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 |
|---|---|---|---|---|
| Bilateral n block inj occipital 64405 CPT 64405 | not published | not published | $189.35 – $1,176.86 | 6 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $345.09 | $713.00 | $189.35 – $427.50 | 27 |
| Biliary endoscopy thru skin CPT 47555 | $977.87 | $2,033.00 | $833.53 – $1,829.70 | 27 |
| Biliary endoscopy thru skin CPT 47556 | $1,104.86 | $2,297.00 | $941.77 – $2,067.30 | 27 |
| Bilicheck CPT 88720 | $7.52 | $16.00 | $5.02 – $14.40 | 27 |
| Bilirubin direct CPT 82248 | $19.74 | $42.00 | $5.02 – $37.80 | 27 |
| Bilirubin total CPT 82247 | $61.57 | $131.00 | $5.02 – $37.80 | 27 |
| Biopsy abdominal mass CPT 49180 | $292.93 | $609.00 | $249.69 – $548.10 | 27 |
| Biopsy bone trocar/needle superficial CPT 20220 | $393.94 | $819.00 | $335.79 – $737.10 | 27 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | not published | not published | $459.22 – $3,372.77 | 6 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | not published | not published | $1,718.26 – $2,518.60 | 6 |
| Biopsy muscle percutaneous needle CPT 20206 | $608.46 | $1,265.00 | $518.65 – $1,138.50 | 27 |
| Biopsy needle liver percutaneous CPT 47000 | $337.18 | $701.00 | $287.41 – $630.90 | 27 |
| Biopsy needle lymph node superficial CPT 38505 | $927.37 | $1,928.00 | $526.85 – $1,156.50 | 27 |
| Biopsy of penis 54100 CPT 54100 | not published | not published | $1,020.08 – $2,518.60 | 6 |
| Biopsy of prostate CPT 55700 | $76.48 | $159.00 | $65.19 – $143.10 | 27 |
| Biopsy of salivary gland 42400 CPT 42400 | $546.90 | $1,137.00 | $450.93 – $1,023.30 | 27 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $2,289.36 – $3,372.77 | 6 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $815.30 | $1,695.00 | $463.30 – $1,017.00 | 27 |
| Biopsy skin incisional single lesion CPT 11106 | $138.18 | $242.00 | $98.49 – $217.80 | 27 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $1,197.69 | $2,490.00 | $1,020.08 – $2,241.00 | 27 |
| Bladder Catheter Insertion (simple) CPT 51702 | $79.94 | $140.00 | $56.98 – $126.00 | 27 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $124.39 | $257.00 | $105.37 – $231.30 | 27 |
| Bld prd mix CPT 86965 | $174.47 | $365.00 | $108.14 – $328.50 | 27 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $3,860.87 – $3,860.87 | 1 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $1,243.64 – $5,422.79 | 6 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $5,096.82 | $12,969.00 | $202.30 – $765.00 | 27 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $6,886.93 | $17,524.00 | $336.29 – $1,271.70 | 27 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $4,550.94 | $11,580.00 | $39.51 – $149.40 | 27 |
| Bln press regulation 71-80cm HCPCS C1815 | $12,831.04 | $25,408.00 | $2,756.04 – $10,422.00 | 27 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $17,697.22 | $35,044.00 | $106.39 – $402.30 | 27 |
| Block tap inj(s) w/wo img bi CPT 64488 | not published | not published | $674.85 – $674.85 | 1 |
| Blood Clotting (PT/INR) Test CPT 85610 | $25.19 | $51.00 | $4.29 – $45.90 | 27 |
| Blood Clotting (PTT) Test CPT 85730 | $9.39 | $19.00 | $6.01 – $17.10 | 27 |
| Blood Count (CBC) Test CPT 85025 | $22.23 | $45.00 | $7.77 – $21.60 | 27 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $9.88 | $20.00 | $6.47 – $18.00 | 27 |
| Blood Culture Test CPT 87040 | $14.66 | $31.00 | $10.32 – $27.90 | 27 |
| Blood draw capillary 36416 CPT 36416 | $15.57 | $34.00 | $3.66 – $30.60 | 27 |
| Blood gases o2 saturation direct measurement CPT 82805 | $111.39 | $237.00 | $78.77 – $213.30 | 27 |
| Blood gases ph venous CPT 82800 | $15.51 | $33.00 | $11.00 – $29.70 | 27 |
| Blood, l/r, irradiated HCPCS P9056 | $337.47 | $706.00 | $111.77 – $635.40 | 27 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $29.14 | $62.00 | $15.92 – $55.80 | 27 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $6.11 | $13.00 | $4.23 – $11.70 | 27 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $6.58 | $14.00 | $4.38 – $12.60 | 27 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $7.52 | $16.00 | $5.32 – $14.40 | 27 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $26.68 | $54.00 | $3.80 – $48.60 | 27 |
| Blood split unit HCPCS P9011 | $193.11 | $404.00 | $21.98 – $48.60 | 27 |
| Blood Transfusion CPT 36430 | $398.27 | $842.00 | $228.33 – $504.90 | 27 |
| Blood typing abo CPT 86900 | $125.95 | $275.00 | $2.99 – $232.20 | 27 |
| Blood typing ag donor ea ag CPT 86902 | $349.00 | $762.00 | $6.35 – $685.80 | 27 |
