45 – $1,065.60 | 27 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $479.18 | $947.00 | $79.00 – $852.30 | 27 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,218.18 | $2,456.00 | $266.89 – $2,210.40 | 27 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,015.31 | $2,047.00 | $266.89 – $1,842.30 | 27 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $811.95 | $1,637.00 | $166.84 – $1,473.30 | 27 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $148.93 | $281.00 | $79.00 – $252.90 | 27 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $158.47 | $299.00 | $79.00 – $269.10 | 27 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $586.96 – $2,518.60 | 6 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $586.96 – $3,372.77 | 6 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $468.52 | $884.00 | $129.45 – $795.60 | 27 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $410.22 | $774.00 | $129.45 – $696.60 | 27 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $586.96 – $3,372.77 | 6 |
| Urea nitrogen CPT 84520 | $19.74 | $42.00 | $3.95 – $37.80 | 27 |
| Urea nitrogen 24 hour urine CPT 84540 | $24.44 | $52.00 | $5.56 – $46.80 | 27 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $246.45 | $465.00 | $166.84 – $418.50 | 27 |
| Urethrocystography void s&i CPT 74455 | $246.45 | $465.00 | $166.84 – $418.50 | 27 |
| Uric acid blood CPT 84550 | $6.58 | $14.00 | $4.52 – $12.60 | 27 |
| Uric acid urine CPT 84560 | $33.84 | $72.00 | $5.08 – $14.40 | 27 |
| Urinalysis microscopic only CPT 81015 | $5.28 | $10.00 | $3.05 – $9.00 | 27 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $3.70 | $7.00 | $2.17 – $6.30 | 27 |
| Urinalysis (with microscopy) CPT 81001 | $5.28 | $10.00 | $3.17 – $9.00 | 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.