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 |
|---|---|---|---|---|
| Urinalysis (without microscopy) CPT 81003 | $56.50 | $107.00 | $2.25 – $6.30 | 27 |
| Urine Culture Test CPT 87086 | $11.82 | $25.00 | $8.07 – $22.50 | 27 |
| Urine pregnancy test CPT 81025 | $30.62 | $58.00 | $8.61 – $23.40 | 27 |
| Urography, antegrade CPT 74425 | $246.98 | $466.00 | $189.66 – $419.40 | 27 |
| Urography inf drip &/or bolus CPT 74410 | $553.32 | $1,044.00 | $129.45 – $939.60 | 27 |
| Vaccine Administration (one shot) CPT 90471 | $21.06 | $60.00 | $24.42 – $54.00 | 27 |
| Valproic acid total therapeutic drug level CPT 80164 | $24.91 | $53.00 | $13.54 – $47.70 | 27 |
| Vancomycin peak therapeutic drug level CPT 80202 | $19.27 | $41.00 | $13.54 – $36.90 | 27 |
| Varicella zoster antibody igg CPT 86787 | $19.40 | $53.00 | $12.88 – $35.10 | 27 |
| Vasectomy CPT 55250 | not published | not published | $1,299.92 – $3,372.77 | 6 |
| Venogram ext bil s&i CPT 75822 | $202.46 | $382.00 | $155.47 – $343.80 | 27 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $173.31 | $327.00 | $133.09 – $294.30 | 27 |
| Ventilator each subsequent day CPT 94003 | $358.90 | $728.00 | $296.30 – $655.20 | 27 |
| Ventilator Management (first day) CPT 94002 | $501.38 | $1,017.00 | $351.81 – $915.30 | 27 |
| Version cephalic external CPT 59412 | $551.78 | $470.00 | $191.29 – $423.00 | 27 |
| Very long chain fatty acids CPT 82726 | $96.35 | $205.00 | $19.75 – $184.50 | 27 |
| Video Swallow Study (Modified Barium Swallow) CPT 74230 | $154.23 | $291.00 | $118.44 – $261.90 | 27 |
| Virus isolation addl studies ea CPT 87253 | $30.74 | $65.00 | $20.20 – $54.90 | 27 |
| Vital capacity test CPT 94150 | $22.27 | $43.00 | $17.50 – $38.70 | 27 |
| Vitamin b-12 CPT 82607 | $25.38 | $54.00 | $15.08 – $48.60 | 27 |
| Vitamin D Test CPT 82306 | $41.83 | $89.00 | $29.60 – $80.10 | 27 |
| Vkorc1 gene CPT 81355 | $118.72 | $265.00 | $88.20 – $238.50 | 27 |
| Volume measurement urine timed CPT 81050 | $5.81 | $11.00 | $3.64 – $9.90 | 27 |
| Walking (Gait) Training (each 15 minutes) CPT 97116 | $16.78 | $72.00 | $17.14 – $64.80 | 27 |
| Warde 1003990 aldosterone CPT 82088 | $126.90 | $270.00 | $40.75 – $110.70 | 27 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $81.78 | $174.00 | $27.80 – $75.60 | 27 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $28.67 | $61.00 | $12.90 – $54.90 | 27 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $35.72 | $76.00 | $25.25 – $68.40 | 27 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $38.54 | $82.00 | $15.50 – $73.80 | 27 |
| Warde 1015200 kappa light chain free CPT 83521 | $32.43 | $69.00 | $17.27 – $54.90 | 27 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $27.73 | $59.00 | $8.02 – $53.10 | 27 |
| Warde 3008005 oligoclonal bands CPT 83916 | $39.01 | $83.00 | $27.39 – $74.70 | 27 |
| Warde 3016000 west nile virus antibody CPT 86788 | $26.35 | $72.00 | $16.85 – $64.80 | 27 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $26.35 | $72.00 | $14.39 – $64.80 | 27 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $20.13 | $55.00 | $12.25 – $49.50 | 27 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $12.77 | $27.00 | $8.90 – $24.30 | 27 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $33.58 | $71.00 | $17.98 – $63.90 | 27 |
| Warde 3400852 arsenic CPT 82175 | $44.65 | $95.00 | $18.97 – $56.70 | 27 |
| Warde 3708165 mercury urine CPT 83825 | $41.36 | $88.00 | $16.26 – $44.10 | 27 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $36.23 | $99.00 | $18.40 – $89.10 | 27 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $21.96 | $60.00 | $11.53 – $50.40 | 27 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $73.79 | $157.00 | $8.10 – $22.50 | 27 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $54.52 | $116.00 | $38.62 – $104.40 | 27 |
| Warde aldolase CPT 82085 | $24.91 | $53.00 | $9.71 – $47.70 | 27 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $66.27 | $141.00 | $16.87 – $45.90 | 27 |
| Warde amiodarone therapeutic drug level CPT 80151 | $42.30 | $90.00 | $18.64 – $81.00 | 27 |
| Warde analysis gene hfe common variants CPT 81256 | $88.26 | $197.00 | $65.36 – $177.30 | 27 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $220.42 | $492.00 | $163.96 – $442.80 | 27 |
| Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites CPT 80339 | $82.72 | $176.00 | $41.89 – $158.40 | 27 |