| Blood typing patient serum CPT 86904 | $70.07 | $153.00 | $16.34 – $137.70 | 27 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $349.00 | $762.00 | $3.83 – $685.80 | 27 |
| Blood typing rh (d) CPT 86901 | $38.47 | $84.00 | $2.99 – $75.60 | 27 |
| Blood typing rh phenotype complete reference CPT 86906 | $38.47 | $84.00 | $7.75 – $75.60 | 27 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $104.41 | $197.00 | $79.00 – $177.30 | 27 |
| Bone biopsy open superficial CPT 20240 | $960.99 | $1,683.00 | $684.98 – $1,514.70 | 27 |
| Bone Density Scan (DEXA) CPT 77080 | $219.42 | $414.00 | $79.00 – $372.60 | 27 |
| Bone/joint imaging ltd area CPT 78300 | $467.81 | $886.00 | $273.41 – $797.40 | 27 |
| Bone marrow imaging body CPT 78104 | $1,136.78 | $2,153.00 | $273.41 – $1,937.70 | 27 |
| Bone marrow imaging ltd CPT 78102 | $784.61 | $1,486.00 | $273.41 – $1,337.40 | 27 |
| Bone survey-lead poisoning CPT 77074 | $122.96 | $232.00 | $79.00 – $208.80 | 27 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $24.16 | $66.00 | $17.03 – $59.40 | 27 |
| Bowel imaging CPT 78290 | $551.76 | $1,045.00 | $273.41 – $940.50 | 27 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $14.91 | $64.00 | $15.23 – $57.60 | 27 |
| Braf gene CPT 81210 | $236.10 | $527.00 | $175.40 – $474.30 | 27 |
| Brain biopsy w/ct/mr guide CPT 61751 | $2,039.44 | $4,240.00 | $936.00 – $3,816.00 | 27 |
| Brain flow imaging only CPT 78610 | $221.23 | $419.00 | $170.53 – $377.10 | 27 |
| Brain image w/flow < 4 views CPT 78601 | $227.57 | $431.00 | $175.42 – $387.90 | 27 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $716.60 | $1,419.00 | $266.89 – $1,277.10 | 27 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $597.42 | $1,183.00 | $241.82 – $1,064.70 | 27 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $477.73 | $946.00 | $166.84 – $851.40 | 27 |
| Brain MRI (with and without contrast) CPT 70553 | $1,300.50 | $2,550.00 | $266.89 – $2,295.00 | 27 |
| Brain MRI (with contrast) CPT 70552 | $1,083.75 | $2,125.00 | $241.82 – $1,912.50 | 27 |
| Brain MRI (without contrast) CPT 70551 | $867.00 | $1,700.00 | $166.84 – $1,530.00 | 27 |
| Brcassure comprehensive panel-sendout CPT 81162 | $2,452.80 | $5,475.00 | $1,824.88 – $4,927.50 | 27 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $851.37 | $1,770.00 | $725.70 – $1,593.00 | 27 |
| Breastbone (Sternum) X-ray CPT 71120 | $134.09 | $253.00 | $58.65 – $227.70 | 27 |
| Breast punct aspir cyst, bil CPT 19000 | $117.36 | $244.00 | $100.04 – $219.60 | 27 |
| Breath recording infant CPT 94772 | $541.31 | $1,045.00 | $353.64 – $940.50 | 27 |
| Bronchial challenge CPT 94070 | $211.86 | $409.00 | $166.46 – $368.10 | 27 |
| Br punct aspir ea add, l CPT 19001 | $51.47 | $107.00 | $43.87 – $96.30 | 27 |
| Bundled special stain group 1 microorganisms CPT 88312 | $57.11 | $114.00 | $36.08 – $102.60 | 27 |
| Bundled special stain group 2 CPT 88313 | $137.78 | $275.00 | $24.53 – $247.50 | 27 |
| Buprenorphine and metabolite - sendout CPT 80348 | $60.63 | $129.00 | $13.33 – $50.40 | 27 |
| Bur rotalink 2.15mm HCPCS C1724 | $6,886.93 | $17,524.00 | $1,162.63 – $4,396.50 | 27 |
| Bx bone trocar/ndl deep CPT 20225 | $650.31 | $1,352.00 | $554.32 – $1,216.80 | 27 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $426.17 | $886.00 | $210.87 – $797.40 | 27 |
| Bx muscle CPT 20200 | $684.63 | $1,199.00 | $487.99 – $1,079.10 | 27 |
| Bx pancreas pq ndl CPT 48102 | $381.91 | $794.00 | $325.54 – $714.60 | 27 |
| Bx pleura pq ndl CPT 32400 | $346.32 | $720.00 | $295.20 – $648.00 | 27 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $74.80 | $131.00 | $31.18 – $117.90 | 27 |
| Bx skin punch ea sep/ addl les CPT 11105 | $71.38 | $125.00 | $29.75 – $112.50 | 27 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $60.53 | $106.00 | $25.23 – $95.40 | 27 |
| Bx soft tiss pelvis+hip area supf 27040 CPT 27040 | $939.39 | $1,953.00 | $533.82 – $1,171.80 | 27 |
| Bx spinal cord pq ndl CPT 62269 | $703.70 | $1,463.00 | $599.83 – $1,316.70 | 27 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $330.93 | $688.00 | $282.08 – $619.20 | 27 |
| C1 esterase inhibitor func - sendout CPT 86161 | $109.80 | $300.00 | $12.00 – $59.40 | 27 |
| Cable cath 22-pin diag HCPCS C1730 | $6,886.93 | $17,524.00 | $141.37 – $534.60 | 27 |
| Cadd pump refill CPT 96521 | $78.95 | $153.00 | $62.27 – $137.70 | 27 |
| Calcium 24 hour urine CPT 82340 | $36.19 | $77.00 | $6.03 – $50.40 | 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.