| Warde anti-mullerian hormone CPT 82166 | $54.52 | $116.00 | $38.62 – $104.40 | 27 |
| Warde apolipoprotein b CPT 82172 | $36.19 | $77.00 | $21.09 – $57.60 | 27 |
| Warde bile acids CPT 82239 | $29.61 | $63.00 | $17.12 – $56.70 | 27 |
| Warde cadmium blood CPT 82300 | $33.37 | $71.00 | $23.64 – $63.90 | 27 |
| Warde calcitonin CPT 82308 | $38.07 | $81.00 | $26.79 – $72.90 | 27 |
| Warde calculus (stone) infrared CPT 82365 | $34.78 | $74.00 | $12.90 – $66.60 | 27 |
| Warde clozapine therapeutic drug level CPT 80159 | $31.96 | $68.00 | $20.15 – $61.20 | 27 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $135.36 | $288.00 | $21.96 – $259.20 | 27 |
| Warde collagen cross links c-telopeptide CPT 82523 | $53.11 | $113.00 | $18.68 – $61.20 | 27 |
| Warde complement total hemolytic CPT 86162 | $22.33 | $61.00 | $20.32 – $54.90 | 27 |
| Warde copper CPT 82525 | $99.17 | $211.00 | $12.41 – $56.70 | 27 |
| Warde cryoglobulin CPT 82595 | $29.61 | $63.00 | $6.47 – $56.70 | 27 |
| Warde erythropoietin CPT 82668 | $26.79 | $57.00 | $18.79 – $51.30 | 27 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $22.33 | $61.00 | $12.09 – $54.90 | 27 |
| Warde folic acid rbc CPT 82747 | $25.85 | $55.00 | $17.65 – $49.50 | 27 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $26.32 | $56.00 | $9.70 – $50.40 | 27 |
| Warde gastrin CPT 82941 | $27.26 | $58.00 | $17.63 – $52.20 | 27 |
| Warde growth hormone (hgh) CPT 83003 | $23.97 | $51.00 | $16.67 – $45.90 | 27 |
| Warde haloperidol therapeutic drug level CPT 80173 | $46.53 | $99.00 | $15.78 – $89.10 | 27 |
| Warde helminth antibody strongyloides igg CPT 86682 | $25.99 | $71.00 | $13.01 – $57.60 | 27 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $33.37 | $71.00 | $12.87 – $63.90 | 27 |
| Warde hepatitis a antibody CPT 86708 | $20.13 | $55.00 | $12.39 – $49.50 | 27 |
| Warde hepatitis be antibody CPT 86707 | $21.59 | $59.00 | $11.57 – $53.10 | 27 |
| Warde hepatitis delta agent antibody CPT 86692 | $31.11 | $85.00 | $17.16 – $76.50 | 27 |
| Warde immunofixation electrophoresis urine CPT 86335 | $32.57 | $89.00 | $29.35 – $80.10 | 27 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $27.91 | $59.00 | $11.53 – $53.10 | 27 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $365.63 | $773.00 | $257.45 – $695.70 | 27 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $87.84 | $240.00 | $23.57 – $63.90 | 27 |
| Warde lipoprotein (a) CPT 83695 | $27.26 | $58.00 | $14.32 – $51.30 | 27 |
| Warde lipoprotein-associated phospholipase a2 CPT 83698 | $65.33 | $139.00 | $46.31 – $125.10 | 27 |
| Warde mitochondrial antibody each CPT 86381 | $28.18 | $77.00 | $25.45 – $69.30 | 27 |
| Warde neutralization rabies CPT 86382 | $46.48 | $127.00 | $16.91 – $62.10 | 27 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $32.43 | $69.00 | $13.25 – $62.10 | 27 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $47.00 | $100.00 | $22.97 – $90.00 | 27 |
| Warde protein c antigen CPT 85302 | $32.11 | $65.00 | $12.01 – $58.50 | 27 |
| Warde sex hormone binding globulin CPT 84270 | $31.02 | $66.00 | $21.73 – $59.40 | 27 |
| Warde somatomedin CPT 84305 | $30.08 | $64.00 | $21.26 – $57.60 | 27 |
| Warde sugars single qualitative each specimen stool CPT 84376 | $30.08 | $64.00 | $5.50 – $57.60 | 27 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $27.73 | $59.00 | $15.76 – $53.10 | 27 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $71.91 | $153.00 | $50.86 – $137.70 | 27 |
| Warde topiramate therapeutic drug level CPT 80201 | $16.92 | $36.00 | $11.92 – $32.40 | 27 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $47.30 | $100.00 | $26.07 – $71.10 | 27 |
| Warde viscosity CPT 85810 | $28.16 | $57.00 | $11.67 – $51.30 | 27 |
| Warde vitamin a CPT 84590 | $29.14 | $62.00 | $11.61 – $55.80 | 27 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $30.08 | $64.00 | $21.23 – $57.60 | 27 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $39.95 | $85.00 | $28.10 – $76.50 | 27 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $27.73 | $59.00 | $9.89 – $53.10 | 27 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $54.52 | $116.00 | $38.50 – $104.40 | 27 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $29.14 | $62.00 | $14.18 – $55.80 | 27 |
| Warde zinc CPT 84630 | $63.45 | $135.00 | $11.39 – $31.50 | 27 |
| Wbc automated CPT 85048 | $3.95 | $8.00 | $2.54 – $7.20 | 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.